Hematology Flashcards by tcarlso 3

What is the receptor on platelets that binds to vWF?

GP Ib

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What is the receptor on platelets that binds other platelets and fibrinogen?

GP IIa/IIIb

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What are the five major causes of eosinophilia?

Neoplasms
Asthma
Allergic processes
CT diseases
Parasites (NAACP)

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What are the histological features of neutrophils?

Multilobed nuclei

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Hypersegmented nuetrophils are seen in what condition?

b12 deficiency (pernicious anemia)

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What is the function of basophils?

Cells that contain heparin and histamine (similar to mast cells)

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What is the cause of hemophilia A?

Factor 8 deficiency

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What is the cause of hemophilia B?

Factor 9 deficiency

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What are the factors that warfarin inhibits?

10 9 7 2 protein S and C

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What is the function of protein S and C?

C is activated by thrombomodulin/thrombin complex, which in turn activates protein S, and deactivates factors 8 and 5

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What is the order of the extrinsic pathway?

3
7
10 (+8)

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What is the order of the intrinsic pathway?

12
11
9
10

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What are the factors that comprise the tenase complex? What does this complex do?

8 and 9

Increases thrombin activation

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What is the MOA of tPA?

activates plasminogen to plasmin

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What is the MOA of clopidogrel?

Prevents ADP receptor binding

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What is the MOA of abciximab?

Ab against GP IIa/IIIb

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What is the MOA of ASA’s antiplatelet effect?

inhibits thromboxane A2 synthesis

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What is von willebrand disease?

Insufficient vWF

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Basophilic stippling of RBCs is found in what diseases? (4)

anemia of chronic disease
alcohol abuse
Pb poisoning
thalassemias

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Bite cells = what disease?

G6PD deficiency

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elliptocytes = what disease?

Hereditary elliptocytosis

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Ringed siderblasts = what disease?

Sideroblastic anemia (microcytic anemia

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What are the five major causes of microcytic anemia?

Fe deficiency
Thalassemias
sideroblastic anemia
Anemia of chronic disease
Pb poisoning

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Heinz bodies = what disease? What are they?

G6PD deficiency

Denatured Hb

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Howell-Jolly bodies = what disease?

hyposplenia or asplenia

What are schistocytes? What are these seen in?

Broken RBCs---DIC, TTP/HUS mechanical heart valves

What are the two major causes of macrocytic anemia?

B12 deficiency | Folate deficiency

What is/are the labs that separate B12 deficiency and folate deficiency?

Methylmalonic acid will be high in B12 deficiency

What is the one reaction in the body that requires THF?

Conversion of homocysteine to methionine

What is TIBC?

The amount of Fe that can be stored on transferrin (the number of open spots, thus higher numbers = lower serum ferritin)

What are the two storage forms of Fe?

Ferritin (dynamic) | Hemosiderin (lost)

What is plummer vinson syndrome?

Fe deficiency Esophageal webs atrophic glossitis

What is the Hb formed when there is are three (or four total) deletions of the alpha globin gene?

HbH (beta4 tetramer)

What is Bart's hb? What disease is it found in?

gamma4 tetramer of Hb, found in 4 alpha gene deletions

What is beta thalassemia minor?

underproduction of beta globin. This is usually asymptomatic, since there is an upregulation of HbA2 (alpha2, delta2)

What are the components of HbA?

alpha2beta2

What are the components of HbA2?

alpha2delta2

What are the components of HbF?

Alpha2gamma2

Mohawk appearance of a skull x-ray = what disease? Why?

beta thalassemia major d/t increased hematopoiesis in the skull bones

What virus are people with beta thalassemia major particularly susceptible to?

Parvovirus B19 d/t infection of erythroid progenitor cells

What are teardrop cells seen in?

Primary myelofibrosis

What are Target cells seen in? (HALT)

HbC disease Asplenia Liver dz Thalassemia

What are iron studies like with Fe deficiency anemia? (Fe, TIBC, ferritin)

Low Fe High TIBC Low Ferritin

What is the major toxicity of Pb poisoning?

Inhibition of ferrochelatase and ALA dehydratase

What are the ssx of Pb poisoning?

Lead lines in gingiva | Encephalopathy

What is the treatment for Pb poisoning?

EDTA or Succimer drops

What are the PBS findings for Pb poisoning?

Microcytic anemia with basophilic stippling

What is the hereditary cause of sideroblastic anemia? What is the inheritance pattern of this?

X-linked deficiency/defect i delta-ALA synthase gene

What drug classically causes sideroblastic anemia? How? What is the treatment for this?

Isoniazid d/t inhibition of ALA synthase | B6 supplementation

What are the PBS findings of sideroblastic anemia?

Ringed sideroblasts d/t Fe laden mitochondria

What are the iron studies like with sideroblastic anemia? (Fe, TIBC, Ferritin)?

Increase Fe Normal TIBC Increased Ferritin

What are homocysteine and methylmalonic acids levels like with folate and B12 deficiencies respectively?

``` B12 = both high Folate = only Homocysteine levels are elevated ```

What is orotic aciduria, and what causes it? How does this present?

Inability to convert orotic acid to UMP because of a effect in UMP synthase Presents in childhood as megaloblastic anemia that cannot be corrected with folate or B12

How do you differentiate orotic aciduria from ornithine transcarbamylase deficiency?

No hyperammonemia with orotic aciduria

What is non-megaloblastic macrocytic anemia?

Macrocytic anemia in which DNA synthesis is not impaired. Usually caused by EtOH-ism or cirrhosis

What are the two different types of normocytic, normochromic anemias?

Hemolytic vs nonhemolytic

What are the following labs like with intravascular hemolysis: - Haptoglobin - LDH - reticulocytes

Decreased haptoglobin (is bound) Increased LDH -Increased reticulocytes

What happens to LDH and unconjugated bili levels in extravascular hemolysis?

Increased LDH and increased bili

What is the role of hepcidin?

binds ferroportin in the intestinal mucosa and macrophages, thus inhibiting Fe uptake

What is the pathophysiology of anemia of chronic disease?

Chronic inflammation leads to increased hepcidin release, and an increase in ferritin levels, as Fe is preferentially stored away from bacteria

What are the following labs like with anemia of chronic disease: - Fe - TIBC - Ferritin

Low Fe Low TIBC High Ferritin

What is the body's main form of Fe storage?

Ferritin

How does CKD lead to anemia?

Low EPO = low hematopoiesis

What is aplastic anemia, and what are the classical findings of it?

Pancytopenia, characterized by normal cell morphology, but hypocellular bond marrow with fatty infiltration

What is the bone aspiration finding of aplastic anemia?

Dry tap (fat cells)

What is the treatment for aplastic anemia?

Marrow transplant | g-CSF

What viruses can cause aplastic anemia? (4)

Parvo B19 HIV HCV EBV

What is the pathophysiology of Fanconi anemia?

DNA repair defect, leading to aplastic anemia

Hematology Flashcards

(68 cards)