Random BL/DD Step 1 Flashcards
Keloid
scarring is excess production of scar tissue that extend beyond borders of the original wound.
It is characterized by excess type III collagen and commonly return after resection.
Vascular endothelial growth factor (VEGF)
promotes angiogenesis and increases vascular permeability.
red blood cells with a “bullseye” target appearance
Target Cells
Target cells are associated with: HbC disease Asplenia Liver disease Thalassemia
Mnemonic: “HALT!” said the hunter to his target.
Coagulative necrosis Pathophysiology
Often due to interruption of the blood supply
Three main causes of THrombocytopenia
Decreased Marrow Production
Spleen Sequestration
Inc destruction
surface proteins on endothelial cells and leukocytes mediate rolling
selectines
C-reactive protein
enhances phagocytosis
can be measured as a sign of ongoing inflamation
Ferritin
Binds and sequesters iron
Hepcidin
Inhibits release of storage iron
Describe the primary function of dendritic cells
Dendritic cells are antigen-sampling and -presenting cells.
MHC2
Degmacytes (or “bite cells”)
red cells formed as a result of macrophage-mediated removal of hemoglobin.
Sickle Cell Trait
Heterozygotes
Hb AS
Do not show symptoms
Most Reactive O2 radical
OH radical
Opsonization
facilitates phagocytosis by tagging specific molecules for phagocytosis.
most important opsonins are IgG and C3b
“helmet cells”
red cell fragments that appear as half-discs with 2-3 pointed extremities. They form when red cells are sieved by fibrin strands in damaged blood vessels.
Liquefactive necrosis
characterized by enzymatic liquefaction of necrotic tissue
During acute inflammation, which cell type dominates 1-2 days following neutrophil infiltration?
Following neutrophils (1-2 days later), macrophages manage the next step of the inflammatory process
4 histologic findings consistent with apoptosis.
~Cell shrinkage
~Chromatin condensation (pyknosis)
~DNA fragmentation (karyorrhexis)
~Membrane blebbing
Aplastic anemia is characterized by
diminished or absent hematopoietic precursors in the bone marrow, usually as a result of injury to the pluripotent stem cell.
disorder encompasses pancytopenia
Integrins
Mediate tight leukocyte binding
Basophilic stippling conditions?
~Thalassemias
~Anemia of chronic disease
~Lead poisoning
~Alcohol abuse
All blood cells arise from
Hematopoietic stem cell
Hematopoiesis
Creation of blood
Hemolysis
Premature RBC destruction
Erythropoietin
Hormone made by the kidney.
Stimulates marrow to produce RBCs
Where is folate absorbed?
Jejunum
Where is vB12 absorbed
Ilium
Methymalonic Acid levels
Increased in b12 def
Normal in folate deficiency
TLR recognizes
PAMPS
part of innate immunity
PAMPS are on
Foreign invaders
CD14
TLR on MACs
Can see lipopolysachs on GN bacteria
NF KB
Transcription factor
“On switch” for acute inflammation response
Leads to production of immune mediators
Arachidonic Acid
COX to PG pathway
and Lipooxygenase pathway
PGI2, PGD, PGE2 mediate
Vasodilation and increased vascular perm
PGE2 mediates
Fever and pain
Cox path
Anemia of chronic disease
Fe is locked in macs
Lower heme production
Lower hemoglobin
leads to micro cystic anemia
Sideroblastic anemia
Lowered proto production
Lowered heme production
Micro cystic anemia
Thalsemia leading to micro cystic anemia
Decreased globin chain
Decreased hemoglobin
Decreased RBC size
Most common form of anemia
Iron Deficiency anemia
Iron is absorbed where?
Duodenum
Entercyte
Transports iron into the blood via ferroportin
Transferrin
Transports iron and delivers it to liver and bone marrow
Which chromosome contains the alpha globin genes?
Chromosome 16
1 alpha globin gene deletion
pt will be asymptomatic
α-thalassemia trait
If 2 alleles are deleted
Mild anemia
If 3 alpha globin alleles are deleted
microcytic, hypochromic anemia
β-globin chains form tetramers (HbH)
β-globin chains form tetramers (HbH)
forms when three alpha globins are deleted
myeloid to erythroid ratio (M:E)
ratio of myeloid precursor cells to erythrocyte precursor cells
varies from 2:1 to 4:1.
increased ratio is seen in myelogenous leukemia
Ferritin
stores iron and releases it in a controlled fashion
Hemosiderin
Iron storage molecule
always found within cells
Myoglobin
iron- and oxygen-binding protein
found in the muscle tissue
Myoglobin is only found in the bloodstream after muscle injury
Transferrin
Iron transporter
Total iron binding capacity
laboratory test that measures the blood’s capacity to bind iron with transferrin
Intrinsic factor
a protein essential for subsequent absorption of vitamin B12 in the ileum.
Pernicious anemia
megoblastic anemia- Autoimmune
loss of gastric parietal cells, responsible for secretion of intrinsic factor, essential for absorption of vitamin B12 in the ileum.
Iron deficiency Anemia
Lab Values
Low Fe serum
Normal TIBC
Low Transferrin Sat
Low ferritin
Hereditary spherocytosis
Hemoytic anemia
Extra-vascular
abnormal erythrocytes are sphere-shaped
DAT test
Direct antigen test
Looks for complement and IgG on RBC
IgG positive warm hemeyoliticanemia
Warm DAT
Warm AIH
manifests in warm blood
IgG is able to bind at any time
Splenectomy might be helpful
Cold DAT
Cold AIH
IgM is binding, precipitates in cold binding complement
Warm AIHA treatment
Glucocorticoid
Splenectomy
Antibody to the B Cells
Which bacteria has lipopolysaccharide and an outer membrane?
Gram negative
Which bacteria has teichoic acid?
Gram positive
CD34 marker
Generic marker of immaturity
B cell lineage markers
CD19
CD22
Marker of T cell lineage
CD3
CD7
Tdt cell markers
Lymphoblast Marker
APL
Acute promyelocytic leukemia (APML, APL) subtype of acute myelogenous leukemia (AML)
Rx, and path?
fuses retonic acid receptor.
Re-tonic acid and arsenic salts treat this
Can give rise to DIC
“APPLE TONIC”
ALL bad prognosis
Infants under 1
People over 10
T-lymphopblast hyperploidy
Slow response to rx
Myleoblast characteristic
aurer rods
rods common in APL
Why do bacterial spores form?
When there are just enough nutrients present
When bacterial spores have enough nutrients, what process occures?
They convert back to vegatative cells through germination
