Path Heme/Onc/Pain/Suffering Flashcards
Dacrocytes morph and seen in
daCRYcyte
Teardrop cells
Seen in bone marrow shit (myelofibrosis) bc squeezed
Schittocyctes seen in and morph
Helmet cells (shizo guy and his helmet)
Seen in hemolytic anemias
Degmacytes morph and seen in
dejame una mordida
G6Pd defficiency
Acanthocytes seen in and morph
Spur cells
Liver disease
Spherocytes morph and seen in
donut
heriditary spherocytosis
Target cells seen in
HALT
HbC dx
Asplenia
Liver dx
Thalassemia
howell jolly bodies: what are they?
where they seen
Nuclear remnant not removed by spleen
seen in splenic dx
Heinz bodies what is and seen in
Precipitated hemoglobin on side of RBC
Removed by taking a bite
PUT HEINZ b4 BITE
Microcytic anemia cutoff
MCV less than 80
Microcytic anemia caused by
Hemoglobin issues
Deffective in thalassemia
Deficiencies
Megaloblastic anemia caused by
Defective DNA
Either folate/b12 deficiency or fanconi anemia
Macrocytic non megaloblastic seen in
Liver dx and alcholism
Reticulocyte count tells you
How well body is replacing the RBCs
Iron defficiency labs
Down: Iron, ferritin
Up: TIBC
Anemia of chronic dx labs
Down: iron, TIBC
Up: ferittin, hepcidin
Transferrin interchangable w
TIBC
α-Thalassemia presentation
Microcitic anemia
severity depends on how many genes affected
Cis/trans in α-Thalassemia by race
Cis: asians
Trans: africans
β-Thalassemia increases risk of _____ (pathogen). leads to:
Parvovirus
leads to aplastic anemia
β-Thalassemia population
mediterrenans
β-Thalassemia presentation
Severe microcytic anemia
Crew cut xray due to marrow expansion
Skeletal deformity (chipmunk face)
Lead inhibits
Ferrochelatase and ALA dehydratase
causes anemia and neuro shit
Sideroblasic anemia caused by
Genetic: x-linked ALA
Myeloplastic anemia
Alcohol
Sideroblastic anemia treatment
Pyridoxine
Sideroblastic anemia labs
Increased: iron, ferritin
Decreased: TIBC
Megaloblastic anemia features
Multilobed neutrophils
RBC enlargment
Folate vs B12 defficiency (labs and presentation)
Folate: ** Normal** methylmalonic acid, no neuro shit
B12: increased methylmalonic acid, neuro problems (meth fucks your brain)
Megaloblastic anemia common presentation
GLOSSITIS
large RBCs clog and sweel tongue
Fanconi anemia caused by
DNA repair defect, bone marrow failure
Aplastic anemia sx
Fatigue, malaise, pallor, mucosal bleeding and petechiae
G6PD cause and genes
Xlinked
RBCs get oxidative stress
Causes hemolysis
FAVA BEANS
Aplastic anemia marrow biopsy
hypocellular bone marrow w/ fatty infiltration
hemolytic anemia in newborn usually due to
Pyruvate kinase deffiency
Paroxysmal nocturnal hemoglobinuria presentation
negative coombs
pancytopenia
venous thrombi
caused by complement activation
Pyruvate kinase deffiency RBC morph
Burr cells
BURR PKD
Nocturnal hemoglobinuria mutation in
PIGA
fucks up GPI anchor which destabilizes membrane
Sickle cell genetics
Point mutation in B-globin gene.
HbS instead of HbA
Glutamic to valine
Sickle cell crisis due to
Oxidative stress, acidosis , low O2
deoxy hemoglobin S polymerizes
Sickle cell anemia aplastic crisis due to
Parvovirus
Sickle cell increased risk of (infection)
Salmonella osteomyelitis
Warm vs Cold autoimmune anemia (and similarities)
Warm: IgG (seen in lupus, CLL)
Cold: IgM (seen in mycoplasma, EBV, CLL)
Both: +Coombs, normocytic anemia
Microangiopathic hemolytic anemia presentation and seen in
Seen in things that cause little clots
mechanical RBC destruction
Macroangiopathic hemolytic anemia due to
Heart valves (stenotic or prosthetic) causing RBC destruction
Lead poisoning what accumulates
ALA and protoporphyrin
Intermittent porphyria due to
Porphobilogen acummulation
Porphyria cutanea sx
Blistering cutaneous photosensitivity
Hyperpigment
Thrombitic thrombocytopenic purpura pathophys
Inhibittion of ADAMST13 leads to decreased vWF accumulation
Platelets aggregate and make microthrombi
TTP vs HUS
TTP has feever
HUS has bloody diarrhea
TTP and HUS presentation
Thrombocytopenia
Hemolytic anemia (microangiopathic)
AKI
vWF is defect in ____pathway. (pt/ptt)
Intrinsic
PTT
DIC labs
Increased bleeding, PT, PTT.
Schistocytes,
Increased D-dimer
Antithrombin defficiency labs
PT and PTT normal
Young woman w/ recurrent pregnancy loss think
Factor V leiden
Factor V leiden pathophys
Mutant factor V resistance to degradation by protein C
Protein C vs S
C: cancel
S: stop
Lymphomas initial presentation
Constitutional sx (low fever, night sweats, weight loss)
Reed-steinberg cells seen in (and morph)
Seen in Hogdkin
Owl eyes
hoot hoot
reed steinberg cell origin
CD 15 and CD 30
Fibrous bands seen in
Hodgkin lymphoma
Burkit lymphoma presentation and gene defect
Young african w/ jaw tumor
8,14 translocation
EBV
Diffuse large b cell lymphoma mutation
BCL2
BCL2 limits apoptosis normally
Mantle cell lymphoma seen in
MAN
Painless follicles in adults think
Follicular lymphoma
Mantle cell lymphoma progression
Very agressive disease
AGGRESSIVE MAN
Marginal Cell lymphoma genes and seen in
gastritis MALT
gene is 11,18’
MUCOSAL
Adult T-cell lymphoma seen in
Japs, caribbean, africa.
HTLV1 virus
Multiple myeloma feautures
CRAB
hyperCalcemia
Renal shit
Anemia
Back pain from Bone lytic lesions
Multiple myeloma findings (microscope)
Rouleaux formation (high rouller stacks chips)
Waldenstrom macroglobulinemia causes _____
Hyperviscosity of blood
Myelodisplastic syndromes patho and risk
Ineffective hematopoesis
Can become AML
ALL associations
Mostly kids (real bad in adults tho)
Down syndrome
ALL better prognosis if (gene defect)
(12,21)
mejor en niños
ALL main finding
Highly increased lymphoblasts
Chronic Lymphocitic leukemia findings (3)
Smudge cells
Slow progress in elderly
Autoimmune hemolytic anemia
Hairy cell leukemia seen in (population)
Adult males
Hairy cell leukemia findings (4)
Filamentous projection on cells (look fuzzy)
Marrow fibrosis (dry tap)
Splenomegaly
Pancytopenia
Hairy cell leukemia mutation
BRAF
Acute myelogenous leukemia findings
Auer rods
Myeloperoxidase +
Increased myeloblasts on smear
Leukemia after radiation/chemo think
Acute myelogenous leukemia
Acute myelogenous leukemia in down syndrome mutation (also AKA)
15,17
Acute Promyelocytic Leukemia
Acute promyelocytic leukemia responds to
Retonic acid aka vitamin A
DIC in down syndrome think
Acute promyelocytic leukemia
Chronic Myelogenous leukemia genetics
9,22 philadelphia chromosome
BCR-ABL
Chronic myelogenous leukemia findings ()
Low leukocyte alk phos (LAP)
Splenomegally
Polycethemia vera mutation
JAK2
Polycythemia vera presentation
Severe pain
red-blue coloration
Shower itch
Polycethemia vera lab finding
EPO low
Essencital thrombocytopenia findings
increased Large, malformed platelets
Myelofibrosis due to
Increased fibroblast activity
Myelofibrosis findings
Decreased RBCs, teardrop RBCs
Whjat is seen in leukomoid reaction
dohle bodies
Lagerhans histiocytosis presentation
Lytic bone lesion in a child
Otitis media
Lagerhans histiocytosis findings
Birbeck granules (tennis rackets)
Hemophilia is defect of ____(pathway)
Intrinsic
Hemophilia A deffiency of ___ and inheritance
VIII
A=8
Hemophilia B deffiency of ___ and gene
IX
X-linked
Hemophilia C deficiency. of ___ and gene
XI
Autosomal recessive
Hemophilia lab finding
PTT increased
PT no chage
Vitamin K deficiency labs
Both Pt and PTT increased with normal bleeding time
Platelet disorder labs
Increased bleeding time, PT/PTT normal
Bernard soulier syndrome labs
Increased bleeding time
Large platelets
RISTOCETIN
Chef soulier makes risoto
Glansmann Thrombasthenia defect
GpIIb/IIIa, decreased platelet to platelet agregation
Bernard soulier defect
GpIB
immune thrombocytopenia labs
Increased megakaryocytes
Decreased platelets
Immune thrombocytopenia antibodies to
GpIIb/IIIa
Things that cause immue thrombocytopenia
Autoimmune, viruses, malignancy, drug reactions
vWF disease findings
Decreased platelet aggregation with increased PTT
Giant cell arteritis population
Elderly female
Giant cell arteritis presentation
Unilateral headache, jaw claudication
Affects carotid branches
Takayasu arteritis due to
Granomalutous thickening and narrowing of aortic arch