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| t(15;17) | Acute promyelocytic leukemia /M3
Females w/ sudden onset of bleeding// DIC
Retinoic acid receptor alpha gene
Retinoic acid= complete remission
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| t(9;22) | CML
Philadelphia chromosome// flower garden/// decreased LAP score
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| t(8;21) | AML/ M2
Adults, dysmeylopoiesis, psuedo pelger huet
Myeloblastic anemia w/o maturation
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| 11q23 | AML/M5
Schilling type
Monoblastic young adults & children
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| t(16;16) | AML myelomonocytic
M4 Eo variation
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| CD 10, CD19, CD22, CD24 | ALL B cell precursors
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| CD2,CD4, CD5, CD8 | ALL T cell precursors
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| CD 19, CD20, CD23, CD5 | CLL
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| CD103, CD11c, CD25, TRAP | Hairy cell leukemia
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| Waldenstrom's macroglobulinemia | Malignancy of the lymphoplasmacytoid cells which manufacture IgM
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| WBC scatter plot: A: top left, B middle, C right, D bottom left | A:monocytes
B:neutrophils
C: Eosinophils
D: lymphocytes
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| Why is the WBC count increased when the PB is analyzed automatically in a sickle cell anemia patient? | Sickled RBC's are resistant to lysis so are counted among the WBC population
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| What reagents are used in the PT test? | Thromboplastin and calcium replace the tissue thromboplastin and calcium necessary in vivo to activate factors VII and VIIa. this ultimately generates thrombin from pro thrombin via the coagulation cascade
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| Which ratio of coagulant to blood is correct for coagulation procedures? | 1:9
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| The anticoagulant of choice for most routine coagulation studies is... | Sodium citrate
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| Which results would be expected for the prothrombin time PT and activated partial thromboplastin time APTT in a patient with polycythemia? | Both prolonged: The blood in a polycythemia patient contain so little plasma that access anticoagulant remains in is available to buy in to reagent calcium thereby resulting in a prolongation of the PT and aPTT
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| Which test would be abnormal in a e patient with Stewart power factor (factor X) deficiency? | Stewart power factor (factor X)!is involved in the common pathway of the coagulation cascade therefore it's deficiency prolongs both PT in aPTT
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| Normal Hgb | A, F, A2
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| Sickle cell trait hgb | A: 50-70%, S: 20-40%, A2,F
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| Sickle cell anemia Hgb | S, F, A2
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| Hgb AC trait | C,A,
A2, F
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| Hgb SC disease | C,S, F
A2
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| Beta thalassemia minor Hgb | A2, A in equal parts
F small
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| Beta thalassemia majior | Lg F, md A2, small A
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| Which clotting factor is not measured by PT and APTT test? | Factor XIII (fibrin stabilizing factor)
It creates covalent bonds between fibrin monomers formed during the coagulation process to produce a stable fibrin clot.
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| What happens in the absence of factor 13 | The hydrogen bonded fiber in a polymers are soluble and 5M urea or in 1% monochloroacetic acid
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| A modification of which procedure can be used to measure measure fibrinogen? | Thrombin time. Fibrinogen can be quantitatively measured by a modification of thrombin time by diluting the plasma since of thrombin clotting time of diluted plasma is inversely proportional to the concentration of fibrinogen. (th clause method)
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| Vitamin K is necessary for activation of which clotting factors | Factors II,VII, IX and X
It is required for Corboxylatiin of glutamate residues of these coagulation factors
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| Is vitamin K enhanced by heprin therapy | No
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| Distribution 30% spleen, 70% peripheral blood Reference ranges for platelets are 150,000 to 400,000/ mm3 the lifespan is 9 to 12 days |
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| What does the PFA test do | A test to see if platelets properly adhere an aggregate at the injury site. Basically checks if platelets are working correctly
It takes the place of the historical bleeding time test
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| What does thrombin do? | Cleves peptides off of the fibrinogen molecules to form fibrin which polymerizes to form insoluble fibrin strands.
thrombin also activates factor 13 which cross-links the fibrin strands at the D region . (birth of the D dimer)
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| Other function is of thrombin are | Feeds back to protonate factors V & VIII
recruits and aggregates platelets
turns on endothelial cell thrombomodulin (receptor/ activator for protein C and protein S system) to in activate factors V and VIII.
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| INR : | International normalized ratio reference ranges under 13 seconds therapeutic goal is 2.0 to 3.5
INR( patient result/ mean of ref range)^ISI
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| APTT | Screen for intrinsic and common pathways
measures all factors except for VII & XIII
monitors heparin therapy.
Reagents: activator (Kaolin, celite, or ellagic acid), PLT phospholipid, cacl2
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| APTT reference range | 20 to 40 seconds
therapeutic goal is 1.5 to 2.5 times normal or use heparin response curve
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| Fibrinogen assay | Quantitative measure of factor I (fibrinogen)
reference ranges : 200 to 400 mg/dl
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| PT prothrombin time | Screen for extrinsic and common pathways
Measures factors I, II, V, VII, and X
Monitors oral anticoagulants (warfarin Coumadin)
Reagents: tissue thromboplastin and CACL2
sensitive to vitamin k factors
INR
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| PT time reference range | < 13 seconds
therapeutic reference range: 2.0 to 3.5
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| Von Willebrand's disease | Wimpy Willy
normal platelets
decreased factor VIII
decreased vWF
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| Bernard-Soulier | Super Bernie giant platelets
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| Reptile lease time | Snake venom enzyme.
Test similar to thrombin time but is not inhibited by heparin (good to use on patients on heparin)
reference range: 18 to 22 seconds
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| Abnormal ristocetin induced aggregation | Bernard- Soulier & von Willebrand
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| Hemophilia A | Inherited disorder
deficiency of factor VIIII, sex linked recessive (men)
spontaneous bleeding into joints, treat with commercial factor VIIII
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| Hemophilia B | Inherited disorder deficiency and factor IX,
sex linked recessive ( men)
clinically identical; hemophilia A
treat with factor IX concentrates
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| Hemophilia C | Inherited disorder, deficiency in factor XI
Incomplete Autosomal recessive,
wide ranging clinical severity, high incidence in Ashkenazi Jews, only contact factor associated with bleeding
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| Von Willebrand disease | Inherited disorder, primary { 1*}defect in the von Willebrand factor, vWF factor Binds platelets via the glycoprotein 1B/V/IX receptor.
2*: deficiency a factor VIII, Autosomal dominant abnormal PFA test treat with cryoprecipitate
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| Factor XIII DEFICIENCY | Inherited disorder, Autosomal recessive, not detected by common coagulation test, poor wound healing, detected with the 5M urea test
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| Inherited disorders coagulation | Hemophilia A, hemophilia B, hemophilia C, von Willebrand disease, factor XIII deficiency
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| Intrinsic pathway | Pk, hk, XII, XI, IV, VIII
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| Extrinsic | III, VII, TF
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| COMMON patheay | X, V, II, I
II: prothrombin
I: fibrinogen
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| What is required to activate Protien C and become fully functional? | Streptokinase
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