Hematology Vocabulary Flashcards

Hemoglobin
Terms Definitions
poly-
many
MCHC calculation
HGB
HCT
hyper-
above, beyond, extreme
rubricyte
12-15 μmN:C= 4:1
fanconi
shows hemoglobin F
Most common CF mutation
F508
Histiocyte
A large fixed macrophage.
Leukocytosis
increased number of WBCs
MDS treatment
Supportive-transfusions, growth factors, iron chelation (prevent transfusion toxicity)
5-Azacytadine
Lenalidomide
Chemo
Stem Cell transplant
what is thrombocytosis
excessive platelets
Howell-Jolly Bodies
Occur in megaloblastic conditions
Tx for PNH
Eculizumab (against C5)
Band
An immature neutrophilic granulocyte with a horseshoe or sausage-shaped nucleus (also called a stab). Comprises 2 to 6 percent of the normal differential count (segmented).
PO₂for alveolar capillaries
almost 100 torrs
Hodgkin disease presentation
nontender lynmphadenopathy
cervical, supraclavicular or axillary nodes are most common
B symptoms are drenching night sweats, 10% weight loss, fever
Neutropenia acquired, intrinsic causes
Leukemia
MDS
Myeloproliferative disorders
Aplastic anemia -- also extrinsic -- immune mediated
Prolymphocytoid transformation
Another CLL transformation

Larger cells, less distinct nucleoli, less dense chromatin
Refractory
ESR
erythrocyte sedimentation rate; shows inflammation or tissue destruction
Whats better dying or living
Living
negative
Erythropoeisis is what kind of feedback?
What does Bleeding Time test?
Primary Hemostasis
favorable genetics in ALL
"hyperdiploidy, Philly unfavorable"
Leuprolide
Mech.: Acts on pituitary to inhibitFSH and LH release Use: Prostate cancer
Homozygous
Possessing identical alleles in regard to a given characteristic.
peripheral neuropathy ret decreased production of myelin is evident with what anemia
perniciouis anemia.
Why are red blood cells red?
hemoglobin
hemophilia etiology
x-linked recessive; manifests in males; females are carriers
Describe echinocytes.
Burrlike erythrocyte with short, evenly spaced projections. Aka burr cell or crenated cell.
Sickle cell clinical manifestation
Anemia
Aplastic episodes (parvovirus)
Delayed growth
Pigment gallstones
Vasooculusion -Avascular hip necrosis, priapism, pain, acute chest, stroke
Leg uclers
etc
vWF epidemiology
Most common inherited bleeding disorder
1% of population had deficiency
Autosomal dominant

Levels vary between normal individuals
Type O blood has less
Alpha granules of platelets
Pro/anti-coagulation factors

vWF, fibrinogen, Factor V, Protein S, platelet factor 4, ADP, Ca2+
Platelet aggregation

Define, mechanism
Platelet to platelet bridging

GPIIb/IIIa changes conformation with activation
Resulting in high affinity for fibrinogen
Chronic Blood Loss
Reduced iron stores
Bleeding ulcer
Hemorrhoids
Menstrual and postmenopausal blood loss
Which cells are mononuclear??
Leukocytes and Monocytes
Sickle cell disease is best differentiated from sickle cell trait by:
Electrophoresis
heme part
each globin chain has a what?
Name the earliest cell destined to become an RBC
BFU-E
Etiology of Folate Deficiency
Decreased intake (alcoholics, indigents); Increased requirements (pregnancy, infancy); Impaired utilization (folate antagonists)
Which G6PD type is positive for favism
Mediterranean
Only factor not decreased in liver disease
8
What ethnic group is sickle-cell anemia and trait almost entirely found in?
African descent
Monocyte
A white blood cell that normally constitutes 2 to 10 percent of the total leukocytes staining count. This cell is 9 to 12 u in diameter and has an indented nucleus and an abundant pale blue-gray cytoplasm containing many fine red-staining granules.
peripheral proteins
part of cytoskeleton, under the membrane, made up of spectrin and others
Pernicious anemia (B12)& folate definiciency anemia (B6)
Macrocytic (lg) Normochromic
What are some symptoms of sideroblastic anemia?
hepatomegaly
splenomegaly
bronze colored skin
What type of anemia?
Sickle cell anemia
Normocytic anemia
shift to the left
increased hbg-oxygen affinity
DPG ↓
pH ↑
temp ↓
What disease states are associated with toxic granulation in leukocytes?
-bacterial infection
-poisoning
-burns
-chemotherapy
-pregnancy
Important prognostic in CML
Remission at 1 yr
Factor X
Converts II to IIa
(prothrombin to thrombin)
In the presence of V
Hepcidin
Acute phase protein -- produced during inflammation
Decreased iron absorption in intestine
Decreased iron release from macrophages
Direct inhibition of erothropoesis
Ferritin
Protein that stores many atoms of Fe
RDW
Red cell distribution width
SD of red cell size/MCV
indicates the variation in size of RBCs

Normal is 11.5-14.5
Low is never bad
Giant myelocyte
"huge, ""lagging"" nucleus; in B12 deficiency"
Anemia General Symptoms of Anemia
GI Manifestations
Anorexia
Abdominal pain
What is normal Hb in Horse
10-20 g/dL
Failure to thrive, bossed skull, severe anemia, and splenomegaly are all symptoms of which of the following disorders:
Thalassemia major
Macrocytes & Microcytes
increased MCV & decreased MCV
Peak age of incidence of HL?
15-35yo and >50yo
What is Clotting Factor 6 thought to be?
Calcium
Bite Cells
Seen in patients with G6PD Deficiency; As RBCs with Heinz bodies pass through the spleen, the Heinz bodies are "plucked" out by macrophages, giving rise to RBCs that appear to have a bite of cytoplasm removed. the resultant loss of membrane induces spherocyte formation which predisposes to RBC destruction by the spleen
ALL Pearls
Most childhood ALL is B-cell type; Childhood ALL has an excellent prognosis; Adult ALL has a poor prognosis
What is the cause of ITP?
autoimmune, anti-platelet Ab
Idiopathic thrombocytopenic purpura (ITP)
autoimmune disorder characterized by the development of antibodies to one's own platelets which are then destroyed in the spleen and/or liver. Childhood ITP frequently follows a viral infection. In children, the disease is self–limited and rarely requires treatment. In adults, treatment begins with corticosteroids. When remission is not sustained, splenectomy is the next form of therapy. Approximately 80% of patients will be cured by one of these modalities. The remainder have a chronic form of ITP
Risk factors for this condition include: pregnancy, long air travel, obesity, smoking, oral contraceptives, surgery, trauma, cancer, COPD, antiphospholipid AB syndrome and can result in permanent damage to venous valves
Deep Vein Thrombosis
jaundice is prevelant in sicke cell anemia how do you assess for it
conjuntiva. sclera.
what is polycythemia vera
is a cancer of reb's
Von willebrand disease
Autosomal disease Defect in clotting factor - vWF assoc with factor VIII Reduced platelet adhesion Similar manifestations Treatment - administration of factor VII with vWF
Most common form of thalassemia in Southeast Asia
Alpha Thalassemia
This RBC form indicates?
Teardrop cell
Myeloid metaplasia w/ myelofibrosis
B12 deficiency presentation
anemia of varying severity and neurologic symptoms of any kind alone or in combination
may have glositis, diarrhea or abdominal pain
Factor V
Secreted by platelets when the are activated, therefore it is at the site of injury

Helps hold IIa and X close together on platelet phospholipid membrane
---prothrombinase complex

Vastly increases conversion to thrombin
Gastric MALT lymphoma
Marginal zone lymphoma arising from gastric mucosa
Usually with H pylori infection
H pylori antigens drive T cell activation, B cell clonal proliferation -->lymphoma
Can be cured with H pylori antibiotic treatment

Presents like a peptic ulcer
Heparin mode of action
activates antithrombin - keeps thrombin from coagulating
What color do basophils stain
Dark blue to black
osmotic environment
does not function well in splendic enviroment
A white cell disorder that presents with a low white cell count, thrombocytopenia, and a mullberry-like inclusion in the monocyte is:
Human ehrlichiosis
What is cryoprecipitated AHF?
Concen. of high molecular weight plasma proteins, contains 250mg of fibrinogen and factor VIII
How does Erythropoietin Direct Erythrocyte Development?
The erythropoietin receptor on erythrocyte precursors has tyrosine kinase activity, and it activates a series of other intracellular kinases that increase the proliferation, growth, and development of erythrocyte precursors.
How Does Lymphatic Fluid Move?
Via Intrinsic and Extrinsic mechanisms; INTRINSIC - lymphangions (endothelial cell lining has a thin wall with smooth m. in rings, it ends with a valve flap), these contract at regular intervals with a refractory period (contractions are coordinated), the endothelial cells can produce compounds like NO which dilate the lymphangion, they have receptors for NE (constricts), ATP (constricts) and beta adrenergic inhibitory mechanisms like the bronchial lining, they are richly innervated and respond to SNS; EXTRINSIC - skeletal mm. and limb movement, heart and vascular pulsations, respiratory movement, intestinal peristalsis, surface massage (intermittent compression over drainage territory can increase lymph flow time 4x)
What factors are mostly associated with the extrinisic pathway
VII and Tissue factor
What is the life span of an erythrocyte?
100-120 days
what is a reticulocyte
immature rbc. 1% of all rbc
Clot dissolution - fibrinolysis
Tissue - type plasminogen activator released from injured tissue 24 hours after clot was formed Urokinase - type plaminogen activataor 

Activators convert plasminogen to plasmin Plasmin - splits fibrinogen and fibrin to finbrinn degredation products which dissolve clot 

In which type of anemia are the symptoms related to loss of blood volume rather than loss of hemoglobin?
posthemorrhagic anemia
hereditary spherocytosis presentation
mild to moderate symptoms of anemia, spherocytes
splenomegaly and jaundice
sometimes cholecystitis
What are the functions of basophils?
Mediation of immediate-type hypersensitivity responses
Modulation of inflammatory responses
Drug induced hemolytic anemias
3 kinds
Hapten

Innocent bystander - drug combines with plasma protein and sticks to RBCs becoming an antigen (quinidine)

Anitgenic - drug induces Ab production that cross reacts with a platlet
Drugs that can induce neutropenia
Antimicrobials - penicillin, cephs, vanco, bactrim
Antihistamines - H2 blockers, cimetidine, rantidine
Anticonvulsants
Antipsychotics
Procanimide

Mechanism -- bone marrow suppression, maturation arrest, anti-neutrophil antibody production
Hemophilas

Deficiency and inheritance
Hemo A - VIII deficient -- X-linked
Hemo B - IX deficient -- X-linked
--christmas disease
Hemo C - XI deficient-- AR
Parahemophilia - V deficient - AR
What is normal Wbc count in cat?
5.0-20.0 X 10^3/microliter
What must be used to get the pacekd cell volume
Anticoagulants
The hemoglobin molecule will either hold onto or release oxygen depending on the:
Pulmonary venous circulation
anisocytosis- definition, diagnosis
RBCs have variable and abnormal sizes; may be normal in neonates, may be seen in chronic anemia
What is the most common transfusion reaction?
Febrile Non-Hemolytic Transfusion Reaction (FNHTR)
What happens to RBC's when the cytoskeleton is abnormal?
abnormalities within cytoskeleton proteins lead to disorders where the RBC can't deform in the capillary beds and will die
Diffuse Large-Cell Lymphoma
The most common subtype of High Grade NHL; 80% are B-cell tumors, 20% are T-cell tumors; 80% occur in adults, 20% occur in kids; Rapidly enlarging mass; 50% arise secondary to immunologic disorders; Usually low stage at presentation; 60% are curable (T-cell forms are usually more aggressive)
What are risk factors for DVT?
elderly, recent surgery, bedridden, cancer
Pure Topo II Inhibitor
Etoposide. DLT - bone marrow, nausea,diarrhea
What is sequestration syndrome?
Rapid accumulation of RBCs in the spleen - should do splenectomy
functions of RBC membrane proteins: integral
integral proteins: ion channels, membrane pumps, structural support in association with peripheral proteins. connect outer surface and cytoplasm. Glycophorin A, B, C and band 3
This reactive morphology occurs in what type of WBC?
Toxic granulation of segmented neutrophils
Describe cabot rings.
Dark blue to purple. Loop, ring or figure eight; may look like beads on a string. One to two per cell. Thought to be remnants of mitotic spindle.
What are supportive measures that can be used to treat DIC?
Tx of platelets
Clotting factors
Fibrinogen
+/- low dose heparin to halt thrombin generation
Weird causes of iron deficiency anemia
Exogenous EPO depletion of stores

Hemolytic anemia leading to iron loss into urine
Testing for coagulation?
What tube?
Plasma
Blue top tube
Citrate is the anticoagulant -- binds Ca making it unable to be a cofactor for coagulation cascade
What do mediator T cells do?
Produce chemical substances called Lymphokines
what anemias is caused by decreased RBC production? (6)
1. iron-deficiency
2. thalassemia
3. colbalamin deficiency (pernicious)
4. folic acid deficiency
5. anemia of chronic disease (e.g leukemia)
6. aplastic
What is reverse ABO testing?
Looking for Ab (check serum/plasma w/ reagent A1 and B cells)
What factors are involved in the intrinsic pathway?
VIII, IX, XI, and XII
Cause of Jaundice in Hemolytic Anemias
Secondary to bilirubin deposition in the skin, sclera, etc.
Hemolytic Transfusion Reactions
1 in 38,000. ALmost always caused by clerical errors. Patients receiving mismatched blood.
Platelet
A round or oval disc 2 to 4 microns in diameter; derived from the cytoplasm of the megakaryocyte, a large cell in the bone marrow; plays an important role in blood coagulation, hemostasis, and blood thrombus formation.
What are some symptoms of immune thrombocytopenic purpura (ITP)?
petechiae (small purplish hemorrhagic spots on the skin)

purpura (hemorrhage into the skin)

major hemorrhage
What are the characteristics of TTP?
1. Abnormal activation of platelets and endothelial cells
2. Fibrin deposition in the microvasculature
3. Peripheral destruction of platelets and red cells
Lymphopenia

Define, suseptibilities, etiologies
ALC < 1000 cell/ul (going to be mostly T helper cell loss, as that is most of the cells)
Suseptible to viral, fungal, mycobacterial, atypical infections

Congenital, meds, infectious, hematologic malignancies (esp Hodgkin's), starvation
how does thalassemia major impact health? what are the s/s?
impairs physical growth and causes retardation mentally

s/s
1. pale
2. splenomegaly/hepatomegaly
3. jaundice
4. thickening of cranium and maxillary cavity
Red blood cell distribution width (RDW)
measure of homogeneity of hgb; increases in iron deficiency first (before any other indices)
Name 2 visual signs that may be apparent in a pt w/ polycythemia vera.
Plethora (facial flushing) and erythromelalgia (red LE)
What are normal levels of Erythropoietin?
10-20 IU/L; In anemia of chronic disease, it's not uncommon to see levels of 200-500 IU/L (unless the chronic disease causing AOCD is renal disease, in which case epo levels would be low because the kidneys aren't making it)
What cardiac sx occur in sickle cell anemia?
tachycardia, acute chest syndrome (fever, CP, inc. WBC, pulmonary infiltrates)
Platelets - thrombocytes
Life span 8-9 Days, first 8 hrs in the spleenFragment of megakarocyte Contain -ER golgi complexes mitochondria (ATP)-Secretory glands -actin, myosin -contractile proteins active in clot retraction Synthesize -fibrin stabilizing factors -growth factor -prostaglandins -multiple enzymes cell membrane -glycoprotein coat -phospholipids -platelet factor III
Labs to differentiate between folate and B12 deficiency
MMA- increased with B12 deficiency and normal with folate

Homocysteine - increased with both

Can also test for serum folate level
elevations over 11000 of WBC is associated with?
infx, inflammation, tissue injury or death, and malignanacy
Name 3 conditions that cause low platelet count.
1) Dec. production (affects BM - chemo, HIV) 2) Inc. destruction (pregnancy) 3) Spleen sequestration
If a pt has no response to the initial tx for ITP, what is considered the definitive tx? What procedure is not indicated to tx ITP?
Splenectomy. Platelet transfusion.
Which Inherited Red Cell Disorders are Protective Against Malaria?
Hemoglobin S (seen in Sickle Cell), Thalassemias, and G-6-PD deficiency are inherited red cell disorders associated wtih a reduction in the morbidity and mortality associated with infection by the malaria parasite.
This anemia is due to destruction of bone marrow, often from metastatic cancer from one of these 3 areas
Metastatic cancer from the breast, lung or prostate can do this
Calculating absolute values for cells
total WBC count x % of cellEX: WBC Count of 8.2 x 10 3rd/μl73 Neutrophils of 100 cellsso .73 * 8200=5.98 x 10 3rd/μl
What are some functions of antibodies
Lyse a cell, coat the microrganism so it cant absorb nutrients prevents cell division of the nutrient
What condition of the fetus can occur when the mother has Rh (-)?
Hemolytic Disease of the Fetus and Newborn (HDFN)
Hydrops Fetalis Form of Alpha Thalassemia
Deletion of all 4 alpha globin genes - (___,___/___,___); Occurs in fetuses - becuase Fetal Hg is made of 2 alpha and 2 gamma chains, there is an excess of gamma chains due to the underproduction of alpha chains, these gamma chains form tetramers known as Hemoglobin Barts which can bind O2, but has such a high affinity for it that it won't give it up to the tissues; Causes intrauterine fetal death
When would you give fresh frozen plasma?
Give this blood product to treat DIC or for Warfarin anti-coagulation
What happens as blood passes through the body tissues?
It picks up carbon dioxide and drops off oxygen.
DHTR is rarely fatal except in what situation?
Hemolytic Disease of the Newborn (Rh D antigen)
What is the tx for B12/folate def. in critically ill pts?
IM B12 (1mg/d) and PO folate (1-5mg/d)
A patient with AML is likely to have a cytochemical panel that is positive for:
Myeloperoxidase, Sudan Black B SBB, Specific Estrase
if a person is going to drink iron, what should you remember?
dilute so that it won't stain the teeth
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