Lecture final Flashcards
what test is the most reliable assessment of the effective erythroid activity of the bone marrow?
retic count
what conditions (including parasitc infections) produce a macrocyitic/normochromic picture?
pernicious anemia
liver disease
folate deficiency
B12 deficiency
what conditions produce a microcytic/hypochromic blood picture?
thalassemia iron deficiency sideroblastic anemia Lead poisoning hookworm infection
what are the typical findings in pernicious anemia?
oval macrocytes
shift to the right
BM WBC precursors, giant band and metas
what is the schilling test and what body fluid is used for the test?
indirect measure of intrinsic factor (pernicious anemia)
urine
what are macropolycytes?
large cells with 5-7 lobes in nucleus. larger than hypersegs
what portion of the red blood cell is damaged leading to the formation of burr cells and thorn cells?
membrane
what are the distinguishing characteristics of hereditary ovalocytosis?
ovalocytes
Normal Hgb and normal cental palor
what is the most unusual and significant finding in patients suffering for AIHA?
positive direct coobs test (DAT)
what poikilogyte is associated with ABO HDN?
spherocytes (not normal)
what poikilocyte is associated with extramedullary hematopoiesis?
tear drop cells
what are the lab finding is PCH?
positive DAT
positive Donath Landsteiner
syptoms after exposure to cold
what are the hemoglobin electrophoresis results in sickle cells anemia?
Has Hgb S and F
No Hgb A
hat hemoglobin is insoluble in reducing agents such as sodium dithionite and sodium meatbisulfate?
Hgb S
which beta chain of the Hgb molecule is abnormal in Hgb C disease, sickle cell anemia and thalassemia major?
beta chain
what does the PBS of a patient with sickle cells trait usually look like?
occcasional target cells otherwise normal
what does the PBS of a patient with IDA show?
pale, microcytic/hypochromic cells
what are the serum iron and TIBC results in IDA?
decreased iron increased TIBC
what is the specific cause of thalassemia?
decreased rate of synthesis of either slpha or beta chains. inherited not normal
what is another name for homozygous alpha thalassemia?
barts disease
what is another name for heterozygous alpha thalassemia?
Hgb H disease
what cause relative polycythemia?
stress
dehydration
severe burns
not increased erythropoeiten
what are the typical lab findings in acute leukemia?
anemia
thrombocytopenia
young cells
what has auer rods and a positive peroxidase stain?
AML
what has a positive periodic acid-Schiff stain
ALL
what has a positive chloroacetate esterase stain?
AMML
what has a prescence of myelomonocytes?
AMML (Naeglis)
what has a presence of the philadelphia chromosome?
CML
what has hypermature lymphs and smudge cells?
CLL
what has extreme thrombocytosis?
CML
what has increased incidence of bleeding disorders
APL
what leukemia is most frequently seen in patients over the age of 50?
CLL
whay type of cells might be expected to be found in the bone marrow of a leukemic patient?
small cells in PBS
acute=blasts
CML=all stage of granulocytes (except IM)
what is the “end stage” of DiGuglielmo’s syndrome?
AML (arythro Leukemia)
what condition would be described as acute granuocytopenia?
agranulocytosis/neutropenia
what are the lab findings in Hodgkins disease?
increase EOS
decreased lymphs
increased monos
Reed sternberg cell
what are the lab findings in multiple myeloma?
occasional plasma cell bence jones protein rouleaux increased sed rate high protein
what is the L.E factor?
anti-nucleoprotein IgG antibody
how is a downey cell described?
a typical lymph in IM scalloping around RBC
blue at the edges aka reactive lymph
what disease is indicated by a positive ANA
SLE (lupus)
with what conditions is a decreased LAP associated?
CML
AML
increased leukomoid reactions
what are the causes of bleeding?
trama decreased clotting factor synthesis DIC increased utilization of clotting factors genetic defects
what is the immediate response to vessel injury?
vasocontriction
what comprises the initial plug in the wall of an injured vessel?
platelets
what is meant by platelet adhesion?
sticks to surfaces
what is meant by platelet aggregation?
platelets stick to each other
which platelet factor is most important in the clotting process?
factor 3
what factor is fibrinogen?
I
what factor is prothrombin?
II
what factor is tissue thromboplastin?
III
what factor is Ca?
IIII
what factor is the labile factor?
V
what if the anti-hemophiliac factor?
VIII
what are the christmas factors?
X XI
what factors are hageman factors?
XII
what factor is hemophilia A?
VIII
what factore is hemophilia B?
IX
what is the stuart power factor?
X
what factor is plasma thromboplastin?
XI
what factor is the hagemans factor?
XII
intrinsic factors
1,2,,5,8,9,10,11,12
extrinsic factors
1, 2, 5, 7, 10
factors in common
1, 2 ,5, 10
vitamin K dependant factors
2, 7, 9, 10
liver factors
everything but 8
labile factors
5, 8
adsorbed plasma factors
5, 8, 11, 12
aged serum factors
7, 9, 10, 11, 12
factors that lac enzymatically active form
5, 8
component of thromboplastin
activated factor x
platelet factor III
Ca ions
factor 5
end result of stage 1
plasma thromboplastin
end result of stage II
thrombin
end result of stage III
fibrin
substance which initiates the extrinsic system
tissue factor 3
not contained in the blood until injury occurs
substance which initiates the intrinsic system
platelet factor 3
plasma factor 12
contact with exposed colagen
precursor of thrombin
prothrombin
substance which converts fibrinogen to fibrin
thrombin
activated substance responsible for clot lysis
plasmin (activated)
final end products of th breakdown of fibrin and of fibrinogen
frag, E
2 D frag.
components which are depleted in DIC
1, 5, 8, platelets
factor deficiency that would be incompatible with life
IV Ca
principle of the coagulyzer (orMLA)
change in optical density cuts the timer off
principle of the fibrometer
completion of electrical circut due to formation of a clot
principle and normal value for duke
ear
1-3 mins
principle and normal value for ivy
forearm
1-7 mins
principle for tourniquet test
capillary fragility
principle and normal value for thrombin time
measure of availability of fibrinogen
15-20 secs (factor 1)
what is the principle of the Lee-White clotting time?
monitoring heparin therapy
detects intrinsic defects
what is the principle of prothrombin consumption test?
meausres amount of prothrombin remaining in serum after clotting
normal values for fibrinogen
200-400 mg/dl
factors which influence clot retention
platelet factor 6
normal fibrin normal hct (thrombosthenin 6)
what deficiency is PT especially sensitive to?
deficiency of factor 7
what abnormalities could be indicated by and increased PTT?
liver disease
hemophilia A and B
what is the principle of plasma recalcification time?
amount of time required for clot to form in plasma
what factor is stypven time most useful for?
russels viper venom -factor 7
what does euglobulin lysis measure?
fibrinolysis
thrombo wellco test especially normal values
if agglutination occurs in 1:5 dilution but not in 1:20
FDP >10>40 in both >40
what factor does 5 M urea test detect?
factor 13
tests useful in the diagnosis of DIC
bleeding time, abnormal PT/PTT, fibrinolysis, factors 1, 5, 8 platelets
effect of asprin in testing
increased BT
abnormal glass bead test
characteristics and lab results for hemophilia A
deficincy of 8
sex linked
recessive
increased PTT
characteristic and lab results for hemophilia B
christmas disease
factor 9
increased PTT
characteristics and lab findings of vonwillebrands disease
increased PTT
abnormal bleeding time
factor 8 def.
characteristics and lab findings of ITP
due to anti-platelets Ab
increased bleeding time
decreased platelets
pinpoint hemorrhages
characteristics and lab findings of glanzmanns thrombasthenia
defect in platelet aggrigation
abnormal platelet funcion
what is the characteristic of hereditary telangiectasia
vascular defect
what is parahemophilia
factor 5 def.
what is the mode of action of coumadin?
anti-vitamin k
what is the mode of action of heparin?
netralized/inactivates thrombin
what test is used to monitor coumadin
PT
what test is used to monitor heparin
PTT
what level must be reached for a clotting factor to cause and abnormality
30-40% abnormal
50-150% normal
what is anti-thrombin III
heparin cofactor needs anti-thrombin to be bound, wouldnt work without it
name a test that will distinguish between primary and secondary fibrinolysis
d dimer
what factors are removed when plasma is adsorbed?
vitamin k dependent
factors 2, 7, 9, 10
what reagents can be used to prepare adsorbed plasma?
barium sulfate
aluminum hydroxide
irreversible aggregation of platelets
1st is reversible 2cnd is not
viscous metamorphosis
what plasminogen activators are now being used to treat heart attack and stroke victims
tPA
tissue plasminogen activator
urokinase
