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Heme-Onc > Pathology > Flashcards

Pathology Flashcards

1
Q

What can increase ESR?

A

Increased Ab formation, inflammation,

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2
Q

What can decrease ESR?

A

Polycythemia, Sickle cell anemia, congestive heart failure

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3
Q

What can cause pruritis after a hot shower?

A

Polycythemia

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4
Q

What is a side effect of Ticlopidine?

A

Neutropenia

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5
Q

What is the mechanism of Ticlopidine?

A

Blocks ADP-Receptor–> blocks platelet aggregation

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6
Q

What is TdT a marker for?

A

Marker for early-stage B-and T-cells

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7
Q

What is the function of TdT?

A

Adds N-nucleotide to junctions of gene segments during VDJ rearrangements

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8
Q

When do cytoplasmic mu-chains become positive?

A

Cell successfully completed VDJ rearrangement, but have not turned off TdT

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9
Q

t9;22 is implicated in what?

A

CML

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10
Q

In CML, there is an increase in which cell lineage?

A

Granulocytes (Neutrophils)

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11
Q

Thrombotic Thrombocytopenia Purpura

A 
Decreased ADAMTS-13 
Young women mostly 
Schistocytes
Systemic symptoms (hemorrhages)
INCREASED bleeding time and LDH
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12
Q

What is the function of ADAMTS-13?

A

Breakdown vWF multimers

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13
Q

What is Hairy Cell Leukemia?

A

Chronic B-cell leukemia of middle-aged men

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14
Q

What do you see in Hairy Cell Leukemia, that you don’t see in most leukemias?

A

Pancytopenia

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15
Q

In Hairy Cell Leukemia, what do neoplastic cells stain for?

A

TRAP

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16
Q

How do you treat Hairy Cell Leukemia?

A

Cladribine (2-CDA)

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17
Q

What is Immune Throbocytopenia?

A

Immune-mediated destruction of platelets by spleen

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18
Q

What do labs show with Immune Thrombocytopenia?

A

Decreased Platelets, Normal RBCs

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19
Q

What do labs show with Thrombotic Thrombocytopenia Purpura?

A

Decreased Platelets, Fragmented RBCs

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20
Q

What do labs show with Microangiopathic Hemolytic Anemia?

A

Normal Platelets, Fragmented RBCs

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21
Q

What do labs show with Thrombasthenia and vWB Disease?

A

Normal Platelets, Decreased platelet function, normal RBCs

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22
Q

What is the function of Haptoglobin?

A

Binds free Hb to decrease oxidative activity

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23
Q

What does a Positive Warm Coombs Test indicate?

A

IgG–> SLE, lymphoma, drugs

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24
Q

What causes Follicular Lymphoma?

A

t(14;18) translocation. Bcl-2–> inhibits apoptosis

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25
Q

Which cytoplasmic markers do the neoplastic cells have in Follicular Lymphoma?

A

CD10, CD19, CD20, and surface IgG

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26
Q

What is the most common Non-Hodgkin Lymphoma?

A

Follicular Lymphoma

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27
Q

Which diseases have Target cells?

A

HbC Disease, Asplenia, Liver Disease, Thalassemia (HALT)

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28
Q

What are Howell-Jolly bodies?

A

Nuclear remnants in RBCs

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29
Q

What do Howell-Jolly bodies represent?

A

Spleen removal (spleen normally removes)

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30
Q

What are Heinz bodies?

A

Oxidized and Denatured Hb inclusions

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31
Q

When do you see Heinz bodies?

A

Acute Hemolytic anemia

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32
Q

What do labs show in Hemolytic anemia?

A

INCREASED unconjugated bilirubin, LDH, and urinary urobiligurin, DECREASED haptoglobin

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33
Q

How to distinguish between PCV and CML (using labs)?

A

PCV: Increased RBCs and Leuk. Alk. Phos.
CML: Decreased RBCs and Leukocyte Alk. Phos.

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34
Q

How does DIC affect PT and PTT?

A

BOTH are prolonged

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35
Q

What happens to Fibrinogen and Fibrin split-products in DIC?

A

Decreased Firbinogen, Increased Fibrin split-products

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36
Q

When do you see “Crew-cute” on skull x-ray?

A

Thalassemia, Sickle cell anemia

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37
Q

What causes “crew-cut” skull on x-ray?

A

Marrow expansion

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38
Q

What do labs show in Anemia of Chronic Disease?

A

Increased Ferritin, Decreased TIBC and Fe

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39
Q

How does Streptokinase work?

A

Binds to Plasminogen–> Plasmin

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40
Q

How to distinguish PCV from Secondary Polycythemia?

A

PCV: Decreased EPO

Secondary Polycythemia: Increased EPO

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41
Q

Which cancers can lead to Secondary Polycythemia?

A

Heptacellular carcinoma, Renal carcinoma, Hemangioblastoma, Pheochromocytoma, Uterine myomata

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42
Q

What is the difference between Heparin and Warfarin skin toxicities?

A

Heparin: ONLY at injection site
Warfarin: Anywhere on body

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43
Q

What is Uterine Leiomyomas?

A

Smooth muscle tumors of Uterus

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44
Q

What are the symptoms of Uterine Leiomyomas?

A

Abundant bleeding and pain during menstruation

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45
Q

What is a complication of Uterine Leiomyomas?

A

Iron-deficiency anemia

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46
Q

Sickle Cell Anemia is due to mutation in what?

A

B-chain

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47
Q

t14;18

A

Follicular Lymphoma

48
Q

t11;14

A

Mantle cell Lymphoma

49
Q

t9;22

A

CML and ALL

50
Q

t15;17

A

AML

51
Q

t8;14

A

Burkitt Lymphoma

52
Q

Which Antibiotics increase the INR or Warfarin?

A

Macrolides

53
Q

What is Leukocyte Alkaline Phosphatase (LAP) a marker of?

A

Activity of mature Granulocytes

54
Q

Which cancers are lytic bone lesions associated with?

A

Multiple Myeloma, lung carcinoma, breat carcinoma

55
Q

Which cancers are blastic bone lesions associated with?

A

Prostate carcinoma, breast carcinoma

56
Q

What happens to PT and PTT levels of Warfarin ovedose?

A

BOTH increase

57
Q

At clinical doses, Warfarin affects which factor(s)?

A

ONLY Factor VII

58
Q

What happens to clotting factor levels in a Warfarin overdose?

A

Decreases VII, II, IX, and X

59
Q

Warfarin has NO effect on what?

A

Fibrinogen levels, Bleeding time (platelet function or count)

60
Q

What is the initiating event in DIC?

A

Excessive Tissue Factor Release

61
Q

How does Placental Abruption lead to DIC?

A

The Human Decidua has abundant Tissue Factor

62
Q

What are the symptoms for Hereditary Spherocytosis?

A

Splenomegaly, jaundice, hemolytic anemia, bilirubin gallstones

63
Q

Which Hb is elevated in B-thalassemia?

A

HbF and HbA2

64
Q

Which Hb is evevated in a-thalassemia?

A

HbH (3 deletions), HbBarts (4 deletions)

65
Q

Do Thrombolytics affect PT and/or PTT?

A

BOTH!!! PT and PTT increase

66
Q

Which macrolide Abx does NOT affect P450?

A

Azithromycin

67
Q

Which lymphocytes does EBV infect?

A

B-cells

68
Q

Which cells predominate in the blood in EBV infection?

A

“Downy Cells”: Atypical, Reactive CD8+ T-cells

69
Q

What are normal features of reactive lymphadenitis?

A

Preserve lymph node structure, multiple large germinal centers, recognizable light and dark zones, tingible macrophages, active mitosis

70
Q

Multiple Myeloma is a disorder of which cells?

A

Plasma cells

71
Q

What are “Schuffner dots”?

A

Red granules in RCBs

72
Q

What do “Schuffner dots” indicate?

A

Malarial infection

73
Q

How does Chloroquine affect psoriasis?

A

It can worsen psoriasis

74
Q

Which area is known to have Chloroquine-resistant malaria?

A

South America

75
Q

When Chloroquine cannot be given, what do you prescribe?

A

Atovaquone + Proguanil

76
Q

What are Auer Rods?

A

Cytoplasmic inclusion of enzymes found in azurophilic granules. Seen in AML!

77
Q

What is an common side effect of chemotherapy for AML?

A

DIC due to release of Auer Rods

78
Q

When does childhood Idiopathic/Immune Thrombocytopenia usually arise?

A

After a viral illness

79
Q

Do you have splenomegaly with Immune Thrombocytopenia?

A

No!

80
Q

How does Immune Thrombocytopenia occur?

A

IgG against GpIIb/IIIa

81
Q

What kind of cells are seen in Hodgkin Lymphoma?

A

Reed Sternberg Cells

82
Q

Which cell markers do Reed Sternberg cells have?

A

CD15 and CD30

83
Q

CD30

A

Lymphocyte activator antigen

84
Q

CD15

A

Granulocyte antigen

85
Q

What is consumed in DIC?

A

Platelets and clotting factors

86
Q

Which lab tests should be ordered to monitor DIC?

A

Platelet count, Fibrinogen, and Fibrin degredation products

87
Q

What are “Smudge Cells” associated with?

A

CLL

88
Q

What are “Smudge Cells”?

A

Fragile B-cells

89
Q

Which cells are usually increased in CLL?

A

B-cells

90
Q

What do cells express in CLL?

A

B-cells that express CD20 and CD5 (normally only in T-cells)

91
Q

What is the difference between D-dimers and Fibrinogen Degredation Products?

A

D-dimers: EXCLUSIVELY from Fibrin clots

FDPs: From Fibrin OR Fibrinogen (Plasmin-mediated)

92
Q

Are D-dimers of FDPs more specific?

A

D-dimers

93
Q

What do D-dimers indicate?

A

Simultaneous activity of Thrombin and Plasmin

94
Q

What is diagnostic for DIC: D-dimers or FDPs?

A

D-dimers

95
Q

D-dimer is used as a screening tool for what?

A

DVT and PE

96
Q

B12 deficiency can result from infection with what?

A

Diphyllobothrium latum

97
Q

What does a neonate with Positive Coombs Test suggest?

A

Immune Hemolytic Anemia from ABO or Rh incompatability

98
Q

How does Rh incompatibility compare to ABO incompatibility?

A

Rh is much more server (hydrops fetalis or death)

99
Q

What is the function of vWF?

A

Form bridge between exposed collagen in subendothelium and GpIb of Platelets

100
Q

How can you treat vWF Disease?

A

Desmopressin or DDAVP

101
Q

What are ALL patients with leukemia prone to?

A

Uric Acid kidney stons

102
Q

What should EVERY patient with Leukemia be treated with ?

A

Xanthine Oxidase inhibitor to prevent Kidney Stones (Febuxostat or Allopurinol)

103
Q

When do you see Auer Rods?

A

AML

104
Q

What is a severe complication of Heparin?

A

Heparin-Induced Thrombocytopenia

105
Q

What do you give a patient if they experience Heparin-Induced Thrombocytopenia?

A

Bivalirudin or Agatroban

106
Q

What are Bivalrudin and Agatroban?

A

Derivatives of Hirudin (leeches). Inhibit Thrombin DIRECTLY

107
Q

Why can Bivalrudin and Agatrban be used in Heparin-Induced Thrombocytopenia?

A

They are not inhibited by Plate Factor 4 (PF4)

108
Q

How does vWB Disease affect lab values?

A

INCREASED Bleeding time, Normal platelet count, PT, and increased/normal PTT

109
Q

Describe location of RBC production in the embryo

A

1st 3 weeks: Yolk sac
4 weeks: Liver
2-4mts: spleen, lymph organs
After 4mts: Bone Marrow

110
Q

What do labs show in Intravascular Hemolysis?

A

Decreased Haptgloubin, Increased Indirect Bilirubin (unconjugated)

111
Q

Which common pain relievers can increase risk for Cardiovascular disease?

A

NSAIDs and COX-2 inhibitors

112
Q

What are the implications for Acetominophen?

A

Pain and fever WITHOUT inflammation

113
Q

What side effect is assoc. with NSAIDs, but not Acetominophen?

A

GI irrritation or Cardiovascular risk

114
Q

What do the Eosinophilic granules in Eosinophils contain?

A

Histaminase, Arylsulfatase, and Major Basic Protein

115
Q

What is the function of Major Basic Protein in Eosinophil granules?

A

Parasite destruction. Also destroys epithelium in Asthma.

116
Q

What is the cell marker for Macrophages?

A

CD14

Heme-Onc (1 decks)

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