Week 1

Question 1

Vitamin B6 deficiency

Answer 1

Associated with microcytic hypochromic anemia. Isoniazid can cause vitamin B6 deficency.

Question 2

Conjugated “direct” Biliruben

Answer 2

has been processed in the liver so it is soluble in water. It is excreted by the gal bladder, and converted to urobilinogen and makes feces brown.

Question 3

Unconjugated “indirect” biliruben

Answer 3

Is heme which has been taken from a broken down RBC in the spleen and is not soluble in water, bound to albumin and is sent to the liver.

Question 4

Porphyrias

Answer 4

Inherited group of disorders from enzyme deficiencies in the pathway for heme biosynthesis. Intermediates of the pathway accumulate and can have toxic effects. Porphiria Tarda is the #1 porpheria and is not life threatening.

Question 5

Porphyria Cutanea

Answer 5

Can be aquired from “Hepatitis C”. Sx. are bullous dermatois, scarring, hyperpigmentation, and hypertrichosis.

Question 6

Ferroprotein

Answer 6

is the iron exporter which transports Fe from the enterocyte into the portal plasma

Question 7

Haephestin

Answer 7

Converts Fe2+ to Fe3+ for transport by transferrin.

Question 8

Transferrin

Answer 8

Plasma iron transporter, binds 2 molecules of Fe3+

Question 9

Hepcidin

Answer 9

Is a polypeptide produced in response to inflammation and leads to increased iron stores by preventing Fe release from the cell. Produced by hepatocytes.

Question 10

Ferretin

Answer 10

is the main source of Fe storage in the cytosol. water soluble and holds up to 4500 atoms of Fe.

Question 11

Iron deficiency

Answer 11

low ferretin, microcytic anemia. Often due to heavy periods, or a GI bleed in younger individuals. Look for source of blood loss.

Question 12

hemochromatosis

Answer 12

too much iron in the blood usually treat by phlembotomy

Question 13

hereditary hemachromatosis

Answer 13

A label for autosomal inherited overload disorders. hereditary conditions affect hepcidin/ ferroportin access. It is genetically heterogenous

Question 14

Type I hereditary hemachromatosis

Answer 14

Is autosomal recessive, incoplete penetrance. “serum feritin is the reason for increased Iron.” death is from liver cirrhosis, or hepatocellular carcinoma. tx. phembotomy

Question 15

Oncotic Pressure

Answer 15

In the arterioles, blood pressure forces fluid out. In the venules, oncotic pressure draws fluid back in due to low bp and high protein and solute concentration

Question 16

Escites

Answer 16

Is a build up of fluid on the belly often due to low albumin levels not drawing fluid back in the venules.

Question 17

Anemia

Answer 17

When hemoglobin or red blood cells are too low in number.

Question 18

Metheglobin

Answer 18

Is hemoglobin containing Fe3+. Some NADPH from glycolyisis is used to convert back to hemoglobin using NADPH and glucuronic acid.

Question 19

Oxidants and the blood

Answer 19

benzocaine, lidocaine nitrites etc. can lead to the oxidation of blood. Treat by the administration of “methylene Blue” or ascorbic acid.

Question 20

2,3 Bisphosphoglycerate

Answer 20

Allows more o2 release from hemoglobin leading to a shift to the right.

Question 21

Pentose phosphate pathway

Answer 21

Major source for Reduced NADPH in RBCs, protecting Hb and other stuff from oxidant injury. We need this pathway to regenerate glutathione back to the nonreduced form so it can keep absorbing radicles

Question 22

Glucose-6-Phosphate Dehydrogenease

Answer 22

Is the enzyme which catalyzes the firs step of the pentose phosphate pathway. erythrocytes cannot make more G6PD. It is the most common enzyme deficiency in the world. It is x-linked. RBCs tend to lyse under conditions of oxidative stress.

Question 23

Innate immune system

Answer 23

Myleoid precursor, recognizing self from non self

Question 24

Adaptive immune system

Answer 24

Lymphoid precursor, T and B cells. Ability to recognize and destroy an individual pathogen.

Question 25

Interferons

Answer 25

are cytokines that limit the spread of viral infections

Question 26

Type 1 interferons

Answer 26

INFalpha and INFBeta produced by cells infected with a virus

Question 27

Type 2 interferons

Answer 27

INF gamma. Released by activated T helper cells to initiate a response in an area of viral infection

Question 28

Toll- like receptors

Answer 28

One family of PAMPs (pathogen associated molecular patterns)

Question 29

TLR3

Answer 29

Recognizes dsRNA and leads to signal transduction of phosphoylation cascade, degradation of IkB releasing NFkB acting as atranscription factor to make INF-B which is secreted out ot the cell to neighboring cells leading to activation of antiviral genes.

Question 30

Epitope

Answer 30

The specific location of an antigen that an antibody binds.

Question 31

Pluripotent stem cell differentiation

Answer 31

IL3 leads to lymphoid progenitor | IL3 and GM-CSF (granulocyte monocyte colony stimulating factor) are present, it will become a myeloid progenitor.

Question 32

Chemokines

Answer 32

Are cytokines which attract cells into inflammed tissues.

Question 33

Diapedesis

Answer 33

The process in which neutrophils, and monocytes and probally others leave the blood stream into the tissues.

Question 34

Erythrocyte series steps

Answer 34

``` Proerythroblast (blast) Basophilic erythroblast Polychromatophilic erythroblast Orthochromic erythroblast Reticulocyte RBC ```

Question 35

Granulocyte series Steps

Answer 35

``` Myeloblast Promyelocyte Myelocyte Metamyelocyte Band Mature ```

Question 36

MCV

Answer 36

Mean corpuscular Volume, how much volume the RBC has. How big is it and is useful for assessing anemia.

Question 37

Direct Antiglobulin Test

Answer 37

Antihuman-antibody antibodies added to blood sample. If red blood cells link together and precipitate out (positive test), it means our own body is attacking the RBCs and is an autoimmune disorder.

Question 38

Hereditary Spherocytosis

Answer 38

Anemia, Jaundice, splenomegaly. Due to defect in spectrin, leading to spherical RBCs which get taken out by the spleen. tx is splenectomy or transfusions.

Question 39

Leukoerythroblastotic Reaction

Answer 39

Is when immature erythrocytes and lymphocytes are present in the blood. May be malignant or benign. Low hemoglobin= physiologic High hemoglobin= likely marrow tumor

Question 40

Lymphocytosis

Answer 40

high white count. If it is all one type of cell, then it is likely malignant. Mature= lots of mature lymphocytes. Reactive= lots of funny looking or not normal lymphocyte precursors. Often caused by infectious MONO

Question 41

Benign vs malignant Lymphocytosis

Answer 41

``` Benign= toxic changes, fewer immature cells, no basophillia, LAP normal/ increased Malignant= very high WBC, lots of immature cells, basophillia, LAP decreased. LAP- enzyme not present in malignant cells ```