451654
Description
Flashcards by littlebluechair, updated more than 1 year ago
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Created by littlebluechair
almost 11 years ago
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| Question | Answer |
| From which embryonic layer are angioblasts derived? | Mesoderm. |
| Name the site of red blood cell production during each of the following developmental phases. | First trimester-yolk sac Second trimester-liver and spleen Third trimester- central and peripheral skeleton Postpartum-Axial skeleton |
| What is the most common inherited hypercoagulable state? | Factor V leiden. |
| The factor V leiden mutation inhibits factor V cleavage by which protein? | Protein C |
| What is the effect of estrogen, endogenous or exogenous, on thrombosis? | Estrogen induces a hypercoagulable state. |
| What clotting factors require vitamin K for their synthesis? | Factors 2, 7, 9, 10 and protein C and S. |
| What common laboratory test is used to access the intrinsic coagulation system? | Partial thromboplastin time (PTT) |
| What common laboratory test is used to assess the extrinsic coagulation pathway? | Prothrombin time (PT) |
| What commonly used anticoagulant interferes with the extrinsic pathway? | Warfarin. |
| The use of the chelator, ethylene diamine tetra acetate (EDTA), as an anticoagulant, in tubes is designed to inactivate what factor in the blood? | Calcium |
| What inhibitor of the coagulation cascade inactivates factor Va and VIIIa? | Protein C |
| What are the two major functions of von Willebrand factor? | Transport of factor VIII Linkage of platelets and collagen. |
| Dysfunction of what clotting component results in mucous membrane hemorrhage, petechiae, purpura, and prolonged bleeding time? | Platelet abnormalities |
| Dysfunction of what clotting component results in hemarthroses, purpura, and prolonged PT and/or PTT? | Coagulation factor abnormalities |
| Name the coagulopathy associated with the following clinical and pathologic features: Most common hereditary bleeding disorder | von Willebrand disease |
| Most common type of hemophilia | Hemophilia A (factor VIII deficiency) |
| Most common cause of acquired platelet dysfunction | Aspirin use |
| Autosomal dominant (AD) disorder causing increased bleeding time | von Willebrand disease |
| Autosomal recessive defect in platelet adhesion caused by GpIIb/IX | Bernard-Soulier disease |
| AR defect in platelet aggregation caused by deficiency of GpIIb/GpIIIa, a membrane receptor responsible for binding fibrinogen. | Glanzmann thrombasthenia |
| Common presentation includes hemarthroses and easy bruising, increased PTT, normal PT | Hemophilia A and B. |
| Prolonged bleeding time with normal platelet count, normal PT and increased PTT | von Willebrand disease |
| Prolonged PT, PTT, increased bleeding time, thrombocytopenia, presence of fibrin split products | Disseminated intravascular coagulation (DIC) |
| Normal PT, PTT, normal platelet count, increased bleeding time | Aspirin use |
| Syndrome characterized by antiplatelet antibodies (commonly anti-Ib-IX or IIb-IIIa), often post-viral infections | Idiopathic thrombocytopenia (ITP) |
| Syndrome characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever and neurologic symptoms | Thrombotic thrombocytopenic purpura (TTP) |
| Widespread hyaline microthrombi in arterioles and capillaries causing schistocytes and helmet cells. | Microangiopathic hemolytic anemia |
| Splenomegaly, epistaxis, petechiae, generalized tender lymphadenopathy, serum antibodies (+) | SLE-autoimmune thrombocytopenia |
| List five of the most common causes of microcytic anemia | Iron deficiency, lead poisoning, chronic disease, sideroblastic, thalassemia. |
| List four of the most common causes of normocytic anemia | Sickle cell anemia, Aplastic anemia, acute blood loss, hemolytic anemia. |
| List five of the most common causes of macrocytic anemia | Liver disease Vitamin B12 deficiency Folate deficiency Alcoholism Hypothyrodism |
| What is the primary site of iron absorption? Vitamin B12? Folate? | Iron absorption- Duodenum Vitamin B12-Terminal ileum (need intrinsic factor) Jejunum-Folate |
| What is the major cause of iron deficiency anemia in adults? | Menorrhagia or gastrointestinal (GI) bleeding (colon cancer, ulcers) |
| What are two common clinical complaints in an anemic patient? | Dyspnea on exertion Fatigue |
| Which amino acid substitution in the B globin gene is most commonly seen in sickle cell anemia? | Glu6-Val |
| What is the major type of hemoglobin in homozygous sickle cell anemia? | HbS |
| In sickle cell disease, what is the mechanism of ischemic necrosis of the bones, lungs, liver, brain, spleen or penis? | Decreased oxygen tension, abnormal RBCs sickle, microvascular occlusions |
| What is the major regulatory enzyme in heme biosynthesis? | Aminolevulinate (ALA) synthase |
| What two common enzyme deficiencies can cause hemolytic anemia? | Glucose 6 phosphate dehydrogenase (G6PD) Pyruvate kinase. |
| What hemolytic anemia is associated with exposure to oxidant stress? | G6PD deficiency |
| What two common RBC membrane defects can cause hemolytic anemia? | 1) Hereditary spherocytosis 2) Paroxysmal noctural hematuria (PNH) |
| What common cause of atypical pneumonia is associated with cold immune hemolytic anemia? | Mycoplasma pneumoniae |
| What type of anemia is caused by lack of intrinsic factor (IF) secretion by gastric parietal cells? | Pernicious anemia (vitamin B12 deficiency) |
| What two autoimmune diseases of the GI tract can cause megaloblastic anemia? | Pernicious anemia (Due to lack of intrinsic factor production) Crohn disease of the distal ileum (due to lack of the intrinsic factor-B12 complex reabsorption) |
| What parasites are capable of causing megaloblastic anemia? | Diphyllobothrium latum (by depleting B12) and Giardia lambia (by depleting folate) |
| How does gastric resection cause megaloblastic anemia? | Parietal cells, which are responsible for intrinsic factor production may be removed when the gastric fundus is resected. |
| What type of malignancy is associated with pernicious anemia? | Gastric carcinoma |
| Name three medications capable of causing autoimmune hemolytic anemia? | Penicillin, Cephalosporins, Quinidine |
| What types of malignancies are associated with autoimmune hemolytic anemia? | Leukemias and lymphomas. |
| What laboratory tests are seen in hemolytic anemia? | Increased in unconjugated bilirubin, increased urine urobilinogen, decreased hemoglobin, hemoglobinuria, decreased haptoglobin, hemosiderosis. |
| Name two commonly used medications that can cause aplastic anemia | Nonsteroidal anti-inflammatory drugs (NSAIDs), Chloramphenicol |
| What test is used to monitor anticoagulation in a patient treated with heparin? | PTT |
| What test is sued to monitor anticoagulation in a patient treated with warfarin? | PT |
| What happens to the total iron binding capacity, serum iron concentration and percent saturation of transferrin in each of the following diseases? | Iron deficiency anemia: Increased TIBC, Decreased serum iron, Decreased % saturation Anemia of chronic disease:-Decreased TIBC, Decreased serum iron, normal saturation Iron overload-Normal TIBC, Increased serum iron, maximal saturation |
| Name the types of anemia associated with the following clinical and pathologic features: | Most common type of anemia-Iron deficiency anemia Abnormal Schilling test-Pernicious anemia |
| ABO incompatility, lymphoid neoplasm, Raynaud phenomena, anti-i antibodies | Cold autoimmune hemolytic anemia |
| Atrophic glossitis | Pernicious anemia |
| Autosplenectomy | Sickle cell anemia |
| Basophillic stipling of erythrocytes, blue/gray discoloration at gumline, wrist/foot drop | Anemia from lead poisoning |
| Celiac sprue | Folate deficiency anemia (megaloblastic) |
| Chronic atopic gastritis | Pernicious anemia |
| Colon cancer | Iron deficiency anemia (early) and anemia of chronic disease (late) |
| Crescent-shaped erythrocytes and Howell-Jolly bodies | Sickle cell anemia |
| Deficiency of a or B globin gene synthesis | Thalassemia |
| Deficiency of decay accelerating factor | Paroxysmal noctural hemoglobinuria. |
| Demyelination of the dorsal and lateral tracts of the spinal cord | Pernicious anemia |
| End stage liver disease | Macrocytic anemia |
| Helmet cells, burr cells, triangular cells | Microangiopthic anemia (secondary to DIC, thrombocytopenic purpura, hemolytic-uremic syndrome (TTP-HUS), or mechanical heart valves) |
| Hypersegmented polymorphonuclears (PMNs) | Vitamin B12 or folate deficiency anemia |
| Increased serum lactate dehydrogenase | Hemolytic anemia |
| Microcytosis, atopic glossitis, esophageal webs (Plummer-Vinson syndrome) | Iron deficiency anemia |
| Pancytopenia and fatty infiltration of bone marrow | Aplastic anemia |
| Systemic lupus erythematosus (SLE), chronic lymphocytic leukemia (CLL), lymphomas, drugs +direct Coombs test (due to IgG autoantibodies) | Warm autoimmune hemolytic anemia |
| AD deficiency of spectrin, positive osmotic fragility test | Heriditary spherocytosis |
| What are the two major categories of lymphoma? | Hodgkin disease Non-hodgkin lymphoma |
| Interleukin (IL-5) secreting Reed Sternberg cells | Hodgkin disease |
| Commonly arises from B cells | Non-hodgkin lymphoma |
| Constitutional symptoms including both fever, night sweats weight loss | Both |
| Mediastinal lymphadenopathy, contiguous spread | Hogkin disease |
| Many cases associated with Epstein Barr virus | Hodgkin disease |
| Peripheral lymphadenopathy, noncontiguous spread | Non-hogkin lymphoma |
| Bimodal age distribution, but most common in young men | Hodgkin disease |
| Peak incidence from 20 to 40 years of age | Non hodgkin lymphoma |
| Associated with immunosuppression including AIDS | Non hodgkin disease |
| Painful lymphadenopathy with alcohol consumption | Hodgkin disease |
| Most common hodgkin disease | Nodular sclerosis |
| Abundance of RS cells | Mixed cellularity |
| Lacunar cells and collagen binding | Nodular sclerosis |
| Commonly seen in older patients with Hodgkin disease | Mixed cellularity |
| Widely disseminated disease with poor prognosis | Lymphocyte depletion |
| Most common in females | Nodular sclerosis |
| Abundance of lymphocytes | Lymphocyte predominance |
| Commonly seen in men 35 years presenting with cervical or axillary lymphadenopathy | Lymphocyte predominace |
| Higher proportion of RS cells relative to lymphocytes | Lymphocyte depletion |
| Overexpression of cyclin D1 | Mantle cell lymphoma |
| Starry-sky appearance on histopathology | Burkitt lymphoma |
| Clinically similar to CLL: characterized by nodules of small lymphocytes | Small cell lymphocytic lymphoma |
| Older adults with BCL2 gene mutation | Follicular lymphoma |
| Often appear at extranodal sites and can cause small bowel obstruction | Diffuse large cell lymphoma |
| Child presenting with enlarging mandibular mass | Burkitt lymphoma |
| Common in children who present with a mediastinal mass and a syndrome similar to that of acute lymphocytic leukemia (ALL) | Lymphoblastic lymphoma |
| TdT+ lymphocytes | Precursor B or T cell acute lymphoblastic leukemia/lymphoma |
| Endemic in Africa and associated with Epstein Barr virus | Burkitt lymphoma |
| 0-14 years old | acute lymphocytic leukemia |
| 15-39 years old | Acute myelogenous leukemia |
| 40 to 59 years old | Acute myelogenous leukemia and chronic myelogenous leukemia |
| More than 60 years old | Chronic lymphoblastic leukemia |
| Very high white cell counts, often more than 200,000 | Chronic myelogenous leukemia |
| Isolated lymphocytosis | chronic lymphoblastic leukemia |
| TdT+ lymphoblasts | Acute lymphocytic leukemia |
| Name the four chronic myeloproliferative disorders | Chronic myelogenous leukemia Polycythemia vera Essential thrombocytosis Myelofibrosis with myeloid metaplasia |
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