Term
|
Definition
| Destruction of bone marrow due to cytotoxic drugs |
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Term
|
Definition
| Loss of tissue responsible for producing RBC in bone marrow |
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Term
|
Definition
| deficiency in RBC production |
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Term
|
Definition
| microcytic, caused by lack of iron. anemia of chronic disease. |
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Term
|
Definition
| hypoproliferative anemia; microcytic; The body has iron available but cannot incorporate it into hemoglobin. Sideroblasts are seen in aspirates of bone marrow; these are atypical nucleated erythrocytes with granules of iron accumulated in perinuclear mitochondria. |
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Term
|
Definition
| anemia of chronic disease; bone marrow failure; endocrine failure |
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Term
|
Definition
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Term
|
Definition
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|
Term
| causes of endocrine deficiencies |
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Definition
|
|
Term
| renal insufficiency and anemias |
|
Definition
| kidney produces erythropoeitin |
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Term
|
Definition
| hyperproliferative; associated with autoimmune disease; G-6-P-DH deficiency (glutathione needed to strengthen RBC membrane or they lyse); also drugs and infections |
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Term
|
Definition
| sickle cell; thasselemia; chronic disease (cancer or infection) |
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Term
| differentiation of stem cell part I |
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Definition
| stem cell factor and IL 1, 3, 6 convert stem cell to myeloid progenitor or lymphoid cell -> lymphoid becomes T and B, myeloid becomes RBC, platelet, netrophil granulocyte |
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Term
| first colony stimulating factor and product |
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Definition
| GM-CSF produces granulocyte monocyte progenitor cell, megakaryocyte progenitor, erythroid progenitor |
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Term
|
Definition
| acts on megakaryoctye progenitors to create megakaryocytes and on megakaryoctyes to produce platelets |
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Term
|
Definition
| acts on neutrophil progenitor to produce neutrophils |
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Term
|
Definition
| acts on monocyte progenitor cell to produce monocytes |
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Term
|
Definition
| granulocyte macrophage CSF growth factor; stimulate myelopoeisis; stimulates CSF-g and CSF-M |
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Term
|
Definition
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Term
|
Definition
| Long lasting granulocyte CSF |
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Term
|
Definition
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Term
|
Definition
| promotes IL-6 dependent myeloma cell line; oprelvekin, IL-11 analog; for nonmyeloid malignancies; leads to thrombopoiesis |
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Term
|
Definition
| enhances recovery of bone marrow and allows for RBC production; used in bone marrow transplant; neutropenia in AIDS; drug-induced bone marrow toxicity |
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Term
| filgrastam adverse reactions |
|
Definition
| enlarged spleen; bone pain; arryhthmias; rash |
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Term
|
Definition
| used in patients with renal insufficiency; risk of elevated BP; used by AZT patients as well |
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Term
|
Definition
| critical in iron deficiency; risky in pts with uncontrolled hypertension due to possible vasospasm |
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Term
|
Definition
| Androgens can stimulate response; possible pregnancy risk |
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Term
|
Definition
| long-lived epo; 3X half lifehyperglycosylated human recombinant |
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|
Term
| iron absorption deficiency causes |
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Definition
|
|
Term
| factors influencing iron absorption |
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Definition
| mucosal block; form of iron (fe 2+ more absorbed); vitamin C; antacids, tetracyclines, oxalates bind iron |
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Term
|
Definition
| part of duodenum that takes up iron; more responsive in event of hypoxia or iron deficiency |
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Term
|
Definition
| lethargy, disorientation, seizures, focal neurological defecits, Cheyne-Stokes respiration, rhabdomyolysis, anorexia |
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|
Term
| hypotonic hyponatremia hypovolemic, low urine sodium (<20) |
|
Definition
| extrarenal loss - GI, Skin, Lung |
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Term
| hypotonic hyponatremia, hypovolemic, high urine sodium (Na > 20) |
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Definition
| renal losses due to diuretics, adrenal insufficiency |
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|
Term
hypotonic hyponatremia, hypervolemic
(reduced EABV) |
|
Definition
| CHF, cirrhosis, nephrosis |
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|
Term
hypotonic hypnatremia, euvolemic
(high urine sodium, >20) |
|
Definition
| exclude hypthyroidism, hypocortisolism, renal failure, SIADH |
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|
Term
| hypotonic, hyponatremia, euvolemic (high urine sodium, >20) |
|
Definition
| primary polydipsia, low solute intake |
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Term
| disorders associated with SIADH |
|
Definition
| pneumonia, TB, aspergillosis, CNS disorders, carcinomas (tumor secreting) |
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Term
| medications causing SIADH |
|
Definition
| cyclophosphamide, NSAID, carbamazapine, chlorpropamide |
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|
Term
| rates of sodium correction |
|
Definition
| increase no more than 12meq/day; decrease no more than 15meq/day |
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|
Term
| hypovolemic treatment to restore organ perfusion |
|
Definition
| 0.9% NaCl 200-300ml/hour to hemostatic stability then increase rate |
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|
Term
| acute isovolemic hyponatremia treatment or Na <115 |
|
Definition
| 3% NaCl w/loop diuretic, 1-2 ml/kg/hr, monitor Q2H, |
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Term
|
Definition
| water 1000-2000 ml/day, NaCl PO, demecloclycline (ADH antagonist) 900 - 1200 mg/day, decrease to 600 - 900mg, CHRONIC ONLY! |
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|
Term
| hypervolemic hyponatremia tx |
|
Definition
| conivaptan or tolvaptan,contraindicated by CYP 3A4 inhibitors - ketoconizole, itraconazole, carithromycin, ritonavir, indinavir |
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Term
|
Definition
| V1a, V2 antagonst, IV bolus then infusion, 20mg/30mins then 20mg/day; no established safety in heart failure |
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Term
|
Definition
| V2 antagonist, 15-60mg/day PO, established safety in heart failure |
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|
Term
| potassium correction overview |
|
Definition
| potassium is primarily IC so small hypo and hyperkalemias typically require large corrections |
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|
Term
| acidosis/alkalosis impacts on serum potassium |
|
Definition
| respiratory has no impact; metabolic acidosis increases K+ concentration, metabolic alkalosis decreases K+ concentration |
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|
Term
| adrenergic system impact on potassium concentrations |
|
Definition
| beta-2 agonists decrease, alpha-1 agonists increase (opposite for blockades) |
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|
Term
| insulin impact on potassium concentrations |
|
Definition
| excess decreases, deficit increases |
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|
Term
| hyperosmolarity impact on serum potassium concentrations |
|
Definition
| increases serum concentration of potassium |
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|
Term
| beta 2 agonism on the loop of henle |
|
Definition
|
|
Term
| pH range compatible with life |
|
Definition
|
|
Term
| liver disease in sickle cell |
|
Definition
| 2%, leads to jaundice, many causes such as iron overload, hep B, hep C |
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|
Term
| osteonecrosis in sickle cell |
|
Definition
| 10-50%, aseptic necrosis of femoral heads; osteomyelitis |
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|
Term
| renal insufficiency in sickle cell |
|
Definition
| up to 20%; severe anemia often comorbidity |
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|
Term
| retinopathy in sickle cell |
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Definition
|
|
Term
| acute aplastic episodes in sickle cell |
|
Definition
| due to parvovirus B19; severe anemia a comorbidity |
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|
Term
| strep pneumoniae w/sickle cell |
|
Definition
| 10% of children <5 years with SCA |
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|
Term
| osteomyelitis w/sickle cell |
|
Definition
| due to salmonella or staph aureus |
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|
Term
| eColi sepsis w/sickle cell |
|
Definition
| through urinary tract infection in adults |
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|
Term
| hydration in sickle cell management |
|
Definition
|
|
Term
| folic acid managment in sickle cell |
|
Definition
| 1mg daily to prevent magaloblasticity |
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|
Term
| infection management in sickle cell |
|
Definition
| prophylaxis, influenza vaccine - particularly to asplenic or functionally asplenic |
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|
Term
| pain management in sickle cell |
|
Definition
| ATC NSAIDS or acetaminophen, acute breakthrough mgmt w/ narcotics |
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|
Term
| transfusion in sickle cell |
|
Definition
| particularly in children' complications iron overload, volume overload, alloimmunization |
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|
Term
| exchange transfusion in sickle cell |
|
Definition
| for life-threatening organ-related events (strokes, PaO2 <70, priopism, resistant ulcers, splenic sequestration) |
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|
Term
| chelation therapy indications |
|
Definition
| for iron overload, ferritin >1000-2000 |
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Term
|
Definition
| deferoxamine 1-2gm SC/10-12 hour; deferasirox 20mg/kg/day PO |
|
|
Term
| radioactive phagocytosis assay |
|
Definition
| use chromium tagged sRBC mixed with macrophage; wash the remainder and lyse the cells to see how much tagged sRBC was taken up |
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Term
| nonradioactive phagocytic assay |
|
Definition
| use latex spheres and methylene blue to see extent of macrophagic activity |
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Term
|
Definition
| expose animal to xenobiotic and then take lymphocytes from exposed and unexposed animal; add CR-51 tumor cells and count release of radiation as a measure of NK activity |
|
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Term
|
Definition
| use confocal microscopy to observe chemotaxis in expose organism v control |
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|
Term
| PFC (plaque forming cell assay) |
|
Definition
| expose mouse to sRBC; after 4D remove spleen; incubate splenocytes with sRBC, C' and agar; cells will secrete IgM and will create plaque in surrounding (lysed) sRBC |
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Term
|
Definition
| add LPS to lymphoblast to activate b cell; phytohemoglutanin to activate t cells; |
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Term
|
Definition
| react antigen with antibody in plate; add anti-antibody; add chromagen; the level of dye will determine the concentration of anti-antibody and the concentration of the original antigen by extension |
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Term
|
Definition
| different cells are colored differently and sorted |
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|
Term
| Cytotoxic Lymphocyte Assay (CTL) |
|
Definition
| mix p815 tumor cell with splenocytes; and sensitize for five days; mix with c51-marked tumor cells; meausure radiation release for lymphocytic activity |
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|
Term
| DHR - Delayed Hypersensitivity Response |
|
Definition
| uses 125 iododeoxyuridine; sensitize mice to KLH; add KLHto ear, measure radiation in that ear v control |
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Term
|
Definition
| infect animal with pollutatant and then infectious agent to determine how immunocomprimised the pollutant made it |
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|
Term
| diethylstilbestrol effects on immune system |
|
Definition
| can depress thymus and prevent t-cell maturation; decreased Mixed Lymphocyte Response; Delayed Type Hypersensitivity; reduces macrophage efficacy |
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|
Term
| glucocorticoid effect on immune response |
|
Definition
| causes lymphocyte depletion; IL-1 and IL-2 suppressed which means no b-cell stimulation; this is a macrophage accessory function |
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Term
|
Definition
| antineoplastic; suppress humoral and cell-mediated responses; suppresses Ig production, DHR, CTL, MLR |
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Term
|
Definition
| antimetabolite; blocks cell replication; antinflammatory by blocking PMN and monocyte; suppresses IgG, CMI, DHR, MLR, GVH (grav versus host) |
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Term
|
Definition
| lacks meylotoxicity; limited by hepato and nephrotoxicity; specific to T-cells through TCR; inhibits IL-2 transcription and t-cell proliferation |
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|
Term
| cocaine and immunosuppression |
|
Definition
| inhibits superoxide production; enhances replication of HIV in vivo |
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Term
|
Definition
| reduced PMN chemotaxis; inhibits PFC response; inhibits t-cell response to mitogen and to IL-2 |
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|
Term
| tobacco immunosuppression |
|
Definition
| macrophage lack enzymes; cannot produce IL-1; decreased serum Ig; NK; |
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|
Term
| Type 2 hypersensitivity mediation |
|
Definition
|
|
Term
| Type 3 hypersensitivity mediation |
|
Definition
|
|
Term
| Type 4 hypersensitivity mediation |
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Definition
|
|
Term
| mechanism leading to anaphylaxis |
|
Definition
| suppressor t-cell deficit leads to excess IgE |
|
|
Term
| three phases of allergic sensitization |
|
Definition
| activation, sensitization, effector |
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|
Term
| pharmacological therapy for type I |
|
Definition
| antihistamine, epinephrine, cromolyn Na (stabilizes mast cells) |
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|
Term
| immunologic therapy for type I allergic reaction |
|
Definition
| repeated antigen injections |
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|
Term
|
Definition
| free antibody spike after antigen is cleared attacks biological system - it attracts neutrophils which does the main damage |
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|
Term
| difference between type II and type III reaction |
|
Definition
| in type II complement destroys cell, in type III it is neutrophil |
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|
Term
| characteristic type IV hypersensitivity response |
|
Definition
| t-cells and macrophage; IL-2, IL-4, IL-5 produced; IL-2 activates t-cells and stimulates macrophage; MHC-1 presents virus infected cell and adaptive response kills all similar cells |
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|
Term
| penicillin and drug allergies |
|
Definition
| most common agent generating allergic response, produces type I-IV; causes 75% of all deaths due to anaphylaxis; type II v penicillin bound to RBC; finally type IV eczema after topical |
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|
Term
| acid anhydride allergic reactions |
|
Definition
| can generate type I - type IV response |
|
|
Term
| immune sample question: absence of germinal centers in lymph node attributal to what? |
|
Definition
|
|
Term
| immune sample question: type I hypersensitivity mediated by which antibody? |
|
Definition
|
|
Term
| volume contraction and metabolic alkalosis |
|
Definition
| volume contraction decreases GFR which decreases elimination of bicarb |
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|
Term
| causes of metabolic alkalosis |
|
Definition
| excess H+ loss from stomach; administration of bases like lactate and acetate; loop and thiazide diuretics - leads to H+ excretion with Na; increased mineralcorticoids increase collecting duct excretion; increased ammoniagenesis; high dose of penicillins (increases electronegativity of duct); |
|
|
Term
|
Definition
| expand vascular volume; normal saline replaces volume and Cl; |
|
|
Term
| 2% weight loss; normal turgor; small reduction in urine output |
|
Definition
| 20ml/kg saline restoration; |
|
|
Term
|
Definition
20% reduction in ECF; replace w/40ml/kg saline
symptoms: decreased turgor; CNS effects; hypotension, pulse rapid and weak |
|
|
Term
|
Definition
| 30% loss of ECF; replace 60ml/kg symptoms: BUN SCR > 20; skin blue and cool |
|
|
Term
| treatment of chloride responsive alkalosis in volume overload |
|
Definition
| carbonic anhydrase inhibitor (acetozalamide)which promotes excretion of bicarb; |
|
|
Term
| treatment of non-chloride responsive alkalosis in volume overload |
|
Definition
| remove offending tumor through surgery; give spironolactone or a potassium sparing diuretic; for patient on exogenous steroid change away from mineralcorticoid to glucocorticoid |
|
|
Term
| metabolic alkalosis associated with nasogastric suction treatment |
|
Definition
| omeprazole or H2 antagonist |
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|
Term
|
Definition
| associated with hypokalemia; acid cannot be excreted so potassium is excreted instead |
|
|
Term
|
Definition
| associated with hyperkalemia; low aldosterone leads to hyperkalemia; potassium involved with ammonia synthesis; ammonia carries hydrogen ions from body |
|
|
Term
| carbonic anhydrase inhibitors role in anion gap |
|
Definition
| increase excretion of bicarb |
|
|
Term
| causes of increasing anion gap |
|
Definition
| ketoacidosis; lactic acid; renal failure; salicylate overdose |
|
|
Term
|
Definition
| proximil tubule rta; reabsorption of bicarb is hindered leading to alkalosis |
|
|
Term
| alkalosis and calcium binding |
|
Definition
| acidosis increases binding; alkalosis decreases is; decreased binding can lead to hypcalcemia and tetany |
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