M4: Hematology

Question 1

Decreased hemoglobin concentration in blood”

Answer 1

ANEMIA

Question 2

What are the size classifications of the 3?
Small- Reduced MCV
Normal MCV
Inc MCV

Answer 2

Microcytic, Normocytic, Macrocytic

Question 3

Anemic, cells stain lightly

Answer 3

Hypochromic

Question 4

Signs Specific to Iron Deficiency Anemia are called?

-Atrophy of Papillae of tongue
-Sides of mouth tear
- Spoon nails

Answer 4

Atrophic Glossitis, Angular Cheilitis/Stomatitis, Koilonychia

Question 5

Most common type of Anemia.

ETIOLOGY:
* Chronic blood loss
* Increased Need
* Poor diet, poor absorption

Answer 5

Iron Deficiency Anemia (Microcytic Anemia)

Question 6

2nd most common type of anemia.
Megaloblasts = large, erythroblasts with Immature Nuclei seen in the marrow.

Answer 6

Vitamin B12/ Folate Deficiency (Macrocytic Anemia)

Question 7

(large, Erythroblasts with Immature Nuclei)
* Blood Film:
Normochromic
Oval Macrocytes (Large, Oval RBCs
Hyper segmented Neutrophils
(Some with >6 Lobes in Nucleus)

Pancytopenia (Reduction in Number or ALL Cells – RBCs/WBCs/Platelets)

Answer 7

Megaloblasts

Question 8

Anemia due to increased/abnormal/premature RBC destruction.

Lab Eval: Hemoglobinemia, Hemoglobinuria Red brown urine, Hemosiderinuria, ↑Bilirubin,↓Haptoglobins

Answer 8

Hemolytic Anemia

Question 9

Abnormalities in Blood Vessel Structure or
Perivascular Connective Tissue Leads to: Easy Bruising

Answer 9

VASCULAR DISORDER

Question 10

Due to deficient number of platelets.

Results from either:
Þ ↓ Platelet Production
Þ ↑ Platelet Destruction
Þ ↑ Platelet Consumption (in large injuries/burns)

Answer 10

THROMBOCYTOPENIA

Question 11

There are enough platelets, but not working properly.
* May be Inherited (rare)…OR
* Acquired: (eg. From Aspirin/other blood thinners)

Answer 11

DEFECTIVE PLATELET FUNCTION

Question 12

Either Not enough vWF….or Dysfunction of vWF.
* vWF is necessary for platelet adhesion.
* Therefore Deficiency > Poor platelet plug
formation

Answer 12

VON WILLEBRAND’S DEFICIENCY

Question 13

Bleeding disorders due to deficiency in 1 or more Coagulation Factors

Answer 13

COAGULOPATHY=DEFECTIVE COAGULATION

Question 14

Most common
- Sex Linked Recessive (Female Carriers;
Affected Males)

Treatment:
Recombinant clotting factors

Answer 14

Hemophilia A: Factor VIII Deficiency

Question 15

AKA. Christmas Disease
- Less common
- Sex Linked Recessive (only affects males)

Treatment:
Recombinant clotting factors

Answer 15

Hemophilia B: Factor IX Deficiency

Question 15

Acquired Coagulopathies:
* Dietary
* Malabsorption
* Or Long-term warfarin

Answer 15

Vitamin K Deficiency (Factors II,VII, IX, X)

Question 16

Acquired Coagulopathies:
AKA. Consumptive Coagulopathy
* Formation of small clots inside blood vessels throughout the body.
* Leads to: ↑Consumption of Platelets & Coagulation Factors.

Answer 16

DIC - Disseminated Intravascular Coagulation

Question 17

Acquired Coagulopathies:
Eg. Biliary Ostruction:
* Hinders absorption of Fat-Soluble vitamins
* Reduced synthesis of Factors II, VII, IX & X
* Eg. Severe Hepatocellular Damage: Reduced synthesis of Factor V & Fibrinogen

Answer 17

Chronic Liver Disease

Question 18

Measures how quickly Thrombin is being
activated.
- Time taken for a clot to form, following addition of animal Thrombin.

Measures:
- The conversion of Fibrinogen to Fibrin
- Deficiency of fibrogen
- Inhibtion of Thrombin

Answer 18

Thrombin Time

Question 19

Time taken for plasma to clot after addition of phospholipids.

Normally 25-45secs
Measures Intrinsic Pathway

Answer 19

Activation Partial Thromboplastin Time

Question 20

Time taken for plasma to clot after addition of tissue faction (Factor lll)

Normally 10-15secs
Measures Extrinsic Pathway

Answer 20

Prothrombin Time

Question 21

A Type of Cancer Caused by Unregulated
Proliferation of Abnormal ‘White Cells’ from a Mutant Hematopoietic Stem Cell.

Answer 21

Leukemia

Question 22

Genetic alteration within a Single Myeloid or Lymphoid Tissue Progenitor

Answer 22

Mutation

Question 23

1 Cause of Chronic Myeloid Leukemia

Answer 23

Philadelphia Chromosome (Chromosomal Translocations)

Question 24

1 cause of Acute Myeloid Leukemia

Answer 24

Monosomy 7 (Chromosomal Deletions)

Question 25

Distinguishing Feature: Children, Good Prognosis, Small Lymphoblasts, Small Cytoplasm, No Granules/Nucleoli

Answer 25

Acute Lymphoblastic Leukemia (ALL)

Question 26

Distinguishing Feature: Adults, Poor prognosis (2mths if untreated), Gum Hypertrophy, Auer Rods, Big Myeloblasts, Big cytoplasm, Granules, Nucleoli

Answer 26

Acute Myeloid Leukemia (AML)

Question 27

Distinguishing Feature:
Elderly Commonest Leukemia Insidious Onset, Good survival (9yrs) but no cure, “Smear cells” on blood film

Answer 27

Chronic Lymphocytic Leukemia (CLL)

Question 28

Distinguishing Feature:
Adults Philedelphia Chromosome in 80% Good prognosis with Glivec (Imatinib)

3 Phases: Chronic, Accelerated, Blast Crisis. Marked Splenomegaly

Answer 28

Chronic Myeloid Leukemia (CML)