Thursday Wk 2 Heme 1 Flashcards
__ is dz w sore throat, malaise, LAD, myalgia, splenomegaly, fever
caused by __ virus
infects B cells by binding __ cell surface receptor
__ T cells become activated to kill the virus
on smear, have abundant __ w cell membrane that __ to neighboring cells
CD4 t cells are much __
CD14 is cell marker for M/M
LPS binds to stimulate __
Mono EBV CD21 CD8 cytoplasm, conforms
reduced
monos/macros
macrophages
Most women cancers are B__ and L__ and C__
L__ is numbr 1 killer, followed by __
__ is necessary for synthesis of NA, conversion of homocysteine to methionine, and one carbon carriers
all in form of T__ from DHFR
Thymidilate __ converts dUMP to dTMP
most enzymes require folate as __, this enzyme needs D__
particularly susceptible to low __ states
w/out TS, dUMP builds up, resulting in __ breaks and apoptosis
adding __ to mediate stops this proccess
breast, lung, colon
lung, breast
folate tetrahydrofolate synthase THF, dihydrofolate folate
DNA
severe anemia following febrile illness in sickle cell pt w low reticulocytes indicates __ viral infection
describes __ crisis, as erythroid precursors are destroyed
less reticulocytes to replace __
virus is N__ and __DNA
EBV is E__ ds__ virus
HepE is n__ ss__+
HIV is E__ ssRNA__
enveloped ssRNA viruses include Orthomyoxyvirus like I, paramyoxyvirs like M/M and Rhabdovirus R
nonenveloped dsDNA viruses include A, P, P
parvoB19
aplastic
erythrocytes
nonenveloped, ssDNA
enveloped, DNA
nonenveloped, RNA
enveloped, +
influenza
measles, mumps, rabies
adenovirus, polyomavirus, papillomavirus
pt w HIV is at high risk for __ viral infection
may result in EBV assc lymphomas like B, and P
Warfarin is eliminated by __ system in the liver
can be __ which upregulates metabolism
may also interact w C__ in intestine, reducing its therapeutic effect
Avoid warfarin and A__ as it inhibits p450 metabolism
EBV
burkitt lymphoma, primary CNS lymphoma
p450
upregulated
cholestyramine
amiodarone
Rhesus antigen is __ on RBC surface
__ antigen is most immunogenic
when Rh neg mother has __ fetus, fetal RBC enter maternal circ and lead to prodxn of IgG antibody
w subsequent preg, Rh pos fetus are at risk for H___
to prevent, mothers are given __ at 28w gestation and postpartum
these antibodies bind __ fetal RBC for sequestration/elimination by the spleen
Anti-A/B antibodies are __ class
transmembrane protein
D
RH pos
hemolytic dz of newborn
Anti-D IgG
Rh pos
IgM
SCD is AR disorder w DNA point __ mutation
changes glutamic acid to __ at codon 6
__ is myeloproliferative dz of hematopoeitic stem cells
mutation is __ involving JAK2
presents w __ RBC mass, inc plasma __ and low __
inc ___, thrmobosis, peptic ulceration or __
patient appears __ and ruddy
dx w low __ levels
tx w ___
missense
valine
PCV J617F inc, volue, EPO platelts, pruritis red EPO phlebotomy
Relative polcythemia develops from D/D
plasma volume is __, everything else norma
Secondary polycythemia
Physiologic hypox has inc RBC __ and __ level, SaO2 is __
EPO producing tumor has high __ and ___ mass
other values __
dehydration, diuresis
dec
mass, EPO, low
EPO, rbc
normal
Hemolytic dz of newborn aka E__
occurs in RH __ mother w rh __ child
positive __ test
profound A/J/K
hydrops __ present w edema
immature, nucleated __ and persistent extramedullary hematopoeisis in the /
erythroblastosis fetalis
neg, pos
coombs anemia, jaundice, kernicterus fetalis RBC liver/spleen
Microcytic, hypochromic anemia in pt of mediterranean descent is B thal __
inc Hb __ conc
DNA mutation impairs trxn, P__ and trnsl of beta globin mRNA
leads to aberrant mRNA __ and chain termination
beta globin is deficient, w normal Hb and __ chains
inc formation of Hb __ and __
when alpha chain tetramers form, they __ and reduce membrane stability
minor A2 processing splicing alpha A2 and F
precipitate
Peau d orange rash has __ skin tht is often itchy
skin is firm and __
w breast edema, likely indicates __ breast carcinoma
cancer cells obstruct __ drainage
Noninvasive BC
DCIS has __ necrosis, is pre__ and confined to __/__
Paget dz has __ lesion, w extension of DCIS into __
red
coarse
inflammatory
lymphatic
central, cancerous, duct/lobules
eczematous, ducts
Invasive BC
Ductal carcinoma made of N and cords
Loblar carcinoma is small cells in __
mammary __ invaded
AA pt w recurrent episodes of ab pain that resolve w hydration, low Hct is __
sx of __ w vasoocclusive crisis of pulm vasculature
preceded by pulm __
in pt w HbS, occlusion results in splenic __
spleen shrinks and becomes __
over time, auto__ occurs and spleen becomes brown (hemosiderin) due to ingestion of RBC by splenic __ (__ hemolysis)
nests
single file
stroma
SCA
ACS
infection
infarct
fibrotic
splenectomy
macros
extravascular
Unfractionated/LMH used for __ in surgeries
inc effect of __, which inhibits factor __ and thrombin
LMWH act on factor __ alone
Direct thrombin inhibs stop __ mediated fibrin formation
L/A used for HIT
D used for DVT prophylaxis
C/T inhibit ADP mediated platelet aggregation for unstable angina/nonSTEMI
DVT prophylaxis
AT3, Xa
Xa
thrombin
Lepirudin, argatroban
Dabigatran
Clopidigrel, ticlopidine
use __ sulfate for heparin overdose
binds heparin, rendering no __ activity
__ is used for warfarin overdose
requires synthesis of __
takes time, so w life threatening hemorrhage, give __ instead
PCC__ contain VK dependent factors and can be used to tx bleeding
Protamine
anticoag
Vk
new factors
FFP
prothrobin complex concentrates
G6PD inherited \_\_ causes hemolytic anemia w \_\_ stressors pathognomonic \_\_ cells G6PD part of \_\_ pathway generates reducing agent \_\_ if no NADPH, reduced glutatione remains oxidized resulting in susceptibility of \_\_to injury
Glutathionine __ catalyzes reduction of oxidized glutathione
absence presents w __ sx
XLR oxidative bite PP NADPH RBC
reductase
similar
majority of cell cycle is spent in __
composed of __ for RNA/prot/lipid/carb synth
S for __ synthesis
G2 for __ synthesis
Rb is active in the __ form
when active, allows cell __ through cycle
assc w many __
found on chromo __
__ heparin is most likely to cause HIT
use direct thrombin inhibs H/L/A
stop heparin __
Glycoprotein 2B3A inhibs A, E, T
interphase
G1
DNA
ATP
hypophosphorylated
progression
cancers
13
unfractionated
hepirudin, lepirudin, argatroban
abciximab, eptifibatide, tirofiban
PNH has mutation in __ gene
dec __ anchor proteins
helps attach cell surface proteins like __ and __
absence leads to complement mediated __
pt has J/F due to hemolytic anemia
hemoglobinuria and T__ at atypical sites, _cytopenia
chronic hemolysis w breakdown of RBC leads to __ in kidney
impairs __ fxn w interstitial scarring
inc risk of __
PICA
GPI
CD55, MAC
hemolysis
jaundice, fatigue
thrombosis, pan
iron overload
PT
Chronic kidney disease
nucleolus is primary site for __ trxn
RNA poly 1 transcribes __ pre rRNA, processed into 18S, 5.8s, and 28 rRNA
thus it is restricted to __
nucleolus also fxns in maturation/assembly of __ subunis
protein components made in __ and transported to nucleolus
regulation occurs via controlling number of __ genes
process is altered in __
rRNA
45s
nucleolus
ribosomal
cytoplasm
active genes
malignany
RNA poly 2 produces m__, s__ and M__
micro RNA causes gene __ via translation arrest/degredation
RNA poly 3 forms t__ and 5s rRNA
5s is essential component for __ subunit
mRNA, snRNA, microRNA
silencing
tRNA
60s
Whole blood is mixed w __ anticoagulant to form packed RBC
when given in large quantity to pt, can chelate Ca w resulting __
Packed RBC usually lose __ to serum, resulting in hyperkalemia
citrate
hypoca
potassium
pt w fever, oozing from IV, low fibrinogen and immature myeloids has __ w APL
look for promyelocytes w __
classic presentation is bleeding in setting of __, consumptive coag w low __ levels, inc fibrin __ products, inc PT/PTT, and low __
referred to as AML __
inversion 16 assc w M4Eo __ subtype of AML
DIC
auer rod
DIC, fibrinogen, degredation, platelet
M3
eosinophilic
Keratin staining is marker for __ origin
Endothelium identified w stain for __ and __ factor
extent of tumor expansion determines __ of tumor
degree of differentiation determines __
such as w D__, A__ and __ figures
if tumor is confined to __ survival is high
if spread is __, less likely for survival
epithelial
CD34, vWf
stage
grade
differentiation, aneuploidy, mitotic
mucosa
further
Familial E__ assc w B globin mutation w reduced binding of 23BPG
binds to dexoxy pocket in __ chains
lowers Hb affinity for O2, allowing for diffusion into __
binding pocket has __ charged AA, attracting __ groups on 23BPG
mutation results in inc Hb __ affinity
Fetal Hb is composed of __
does not bind __, this O2 affinity is much higher
Hb __ forms hexagonal crystals and results in red cell __ w chronic hemolytic anemia
erythrocytosis B globin peripheral tissues pos, neg O2
A2G2
23BPG
C, dehydration
admin folate to B12 def pt can worsen __ and cause abnormal myelin __
depletes conc of __ cobalamin available, leading to development of neuro sx
Folate overdose antagonizes P__ leading to seizures
endemic Burkitt lymphoma presents w __ mass
assc w __ infection
t is __, assc w inc __ exp
starry sky appearance w macros and __ in sea of medium sized lymphs
demyelination, synthesis
methylated
phenytoin
jaw
EBV
8, 14, cMYC
apoptotic bodies
Follicular lymphoma assc w __ translocation
overexpressed __
General LAD and affects __
young pt w fver, pharyngitis, LAD think __ as dx
atypical lymphs have abundant __ and lack bizarre __ differentiating it from ca
assc w __ and __ lymphoma and as well as __ carcinma
short segments of newly synthesized DNA on lagging strand are called __ fragments
14, 18
BCL2
elderly
IM
cytoplasm, nueli
Hodkin, NH, nasopharyngeal
Okazaki
Unfractionated heparin is __ than LMW heparin
thus it can inhibit both _ and __, w more inactivation
tPA can only bind plasminogen in presence of __
thus, action is __ specific
Protein __/__ are depleted first w warfarin therapy
bridge pt w __ to prevent procoag state
larger
Xa and thrombin
fibrin
clot
C/S
heparin
vomiting reflex controlled by __ in 4th ventricle w a CTZ
NTS in medulla receives info from AP, __ tract via vagus nerve, V__ system and CNS
NTS then projects to medullary nuclei to control __
5 major receptors __ musc, __ dopaminergic, __ histiaminic, __ Serotonin, and __ neurokin
5HT3 antags O/G/D prevent __ induced vomiting
block __ mediated N/V and block central __ in AP
NK 1 antags A also useful in chemo induced emeses
inhibit __ to prevent acute/delayed vomiting
D2 antags M also useful
se include D/D
AP
gi, vestibular
vomiting
M1, D2, H1, 5HT3, NK1
Odansetron, ganisetron, dolasetron
vagus, serotonin
Aprepitant
Substance P
Metoclopramide
dizzy, dystonic
antimuscarinics S
Antihistamines D/M/P used for __ sickness and hyperemesis __
blasts in peripheral blood suggest __
ALL is most common in young __ up to YA
sx include F, Fatigue, P, P and bone pain
can see LAD, HSM
__ ALL more likely to cause thymic mass and SVC syndrome
can compress __ w dysphagia
or trachea w __
B/T cells both contain __
__ cells contain CD10, 19, 20
__ cells contain CD2-5, 7, 8
scopolamine
diphenhydramine, meclizine, promethazne
motion, gravidarum
leukemia
male
pallor, petechiae
T cell
esophagus
stridor
TdT
B
T
acute megakaryoblastic leukemia seen in down syndrome pt w translocation __
Follicular lymphoma composed of __ small cleaved cells
typically pack __ and obscure normal architecture
__ inguinal LN found over the femoral triangle
drains cutaneous lymph from __ down
include __ genitalia and __ below dentate line
exception is __ penis and skin on posterior __ which go to deep inguinal LN
1, 22
centrocytes
follicles
superficial
umbilicus
external, anus
glans, calf
pt w NSCLC __ may have a EML-4ALK mutation
inversion of short arm chromo __ that creates a fusion
results in constituitely active __ similar to CML
can tx w C__ Protein kinase inhib
other mutations in adenocarcinoma are E and K
adenocarcinoma
2
tyrosine kinase
crizotinb
EGFR, KRAS
G6PD is rate limiting step of __
transforms G6P to 6-__
generates NADH and __
pathway necessary to make __ and protecting RBC against oxidative damage
adult w brain tumor showing necrosis, surrounded by tumor cells (pseudopalasading necrosis) has __
often see __ at periphery
arise from __
Cyst formation and rare mitoses indicates __ cyst in 3rd ventricle
Reticulin deposit and inflam infiltrates indicates __ xanthoastrocytoma
__ have whorled pattern of growth/Psammoma bodies
PPP
phosphogluconate
R5P
glutathione
GBM
capillaries
astrocytes
colloid
pleomorphic
meningiomas
_ is AD disorder of heme sytnehsis w deficiency in \_\_ deaminase pt presents w GI and \_\_ sx key feature is \_\_ urine that darkens w light/air tx by inhibiting \_\_ usually upregulated by all p450 \_\_ down regulated by \_\_/\_\_ avoid A/S tx w \_\_ admin and \_\_ loading
DVT arises due to virchow triad of __ injury, venous __ and __ state
AIP PBG neuropsych red urine ALAS inducers heme, glucose alcohol, smoking heme, carbohydrate
endothelial, stasis, hypercoagulable
Sickle cell anemia results in Hb molecules that aggregate in __ cx
sickle w low __,inc __ or D__
cannot pass through microvasculature, resulting in micro__ and painful __ crises
organs w slow blood movement S/L have less O2
organs w high metabolic demands B/H/P extracts lots of blood
also occurs w high levels of __ promoting the T state of deoxygenation
anoxic
O2, acidicity, dehydration
infarcts, vasoocclusive
spleen, liver
brain, heart, placenta
23BPG
