Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

HY Heme Part I

Day 15.3

QuestionAnswer
What allows RBCs to change shape as they pass through vessels? Spectrin (biconcavity and flexibility)
What are some of the different causes of polycythemia? Polycythemia vera, renal cell CA, pheochromocytoma, hemangioblastoma, chronic hypoxia (COPD, Obstructive Sleep Apnea/OSA), Down syndrome (at birth)
What coagulation factor is deficient in hemophilia A? Factor 8 (Ate)
What coagulation factor is deficient in hemophilia B? Factor 9 (B9)
What clotting factors require vitamin K for synthesis? Protein C and S, and factors 2, 7, 9, and 10
What are the treatment for overdose of heparin? Protamine sulfate
What is the treatment for overdose of warfarin? Vit K and fresh frozen plasma
What lab value is used to monitor the following medications: heparin? PTT
What lab value is used to monitor the following medications: warfarin? PT/INR (INR should be around 2-3)
What lab value is used to monitor the following medications: enoxaparin? Factor Xa activity
What is the treatment for heparin induced thrombocytopenia (HIT)? Switch to a hirudin derivative like lepirudin or bivalirudin, or argatroban. These drugs directly inhibit thrombin and are a good alternative to heparin for anticoagulating patients with HIT.
What are the 3 steps of platelet stimulation? 1. Adhesion 2. Activation 3. Aggregation of platelets via GpIIb/IIIa
Which factor complexes with and stabilizes factor VIII and is responsible for platelet adhesion to the vessel wall and to other platelets? Von Willebrand's Factor
What pathologic form of RBC would you see in the following diseases?: lead poisoning basophilic stippling
What pathologic form of RBC would you see in the following diseases?: G6PD deficiency bite cells and Heinz bodies (Heinze ketchup is yummy so macrophages want to take a big bite out of it!)
What pathologic form of RBC would you see in the following diseases?: DIC schistocytes/helmet cells
What pathologic form of RBC would you see in the following diseases?: abetalipoproteinemia spur cells/acanthocytes
What pathologic form of RBC would you see in the following diseases?: asplenia Howell-Jolly bodies
Iron-protein complex that acts as a cellular storage protein for iron and is an acute phase reactant Ferritin
Protein that binds ferric molecules and transports them through the plasma. Transferrin
Where is transferrin synthesized and what happens to it in iron deficiency? It is synthesized in the liver. Levels increase with iron deficiency.
What are the 3 actions of thromboxane A2 (Goljan)? Potent vasoconstriction (keeps clot from washing away), platelet aggregation (par excellence!), and bronchoconstriction (can cause problems in asthmatics)
What converts fibrinogen to fibrin? Is this pro-coagulation or anti-coagulation? Thrombin; pro-coagulation; coagulase can also convert fibrinogen to fibrin
What amino acid change is responsible for sickle cell disease? Glu--> Val in beta chain
What is the amino acid change responsible for hemoglobin C disease? Glu-->Lys in beta chain
What is the difference between normal adult hemoglobin and normal fetal hemoglobin? Adult has 2 alpha and 2 beta chains. Fetal replaces the 2 beta chains with 2 gamma chains (2 alpha, 2 gamma)
What hemoglobin modification is seen with poorly controlled diabetes (be specific!)? Normal Hbg gets non-enzymatically glycosylated (glucose gets attached to it), creating Hb A1c (Goljan said this was important to know!)
What diseases occur when there are no alpha chains in hemoglobin? Severe alpha thalassemia: Hb Bart (4 gamma chains)--> hydrops fetalis, Hb H (4 beta chains)
What is the cause of anemia given the following statement?: microcytic anemia + dysphagia + glossitis Plummer Vinson syndrome (Fe deficiency anemia)
What is the cause of anemia given the following statement?: microcytic anemia + >3.5% HbA2 Beta thalassemia minor
What is the cause of anemia given the following statement?: megaloblastic anemia not correctable by B12 or folate orotic aciduria
What is the cause of anemia given the following statement?: megaloblastic anemia along with peripheral neuropathy B12 deficiency
What is the cause of anemia given the following statement?: microcytic anemia + basophilic stippling lead poisoning
What is the cause of anemia given the following statement?: microcytic anemia reversible with B6 sideroblastic anemia
What is the cause of anemia given the following statement?: HIV positive patient with macrocytic anemia zidovudine
What is the cause of anemia given the following statement?: normocytic anemia + red urine in the morning paroxysmal noctural hemoglobinuria (PNH)
What is the cause of anemia given the following statement?: normocytic anemia and elevated creatinine chronic kidney disease (low erythropoietin levels)
What test am I? Prepared antibodies are added to a pt's washed RBC to detect the presence of immunoglobulins already present on the RBC (using an Ab to detect an Ab) Direct Coomb's Test (DAT)
Name 3 situations in which a direct Coomb's test might be +. 1. Hemolytic disease of the newborn 2. Drug induced autoimmune hemolytic anemia 3. Hemolytic transfusion rxns
What test am I? Pt's serum is incubated with normal RBCs to detect for the presence of Abs. Indirect Coomb's test
Name 2 situations in which an indirect Coomb's test might be used. 1. Used to test blood prior to an infusion. 2. Screening for maternal antibodies to a fetus' blood
Antibodies against RBCs that interact more strongly at low temps (4C) than at body temp Cold agglutinins
Which immunoglobulin class is usually seen with cold agglutinins? IgM
Name 3 conditions you would see cold agglutinins in. 1. Mycoplasma pneumoniae 2. EBV 3. Some malignancies
Antibodies that react against RBC protein antigens at body temperature. Warm agglutinins
Warm agglutinins are usually which immunoglobulin class? IgG
Name 4 conditions you would see warm agglutinins in. 1. Viruses (EBV, also HIV) 2. SLE 3. Malignancies (CLL, non-Hod lymphoma) 4. Congenital immune abnormalities
What is the RLS in heme synthesis? Delta-aminolevulonic acid synthase
What is the cause of ITP (idiopathic thrombocytopenic purpura)? Anti-GpIIb/IIIa antibodies that cause autoimmune destruction of peripheral platelets
What is the defect in Bernard Soulier disease? Can't form platelet plug due to decreased GpIb (defect in platelet-to-collagen adhesion)
What is the MC inheritied bleeding disorder? von Willebrand's disease
What are some of the hereditary syndromes of thrombosis (4)? 1. Factor V Leiden mutation (MCC) 2. Prothrombin gene mutation 3. Antithrombin 3 (ATIII) deficiency 4. Protein C or S deficiency
What disease am I used to test for?: Ham's test PNH diagnosis
What disease am I used to test for?: DEB test Fanconi's anemia diagnosis
What disease am I used to test for?: Heinz bodies G6PD deficiency
What disease am I used to test for?: D dimers DIC (D dimer= fibrin degradation products)
What disease am I used to test for?: basophilic stippling Thalassemia, anemia of chronic disease, Fe deficiency anemia, and lead poisoning (key one to know)
What disease am I used to test for?: osmotic fragility test Hereditary spherocytosis
What disease am I used to test for?: + risocetin test von Willebrand's disease
What rapid onset, rapidly progressive disease presents with over 50% myeloblasts in the bone marrow, numerous immature blast cells, and is associated with pancytopenia (anemia, bleeding tendency, and infection)? AML
What rapid onset, rapidly progressive disease presents with over 50% lymphoblasts in the bone marrow, numerous immature blast cells, and is associated with pancytopenia (anemia, bleeding tendency, and infection)? ALL
Which acute leukemia is MC in children and young adults? ALL
Which acute leukemia has a median age of onset of 50yo? AML
Which acute leukemia commonly has bone pain? ALL
Which acute leukemia is associated with the Tdt enzyme? ALL
Which acute leukemia is PAS+? ALL
What is the prognosis of ALL? Very good
Which acute leukemia is CD13, CD33 +? AML
Which acute leukemia has Auer rods? AML
Which acute leukemia is PAS -? AML
Name 3 medical interventions a/w AML. 1. Radiation 2. Benzene 3. Alkylating agents (e.g., Hodgkin's tx)
Name 3 syndromes that are risk factors for AML. 1. Down syndrome 2. Fanconi syndrome 3. Bloom syndrome
Myeloproliferative disease, myelodysplastic syndrome, and aplastic anemia have what cancer risk factor in common? AML
Which cancer can be treated with all-trans retinoic acid? What is the assoc'd translocation? M3 type of AML; t(15;17)
What cancer am I?: t(9;22) CML (bcr-abl)
What cancer am I?: t(8;14) Burkitt lymphoma (c-myc)
What cancer am I?: t(11;22) Ewing sarcoma
What cancer am I?: t(11;14) Manle cell lymphoma
What cancer am I?: t(14;18) Follicular lymphoma (bcl-2 activation)
Proliferative disorder of dendritic cells. Birbeck granules on EM are characteristic; S100 and CD1a +. Langerhans cell histiocytosis
Created by: sarah3148