Shared Flashcard Set

Details

Hematology / Oncology
Hematology / Oncology
96
Other
Graduate
11/22/2009

Additional Other Flashcards

 


 

Cards

Term
What are the precursors for RBC's, thrombocytes, neutrophils, eosinophils, basophils, macrophages, mast cells, natural killer cells, T cells, B cells and plasma cells?
Definition
RBC = erythroblast. Thrombocyte = megakaryoblast. Neutrophil, Eosinophils, Macrophage and Basophil = myeloid stem cell. Mast cell = Basophil. Natural Killer cells, T cells and B cells = lymphoid cell. Plasma cell = B cells.
Term
What is the precursor to all cells?
Definition
Pluripotent cell.
Term
What is a reticulocyte?
Definition
an immature RBC
Term
What is EPO? Where is it produced? What triggers its release?
Definition
Glycoprotein that directly stimulates RBC formation. Produced by kidneys & liver. Triggered by a decrease in RBCs, iron deficiency or a decrease in O2.
Term
What is the average life span of a RBC?
Definition
120 days
Term
What is polycythemia?
Definition
excess RBCs
Term
What is the definition of anemia?
Definition
decrease in # of RBCs or a decrease in RBC function.
Term
Do dialysis patients have EPO?
Definition
They lack EPO.
Term
What kind of anemia involves the destruction of stem cells?
Definition
Aplastic anemia
Term
What kind of anemia results from vitamin B12 and folate deficiencies?
Definition
Megaloblastic anemia
Term
What anemia is characterized by the inability to produce globulin chains?
Definition
Thalassemias
Term
What type of anemia results from depleted Fe stores?
Definition
Iron deficiency anemia
Term
What kind of anemia is characterized by the inability to incorporate stored iron to make heme?
Definition
Anemia of chronic disease
Term
How long does it take reticulocytes to lose their DNA and become mature RBCs?
Definition
24 hours
Term
What is anisocytosis?
Definition
an abnormal variation in size between RBCs.
Term
What is micro and macrocytosis?
Definition
Microcytosis: cell size < 6µm
Macrocytosis: cell size > 8µm
Term
What is hypochromia?
Definition
Hypochromia: cells with ↓ conc of Hb
Term
What is poikilocytosis?
Definition
abnormal RBC shape
Term
What are spherocytosis, sickle cells, target cells and schistocytes?
Definition
Spherocytosis: spherical, w/o pale centers.
Sickle cells: crescent shaped cells.
Target cells: dark center & periphery with a clear ring in between (look like a bullseye).
Schistocytes: fragmented, irregularly contracted cells.
Term
How many O2 molecules are carried on oxyhemoglobin?
Definition
4
Term
How do WBCs travel out of the blood vessels? What signals them to go to a certain area?
Definition
travel out of the blood vessels (diapedesis). Move in amoeboid motion by positive chemotaxis (follow a chemical trail of damaged cells or other leukocytes) to an area of infection.
Term
Which WBCs are the granulocytes? agranulocytes?
Definition
Granulocytes are neutrophils, eosinophils and basophils. Agranulocytes are lymphocytes and monocytes.
Term
Describe the function of neutrophils, eosinophils and basophils.
Definition
Neutrophil (PMN)- phagocytize bacteria.
Eosinophil – kill parasitic worms and implicated in allergy/asthma
Basophile – release histamine
Term
What are the functions of the agranulocytes, (lymphocytes and monocytes)?
Definition
Lymphocyte - mount immune response via direct attack or antibodies.
Monocyte - phagocytosis, they become macrophages in tissues.
Term
What are band cells? What do they signify?
Definition
They are immature Neutrophils and signify infection or cancer.
Term
What is included in a CBC?
Definition
includes: Hgb/Hct
RBC count
RBC indices
WBC count
WBC differential
platelet count
reticulocyte count
Term
What is Hgb? Norms for males and females?
Definition
measure of total amt Hgb in peripheral blood. Reflects # RBCs in blood.
norms: males 14-18 g/dl
females 12-16 g/dl
Term
What is Hct? Norms for males and females?
Definition
(AKA packed cell vol) measure of % of the total blood vol that is made up of RBCs (height after centrifuge)
norm: males 42-52%
females 37-47%
Term
What does a reticulocyte count measure? Norms?
Definition
Bone marrow function. norm: adult/child 0.5-2% of RBCs
Term
What does a Reticulocyte index tell us? Normal value?
Definition
Determines if retic count indicates an appropriate erythropoietic response from RBC marrow. Normal value = 1.0
Term
What is the MCV (Mean Corpuscular Volume)?
Norms?
Definition
Volume of a single RBC. Norms = 82-98 um.
Term
What is the best test to classify anemias? How does it classify them?
Definition
MCV. Can be microcytic, normocytic or macrocytic.
Term
What is the MCHC measure? Norms? What is its diagnostic value?
Definition
Measures the average concentration of Hb in RBCs. Norm = 31-37 g/dl. It is used to monitor for anemia.
Term
What is MCH? Norms? Diagnostic value?
Definition
Amount of Hb per RBC. Norm = 30-34 pg/cell. It is used to diagnose severe anemia.
Term
What does a WBC differential measure? Norms?
Definition
Differential measures the % of each type of leukocyte in the sample. Norms = neutrophils (50-70%), lymphocytes (20-40%), monocytes (2-8%), eosinophils (1-4%) and basophils (0.5-1%). NeverLetMonkeysEatBananas
Term
Normal WBC count?
Definition
5,000-10,000/mm3
Term
What is leukocytosis and leukopenia? Causes of each?
Definition
Luekocytosis - ↑ in # WBCs
cause: infection, inflammation, tissue necrosis, leukemic neoplasia

Leukopenia - ↓ in # WBCs
cause: bone marrow failure
Term
What is the average life span and normal values for platelets?
Definition
Life span is approx 10 days.
Norm = 150,000 – 300,000/mm3
Term
Where does B12, folate and iron deficiency cause anemia?
Definition
In the bone marrow, it causes RBC defects.
Term
What kinds of anemias are microcytic?
Definition
iron deficiency, thalassemia, lead poisoning, hemorrhagic, hemolytic (transfusion rxn)and aplastic (red bone marrow destruction.
Term
What kinds of anemias are normocytic?
Definition
Chronic disease and malignancy
Term
What kinds of anemias are macrocytic?
Definition
B12 deficiency, folate deficiency, alcoholism, hypothyroidism, chronic liver disease with acute heme malignancies.
Term
Important Hx questions for anemia?
Definition
blood loss, fatigue, FHx of anemia, diet, PICA (ice cravings) or ASA/NSAID use.
Term
Important PE checks for anemia?
Definition
skin color, check the tongue and the mouth, nails, heart rate, heart murmurs and dyspnea.
Term
Where is iron primarily absorbed? How does anemia, hypoxia, increased EPO and decreased iron stores affect iron absorption? How does inflammation and an increase in iron stores affect iron absorption?
Definition
In the duodenum. They all increase iron absorption. Inflammation/increase in stores leads to a decreased absorption of iron.
Term
Where is iron stored?
Definition
In the spleen and bone marrow.
Term
What is the most common cause of microcytic anemia in children and women during childbearing years?
Definition
Iron deficiency
Term
In what state is iron transported? Stored?
Definition
Transported as transferrin and stored as ferritin.
Term
What is Koilonychia?
Definition
Fingers are enlarged and spoon shaped due to chronic deoxygenation.
Term
How are Hemoglobin and Hematocrit, serum iron and TIBC affected by iron deficiency anemia?
Definition
H&H and serum iron are decreased and TIBC is increased.
Term
What are the forms of iron given for Tx of iron deficiency anemia?
Definition
Oral - ferrous sulfate, ferrous gluconate, polysaccharide iron preps.
IV - iron-dextran for urgent replacement
Term
What are some major causes of Hemolytic anemias?
Definition
G6PD, Sickle cell, TTP (Thrombotic thrombocytopenic purpura), HUS (hemolytic-uremic syndrome), DIC (Disseminated intravascular coagulation) and autoimmune disease.
Term
What are some major causes of autoimmune hemolytic anemia? Describe what happens.
Definition
ABO incompatibility, transfusion rxn, thermal burns and drugs. The RBCs are coated with antibodies or compliment and the body attacks them.
Term
Which antibodies are "warm" and which are "cold"? Which usually cause hemolytic anemia in the elderly?
Definition
IgG = “warm” antibodies.
IgM = “cold” antibodies.
IgM causes hemolytic in the elderly often post infection.
Term
What will be some distinct charcateristics with hemolytic anemias on PE, labs and smear?
Definition
jaundice, splenomegaly, increased bilirubin and spherocytes (dense RBCs without pale centers) on smear.
Term
Briefly describe the difference between a Direct Coombs test and an Indirect one.
Definition
Direct uses the patients blood to test their RBCs and indirect uses their serum to check for antibodies.
Term
How will the lab results differ for warm vs. cold hemolytic anemia?
Definition
Warm will have a + Coombs test (will have IgG on the RBC membrane) and cold will have a - Coombs test (negative for IgG, IgM, + for complement).
Term
What is the MOA for Aplastic anemia? How do these look on CBC?
Definition
Pluripotent stem cells in the bone marrow are injured. They can be microcytic or normocytic but will have Pancytopenia.
Term
What are some S&S for Aplastic anemia?
Definition
bleeding, eccymosis, petechiae, fatigue, pallor, lethargy, dyspnea,palpitations, tachycardia, murmurs, fever/chills and increased risk for infection.
Term
What is needed to treat Aplastic anemia? What is a common complication of the treatment?
Definition
A bone marrow transplant. 20-30% get severe graft vs host disease.
Term
What kind of MCV anemia is B12 deficiency? What is it called if the deficiency comes from an inability to absorb vitamine B12?
Definition
A macrocytic anemia. It is called pernicious anemia if the problem is with absorption and not diet.
Term
What are some common causes of B12 deficiency anemia?
Definition
vegetarian diet, post gastrectomy, and Crohn's disease.
Term
What symptoms are present with Pernicious anemia but not folate deficiency that helps distinguish between the two?
Definition
Pernicious will have symmetric paresthesias of the feet and hands.
Term
How is Pernicious anemia diagnosed?
Definition
By Schilling Test (radioisotopes of B12 are ingested and you watch for absorption or malabsorption).
Term
How will Pernicious anemia appear on labs? Treatment for Pernicious anemia?
Definition
pancytopenia, macrocytic and decreased folic acid. Treatment is IM B12 (cyanocobalmin) supplementation for life.
Term
What kind of defects are seen with folate deficiency anemic pregnant mothers? What is it usually associated with?
Definition
It is associated with neural tube defects in neonates and is usually associated with alcoholism.
Term
What are some S&S of folate deficiency anemia?
Definition
memory changes, irritability and personality changes but NO neurological changes (only B12 deficiency).
Term
How is folate deficiency diagnosed on peripheral smear and serum testing?
Definition
Macro-ovalocytes (large oval RBCs), hypersegmented PMNs (Neutrophils), Howell-Jolly bodies (small peices of DNA in RBCs), low folate levels and normal B12 levels.
Term
What are some common folate sources?
Definition
Dark leafy green veggies, okra, lentils, kidney beans and sunflower seeds.
Term
What is the cause of Anemia of Chronic Disease? How will it look on MCV?
Definition
It is due to a decrease in EPO production from chronic renal, liver, endocrine or thyroid failure or malignancies. It is normocytic on MCV.
Term
What will Anemia of Chronic Disease appear on peripheral smear? CBC? What is the treatment?
Definition
Hb and Hct will be decreased, RBCs will be deformed (Burr cells), MCV,MCH,MCHC are all normal, serum iron is normal and WBCs/platelets are normal. Treatment is recombinant human EPO.
Term
Which anemias are inherited?
Definition
G6PD anemia, sickle cell anemia and Thalassemia anemia.
Term
What is the most common metabolic disease of the RBC?
Definition
G6PD anemia.
Term
Describe G6PD anemia. What is the characteristic of G6PD seen on histology?
Definition
It is an X-linked recessive disorder where they are missing the G6PD enzyme which damages RBC membranes and results in Heinz bodies (inclusions within red blood cells composed of denatured hemoglobin) and bite cells on histology.
Term
What are the causes of acute G6PD anemia problems?
Definition
The RBCs are more sensitive to oxidative stress and it is exacerbated by infection, drugs (ASA), and dietary (tell them to avoid red wine, legumes, blueberries and soy.
Term
How is G6PD anemia diagnosed?
Definition
By bite cells (cells that look like they have a bite taken out of them) and Heinz bodies (inclusions within red blood cells composed of denatured hemoglobin) on smear.
Term
Describe Sickle Cell anemia.
Definition
It is an autosomal recessive gene seen almost entirely in blacks and it involves a mutation of the beta chain of Hb that causes the RBCs to "sickle" under deoxygenated conditions.
Term
Describe what happens in a sickle cell crisis.
Definition
The sickled cells clog the capillaries and venules, leadign to tissue ischemia and acute pain and end organ damage.
Term
What are some causes of an acute Sickle Cell exacerbation?
Definition
cold weather, high altitude, dehydration, acidosis and hypoxemia.
Term
What are some long term sequela of sickle cell anemia?
Definition
splenomegaly, abnormal spleen function, renal failure, avascular necrosis of femoral head, strokes, retinopathies and priapism (painful erect penis/clitoris that will not return to its flaccid state)
Term
How is sickle cell diagnosed based on blood smear?
Definition
It will have anisocytosis, poikilocytosis, Howell-Jolly bodies and sickled cells on smear.
Term
What is the treatment of choice for sickle cell anemia?
Definition
stem cell transplant (curative)
Term
Describe how Thalassemia leads to anemia.
Definition
It is a genetically inherited disorder resulting in decreased or absent synthesis of alpha or beta globin chains of the hemoglobin molecule which results in abnormal RBCs that do not live as long and leads to anemia.
Term
Where is Alpha-Thalassemia more common? Beta? What is the prominent feature of Thalassemia?
Definition
Alpha = Asian origin. Beta = Mediterranean origin. Prominent feature is microcytosis out of proportion to the degree of anemia and it is hypochromic.
Term
What is Hgb H and Bart's Hgb (hydrops fetalis)?
Definition
Hgb H is in alpha-Thalassemia and only 2 of the 4 chains are deleted and results in mild anemia. Bart's Hgb is when all 4 chains are deleted and results in a stillborn child or one that dies within days.
Term
How will alpha-Thalassemia appear on labs? Smear? How is it diagnosed?
Definition
Hypochromic, microcytic, will have target cells on smear and there will be evidence of hemolysis. It is diagnosed by Hb electrophoresis.
Term
How do you treat alpha-Thalassemia? Do you want to give them iron?
Definition
Treat with folic acid supplements, do not give iron because the problem is incorporating the iron not an iron deficiency.
Term
Describe Beta-Thalassemia minor. MCV and MCHC? How is it diagnosed?
Definition
Occurs in people that are heterozygous for the B-Thalassemia gene, they are usually asymptomatic but the RBCs are hypochromic and microcytic. Diagnosis made by Hb electrophoresis.
Term
Where is B-Thalassemia major common? AKA? When is the onset? S&S?
Definition
Common in people of Mediterranean, Middle East, India, or Pakistani descent. It is also known as Cooley's anemia. The onset of symptoms is 4-6 months after birth when they switch from HgF to adult Hb. S&S = severe anemia, growth retardation, abnormal facies, pathologic fractures, osteopenia, bone deformities, splenomegaly and jaundice.
Term
How is Beta-Thalassemia major treated?
Definition
treated with chronic blood transfusions, bone marrow transplant and chelation therapy if iron gets too high.
Term
What is Polycythemia Vera?
Definition
A condition with an abnormally elevated Hgb or Hct that increases the blood viscosity.
Term
How will Polycythemia appear on a smear?
Definition
With way too many RBCs.
Term
What could be some causes of polycythemia?
Definition
dehydration, allergic reaction, chronic hypoxia or renal tumors (secrete too much EPO).
Term
What are some Sx of polycythemia vera? At what Hgb concentration is the patient at risk for arterial/venous thrombosis and marked decrease in blood flow to vital organs?
Definition
fatigue, headache, malaise and pruritis after bathing. Hgb > 20g/dl.
Term
What is the treatment for Polycythemia Vera?
Definition
Treatment is phlebotomy QD (once a day) or myelosuppressive drugs (Hydroxyurea).
Term
What is the normal RBC count for men and women?
Definition
males: 4.3 – 5.7 x10³/µL
female: 3.8 – 5.1 x10³/µL
Supporting users have an ad free experience!