Random Facts 2 Flashcards
How to distinguish btwn Fe deficiency and thalassemia
Can be distinguished by the RDS
- both are microcytic anemias
- Fe deficiency: RBC in many stages => high RDW
- thalassemia will have less variation => lower RDW
When is a Coombs test indicated?
When testing for hemolytic anemia
-differentiates immune vs. non-immune hemolytic anemia
What are some causes of non-immune hemolytic anemia
Non-immune hemolytic anemia = negative Coombs test
Extracorpuscular defect = something outside the RBC destroying it
ex: artificial valve smashing RBCs
Intracorpuscular defect = something wrong w/ the RBC itself
ex: congenital spherocytosis
Describe the mechanism of a direct Coombs test
Purpose = to see if there are antibodies on the surface of the pt’s RBC (testing for autoimmune hemolytic anemia)
-take washed pt’s RBC + Coombs’ reagent (antihumanized antibody) that will agglutinate if antibodies are present on the red cell’s surface
Differentiate warm vs. cold antibody autoimmune hemolytic anemia
Warm up the sample and cool of the sample and see in which situation lysing increases
Warm (you warm up sample and lysing increases) means the process is IgG mediated
Cold (you cool down sample and lysing increases) mean the process is IgM/complement mediated
What bacterial infection is associated w/ a cold induced hemolytic anemia?
Mycoplasma
What is the most common congenital hypercoagulable defect?
factor V leiden
Most abundant white cell in normal CBC
45-70% neutrophils (which = granulocytes, polys, and PMNs)
What is erythroferrone?
(a) What cells produce it?
(b) Fxn
Erythroferrone = released by bone marrow cells to communicate w/ the GI tract indirectly thru the liver
- Bone marrow secretes ERFE when it receives a signal (ex: EPO) to rev up hematopoeisis
- ERFE then inhibits the liver’s secretion of hepcidin
- less hepcidin available to inhibit ferroportin on enterocyte membrane => more Fe absorbed from the gut
Fanconi’s anemia
= genetic disorder of chromosomal instability due to mutation in DNA stress repair gene
=inherited bone marrow failure syndrome
Dyskeratosis congenita
= inherited bone marrow failure syndrome
-disorder of telomere maintenance
Lab findings in PNH
Indicative of intravascular hemolysis =>
hemoglobinuria, and free Hgb in the blood
Treatment for PNH
Antibody against CD5 to prevent formation of complement membrane attack complex
Most common presenting symptom of CML
Neutrophilia/Granulocytosis
-high white count w/ predominantly increased neutrophils
Mechanism of disease in P. vera
JAK2 mutation => loss of autoinhibition of the JAK-STAT proliferation pathway
Describe the spent phase of P. vera
Mimics myelofibrosis
Mechanism of primary myelofibrosis
Platelet derived growth factors + TGF-beta act as fibrogenic growth factors that stimulate bone marrow fibroblast proliferation
What pathology is associated w/ the following on peripheral smear:
Acanthocyte
= spurr cell
-indicative of liver disease
What pathology is associated w/ the following on peripheral smear:
Dagmacute
= bite cell
- indicative of G6PD deficiency
- spleen basically takes a bite out of the RBC to make up for inability of cell to deal w/ oxidative stress
What pathology is associated w/ the following on peripheral smear:
Elliptocyte
Hereditary elliptocytosis
-causes anemia b/c the spleen destroys
What pathology is associated w/ the following on peripheral smear:
Ringed Sideroblast
Indicative of sideroblast anemia
-problem w/ protoporphyrin production => underproduction of heme
What pathology is associated w/ the following on peripheral smear:
Schistocyte
= Helmet cell = fragmented cell
-associated w/ DIC, TTP, HUS, HELLP
What pathology is associated w/ the following on peripheral smear:
Dacrocyte
= tear drop cell
-myelofibrosis
What pathology is associated w/ the following on peripheral smear:
Target cell
HbC disease, asplenia, liver disease, thalassemia
‘HALT to the target’
What pathology is associated w/ the following on peripheral smear:
Howell-Jolly bodies
= basophilic nuclear remnants in RBC that are usually removed by splenic macrophages
-indicative of functional hyposplenia or asplenia
Common complications of CLL
Secondary malignancy and immune dysfunction
-b/c hypogammaglobulinemia and T cell dysregulation
Small cleaved cells on bone marrow biopsy
Indicative of follicular lymphoma or diffuse lymphoma
Most common subtype of Hodgkin’s lymphoma
HL = neoplasia of large B cell
-most common subtype = nodular sclerosing
Rituximab
Monoclonal anti-CD20 antibody used in NHL (nonHodgkin’s lymphoma)
