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Hematology
PASS program drill notes
| Question | Answer |
|---|---|
| What is a Neutrophil? | The Phagocyte (has anti-microbials, most abundant) |
| What is an Eosinophil? | The Parasite Destroyer, Allergy inducer |
| What is a Monocyte? | The Destroyer => MP (hydrolytic enzymes, coffee-bean nucleus) |
| What is a Basophil? | The Allergy helper (IgE receptor ==> histamine release) |
| What is a Lymphocyte? | The Warrior ==> T, B, NK cells |
| What is a Platelet? | The Clotter (no nuclei, smallest cells) |
| What is a Blast? | Baby Hematopoietic cell |
| What is a Band? | Baby neutrophil |
| What does high WBC and high PMNs tell you? | Stress demargination |
| What does high WBC and <5% blasts tell you? | Leukemoid reaction, see in burn patients (extreme demargination looks like leukemia) |
| What does high WBC and >5% blasts tell you? | Leukemia |
| What does high WBC and bands tell you? | Left shift ===> have an infection |
| What does high WBC and B cells tell you? | Bacterial infection |
| What diseases have high Eosinophils? | "NAACP" Neoplasm (lymphoma) Allergy/ Asthma Addison's disease (no cortisol --> relative eosinophilia) Collagen Vascular disease Parasites |
| What diseases have high monocytes (>15%)? | "STELS" Syphilis --> chancre, rash, warts TB --> hemoptysis, night sweats EBV --> teenager sick for a month Listeria --> baby who is sick Salmonella --> food |
| What do high retics (>1%) tell you? | RBC being destroyed peripherally |
| What do low retics tell you? | Bone marrow not working right (↓production) |
| What is Poikilocytosis? | Different shapes |
| What is Anisocytosis? | Different sizes |
| What is the RBC lifespan? | 120 days |
| What is the platelet lifespan? | 7 days |
| What does -penia tell you? | Low levels (usually due to a virus or drug) |
| What does -cytosis tell you? | High levels |
| What does -cythemia tell you? | High levels |
| What is the difference between plasma and serum? | Plasma ==> no RBC Serum ==> no RBC or Fibrinogen |
| What is Chronic Granulomatous disease? | NADPH oxidase deficiency --> recurrent Staph/Aspergillus infections (Nitroblue Tetrazolium stain negative) |
| What doe MPO deficiency cause? | (+) Catalase infections |
| What is Chediak Higashi? | Lazy leukocyte syndrome: lysosomes are slow to fuse around bacteria |
| What organ can make RBCs if the long bones are damaged? | Spleen ===> Splenomegaly |
| What causes a shift to the right in the Hb curve? | "All CADETs face right" 1. ↑CO2 2. Acid/Altitude 3. ↑ 2,3-BPG 4. Exercise 5. ↑ temperature |
| How does CO poison Hb? | Competitive inhibitor of O2 on Hb => cherry-red lips, pinkish skin hue |
| How does Cyanide (CN) poison Hb? | Non-competitive inhibitor of O2 on Hb ==> almond breath |
| What is Met-Hb? | Hb with Fe3+ |
| What is Acute Intermittent Porphyria (AIP)? | ↑Porphyrin, urine gamma-ALA, porphobilinogen => abdominal pain, neuropathy, red urine |
| What s Porphyria Cutanea Tarda? | Sunlight ==> skin blisters with porphyrin deposits, Wood's |
| What is Erythrocytic Protoporphyria? | Porphyria cutanea tarda in a baby |
| What is Sickle Cell disease? | Homozygous HbS => (ßGlu6 --> Val) ==> vasoocclusion, necrosis, dactylitis (painful fingers/toes) at 6 months of age, protects against malaria |
| What infectious condition is protected by Sickle Cell disease? | Malaria |
| What is Sickle Cell Trait? | Heterozygous HbS ==> painless hematuria, sickle with extreme hypoxia (can't be a pilot, fireman, diver) |
| What is Hb C disease? | (ßGlu6 --> Lys), still charged ==> no sickling |
| What is α-Thalassemia? | 1 deletion ====> Normal 2 deletions ====> "trait"; Microcytic anemia 3 deletions =====> Hemolytic anemia, Hb H= ß4 4 deletions ====> Hydrops fetalis, Barts Hb => gamma 4 |
| What is ß-Thalassemia? | 1 deletion ==> "ß minor; HbA2 and HbF 2. deletions "trait/intermedia/major": only HbA2, and HbF ==> hypoxia at 6 months |
| What is Cooley's anemia? | See with ß-thalassemia major (no HbA ==> excess RBC production); baby making blood for everywhere ==> frontal bossing, hepatosplenomegaly, long extremities |
| What is Virchow's triad? | Thrombosis risk factors: 1. Turbulent blood flow "slow" 2. Hypercoagulable state "sticky" 3. Vessel wall damage "escapes" |
| What does acute hypoxia cause? | Shortness of breath |
| What does chronic hypoxia cause? | Clubbing of fingers/toes |
| What is extravascular hemolysis? | RBC destroyed in spleen (problem w/ RBC membrane) => splenomegaly |
| What enzymes need lead (Pb)? | 1. gamma-ALA dehydratase 2. Ferrochelatase |
| What does EDTA bind? | Anything that is 2+ (X2+) |
| What disease has a smooth philtrum? | Fetal alcohol syndrome |
| What disease has a long philtrum? | William's |
| What disease has sausage digits? | 1. Pseudo-hypoparathyroidism, Psoriatic arthritis |
| What disease has 6 fingers? | Trisomy 13 |
| What disease has 2-jointed thumbs? | Diamond-Blackfan anemia |
| What disease has painful fingers? | Sickle cell disease |
| What are the Microcytic anemias? | FAST Lead 1. Fe deficiency 2. Anemia of chronic disease 3. Sideroblastic anemia 4. α-thalassemia 5. ß-thalassemia 6. Pb poisoning |
| What are the labs/features for Iron deficiency anemia? | ↑TIBC, menses, GI bleed, koilonychia |
| What is the main lab or feature to differentiate Anemia of Chronic Disease? | ↓TIBC |
| Which enzyme is decreased in Sideroblastic anemia? | Gamma-ALA synthase |
| What is the MCC for acquired Sideroblastic anemia? | Blood transfusion |
| What are some features associated with α-Thalassemia? | AA, Asians (Chr. 16 deletion) |
| What are features associated with ß-thalassemia? | Mediterranean (Chr. 11 point mutation) |
| What are features of Lead (Pb2+) poisoning? | ↓gamma-ALA dehydratase, ↓ ferrochetalase, x-ray blue line, eating old paint chips |
| What are the main Megaloblastic anemias? | 1. Vitamin B12 deficiency 2. Folate deficiency 3. Alcohol |
| What are the common causes for megaloblastic anemia due to cobalamin deficiency? | Tapeworms, vegans, type A gastritis, pernicious anemia |
| What are common physical manifestations of Megaloblastic anemia due to folate deficiency? | Old food, glossitis |
| What are features of Alcohol-induced megaloblastic anemia? | Fetal Alcohol Syndrome: smooth philtrum, stuff doesn't grow |
| What are the most significant Intravascular Hemolytic anemias? | 1. G6PD deficiency 2. Cold autoimmune |
| What are common causes of G6PD deficiency? | Sulfa drugs, moth balls, fava beans, sudden drop in Hb |
| What immunoglobulin is associated with Intravascular Hemolytic anemias? | IgM |
| What are causes and features of Cold autoimmune hemolytic anemia? | Mononucleosis, mycoplasma infections; RBV agglutination |
| What is the associated Ig for Extravascular Hemolytic anemias? | IgG |
| What is the cause and test to diagnose Spherocytosis? | Defective Spectrin or Ankyrin proteins, + Osmotic Fragility test |
| What are common features of Warm autoimmune extravascular anemia? | Anti-Rh Ab, dapsone, PTU, anti-malarials, sulfa drugs |
| What are common features of Paroxysmal cold autoimmune extravascular anemia? | Bleeds after cold exposure; Donath- Landsteiner antibody |
| What are the classic bone features associaed with Sickle cell anemia? | Crew haircut x-ray, avascular necrosis of femur, short fingers |
| What are the 2 production anemiasJ? | Diamond-Blackfan anemia and Aplastic anemia |
| What are common fetures of Diamond-Blackfan anemia? | No RBCs, 2-jointed thumbs |
| What are clues for Aplastic anemia? | Pancytopenia, autoimmune, benzene, AZT, CAM, and radiation |
| What is Basophilic Stippling? | Lots of immature cells, ↑mRNA (Pb poisoning) |
| What is a Bite cell = Basket cell? | Unstable Hb inclusions (G6-PD deficiency) |
| What is Burr cell = Echinocyte? | Pyruvate kinase deficiency, liver disease, post-splenectomy |
| What is Cabot's ring body? | Vitamin B12 deficiency, Pb poisoning |
| What is a Doehle body? | PMN leukocytosis (infection, steroids, tumor) |
| What is a Drepanocyte? | Sickle cell anemia |
| What is a Helmet cell? | Fragmented RBC (Hemolysis: DIC, HUS, TTP) |
| What is a Heinz body? | Hb precipitates and sticks to cell membranes (G6PD deficiency) |
| What is a Howell-Jolly body? | Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia, spleen trauma, cancer) |
| What is a Pappenheimer body? | Iron precipitate inside cell (sideroblastic anemia) |
| What is a Pencil cell = Cigar cell? | Iron deficiency anemia |
| What is a Rouleaux formation? | Multiple Myeloma |
| What is a Schistocyte? | Broken RBC (DIC, artificial heart valves) |
| What is a Sideroblast? | Macrophages pregnant with Fe (genetic or multiple transfusions) |
| What is a Spherocyte? | Old RBC |
| What is a Spurr cell = Acanthocyte? | Lipid high in serum |
| What is a Stomatocyte? | Liver disease |
| What is a Target cell = Codocyte? | Less Hb (Thalassemia or Fe deficiency) |
| What is a Tear drop cell = Dacrocyte? | RBCs squeezed out of marrow (hemolytic anemia, bone marrow) |
| What is the Clotting Cascade? | How you stop bleeding |
| What are the Vitamin K clotting factors? | 10, 9, 7, 2, Protein C, and Protein S |
| What do platelet problems cause? | Bleeding from skin and mucosa |
| What do clotting factor problems cause? | Bleeding into cavities |
| What causes increased PTT and bleeding time? | von Willebran disease and Lupus |
| What is Bernard-Soulier? | Baby with bleeding from skin and mucosa, big platelets (low gp1b) |
| What is Glanzmann's? | Baby with bleeding from skin and mucosa (low gpIIb/IIIa) |
| What disease is associated with low gpIIb / IIIa? | Glanzmann's |
| How does Factor 13 deficiency present? | Umbilical slump bleeding (1st time baby has to stabilize a clot) |
| How does von Willebrand Disease present? | Heavy menstrual bleeding |
| What is Factor V Leiden? | Protein C can't break down Factor 5 => more clots |
Created by:
rakomi
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