Term
| Complications from Mitral Valve Prolapse |
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Definition
| Stroke, Arrhythmias, Infective endocarditis |
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Term
| Three thins a person may undergo one hour before ventricular fibrilllation? |
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Definition
| tachycardia, hyperventilation, hypotension. (Also, substernal chest pain radiating to the neck. Occlusion and narrowing of a. of the heart) |
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Term
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Definition
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Term
| Lab tests of SGOT (AST) show: |
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Definition
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Term
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Definition
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Term
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Definition
| general ACUTE or CHRONIC tissue damage |
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Term
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Definition
| ACUTE Infection or acute inflammation |
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Term
| Lab tests of SGPT (ALT) show: |
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Definition
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Term
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Definition
| bleeding into the joint (associated with elevated PTT) and lack of factor VIII |
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Term
| A prolonged/ increased prothrombin (PT) time is associated with: |
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Definition
Malabsorption
Cirrhosis
Vitamin K deficiency
Bile duct obstruction |
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Term
| Liver makes all clotting factors except: |
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Definition
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Term
| Prolonged Bleeding Time is associated with: |
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Definition
| Platelet dysfunction; vascular dysfuction (deficiency of von Willebrand factor) |
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Term
| Late cyanosis Congenital heart disease (Left to Right shunts) |
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Definition
VSD
ASD
Complete endocardial cushion defect
Sinus venosus
Patent foramen ovale
Patent ductus arteriosus (PDA) |
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Term
| Cyanotic Congenital Heart Disease (Right to Left shunts) |
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Definition
Tetralogy of Fallot
Transposition of the great vessels
Persistent truncus arteriosus |
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Term
| Neoplastic disorder that INVOLVES LYMPH NODES: |
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Definition
Hodgkin disease
(has RS cells- "owl eyes") |
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Term
| Non-Hodgkin Lymphomas presentation: |
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Definition
Usually discovered in only chain of nodes
Involves lymph nodes or lymphoid tissue in other parts of the body
No RS cells |
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Term
| Burkitt Lymphoma presentation- histologically: |
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Definition
| Large lymphocytes with lipid-containing vacuoles "STARRY SKY PATTERN" |
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Term
| Multiple Myeloma keywords |
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Definition
excess abnormal immunoglobulins + infiltration of various plasma cells
Bone pain + hypercalcemia
urine Bence-Jones proteins
Cytoplasmic inclusions called Russell bodies
"Punched out" defects on x-ray
Amyloid deposition in various soft tissue |
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Term
| Physical examination for Folic acid deficiency include: |
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Definition
Months to develop
Skin pallor
Angular cheilitis
Generalized depapillation of his tongue
Macrocytic anemia |
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Term
| Physical examination for B12 deficiency include: |
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Definition
Years to develop
Burning sensation of tongue, lips, taste disturbances
Patchy or diffuse erythema, or pallor
Surface atrophy, lobulation
Skin may be yellow-gray |
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Term
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Definition
Anemia
Bleeding disorder
Gingival enlargement |
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Term
| Chronic Leukemia Features what signs and symptoms: |
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Definition
Fatigure
Weakness
Weight loss
Anorexia Hepato and splenomegaly lymphadenopathy
Thrombocytopenia |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| packed RBCs/ volume (N = 37-54%) |
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Term
| Mean Corpuscular (Cell) Volume |
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Definition
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Term
| Red Blood Cell Distribution Width |
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Definition
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Term
| children 6 mo-5 years: Hb |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Inadequate intake of iron results in insufficient hemoglobin synthesis and hypochromic and microcytic red cells |
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Term
| Anemia of Chronic Disease |
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Definition
| Caused by production of inflammatory cytokines, which cause iron to be sequestered in macrophages, resulting in an anemia that is usually normochromic and normocytic |
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Term
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Definition
| Caused by deficiencies of folate or vitamin B12, results in enlarged abnormal hematopoietic precursors (megaloblasts) in the bone marrow, ineffective hematopoiesis, and (in most cases) pancytopenia |
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Term
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Definition
| Caused by bone marrow failure (hypocellularity) due to diverse causes, including exposures to toxins and radiation, idiosyncratic reactions to drugs and viruses, and inherited defects in DNA repair and the enzyme telomerase |
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Term
| Myelophthisic Anemia- what is it? What does it lead to? |
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Definition
| Caused by replacement of the bone marrow by infiltrative processes such as metastatic carcinoma and granulomatous disease. Leads to the release of early erythroid and granulocytic precursors (leukoerythroblastosis) and the appearance of tear-drop red cells in the peripheral blood |
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Term
| Chronic blood loss results in |
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Definition
|
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Term
| Dec production of RBC due to |
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Definition
B12 or folic acid def
Thalassemia
Aplastic anemia |
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Term
| Increased destruction of RBC in what diseases? |
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Definition
Thalassemia
Sickle cell anemia
Immunohemolytic |
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Term
| Increased destruction of RBC in what diseases? |
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Definition
Thalassemia
Sickle cell anemia
Immunohemolytic |
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Term
| Signs and symptoms of iron def: |
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Definition
“Burning” tongue
Patchy or diffuse erythema
Atrophy of filiform papillae
Taste alteration
Fissuring
All of the above may be due to candidosis (candiasis)! |
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Term
| Signs and symptoms of Thalassemia |
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Definition
Frontal bossing
“hair-on-end” appearance of calvaria
Enlarged jaws
‘Honeycomb’ bone pattern |
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Term
| Features of aplastic anemia (the numbers for granulocytes, platelets, reticulocytes / uL) |
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Definition
- G <500
- P <20, 000
- R <10, 000
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Term
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Definition
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Term
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Definition
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Term
|
Definition
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Term
| Signs and Symptoms of Aplastic Anemia |
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Definition
pallor
gingival bleeding, mucosal petechiae, purpura, ecchymoses
gingival enlargement
mucosal ulcers |
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Term
| Hemolytic anemia: Common features |
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Definition
Fatigue, weakness, headache, rapid pulse
Jaundice
Splenomegaly (early on)
Do not confuse hemolytic anemia with hypercarotinemia (too many carots, shrimp in diet) – sclerae not yellow! |
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Term
| Signs and symptoms of sickle cell anemia |
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Definition
- Reduced trabeculation
- “Hair-on-end” appearance of calvaria
- Delayed dental eruption
- Dental hypoplasia
- Ishemic necrosis
- Neuropathy
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Term
| Manifestation of Sickle Cell Crisis |
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Definition
Capillary blockage to ischemia, infarction to severe pain
Hemolysis: Anemia, jaundice
+/- fever |
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Term
| What kind of anemia is Hereditary spherocytosis |
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Definition
| Hemolytic; sphere shaped instead of looking donut shaped |
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Term
| "Hair on end" that is seen in thalassemia major is due to: |
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Definition
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Term
| RBC appearance in thalassemia minor: |
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Definition
Target cells
microcytic
hypochromic |
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Term
| Most frequent site for atherosclerosis? |
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Definition
|
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Term
| calcific aortic valve stenosis most commonly develops due to: |
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Definition
AGING!
Other predisposing conditions include calcification of a congenital bicuspid aortic valve and acute rheumatic fever |
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Term
| Most common cause of mitral valve stenosis? |
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Definition
| Chronic rheumatic heart disease |
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Term
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Definition
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Term
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Definition
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Term
| Three key facts with mitral valve stenosis? |
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Definition
No pathologic change in the LV
You can have stenosis with or without insufficiency
Fish mouth appearance of the defected valve |
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Term
| Most common cause of aortic valve stenosis if pt is older than 50? |
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Definition
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Term
| Most common cause of aortic valve stenosis if pt is younger than 50? |
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Definition
| Congenital bicuspid aortic valve |
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Term
| Two very important facts about AORTIC VALVE STENOSIS |
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Definition
Rheumatic heart diseae is the second most common cause
There IS A PATHOLOGIC CHANGE in the LEFT VENTRICLE |
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Term
| von Willebrand disease characteristics: |
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Definition
- The platelet count is normal
- Men and women are affected equally
- There is impaired platelet ADHESION
- Factor VIII levels are decreased
- The clinical presentation is variable
- Prolonged bleeding time
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Term
| Deficiency of vWF leads to: |
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Definition
| failure of platelet adhesion |
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Term
| The hallmark of left side failure is: |
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Definition
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Term
| Girl has track marks, fever, leukocytosis. What is true about staph infections in this setting? |
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Definition
Staph infection can infect normal valves
Tricuspid valve is usually damaged
Right heart failure can occur |
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Term
| Chronic lymphocytic leukemia is often the consequence of: |
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Definition
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Term
| What is more common: B or T cell non-hodgkin lymphomas? |
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Definition
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Term
| In the absence of systemic signs and symptoms, bilateral non-painful symmetric enlargement of the palatine tonsils in a 24 yr old is MOST consistent with? |
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Definition
| Reactive lymphoid hyperplasia |
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Term
| Complications resulting from an acute MI include: |
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Definition
Arrhythmias
Mitral valve prolapse
Pericarditis
Mural thrombosis
Hemopericardium |
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Term
| Severe with right leg. Angina, atrial fibrillation, and history of intermittent claudication in the right left: |
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Definition
Thromboembolism arising from the left atrium
Thrombotic occlusion of the femoral artery with underlying atheroma |
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Term
| Three things associated with thrombocytopenia? |
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Definition
Leukemia
Atherosclerosis
B12/folate def. |
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Term
| Intrinsic pathway affects? |
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Definition
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Term
| Intrinsic pathway includes: |
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Definition
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Term
| Extrinsic pathway affects? |
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Definition
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Term
| Extrinsic pathway includes? |
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Definition
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Term
|
Definition
both Intrinsic and Extrinsic
Factors 10, 5, 2 make fibrin |
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Term
| Which factors are vitamin-K dependent? |
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Definition
| Factors 2, 7, 9, 10 are Vitamin-K dependent and are the most sensitive to liver disease |
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Term
| Platelet count and bleeding time are affected by? |
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Definition
| Platelets and vasculature |
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Term
| What three things get affected by coagulation factors? |
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Definition
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Term
| Quantitative platelet problems |
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Definition
| (thrombocytopenia) low CBC and prolonged bleeding time |
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Term
| Qualitative platelet problems |
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Definition
| (abnormal function) normal CBC but prolonged bleeding time |
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Term
|
Definition
| (affecting the endothelium) normal CBC but prolonged bleeding time |
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Term
| Intrinsic Pathway dysfunctions |
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Definition
| (12, 11, 9, 8) prolonged PTT |
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Term
| Extrinsic Pathway dysfunctions |
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Definition
| (Factor 7 only) prolonged PT |
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Term
| Common Pathway dysfunctions |
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Definition
| (10, 5, 2) prolonged PTT and PT |
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Term
| Bleeding disorders- Hereditary etiologies (3) for vascular disorders: |
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Definition
Ehlers-Danlos Syndrome = problems w/ CT
• Henoch-Scholein Purpura = problems w/ vasculitis
• Hereditary Hemorrhagic Telangiectasia |
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Term
| Thrombocytopenias: two clinical presentations: |
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Definition
superficial bleeding (petechiae, purpura)
• low platelet count and prolonged bleeding time |
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Term
| thrombocytopenia- surgical bleeding if counts are |
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Definition
|
|
Term
| thrombocytopenia- spontaneous bleeding if counts are |
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Definition
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Term
| thrombocytopenia- cerebral bleeding if counts are |
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Definition
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Term
|
Definition
| GP1B deficiency adhesion problems |
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Term
| Glanzmann’s Thrombasthenia |
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Definition
| GP2B deficiency aggregation problems |
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Term
| Clinical presentation (2) of thrombocytopathies |
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Definition
superficial bleeding (petechiae, purpura)
• normal platelet count and prolonged bleeding time |
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Term
| 4 Clinical presentations of hemophilias? |
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Definition
deep bleeding (ecchymosis, hemarthrosis, GI, GU)
• normal platelet count
• prolonged bleeding time
• prolonged PT and PTT |
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Term
| Acquired etiologies for Hemophilias? |
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Definition
Vitamin-K deficiency = affects Factors 2, 7, 9, 10
• Liver disease = affects all coagulation factors – EXCEPT VWF – and 2, 7, 9, 10 are affected first,
• Kidney disease
• D.I.C. |
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Term
|
Definition
(autosomal dominant)
- affects VWF and Factor-8
- prolonged PT and PTT
- treat w/ Cryoprecipitate |
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Term
|
Definition
(autosomal recessive)
- affects Factor-8
- prolonged PTT
- treat w/ Factor-8 concentrate |
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Term
|
Definition
(autosomal recessive)
- affects Factor-9
- prolonged PTT
- treat w/ Factor-9 concentrate |
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Term
| anything that induces more RBC / WBC/ protein production ? (4) |
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Definition
- Thrombocytosis = platelets
- Polycythemia Vera = RBC’s
- Leukemias = WBC’s
- Myultiple myeloma = proteins |
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Term
|
Definition
| (normal = 1800 – 8000; 50%) = an increase in circulating neutrophils in response to bacterial infections or tissue necrosis |
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Term
|
Definition
| (normal = 0 – 500; 3%) = an increase in circulating eosinophils in response to parasitic infections, allergies, Hodgkin’s Disease, vasculitis |
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Term
|
Definition
| (normal = 0 – 800; 10%) = an increase in circulating monocytes in response to granulomatous diseases (like TB, SLE, SBE) |
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Term
| Acute Lymphocytic Leukemia |
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Definition
- indicates that the mutation occurred early in the differentiation process poor prognosis
- the abnormal cells in circulation are blastic (immature), poorly-differentiated |
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Term
| Chronic Lymphocytic Leukemia |
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Definition
- indicates that the mutation occurred later in the differentiation process better prognosis
- the abnormal cells in circulation may be well-differentiated but they are NOT normal |
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Term
|
Definition
• Non-Hodgkin’s Lymphomas
• Hodgkin’s Disease
• Burkitt’s Lymphoma |
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Term
|
Definition
Myelodysplastic Syndrome can be mild and remain in the non-proliferative state
immature cells are dysplastic = un-organized appearance but not yet malignant
decreased cell count = cytopenia
• Myelodysplastic Syndrome can become aggressive and start rapidly proliferating into myeloproliferative syndromes |
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Term
| Myeloprolferative Syndromes |
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Definition
Acute / Chronic Myelogenous Leukemia = if neutrophils predominate
• Acute / Chronic Monocytic Leukemia = if monocytes predominate
• Polycythemia Vera = if RBC’s predominate |
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Term
| What would a bone marrow biopsy show in leukemias? |
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Definition
The bone marrow is so hypercellular that there just isn’t enough room for normal cells to proliferate
1) bone marrow expansion to bone pain
2) pancytopenia to makes you more susceptible to infections & bleeding
3) extramedullary hematopoiesis to hepatomegaly & splenomegaly |
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Term
|
Definition
| lymphadenopathy occurs only in the early stages when the there is “homing” of cells back to the lymph nodes |
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Term
|
Definition
| lymphadenopathy occurs only in the late stages when there is diffuse organ infiltration |
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|
Term
| hepatomegaly & splenomegaly due to several reasons: |
|
Definition
1) extramedullary hematopoiesis
2) organ infiltration
3) horning back to the spleen for antigen presentation (lymphocytic type of leukemia only) -- recall that the spleen is also a lymphoid organ
4) liver infiltration liver dysfunction cant make coagulation proteins |
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Term
| ACUTE LYMPHOCYTIC LEUKEMIA (ALL) |
|
Definition
affects the B-cells = large & poorly-differentiated (blastic)
- involves deregulation of the C-myc oncogene
- pancytopenia infections (↓ neutrophils); bleeding (↓platelets); anemia (↓RBC’s)
- early lymphadenopathy
- hepatosplenomegaly |
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|
Term
| CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) |
|
Definition
most likely to affect males 50+ yrs old
- affects the B-cells = small & well-differentiated
- CLL w/ aggressive mutations has a tendency to become aggressive ALL
- CLL patients who don’t have the aggressive mutation for that tendency will have a long survival
- there is some genetic predispotion
- pancytopenia infections (↓ neutrophils); bleeding (↓platelets); anemia (↓RBC’s)
- early lymphadenopathy
- hepatosplenomegaly |
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Term
| ACUTE MYELOGENOUS LEUKEMIA (AML) |
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Definition
- AML tends to occur within 2 yrs after exposure to radiation, chemotherapy, benzene
- AML can arise from Myelodysplastic Syndrome (non-proliferative)
- AML has the same clinical presentation as ALL
Same: Both ALL and AML have blastic cells w/ large cytoplasm b/c they are both acute leukemias involving immature cells
Different: Special tests and staining techniques must be done to be able to differentiate ALL blast cells -vs- AML blast cells
AML cells have AUER RODS and tests positive for Myeloperoxidase |
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Term
| CHRONIC MYELOGENOUS LEUKEMIA (CML) |
|
Definition
involves a translocation b/t chromosomes #9 & 22 = Philadelphia chromosome
- affects the granulocytes & thrombocytosis
- extreme splenomegaly
- elevated peripheral blood counts
- erythroid cell line can either be normal or low
- myelofibrosis of the bone marrow in severe end-stage cases pancytopenia
- CML left un-treated has a tendency to become aggressive AML |
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Term
|
Definition
| chronic to acute (BUT NEVER THE OTHER WAY AROUND) |
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|
Term
| Clinical presentation of lymphomas? |
|
Definition
• painless lymphadenopathy
• fever, fatigue, weight loss, night sweats
• when the advanced disease becomes Leukemia, it has the same clinical presentation as Leukemia because IT IS Leukemia |
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|
Term
|
Definition
characterized by mandibular tumors (on top of the bone, not within the bone)
- STARRY SKY histology = characterized by tumor cells located against a background of many lymphocytes -- like Van Goh’s famous painting
- involves deregulation of the c-myc oncogene
- involves translocation between chromosomes #8 & #14
- this disease is considered a high-grade aggressive & rapidly-proliferating
- therefore it is very curable in patients w/ good immune systems |
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|
Term
|
Definition
- bi-modal incidence = most common in 20’s (curable) and 50’s (poor prognosis)
- diagnosis is based on histology from lymph node & bone marrow biopsies LP
- REED-STERNBERG CELLS = owl’s eyes appearance due to the 2 big nuclei
- Pel-Epstein fever (fluctuating), prutitis (itchiness)
- otherwise, same exact clinical presentation as Lymphoma |
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