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