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USMLE1 HemeOnc Non-Pharm
N/A
23
Medical
Graduate
04/15/2011

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Cards

Term
Sequence of granulocyte differentiation? (5)
Definition
Promyelocyte
Myelocyte
Metamyelocyte
Band
Granulocyte (Neutrophil, Eosinophil, Basophil)
Term
RBC energy source?
Definition
All glucose, anaerobic
90% via lactate dehydrogenase
10% via HMP shunt
Term
Platelets:
Dense granules?
Alpha granules?
vWF receptor?
Fibrinogen receptor?
Life span?
Definition
Dense: ADP, calcium
Alpha: vWF, fibrinogen
vWF: GpIb
Fibrinogen: GpIIb/IIIa
Lifespan: 8-10 days
Term
Mast cell granule contents?
Definition
Histamine
Heparin
Eosinophil chemotactic factors
Tryptase (specific marker)
Term
Basophil granule contents?
Definition
Histamine
Heparin
Leukotrienes (D4)
Term
Eosinophil granule contents?
Definition
Major basic protein (anti-helminthic)
Histaminase, arylsulfatase (anti-allergenic)
Term
Neutrophil granule contents?
Definition
Hydrolytic enzymes
Lysozyme
Myeloperoxidase
Lactoferrin (multiple antibiotic effects)
Term
Bernard-Soulier syndrome?
Definition
Lack GpIb. Platelets cannot bind vWF.
Term
Glanzmann's thrombasthenia?
Definition
Lack GpIIb/IIIa - no fibrinogen crosslinking.
Term
Hereditary sideroblastic anemia
Definition
X-linked defect in ALA synthase gene.
Ringed sideroblasts (RBC w/ iron laden mitochondria), high Fe, normal TIBC, high ferritin.
B6 therapy.
Term
Lead poisoning
Signs
Tx
Definition
LEAD
Lead lines on gingiva (Burton's lines)
Encephalopathy and Erythrocyte basophilic stippling
Abdominal colic, sideroblastic Anemia
Drops: wrist and foot.
Dimercaprol, EDTA, Succimer in children
Term
Anemia of chronic disease
Definition
Inflammation causes increased hepcidin release, decreased release of iron from macrophages.
Low Fe, low TIBC, high ferritin.
Term
Aplastic anemia causes
Definition
Radiation
Drugs (chemo, toxins)
Viral (B19, EBV, HIV, HCV)
Fanconi's anemia (congenital DNA repair defect)
Idiopathic (autoimmune, may follow acute hepatitis)
Term
HbM defect
Definition
mutation in heme binding pocket of alpha or beta chain. Most common His -> Tyr. Persistent methemoglobinemia (resists reduction to Fe2+)
Term
Give lab values: Fe, TIBC, Ferritin, %Transferrin saturation.
Fe deficiency
Chronic disease
Hemochromatosis
Pregnancy/OCPs
Lead poisoning
Definition
Fe def: low Fe, high TIBC, low ferritin, low T%
ChronicDz: low Fe, lower TIBC, high ferritin, high T%
Hemo: high Fe, low TIBC, high ferritin, high T%
Preg: norm Fe, high TIBC, norm ferritin, low T%
Lead: high Fe, low TIBC, norm ferritin, high T%
Term
Acute intermittent porphyria
Definition
Lack porphobilinogen deaminase.
Accumulate porphobilinogen, ALA, uroporphyrin (in urine).
Sx: 5Ps
Painful abdomen
Pee red
Polyneuropathy
Psychological disturbance
Precipitated by drugs
Tx: glucose and heme, inhibit ALA synthase
Term
Porphyria cutanea tarda
Definition
Lack uroporphyrinogen decarboxylase.
Accumulate uroporphyrin - tea colored urine
Blistering cutaneous photosensitivity.
Most common porphyria.
Term
Idiopathic Thrombocytopenic Purpura
Definition
anti-GpIIb/IIIa antibodies. Platelet destruction.
Increased megakaryocytes.
Term
Thrombotic thrombocytopenic purpura
Definition
Antibodies to ADAMTS13 (vWF metalloprotease).
Large vWF multimers, platelet aggregation, thrombosis.
Schistocytes, high LDH (microangiopathic hemolytic anemia).
PENTAD: Neuro, Renal, Fever, Thrombocytopenia, Microangiopathic hemolytic anemia
Term
Teardrop RBC?
Definition
Myelofibrosis
Term
JAK2 mutations associated with what diseases?
Definition
Chronic myeloproliferative disorders
(Polycythemia vera, Essential thrombocytosis, Myelofibrosis)
Increasingly sensitive to growth factors.
Term
What markers indicate better ALL prognosis? (2)
Definition
t(12;21)
CD10 (CALLA) positive
Term
Pure Red Cell Aplasia
Definition
Absence of erythroid cells and precursors, with normal granulopoiesis, thrombopoeisis.
Idiopathic, thymoma association, or parvovirus B19 associated (preferentially destroys proerythroblasts).
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