Term
| A term used to describe erythrocytes that are larger than normal (>100fL). May be indicative of several underlying issues (6). How would you treat it? |
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Definition
Macrocytosis
B12 deficiency
Folate deficiency
Myelodysplasia
Drug/alcohol use
Liver dz
high reticulocyte count (machine error)
Treatment: treat the underlying issue that's causing the macrocytosis |
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Term
In what disease are smudge (aka basket) cells present?
What makes them smudged? |
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Definition
Chronic lymphoid leukemia (CLL)
in CLL, there is an increase in the number of monoclonal B lymphocytes that express the CD5 antigen. These lymphocytes tend to smudge when smeared on a slide. |
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Term
| ___ is a tyrosine kinase that plays a significant role in the etiology of polycythemia vera. It is located on the short arm of chromosome 9(p). When thrombopoietin and erythropoietin bind to their receptors, it leads to the autophosphorylation of this enzyme, which phosphorylates the proteins responsible for cell proliferation, differentiation, and resistance to apoptosis. Thus, when this enzyme is activated, too many RBCs and platelets are produced, which leads to viscous blood. |
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Definition
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Term
____: seen in a peripheral blood smear, these are dense, small, blue protein debris from the nucleus of RBCs that are normally removed by the spleen by persist in pts that have had a splenectomy. They can also be seen in pts with defective spleen.
They are basophilic nuclear remnants found in circulating erythrocytes. |
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Definition
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Term
Rai system: staging system for what disease?
Which stages?
A. lymphadenopathy is present
B. Anemia
c. Absolute lymphocyte count >5,000
D. Thrombocytopenia
E. Splenomegaly or hepatomegaly (indicates spread to other organs) |
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Definition
Stage 0 - Absolute lymphocyte count >5,000
Stage 1 - Stage 0 + lymphadenopathy
Stage 2 - Stage 1 plus hepatosplenomegaly
Stage 3 - anemia
Stage 4 - thrombocytopenia + other symptoms |
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Term
| ___: seen in a peripheral blood smear, it is characterized by diffuse fine or coarse blue dots in a RBC. The blue dots usually represent RNA residue and are common characteristics in what two diseases? |
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Definition
Basophilic stippling.
lead poisoning and toxic thalassemia |
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Term
| ____: triggered by an infection and characterized as a microangiopathic hemolytic anemia with fragmented RBCs in the peripheral blood smear, mild thrombocytopenia, and acute renal failure. It is caused by an inherited defect in complement regulatory proteins which are activated when an infection occurs. The syndrome can recur and when it does, it has a very serious prognosis. |
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Definition
| Hemolytic uremic syndrome |
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Term
Paroxysmal Noctural Hemoglobinuria
What is the unique clinical triad?
What are the 3 possible outcomes?
How do pts usually present? |
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Definition
hemolysis
pancytopenia
venous thrombosis
3 outcomes: AML, aplastic anemia, or spontaneous full recovery
pt usually presents after passing blood instead of urine |
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Term
| What are the two hematopoietic lines from which RBCs and WBCs originate? |
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Definition
erythroid: RBCs
granulocytic: WBCs
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Term
| What 6 things must be present for hematopoiesis to occur? |
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Definition
stem cells
proper env
B12
folic acid
iron
erythropoietin
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Term
____ is a hormone that is secreted in the renal cortex in response to low O2 saturation in the blood. It is the body's main way of regulating the production of RBCs.
When it binds to its receptors in the bone marrow, it initiates a ___ cascade and it initiates the production of ___. |
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Definition
erythropoieitin
JAK2, Hemoglobin |
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Term
| Progression of WBC production |
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Definition
Hematopoeitic stem cell
V (IL3 and colony stimulating factor)
Myeloblast
V
promyelocyte
V
Myelocyte (neutrophilic, basophilic, eosinophilic)
V
metamyelocyte
V
Band cell
V
Granulocyte |
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Term
| What is the most common type of anemia |
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Definition
|
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Term
| What are some processes by which iron deficiency anemia via malabsorption could occur? |
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Definition
celiac disease
pernicious anemia
crohn's disease
gastric bypass
antacids |
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Term
| what is the general underyling process of anemia of chronic disease? |
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Definition
| cytokines released by leukocytes (through a variety of effects) reduce hemoglobin levels |
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Term
| What does it mean if bone marrow is hypocellular? |
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Definition
| more fat than hematopoeitic cells |
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Term
| 3 main causes of aplastic anemia |
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Definition
damage of the hematopoeitic cell department that causes bone marrow to become hypocellular
drug injury
immune-mediated injury - causes T cells to become cytotoxic |
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Term
| ____ is the most common chronic myeloproliferative disroder |
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Definition
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Term
| If pt presents with erythrocytosis and leukocytosis, thrombocytosis, or both... think what disease? |
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Definition
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Term
A young RBC that contains no nucleus but has residual RNA.
Mature to RBC within ___ days of being released into peripheral blood.
Comprise about __% of circulating RBCs
Increased concentration seen in what two conditions?
Decreased concentrations seen in what 3 conditions? |
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Definition
Reticulocyte
2 days
1%
Increased: hemolytic anemia or blood loss
Decreased: ineffective erythropoeisis, aplastic anemia, and hypocellularity of bone marrow |
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Term
| The hemoglobin content of the average RBC. |
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Definition
| Mean corpuscular hemoglobin (MCH) |
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Term
| An actual increase in the number of leukocytes in the blood, as distinguished from a relative increase |
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Definition
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Term
| What is a condition in which there may be a relative ((not actual) increase in the number of leukocytes in the blood |
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Definition
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Term
| A condition in which the number of leukocytes in the circulating blood is lower than normal (4,000-5,000/mm3) |
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Definition
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Term
| Loss of structural differentiation, especially seen in most malignant neoplasms |
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Definition
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Term
The time required for clotting after thromboplastin and calcium are added to blood. If this time is diminished, the clotting time increases or decreases?
This is used to evaluate intrinsic or extrinsic clotting system? |
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Definition
prothrombin time (PT)
increases
extrinsic |
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Term
| The prothrombin time ratio that would have been obtained if standard reagent had been used in a prothrombin time determination. |
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Definition
| INR (international normalized ratio) |
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Term
| Any of a family of genes which, under normal circumstances, code for proteins involved in cell growth or regulation but may foster malignant processes ifmutated or activated by contact with retroviruses |
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Definition
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Term
A toxic change in a neutrophil that results in rapid cell growth, which leaves old/immature cytoplasm in the cell which present as blue spots when stained (known as basophilic granulation).
What is this indicative of? |
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Definition
Dohle body
indicative of bacterial infection |
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Term
| ____: a complex process which causes bleeding or hemorrhage to stop. can be acheived throguh what 3 processes? |
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Definition
| hemostasis: vascular vasoconstriction, coagulation via fibrin clot, thrombus formation (white clot) via platelets |
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Term
| 2 main pathways through which blood clotting occurs: |
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Definition
| contact system and tissue factor |
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Term
| Explain the contact system of coagulation |
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Definition
activate by damage to a vessel that leaves the vascular endothelium exposed (cute, viral infection)
1. Factors XII, XI, IX, and VIII are activated.
2. These factors activate Factor X
3. Factor X converts prothrombin to thrombin (under regulation of factor V)
4. Thrombin converts fibrinogen to fibrin
5. Fibrin forms a clot
Clot breakdown:
Fibrin is converted to FDP (a D-dimer) by plasmin |
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Term
| Explain the tissue factor method of coagulation |
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Definition
Damaged cells are dumped out into the body, as in severe trauma to the brain
1. Factor VII activates Factor X
2. Factor X converts prothrombin to thrombin
3. thrombin converts fibriongen to fibrin
4. fibrin forms a clot
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Term
What test is done to see how the contact system of coagulation is working?
what else does it check? |
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Definition
PTT (partial thromboplastin time)
also for unfractionated heparin & hemophilia |
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Term
What test is done to measure the tissue factor system of coagulation?
What else does it measure? |
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Definition
PT/INR (protime)
also Coumadin (warfarin) and to evaluate liver fxn |
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Term
| Where are almost all coagulation factors made? |
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Definition
| liver (except for Factor VIII) |
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Term
| Coagulation is vitamin __ dependent |
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Definition
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Term
Large B lymphocytes with large cytoplasmic:nuclear ratio. Appear as "owl eyes" under the microscope as they are either multinucleated or have bi-lobed nuclei.
What disease are these cells NECESSARY for the diagnosis of? |
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Definition
reed-sternberg cells
Hodgkin's lymphoma |
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Term
| What are the "b" symptoms |
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Definition
Pel-Ebstein (cyclic) fever
weight loss
drenching night sweats
generalized pruritis
alcohol-induced pain
anemia |
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Term
| Staging via Ann Arbor Staging classification |
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Definition
Stage 1: one lymph node region
Stage II: two lymph node regions on one side of the diaphragm
Stage III: Lymph node involement on both sides of the diaphragm
Stage IV: disseminated disease with bone marrow or liver involvement
Stage A: no constitutional symptoms
Stage B: 10% weight loss over 6 mos, fever, or night sweats |
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Term
| What drugs are included in RCHOP? |
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Definition
| rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone |
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Term
| What are some factors that would create a poorer prognosis for Hodgkin's? |
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Definition
age
bulky tumors
lymphocyte depletion or mixed cellularity
recurrence |
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Term
| What are some things to take into account in follow up of a hodgkin's pt? |
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Definition
complications from chemo
immunosuppresion after lymphoma is gone
particular susceptibility to haemophilus and pneumococcus |
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Term
| 5 year survival rates for Non-Hodgkin's |
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Definition
Low grade: 75%
Low-Intermediate: 51%
High-intermediate: 43%
High: 26% |
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Term
| Hereditary disorders characterized by reduction in the synthesis of globin chains (a or B). Reduced globin synthesis causes reduced Hb synthesis and eventually produces a hypochromic, microcytic anemia bc of the defective hemoglobinization of RBCs. are considered hypoproliferative anemais, hemolytic anemias, and anemias related to abnormal hb. |
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Definition
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Term
| Follow up for thalassemias |
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Definition
| serious disease requires frequent transfusions and close watch for iron overload |
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Term
|
Definition
| combo pancytopenia and circulating blasts plus no evidence of myeloid lineage on CBC |
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Term
What are some microcytic anemias?
What are some characteristics of them? |
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Definition
MCV < 76fL
Hypochromic RBCs = lower MCH
iron deficiency
thalassemia
sideroblastic anemia
anemia of chronic disease
lead poisoning
pyridoxine deficiency
myeloma |
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Term
What are some macrocytic anemias?
What are some characteristics? |
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Definition
MCV > 100fL
Hgb lower than normal
megaloblastic anemias (folate and B12 deficiency)
Polycythemia vera |
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Term
| pancytopenia with hypocellular bone marrow biopsy containing no abnormal cells. what diagnosis? |
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Definition
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Term
| General term for immature or precursor blood cells |
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Definition
|
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Term
| an erythroblast containing granules of ferritin stained by prussion blue reaction |
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Definition
|
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Term
| pronounced reductionin the number of erythrocytes, all types of leukocytes, and platelets in circulating blood |
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Definition
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Term
| Hypersegmented polymorphonuclear cells - what are they and when would you expect to see them? |
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Definition
| increased number of nuclear lobes, seen in hyperadrenocorticism or during treatment with corticosteroids and in blood that has been in transit for long periods |
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Term
| the presence of many microcytes in circulating blood |
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Definition
| Microcytosis (microcythemia) |
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Term
| the average volume of RBCs calculated from Hct and RBC count |
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Definition
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Term
the presence of abnormally shaped RBCs in peripheral blood
The presence of abnormally sized RBCs |
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Definition
poikilocytosis
anisocytosis |
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Term
| an abnormal minute chromosome, formed by a rearrangement of chromosome 9 & 22, found in cultured leukocytes of many pts with which disease? |
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Definition
philadelphia chromosome
chronic myelogenous (granulocytic) leukemia
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Term
a screening procedure to detect congenital and acquired platelet disorders; test is performed at bedside and usually lasts 1-3 minutes.
May be prolonged in what cases? |
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Definition
bleeding time
thrombocytopenia, hemophilia, diminished prothrombin, liver disease, phosphorous or chloroform poisoning |
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Term
| Cancers caused by tobacco use |
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Definition
lung, oral cavity, naso, oro, hypopharynx, nasal cavity, sinuses, larynx, esophagus, stomach, pancreas, liver, kidney, ureter, urinary blader, cervix, myeloid leukemia, colorectal cancer, breast cancer
synergistic effect with alcohol
increases with increased packs/day |
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Term
| How is the genetic influence for cancer controlled? |
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Definition
Protoncogenes that have a gain of function to become oncogenes
Gatekeeper & caretaker (tumor suppressor) genes - BRCA 1 & 2 and P53.
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Term
| ____ are platelet precursor cells |
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Definition
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Term
| What are some things that could cause thrombocytopenia? |
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Definition
1. isolated event (drug-induced, infection)
2. ITP
3. TTP
4. Occult leukemia
5. HIV
6. enlarged spleen
7. aplastic anemia
8. pseudothrombocytopenia
9. myelodysplasia
10. B12 deficiency
11. sepsis
12. microangioplastic hemolytic anemia
13. chemo/radiation |
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Term
| What's an indication for a direct coombs' test? |
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Definition
hemolytic anemias (autoimmune, ITP)
Pos if coagulation occurs after addition of anti-human antibodies |
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Term
| What's an indication of an indirect Coombs' test? |
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Definition
Prenatal testing, prior to blood transfusion
pos if coagulation occurs when put in contact wtih RBCs of unknown antigenicity |
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Term
| ___ is the most common inherited bleeding disorder |
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Definition
|
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Term
| what kind of cancer does a person with AIDS have an increased chance for? |
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Definition
| those associated with viruses (cervical, lymphoma, kaposi's sarcoma) |
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Term
what are some characteristics of neoplastic cells?
What are two particularly special characteristics? |
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Definition
pleiomorphic
large nuclear/cytoplasmic ratio
frequent mitosis
loss of orderly maturation/differentiation
loss of cell-cell cohesion
loss of vulnerability to apoptosis
special:
Reduced repair capacity (makes them susceptible to chemo)
Able to and must promote angiogenesis es, VEGF |
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Term
what TNM stage?
2 cm breast cancer with neg nodes and no distant metastasis |
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Definition
|
|
Term
| 2 major toxicities of cancer cells |
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Definition
|
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Term
Monoclonal antibody nomenclature infix:
Target:
Tu =?
Neu = ?
Cir = ?
Type:
xi = ?
zu = ? |
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Definition
tu - tumor
neu - neural
cir - circulation/blood cells
xi- chimeric
humanized - zu |
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Term
|
Definition
a protooncogene that should be turned off in adulthood
it is positive in about 1/3 of breast cancers and represents a worse prognosis |
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