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Step 1 > PP Hematology > Flashcards

PP Hematology Flashcards

0
Q

What is an Eosinophil?

A

The Parasite Destroyer

Allergy Inducer

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1
Q

What is a neutrophil?

A

The Phagocyte (has anti-microbials, most abundant)

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2
Q

What is a Basophils?

A

The Allergy Helper ( IgE receptor => histamine release)

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3
Q

What is a Monocyte?

A

The Destroyer => MP (hydrolytic enzyme, coffee-bean nucleus)

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4
Q

What is a Lymphocyte?

A

The Warrior => T, B, NK cells

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5
Q

What is a Platelet?

A

The Clotter ( no nuclei, smallest cells)

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6
Q

What is a Blast?

A

Baby Hematopoietic cell

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7
Q

What is a Band?

A

Baby Neutrophil

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8
Q

What does high WBC and high PMNs tell you?

A

Stress Demargination

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9
Q

What does high WBC < 5% blast tell you?

A

Leukemoid reaction

Seen in burn pts ( extreme demargination looks like leukemia)

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10
Q

What does high WBC and >5% blast tell you?

A

Leukemia

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11
Q

What’s does high WBC and bands tell you?

A

Left shift => have infection

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12
Q

What does high WBC and B cell tell you?

A

Bacterial infection

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13
Q

What diseases have high eosinophils?

A

“NAACP”

  • Neoplasm (lymphoma)
  • Allergy/ Asthma
  • Addison’s disease (no cortisol -> relative eosinophilia)
  • Collagen vascular disease
  • Parasites
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14
Q

What disease have high monocytes (>15%)?

A

“STELS”

  • Syphilis: chancre, rash, warts
  • TB: hemoptysis, night sweats
  • EBV: teenager sick for a month
  • Listeria: baby who is sick
  • Salmonella: food poisoning
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15
Q

What do high retics (>1%) tell you?

A

RBC being destroyed peripherally

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16
Q

What do low retics tell you?

A

Bone marrow not working right (decrease production)

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17
Q

What is Poikilocytosis?

A

Different shapes

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18
Q

What is Anisocytosis?

A

Different size

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19
Q

What is the RBC lifespan?

A

120days

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20
Q

What is the platelets lifespan?

A

7days

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21
Q

What does -penia tell you?

A

Low levels ( usually due to virus or drugs)

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22
Q

What does -cytosis tell you?

A

High levels

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23
Q

What does -cythemia tell you?

A

High levels

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24
Q

What is the difference between plasma and serum?

A

Plasma: no RBC
Serum: no RBC or fibrinogen

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25
Q

What is Chronic Granulomatous Disease?

A

NADPH oxidase deficiency -> recurrent

Staph/Aspergillus infections ( nitroblue tetrazolium stain negative)

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26
Q

What does MPO deficiency cause?

A

Catalase + infections

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27
Q

What is Chediak Higashi?

A

Lazy lysosomes syndrome: lysosomes are slow to fuse around bacteria

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28
Q

What organ can make RBCs if the long bones are damaged?

A

Spleen=> splenomegaly

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29
Q

What causes a shift to the right in the Hb curve?

A

“All CADETs face right”

  • Increase CO2
  • Acid/Altitude
  • 2,3 -DPG
  • Exercise
  • Temp
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30
Q

How does CO poison Hb?

A

Competitive inhibidor of O2 on Hb => cherry-red lips, pinkish skin hue

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31
Q

How does Cyanide poison Hb?

A

Non-competitive inhibitor of O2 on Hb => almond breath

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32
Q

What is MetHb?

A

Hb w/ Fe+3

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33
Q

What is Acute Intermittent Porphyria?

A

Defected enzyme: Porphobilinogen deaminase
Accumulation of: Prophobilinogen, delta ALA, uroporphyrin
Symptoms: Painfull abdomen, Port wine ( colored urine), Prolyneuropathy, Psychological disturbances, Precipitated by drugs

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34
Q

What is Porphyria Cutanea Tarda?

A

Defected enzyme: Uroporphyrinogen decarboxylase
Accumulation of: uroporphyrin ( tea color urin)
Symptoms: blistering cutaneous photosensitivity

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35
Q

What is Erythrocytic Protoporphyria?

A

Porphyria cutanea tarde in a baby

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36
Q

What is Sickle cell disease?

A

Homozygous HbS: ( Glu -> Val ) => vaso occlusion, necrosis, dactylitis (painful finger/ toes) at 6 month,

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37
Q

What is Sickle cell trait?

A

Heterozygous HbS => painless hematuria, sickle with extreme hypoxia, have resistance to malaria

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38
Q

What is Hb C disease?

A

Glu -> Lys

Still charged => no sickling

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39
Q

What is Alfa -thalassemia?

A
  • 1deletion: normal
  • 2 deletion “ trait”: Microcytic anemia
  • 3 deletion: Hemolytic anemia, Hb H= B4
  • 4 deletion: Hydrops fetalis, Hb Bart= y4
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40
Q

What is beta-thalassemia?

A
  • 1deletion “B minor” : increase HbA2 and HbF
  • 2 deletions “ trait /intermedia/ major”: only HbA2 and HbF => hypoxia
    at 6 month
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41
Q

What is Cooley’s anemia?

A

See w/ beta thalassemia major ( no HbA => excess RBC production)
Baby making blood from everywhere => frontal bossing, hepatosplenomegaly, long extremities

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42
Q

What is Virchow’s triad?

A

Thrombosis risk factors:

  1. Turbulent blood flow “ slow”
  2. Hypercoagulable “sticky”
  3. Vessel wall damage
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43
Q

What does acute hypoxia causes?

A

Shortness of breath

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44
Q

What does chronic hypoxia causes?

A

Clubbing of fingers/toes

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45
Q

What is intravascular hemolysis?

A

RBC destroyed in blood v. -> low haptoglobin ( binds free floating Hb)

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46
Q

What is extravascular hemolysis?

A

RBC destroyed in spleen (problem with RBC membrane) => splenomegaly

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47
Q

What enzymes need lead (Pb)?

A

Delta-ALA dehydrase

Ferrochelatase

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48
Q

What does EDTA bind?

A

X2+

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49
Q

What disease has a smooth philthrum?

A

Fetal alcohol syndrome

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50
Q

What disease has a long philthrum?

A

Williams

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51
Q

What disease has sausage digits?

A

Pseudo-hypoparathyroidism

Psoriatic arthritis

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52
Q

What disease has 6 fingers?

A

Trisonomy 13

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53
Q

What disease has 2-jointed thumbs?

A

Diamond-Blackfan

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54
Q

What disease has painful fingers?

A

Sickle cell disease

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55
Q

What are the Microcytic Hypochromic anemias?

A

“FAST Lead”
- Fe deficiency ( increase TIBC, GI bleed, koilonychia)
- Anemia of chronic disease ( decrease TIBC)
- Sideroblastic anemia ( decrease delta-ALA synthase, blood
transfusion)
- Alfa Thalassemia ( AA, Asian (chr. 16 deletion)
- beta Thalassemia (Mediterranean ( chr. 11 point mutation))
- Pb poisoning ( decrease delta-ALA dehydrogenase, decrease ferrochelatase, x-ray blue line, eating old paint chips)

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56
Q

What are the Megaloblastic anemias?

A
  • vit. B12 deficiency
  • Folate deficiency
  • Orotic Aciduria
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57
Q

What are the Intravascular Hemolytic anemia?

A

PNH

Autoimmune hemolytic anemia

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58
Q

What are the Exatravascular Hemolytic anemia?

A 
Hereditary spherocytosis
G6PD defi
PK defi
Sickle cell disease
HbC
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59
Q

What are the Production Anemias?

A
  • Diamond-Blackfan: no RBCs, 2-jointed thumbs
  • Aplastic anemia: Pancytopenia, autoimmune, benzene, AZT, CAM,
    radiation
60
Q

What is Basophilic Stippling?

A 
Lots of immature cells
Increase mRNA ( Pb poisoning)
61
Q

What is a Bite cell = Basket cell?

A

Unstable Hb inclusion (G6-PD deficiency)

62
Q

What is a Burr cell = echinocyte?

A

Pyruvate kinase deficiency
Liver dz
Post-splenectomy

63
Q

What is Cabot’s ring body?

A

Vit B12 defi

Pb poisoning

64
Q

What is a Doehle body?

A

PMN leukocytosis ( infection, steroids, tumors)

65
Q

What is a Drepanocyte?

A

Sickle cell anemia

66
Q

What is a Helmet cell?

A

Fragmented RBC ( hemolysis: DIC, HUS, TTP)

67
Q

What is Heinz body?

A

Hb presipitates and sticks to cell mm (G-6PD deficiency)

68
Q

What is a Howell-Jolly body?

A

Spleen or bone marrow should have removed nuclei fragment ( hemolytic anemia, spleen trauma, cancer)

69
Q

What is a Pappenheimer body?

A

Fe ppt inside cell ( Sideroblastic amenia)

70
Q

What is a Pencil cell = cigar cell?

A

Fe deficiency anemia

71
Q

What is a Roleaux formation?

A

Multiple myeloma

72
Q

What is Schistocyte?

A

Broken RBC ( DIC, artificial heart valves)

73
Q

What is a Sideroblast?

A

Macrophages pregnant w/Fe (genetic or multiple transfusion)

74
Q

What is a Spherocyte?

A

Old RBC

75
Q

What is a Spur cell = Acanthocyet?

A

Lipid bilayel dz.

76
Q

What is Stomatocyte?

A

Liver dz

77
Q

What is a Target cell = Codocyte?

A

Less Hb ( Thalassemia or Fe defi)

78
Q

What is Tear drop cell = Dacrocyte?

A

RBCs squeezed out of marrow ( hemolytic anemia, bone marrow cancer)

79
Q

What is the Clotting Cascade?

A

How you stop bleeding

80
Q

What do platelet problem cause?

A

Bleeding from skin and mucosa

81
Q

What do clotting problems cause?

A

Bleeding into cavities

82
Q

What causes increased PTT and bleeding time?

A

von Willebrand disease and Lupus

83
Q

What is Bernard-Soulier?

A 
Baby w/ bleeding from skin and mucosa
Big platelet ( low GP1b)
84
Q

What is Glanzmanns ?

A

Baby w/ bleeding from skin and mucosa ( low GP2b3a)

85
Q

How does Factor 13 deficiency present?

A

Umbilical stump bleeding ( 1st time baby has to stabilize a clot)

86
Q

What is Factor V Leiden?

A

Protein c can’t breack down Factor 5 => more clots

87
Q

How does Von Willebrand Disease present?

A

Heavy menstrual bleeding

88
Q

What are the type of VWD?

A

Type1 (AD): decrease VWF production
Type2 (AD): decrease VWF activity
Type3 (AR): no VWF

89
Q

What is Hemophylia A?

A

Defective factor 8 ( < 40% activity) => bleed into cavities

90
Q

What is Hemophilia B?

A

Factor 9 deficiency => bleed into joint

91
Q

What disease have low LAP?

A

CML

PNH

92
Q

What has high LAP?

A

Leukemoid reaction

93
Q

What is the deference between acute and chronic leukemia?

A 
Acute:
- starts in bone marrow
- squeezes RBC out of marrow
Chronic:
- starts in periphery
- not constrained => will expand
94
Q

What is the difference between myeloid and lymphoid leukemia?

A 
Myeloid: 
- increase RBC, WBC, platelets, MP
- bone marrow biopsy
Lymphoid:
- increase NK, T, B cells
- do lymph node biopsy
95
Q

What defines ALL?

A

< 15 y / o males
Bone pain
PAS stain +
TdT +

96
Q

What defines AML?

A

15-30 y/o males
Sudan stain
Auer rods

97
Q

What defines CML?

A

30-50 y/o females
t(9,22) “ Philadelphia chromosome”
bcr-abl
Decrease ALP

98
Q

What defines CLL?

A

> 50 y/o males w/ lymphadenopathy
“Soccer ball” nuclei
Smudge cells

99
Q

What defines Hodgkin’s lymphoma?

A

EBV

May have Reed-Sternberg cells

100
Q

What are the B cell Non-Hodgkin’s lymphoma?

A

Follicular: t(14:18), bcl-2
Burkitt: t(8:14), c-myc, starry sky MP
- American kids: abdominal mass
- African kids: jaw mass

101
Q

What are the T cells Non-Hodgkin’s lymphoma?

A

Mycosis Fungoides: total body rash

Sezary Syndrome: cerebreform cells

102
Q

What is Polycythemia Ruba Vera?

A

Hct > 60%
Decrease Epo
Budd-Chiari
Plethora “ pruritis after bathing”

103
Q

What is Essential Thrombocytopenia?

A

Very high platelets
Stainable Fe
Decrease c-mpl

104
Q

What is Myelofibrosis?

A

Megakaryocytes

Fibrotic marrow => teardrop cells, extramedular hematopoiesis

105
Q

What are plasma neoplasms?

A

Produce lots of Ab

106
Q

What is Waldenstrom Macroglobulinemia?

A

IgM

Hypervicous

107
Q

What is Monoclonal Gammopathy?

A

Old person 2w/ gamma spike

108
Q

What is Mùltiple Myeloma?

A

Serum M prot ( IgG)
Urine Bencen-Jones protein
Rouleaux
Punched-out lesion

109
Q

What is heavy chain disease?

A

Increase IgA

110
Q

What is Histocytisis X?

A

Kids w / eczema
Skull lesions
Diabetes Insipidus
Exophthalmos

111
Q

What does the Coombs test tell you?

A

Ab involved

112
Q

What does the direct Coombs test tell you?

A

On surface => hemolytic anemia

113
Q

What does an indirect Coombs test tell you?

A

In serum

114
Q

What is type and cross?

A

You know you can use that blood

Save it for specific pts

115
Q

What is type and match?

A

Type it and wait

116
Q

What is forward typing?

A

Uses Ab to detect Ag “Fab”

117
Q

What is backward typing?

A

Uses Ag to detect Ab

118
Q

What does Type A blood tell you?

A

Have the A antigen

119
Q

What does blood Type O tell you?

A

Have no antigen

Universal donor

120
Q

What does blood Type AB tell you?

A

Have both antigen

Universal recipent

121
Q

What does Rh + tell you?

A

Has D antigen

122
Q

What does Rh - tell you?

A

Does not have the D antigen

123
Q

What is Hemolytic Disease of the Newborn?

A

Rh- moms placenta tears
100cc baby’s blood sees
Moms produce Ab
Attacks fetus

124
Q

What is RHOGAM?

A

Anti-D IgG

125
Q

When do you give RHOGAM?

A

1st dose: 28wk gestation ( of 2nd child)

2nd dose: 72h post delivery ( Rh+ baby)

126
Q

What is the most common transplant?

A

Blood

127
Q

What is a Syngenic transplant?

A

Twin to twin

128
Q

What is an Autograft?

A

Self to self transplant

129
Q

What is an Allograflt?

A

Human to human transplant

130
Q

What is Xenograft?

A

1 species to another species

131
Q

What is Hyperacute rejection?

A

Within 12h ( preformed Ab)

132
Q

What is Acute rejection?

A

4 days to years laters ( T-cells, MP)

133
Q

What is Chronic rejection?

A

> 7 days (fibroblast)

134
Q

What is Graft vs. Host disease?

A

Bone marrow transplant reject

135
Q

What are immunoprivileged sites?

A

No lymphatic flow => no Ag => easy to transplant ( brain, cornea, thymus, testes)

136
Q

What is INR?

A

Measured PT / control PT

137
Q

What pathology are associated with Acanthocyte?

A

Liver disease

Abetalipoproteinemia

138
Q

What pathology are associated with Basophilic stippling?

A

Thalassemia
Anemia of chronic disease
Lead poisoning

139
Q

What pathology are associated with Bite cell?

A

G6PD deficiency

140
Q

What pathology are associated with Ringed sideroblasts?

A

Sideroblastic anemia

141
Q

What pathology are associated with Schistocyte, Helmet cell?

A

DIC
TTP/ HUS
Traumatic hemolysis

142
Q

What pathology are associated with sickle cell?

A

Sickle cell anemia

143
Q

What pathology are associated with Spherocyte?

A

Hereditary spherocytosis

Autoimmune hemolysis

144
Q

What pathology are associated with Teardrop cell?

A

Bone marrow infiltration

145
Q

What pathology are associated with Target cell?

A

HbC disease
Asplenia
Liver disease
Thalassemia

146
Q

What pathology are associated with Heinz bodies?

A

G6PD deficiency

147
Q

What pathology are associated with Howell-Jolly bodies?

A

Functional hyposplenia or asplenia

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