| What are the most common leukemias? |
Acute LymphoBLASTIC leukemia (ALL); Acute Myelogenous leukemia (AML);
Chronic myelogenous leukemia (CML); Chronic LymphoCYTIC leukemia (CLL) |
| What are the two major types of leukemias? |
myeloid (granulocytic-monocytic) and lymphoid (lymphocytic) |
| Flow cytometry and cluster of differentiation are lab procdures to
detect what? |
leukemias |
| As a result of leukemia, what lab findings do you find in the
PERIPHERAL blood? |
immature blood cells (due to pancytopenia in the marrow) |
| What is the most common eventual cause of death in patients w/
leukemias? |
uncontrollable infection |
| Why does anemia, recurrent infection and bleeding occur in leukemia, a
WBC disorder? |
because the malignant cells overtake the RBC, WBC and platelet
precursors in the marrow |
| T or F: most cases of luekemias are caused by HTLV-1. |
False; most cases are unknown |
| What clotting factor is congenitally deficient in Hemophilia A? |
Factor VIII |
| Hemophilia A & B are what type of bleeding disorders? |
congenital clotting factor defeiciency |
| What are 2 anticoagulants that inhibit coagulation factor production?
|
Heparin and Warfarin |
| DIC is responsible for what clotting factor disease? |
Acquired, excessive consumption of platelets |
| What does the anticoagulant coumadin do? |
prevents vitamin K utilization in the liver (decreases clotting
factors) |
| Why is chronic liver disease also known as hypofibrinogenemia |
Because fibrinogen is the most abundant clotting factor produced in
the liver |
| Why does chronic liver disease cause inadequate production of clotting
factors? |
All clotting factors (except von willenbrand's factor) are produced in
the liver, thus, liver disease will cause a decrease in these |
| ________ clotting factor deficiencies are caused by inadequte
production, excessive consumption, inhibition by anticoagulants. |
Acquired |
| Aspirin, NSAIDS, ESRD (accumulation of metabolites) and Plavix all
lead to ___________ |
qualitative (acquired) platelet related bleeding disorder |
| Two forms of Qualitative platelet bleeding disorders: |
Acquired; congenital |
| DIC (yes, that's right), (Shock, infection tumors, injured endothelial
cells, activation of coagulation system, widespread thrombi, fibrinolysis,
bleeding) all contribute to __________. |
Increased platelet loss (via CONSUMPTION) |
| Hypersplenism leads to _____________. |
increased platelet loss (via REMOVAL) |
| Autoimmune destruction, SLE, HIV,Heparin-induced thrombocytopenia, all
contribute to _________. |
increased platelet loss (via DESTRUCTION) |
| Aplastic anemia, leukemia, infecious agents (ie rubella), and drugs
(interfere w/ megakaryocytes) are contributory to ______________. |
decreased platelet production |
| The etiology of this disease is: Decreased production of platelets,
Increased loss of platelets |
thrombocytopenia |
| Petechiae, and ecchymoses (skin+mucous membranes) are signs of what
bleeding disorder? |
thrombocytopenia |
| What occurs when platelet levels reach below 20,000/mm3? |
Sponaneous bleeding, elevated bleeding time |
| What platelet level characterizes thrombocytopenia? |
<100,000/mm3 |
| This type of bleeding disorder can be qualitative or quantitative |
Platelet-related bleeding disorders |
| What bleeding disorder? Petechiae & eccymoses, skin, mucous
membranes, after minor trauma/spontaneously; normal platelet count, PT
& PTT bleeding time |
Vessel wall weakness & immune-related bleeding disorder |
| What bleeding disorder? Autoimmune vasculitidies, allergic drugs rxns.
|
Immune mechanisms |
| Scurvy, Amyloid, chronic systemic steroid use, inherited conditions
infectious causes, and aging can all cause what type of bleeding disorder?
|
Vascular disorder |
| What are 3 mechanisms of vascular bleeding disorders? |
Trauma, Vessel wall weakness, immune mechanisms |
| What is the international normalized ratio (INR)? |
PT/reference lab control plasma (normal = 1.0, elevated # equals
clotting problem) |
| Increased PTT is shown with a defect of factors
__,___,___,___,___,___,prothrombin, fibrinogen or acquired antibody that
interferes with intrinsic pathway. |
V,VIII (especially, emphasized in class!), IX, X, XI, XII |
| Assesses the integrity of the INTRINSIC and common clotting pathways
|
PTT |
| What lab evaluation? Time required for plasma to clot |
Partial thromboplastin time (PTT) |
| Deficiency of factors V, VII, or X, prothrombin, or fibrinogen is a
diagnosis of ____________ Prothrombin time (PT) |
increased |
| What lab evaluation? Tests adequacy of Extrinsic and common
coagulation pathways |
PT (prothrombin time) |
| What lab evaluation? Time needed for plasma to clot in presence of
exogenous source of thromboplastin and calcium |
PT (prothrombin time) |
| What is the normal platelet count? |
150,000-450,000 platelets/mm3 |
| Which laboratory evaluation? In vivo assessment of platelet response
to vascular injury, normal=several minutes, elevated=defect in platelet #
or function |
Bleeding Time |
| What disease? Bone destruction, punched out radiolucencies, soft
tissue lesions, children. |
Langerhans cell histiocytosis |
| What other variants of Multiple myeloma are there? |
solitary myeloma, extramedullary plasmacytoma (soft tissue),
monoclonal gammopathy of undetermined significance (MGUS) |
| What disease? Lab findings: monoclonal Ig spike, Bence-Jones Protein,
Abnormal plasma cells, amyloid deposition, light chain proteinuria |
multiple myeloma |
| What disease? Bone pain & destruction, hypercalcemia, metastatic
calcification, renal damage, bone fractures |
Multiple myeloma |
| What disease? Adults (45-50 yrs), NOT in children, bone destruction,
punched out radiolucencies |
Multiple myeloma |
| What WBC disorder involves malignant plasma cells? |
Multiple myeloma |
| T or F: bone marrow biopsy must be performed to confirm diagnosis of
leukemia |
true |
| Desmopressin, factor VIII, XI concentrates are used in hospital based
Tx for patients with _____________ |
hemophilia |
| For warfarin patients, INR must be below __________for minor surgeries
|
2.5-3.5 |
| ________ heparin patients must be hospitalized for Tx, while
__________ heparin patients are generally not a concern |
standard; low molecular weight |
| T or F: Plavix is a concern for inc. bleeding during Tx |
FALSE |
