Hematology & Oncology Flashcards – First Aid for the USMLE STEP 1

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  • erythrocyte carries what?
    O2 to tissues and CO2 to lungs
  • structural features of erythrocyte?
    "anucleate and biconcave, with large surface area to volume ratio for rapid gas exchange"
  • life span of erythrocyte?
    120 days
  • source of energy of erythrocytes?
    "glucose (90% used in glycolysis, 10% used in HMP shunt)"
  • function of erythrocyte membrance Cl-/HCO3- antiporter?
    allows RBS to sequester HCO3- and transport CO2 from the periphery to the lungs for elimination
  • erythrocytosis =?
    polycythemia= (increase) hematocrit
  • anisocytosis = ?
    varying sizes of RBC
  • poikilocytosis = ?
    varying shapes of RBCs
  • what is a reticulocyte?
    "immature erythrocyte, marker of erythroid proliferation"
  • platelet is involved in what?
    primary hemostasis
  • what is a platelet made of?
    small cytoplasmic fragment derived from megakaryocytes
  • life span of platelets?
    8-10 days
  • what happens when platelets are activated by endothelial injury?
    aggregates with other platelets and interacts with fibrin to form platelet plug.
  • platelets contain which granules?
    "dense granules ( ADP, Calcium) alpha granules (vWF, fibrinogen)"
  • how much of platelet pool is stored in the spleen?
    1/3
  • thrombocytopenia or platelet dysfunction results in what?
    petechiae
  • vWF receptor =?
    GpIb
  • fibrinogen receptor = ?
    GpIIb/IIIa
  • leukocyte class divided into what groups?
    "granulocytes (neutrophil, eosinophil, basophil) mononuclear cells (monocytes, lymphocytes)"
  • leukocytes are responsible for what?
    defense against infections
  • normal leukocyte count?
    4000-10000
  • what is normal WBC differential?
    Neutrophils Like Making Everything Better Neutrophils - 54-62% Lymphocytes- 25-33% Monocytes- 3-7% Eosinophils- 1-3% Basophils 0-0.75%
  • functions of neutrophil?
    acute inflammatory response cell phagocytic
  • when are neutrophils increased?
    bacterial infections
  • type of nucleus in neutrophils?
    multilobed nucleus
  • in neutrophills small more numerous specific granules contain what?
    ALP collagenase lysozyme lactoferrin
  • "in neutrophils, larger less numerous azurophilic granules contain what?"
    acid phosphatase peroxidase beta glucuronidase
  • hypersegmented neutrophils (polys) > 50 lobes seen in what?
    Vit B12/folate deficiency
  • (increase) band cells (immature neutrophils) reflect states of what?
    "increased myeloid proliferation (bacterial infections, CML)"
  • monocytes differentiate into what?
    macrophages in tissues
  • features of monocyte nucleus?
    large kidney shaped
  • features of monocyte cytoplasm?
    extensive frosted glass cytoplasm
  • where are monocytes found?
    in the blood
  • functions of macrophage?
    "phagocytoses bacteria, cell debris, and senescent RBCs and scavenges damaged cells and tissues"
  • life span of macrophage?
    long life in tissues
  • macrophages differentiate from what?
    circulating blood monocytes
  • macrophages are activated by what?
    gamma-interferon
  • macrophage can function as antigen presenting cell via what?
    MHC II
  • what is the cell surface marker for macrophages?
    CD14
  • functions of eosinophils?
    defend against helminthic infections (major basic protein)
  • features of eosinophil nucleus?
    bilobate nucleus
  • eosinophils are packed with what?
    large eosinophilic granules of uniform size
  • eosinophils are highly phagocytic for what?
    Ag-Ab complexes
  • eosinophil produces what?
    histaminase and arylsulfatase (helps limit reaction following mast cell degranulation)
  • what are the causes of eosinophilia?
    NAACP: Neoplastic Asthma Allergic processes Collagen vascular diseases Parasites (invasive)
  • basophil mediates what?
    allergic reaction
  • features of basophil granules?
    "densely basophilic granules containing heparin, histamine, and leukotrienes (LTD4)"
  • what does basophilic mean?
    staining readily with basic stains
  • mast cell mediates what?
    allergic reaction in local tissues
  • mast cells resemble what?
    resemble basophils structurally and functionally but are not the same cell type
  • mast cells can bind what?
    Fc portion of IgE to membrane
  • what happens to mast cells when IgE cross links upon antigen binding?
    "degranulation, which releases histamine, heparin, and eosinophil chemotactic factors"
  • mast cells involved in which HSR?
    type I HSR
  • function of Cromolyn sodium?
    prevents mast cell degranulation (used for asthma prophylaxis)
  • function of dendritic cells?
    highly phagocytic antigen presenting cells function as link between innate and adaptive immune system
  • dendritic cells express what on surface?
    MHC II and Fc receptor
  • what are dendritic cells in skin called?
    Langerhans cells
  • lymphocyte mediates what type of immunity?
    adaptive immunity
  • lymphocytes divided into which cell types?
    B cells and T cells
  • microscopic features of lymphocytes?
    "round, densely staining nucleus with small amount of pale cytoplasm"
  • B lymphocytes part of which immune response?
    humoral
  • B lymphocyte arises from what?
    stem cells in bone marrow
  • where do B cells mature?
    marrow
  • B cells migrate to where?
    "pripheral lymphoid tissue (follicles of lymph nodes, white pulp of spleen, unencapsulated lymphoid tissue)"
  • "when Ag is encountered, B cells do what?"
    differentiate into plasma cells that produce Ab and memory cells
  • B cells can function as APC how?
    via MHC-II
  • surface markers of B cells?
    CD19 CD20
  • plasma cell produces what?
    large amounts of Ab specific to a particular Ag
  • microscopic features of plasma cell?
    "off-center nucleus, clock-face chromatin distribution, abundant RER, well developed golgi apparatus"
  • which is a plasma cell cancer?
    multiple myeloma
  • T cell mediates what?
    cellular immune response
  • T cell originates from what?
    stem cells in bone marrow
  • T cell matures where?
    in the thymus
  • T cells differentiate into what?
    "1. cytotoxic T cells (express CD8, recognized MHC-I) 2. helper T cells ( express CD4, recognize MHC II) 3. regulatory T cells"
  • what is necessary for T cell activation?
    CD28 costimulatory signal
  • majority of circulating lymphocytes are what?
    T cells (80%)
  • surface markers of Th?
    CD3 CD4
  • surface markers of Tc?
    CD3 CD8
  • features of blood group A?
    A Ag on RBC surface and anti-B Ab in plasma
  • features of blood group B?
    B Ag on RBC surface anti-A Ab in plasma
  • features of blood group AB?
    A and B Ag on RBC surface no Ab in plasma = universal recipient of RBC = universal donor of plasma
  • features of blood group O?
    neither A nor B Ag on RBC surface; both Ab in plasma = universal donor of RBC = universal recipient of plasma
  • incompatible blood transfusions can cause what?
    "immunologic response, hemolysis, renal failure, shock, death"
  • what type of Ab are Anti-A and anti-B?
    IgM (do not cross placenta)
  • what type of Ab is anti-Rh?
    IgG (cross placenta)
  • Rh- mothers exposed to fetal Rh+ blood make what?
    anti-Rh IgG
  • what happens to mothers with anti-Rh IgG in subsequent pregnancies?
    "anti-Rh IgG crosses placenta, causing hemolytic disease of the newborn in next fetus that is Rh+"
  • what is the treatment for hemolytic disease of the newborn?
    Rho(D) immune globulin for mother at first delivery to prevent initial sensitization of Rh- mother to Rh antigen
  • 1st step in intrinsic coagulation pathway?
    XII-->XIIa
  • what can catalyze XII --> XIIa?
    Collagen basement membrane activated platelets HMWK
  • 1st step in extrinsic coagulation pathway?
    VII --> VIIa after interaction of FVII with thromboplastin (tissue factor)
  • fate of FVIIa in extrinsic coagulation pathway?
    activates FIX and FX
  • XIIa catalyzes what?
    XI --> XIa prekallikrein --> kallikrein
  • XIa catalyzes what?
    IX --> IXa
  • what catalyzes VIII --> VIIIa?
    IIa
  • VIII and IXa catalyze what?
    X --> Xa
  • what catalyzed V--> Va?
    IIa
  • Va and Xa catalyze what?
    II (prothrombin) --> IIa (thrombin)
  • IIa catalyzes what?
    VIII --> VIIIa V --> Va XIII --> XIIIa fibrinogen --> fibrin monomers
  • Kallikrein catalyzes what?
    HMWK --> bradykinin plasminogen --> plasmin
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