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Hem-Onc
| Question | Answer |
|---|---|
| WBC Differential | Neutrophils > Lymphocytes > Monocytes > Eosinophils > Basophils |
| Anisocytosis | Varying sizes |
| Poikilocytosis | Varying shape |
| Eosinophilia Cause | NAACP: Neoplasia, Asthma, Allergies, Collagen vascular diseases (Churg-Straus), Parasites |
| INF-Gamma | Activates macrophages |
| Phospholipid & Ca++ Mediated Factor Activity | Factors 5(10), 7, 9, 11 |
| Vitamin-K Dependent Factors | Factors 2, 7, 9, 10, Prot S, C. |
| Activated Protein C Targets | Factor 8a, 5a (10a synthesis & effector co-factors) |
| Antithrombin III Targets | Factor 9a, 10a, 11a (Intrinsic focus) |
| Kalikrein Function | HMWK->Bradykinin & Plasminogen->Plasmin |
| Plasmin Function | Cross-link Fibrin & C3->C3a |
| Platelet Aggregation Regulation | Pro: TXA2, Anti:PGI (prostacyclin) & NO |
| Target Cell DDx | HALT, said the hunter to his target: HbC, Asplenia, Liver disease, Thalasemia |
| Macrocytic Anemia | MCV>100. High Retic Ct. Megaloblastic (DNA synthesis problem). 1)B12,Folate Def 2)Sulfa drugs, AZT, Phenytoin 3)Reticulocytosis(secondary) |
| Microcytic Anemia | MCV<80. Etiology: 1)Iron Deficiency: Low Fe, High TIBC, Low Ferritin 2)Thalassemias Target cells 3)Lead poisoning:dimorphic,sideroblastic cells |
| Normocytic Anemia | 1)Hemorrhage, AI hemolytic anemia 2)G6PD (X-linked),Pyruvate Kinase Def (AR) 3)Hereditary spherocytosis 4)Aplastic anemia/leukemia 5)Chronic Disease (reticuloendothelial macrophages hide iron from potential pathogens) |
| Transferrin | FE/TIBC |
| TIBC | Indicates the “need for iron” |
| Ferritin | Indicates how much iron a person has |
| Aplastic Anemia Etiology | 1)Radiation 2)Chemicals: Benzene, chloramphenicol, alkylating agents, antimetabolites 3)Viral:ParvoB19, EBV, HIV 4)Fanconi’s Anemia 5)Idiopathic. |
| Aplastic Anemia Tx | Allogenic bone marrow xplant. RBC & platelet transfusion. G-CSF, GM-CSF: Granulocyte (+Macrophage) Colony Stimulating Factor |
| Sickle Cell Complications, Tx | Low O2, H20-> Aplastic crisis (ParvoB19 infx), Spleen sequestration, Increased risk for encapsulated organism infx, Salmonella osteomyelitis, pain crisis (vaso-occlusion), renal papillary necrosis. Tx: Hydroxyurea increases HBF production. |
| Hb H | Beta tetramers. Only 1 functional Alpha gene. Thalassemia |
| Hb Barts | Gamma Tetramers. No functional alpha gene. Hydrops Fetalis- fetal death. Thalassemia. |
| Beta Thalassemia | Major: Crazy hepatosplenomegaly. Crew cut skull. Frequent blood transfusions -> Hemachromatosis, heart failure. Minor: Meh. |
| Warm Agglutinin | IgG-mediated Chronic Immune Anemia: SLE, CLL, methyldopa |
| Cold Agglutinin | IgM-mediated Acute Immune Anemia: Mono, Mycoplasma Pneumoniae |
| Erythroblastosis Fetalis | Rh negative mother’s serum antibodies attack newborn’s Rh+ RBCs |
| Coombs Test | Determines Autoimmune cause of hemolytic anemias. Direct: Anti-Ig antibodies agglutinate Ig-bound RBCs. Indirect: Pt’s anti-RBC Igs attack & agglutinate normal RBCs |
| Paroxysmal Nocturnal Hemoglobinuria | Membrane defect(GP1 def)-> more susceptible to complement lysis. Elevated Urine Hemosiderin. |
| Microangiopathic Anemia | “Fragmentation” hemolytic anemia. DIC, TTP, HUS, SLE, HTN-> schistocytes. |
| DIC Etiology | STOP Making New Thrombi! Sepsis, Trauma, Obstetric complications, acute Pancreatitis, Malignancy, Nephrotic syndrome, Transfusion. Depletes coagulation cascade & platelets. |
| Idiopathic v. Thrombotic Thrombocytopenic Purpura | Idiopathic: Antiplatelet antibodies, more megakaryocytes. Thrombotic: Vascular damage-> thrombosis. Elevated LDH, neuro & renal sx. |
| Hemophilia A vs B | A:Factor 8 deficiency. B: Factor 9 Deficiency. Both X-linked. |
| Bleeding Time, PT, PTT | Bleeding Time: Marker for platelets only, PT: Extrinsic PWY, PTT: Intrinsic PWY |
| Bernard-Soulier | Low GP1b, low platelet ct. |
| Glanzmann’s Thrombasthenia | Low GP IIb-IIIa. Poor aggregation |
| t(9;22) | CML- Philadelphia Chromosome |
| t(8;14) | Burkitt’s Lymphoma. C-myc |
| t(14,18) | Follicular Lymphoma. bcl-2 |
| t(15,17) | Acute promyelocytic (M3-type) AML. Tx w/ all-trans retinoic acid |
| t(11;22) | Ewing’s Sarcoma |
| t(11;14) | Mantle Cell Lymphoma |
| Histiocytosis X | Lagerhans macrophages w/ Birbeck Granules “Tennis rackets” ->-> Restrictive Pulm Dz |
| Extrinsic Pathway | 7, 10, 5, 2, 1 |
| Intrinsic Pathway | 12, 11, 9, 8, 10, 5, 2, 1 |
| vWF Disease | Most common heritable coagulopathy-> prolonged bleeding time. Autosomal DOMINANT > Hemophilia A > B(XR). Normal bleeding time. |
| AT3 Deficiency | 1) Estrogen use 2)congenital |
Created by:
Kyle Tiemeier
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