Notes in Week 2

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Published	12/13/2023	{{c3::Lymphadenopathy}} is usually non-tender rounded ("{{c1::rubbery}}") lymph nodes. Can cause {{c2::obstruction}}, especially if growth is fast.
Published	12/13/2023	B symptoms:1. {{c1::Fever}}2. {{c2::Drenching sweats}}3. {{c3::Unintentional weight loss}}
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Published	12/13/2023	Blood Cell Disorders:{{c1::Aplastic anemia}}: stem cells are {{c2::gone}}
Published	12/13/2023	Blood Cell Disorders:{{c1::Clonal hematopoiesis of indeterminate potential (CHIP)}}: stem cells have {{c2::growth advantage}}
Published	12/13/2023	Blood Cell Disorders:{{c1::Myelodysplastic syndrome (MDS)}}: stem cells support ineffective {{c2::hematopoiesis}}
Published	12/13/2023	Blood Cell Disorders:{{c1::Myeloproliferative syndromes}}: stem cells have {{c2::increased}} proliferation and {{c3::normal}} maturation
Published	12/13/2023	Blood Cell Disorders:{{c1::Acute leukemias}}: stem cells have increased {{c2::proliferation}} but do not {{c3::mature}}
Published	12/13/2023	Myelodysplastic syndrome: also called {{c1::refractory}} anemia, {{c1::pre}}leukemia, or {{c1::smoldering}} leukemia
Published	12/13/2023	Myelodysplastic syndrome: {{c1::clonal}} myeloid disorder arising from {{c2::stem cell}} mutations
Published	12/13/2023	Myelodysplastic syndrome: characterized by ineffective {{c1::hematopoiesis}} and cyto{{c2::penias}}
Published	12/13/2023	The arrow is pointing to {{c1::Auer rods}}
Published	12/13/2023	Leukemia: occurs mainly in {{c1::blood}} and {{c1::bone marrow}}Lymphoma: occurs mainly in {{c2::lymph nodes}}Myeloma: occurs mainly in {{c3::plasma c…
Published	12/13/2023	{{c1::Acute::Acute/Chronic}} neoplasms will generally have more {{c2::immature::mature/immature}} cells
Published	12/13/2023	The arrows are pointing to which type of cell?{{c1::Plasma cells}}
Published	12/13/2023	This is an indication of {{c1::monoclonal gammopathy}}
Published	12/13/2023	Multiple myeloma symptoms:C{{c1::alcium elevated (hypercalcemia)}}R{{c2::enal failure}}A{{c3::nemia}}B{{c4::one disease}}
Published	12/13/2023	Urine "dipstick" {{c1::does not::does/does not}} pick up M-spike
Published	12/13/2023	Lymphadenopathy can cause both {{c1::spleno}}megaly and {{c1::hepato}}megaly, with {{c2::diffuse}} enlargements happening more with {{c3::slow}}-growi…
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Published	12/13/2023	From left to right, there is a transformation from {{c1::indolent}} to {{c1::aggressive}} lymphoma
Published	12/13/2023	Most common indolent lymphoma is {{c1::follicular lymphoma}}
Published	12/13/2023	{{c1::Diffuse large B-cell lymphoma}}:Most common Non-hodgkin lymphoma{{c2::LDH}} elevated in majority of casesAll {{c3::indolent}} lymphomas can tran…
Published	12/13/2023	{{c2::Smudge}} cells (bottom right) are indicative of chronic {{c1::lymphoid}} leukemia
Published	12/13/2023	This is indicative of chronic {{c1::myeloid}} leukemia
Published	12/13/2023	Chronic {{c2::myeloid}} leukemia can be treated using {{c3::tyrosine-kinase}} inhibitors (ending in -{{c1::inib}})
Published	12/13/2023	Chronic {{c1::myeloid}} leukemia's main genetic driver is {{c2::BCR-ABL}} (t({{c3::9;22}})), also called the {{c4::Philadelphia}} chromosome
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Published	12/13/2023	This best describes {{c1::acute myeloid}} leukemia
Published	12/13/2023	This is indicative of {{c1::acute myeloid}} leukemia
Published	12/13/2023	AML mainly occurs in {{c1::older}} populations
Published	12/13/2023	This is indicative of {{c1::acute lymphoblastic}} leukemia
Published	12/13/2023	{{c1::B}} cell ALL is the more common version of ALL
Published	12/13/2023	ALL mainly occurs in {{c1::younger}} populations
Published	12/13/2023	One common environmental exposure for MDS/acute leukemias is {{c1::benzene}}
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Published	12/13/2023	{{c2::M2}} AML (AML with {{c2::maturation}}) is the most common subtype of AML. 50% of these will have t({{c1::8;21}})
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Published	12/13/2023	The most common cause of agranulocytosis is {{c1::drug toxicity}}
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Published	12/13/2023	Leukemoid reaction is defined by leukocytosis exceeding {{c1::50,000}}/mm^3
Published	12/13/2023	Identify the neutrophils:{{c1::, etc.}}
Published	12/13/2023	Identify the myelocytes: {{c1::}}
Published	12/13/2023	Identify the blasts: {{c1:: (just one)}}
Published	12/13/2023	{{c1::Karyotypes}} can be used to look at the {{c2::whole genome}} or {{c2::large}} abnormalities
Published	12/13/2023	Karyotypes need {{c2::fresh}} PB, BM, or tissue and must be fixed in {{c1::metaphase}}
Published	12/13/2023	{{c1::FISH (Fluorescent in situ hybridization)}} is designed to detect {{c2::small}} genetic abnormalities and answering {{c2::specific}} questions
Published	12/13/2023	FISH needs {{c1::fresh OR fixed}} tissue and can examine cells in {{c2::interphase::cell phase}} or {{c2::metaphase::cell phase}}
Published	12/13/2023	{{c2::PCR based assays}} are useful for asking specific questions or some {{c1::translocations}}
Published	12/13/2023	PCR based assays can use {{c1::fresh, frozen or fixed}} tissue
Published	12/13/2023	Chronic myeloid neoplasms{{c1::Myeloproliferative neoplasms}}: {{c2::effective}} hematopoiesis --> {{c3::high}} cell counts{{c1::Myelodysplastic sy…
Published	12/13/2023	Auer rods are indicative of {{c1::acute myeloid}} leukemia
Published	12/13/2023	To determine myeloid vs lymphoid cells, we can use {{c1::flow cytometry}} or {{c2::immunohistochemical stains}}
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Published	12/13/2023	Acute leukemia causes a {{c2::block}} in differentiation (high proportion of {{c1::blasts}})
Published	12/13/2023	This is an example of {{c1::Reed-sternberg cells}}, indicating {{c2::Hogkins lymphoma}}
Published	12/13/2023	Reed-sternberg cells are {{c1::CD30}}+, {{c1::CD15}}+, {{c2::CD20}}- (cell markers)
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Published	12/13/2023	The {{c1::cortical area (follicles)}} in lymph nodes mainly contain {{c2::B}} cells, while the {{c1::paracortex}} region mainly contain {{c2::T}} cell…
Published	12/13/2023	A subtype of {{c2::AML}} that has a c({{c3::15;17}}) translocation is known as {{c1::acute promyelocytic leukemia (APL)}}
Published	12/13/2023	Glucocorticoids are anti-{{c1::inflammatory}} and {{c2::lympho}}lytic and are useful for {{c3::acute lymphoblastic leukemia::malignancy}}
Published	12/13/2023	{{c3::Cyclophosphamide}} is a type of {{c1::conventional synthetic disease-modifying antirheumatic drug (cs-DMARD)}} which works by {{c2::cross-linkin…
Published	12/13/2023	{{c1::Methotrexate}} is a {{c2::folic acid}} analog and inhibits synthesis of {{c3::tetrahydrofolate (THF)}}. It increases intracellular formation of …
Published	12/13/2023	Drug resistance mechanisms for methotrexate:Decreased drug transport via reduced {{c1::folate}} carrierDecreased cytotoxic MTX {{c2::polyglutamate}} f…
Published	12/13/2023	{{c1::Imatinib}} is the first inhibitor of the {{c2::tyrosine kinase}} domain on the {{c3::BCR-ABL}} oncoprotein by preventing {{c4::phosphorylation}}…
Published	12/13/2023	{{c1::Rituximab}} is a chimeric monoclonal antibody that targets {{c2::CD20::cell marker}} {{c3::B}}-lymphocytes, depleting them.
Published	12/13/2023	{{c1::Graft-versus-host disease (GvHD)}} is a disorder where the {{c2::donated}} tissue attacks the {{c2::host}} cells
Published	12/13/2023	{{c1::Graft-versus-leukemia (GVL)}} is a reaction when {{c2::donor}} cells eliminate host {{c2::leukemic}} cells
Published	12/13/2023	Graft {{c1::rejection}} occurs when {{c2::host}} cells attack {{c2::donor}} cells
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Published	12/13/2023	{{c1::Blinatumomab (BiTE)}} works by simultaneously attaching to {{c2::T}} cells and {{c2::cancer}} cells and brings them {{c3::closer}} together
Published	12/13/2023	{{c2::Infection-induced}} Hemolytic Anemia: mainly caused by {{c1::malaria}} and {{c1::babesiosis}}
Published	12/13/2023	{{c2::Drug-induced}} Hemolytic Anemia: commonly caused by {{c1::antibiotics}}, {{c1::NSAIDS}}, immunotherapy, and chemotherapy
Published	12/13/2023	Paroxysmal nocturnal hemoglobinuria clinical sign: dark urine on {{c1::1st morning}} urination
Published	12/13/2023	{{c1::G6P Deficiency}}: Inherited hemolytic disease that is asymptomatic until exposed to {{c2::oxidative stressors}} and is the most common {{c3::enz…
Published	12/13/2023	{{c1::Hereditary Spherocytosis and Elliptocytosis}}: Inherited hemolytic disease with {{c2::mild}} symptoms that can cause splenomegaly and pigment st…
Published	12/13/2023	Standard clinical presentations of hemolytic anemias:{{c2::Weakness}}{{c1::Jaundice}}{{c3::Dark-colored}} urine
Published	12/13/2023	Direct Antiglobulin Test (DAT): primarily used to detetermine {{c1::autoimmune}} {{c2::hemolytic anemias}}
Published	12/13/2023	{{c1::Direct Antiglobulin Test (DAT)}}: {{c2::Coombs}} reagent binds to RBCs. {{c3::Agglutination}} indicates a positive test meaning there are {{c4::…
Published	12/13/2023	{{c1::Indirect}} Antiglobulin Test: Primarily used during {{c2::pregnancy}} and {{c3::blood transfusions}}
Published	12/13/2023	General treatment approach to {{c2::hemolytic anemia}}:If asymptomatic, no treatment neededSupportive care{{c1::Folic acid}} supplementation{{c3::Bloo…
Published	12/13/2023	{{c3::Warm Autoimmune Hemolytic Anemia}} Pathophys:{{c1::IgG}}-mediated extravascular hemolysis occurs at {{c2::body temperature::temperature}}
Published	12/13/2023	{{c1::Cold Agglutinin Disease}} Pathophys:Hemolysis occurs at colder temperatures{{c2::IgM}} and complement causes RBC {{c3::agglutination}} and extra…
Published	12/13/2023	{{c2::Thrombotic Thrombocytopenic Purpura}} Pathophys:{{c4::RBCs}} are damaged and rupture in {{c3::narrowed/obstructed}} vesselsInherited or acquired…
Published	12/13/2023	Thrombotic Thrombocytopenia Purpura Diagnosis:{{c1::Schistocytes}} and {{c1::helmet cells}} (Types of RBCs on smear){{c2::PLASMIC}} score{{c3::AKI}} i…
Published	12/13/2023	{{c2::Hemolytic Uremic Syndrome}} Pathophys:Associated with {{c1::E.coli::organism}}{{c3::Shiga}} toxin binds {{c4::glycosphingolipid}} on cells
Published	12/13/2023	{{c1::Disseminated Intravascular Coagulation}} Pathophys:Homeostatic imbalance between {{c2::coagulation}} and {{c2::bleeding}}Positive feedback cause…
Published	12/13/2023	{{c1::Macroangiopathic Hemolytic Anemia}} Pathophys:{{c2::Mechanical}} hemolysis in large vessels/heart{{c3::Prosthetic}} cardiac valves, shunts, LVAD…
Published	12/13/2023	{{c1::Acute Transfusion Reaction}} Pathophys:Host antibodies attack donor RBCsMostly due to {{c2::ABO incompatibility}} (clerical error)Can be if RBCs…
Published	12/13/2023	{{c2::Delayed Transfusion Reaction}} Pathophys:{{c1::Anamnestic}} responseRapid production of antibody on {{c3::second}} encounter to same antigen
Published	12/13/2023	{{c1::Erythroblastosis Fetalis}} Pathophys:{{c2::IgG}} from mother passes through placenta and binds fetal RBC antigens{{c3::Alloimmune}}-induced RBC …
Published	12/13/2023	{{c5::Paroxysmal Nocturnal Hemoglobinuria}} Pathophys:{{c1::X-linked}} genetic disorder for {{c2::PIGA}} gene{{c3::GPI}} anchors for complement inhibi…
Published	12/13/2023	{{c3::G6P Deficiency}} Pathophys:{{c1::X-linked::Inheritance}} disorderG6PD has short half-lifeIncreased oxidative injury causes accumulation of {{c2:…
Published	12/13/2023	{{c1::G6PD Deficiency}} Diagnostics:G6PD enzyme assayPresence of {{c2::Heinz}} bodies and {{c2::Bite}} cells on blood smearHistory of exposure to {{c3…
Published	12/13/2023	{{c2::Sickle Cell Anemia}} Pathophys: {{c4::Homozygous}} autosomal codominant mutation of {{c3::HBB}} gene causes misshapen {{c5::B-globin}}Subst…
Published	12/13/2023	Sickle Cell Anemia Treatment:{{c1::Hydroxyurea}}: increases fetal hemoglobin and inhibits HbS sicklingProphylactic {{c2::penicillin}}
Published	12/13/2023	{{c4::Hereditary Spherocytosis}} Pathophys:Mutation of {{c1::spectrin}}, {{c2::ankyrin}}, band {{c3::3}} or {{c3::4.2}}
Published	12/13/2023	{{c3::Hereditary Elliptocytosis}} Pathophys:Mutation of {{c1::alpha}} spectrin, {{c1::beta}} spectrin, protein {{c2::4.1}}
Published	12/13/2023	{{c1::Pyruvate Kinase Deficiency}} Pathophys:{{c2::Autosomal recessive::Inheritance}} mutation for PK50% reduction of RBC {{c3::ATP}}Disrupts membrane…
Published	12/13/2023	{{c2::Hemoglobin C Disease}} Pathophys:{{c1::Autosomal recessive}} mutationSubstitution of {{c3::Valine}} for {{c3::Lysine}}Decreased hemoglobin …
Published	12/13/2023	{{c1::Hemoglobin S Trait}} Pathophys:{{c2::Heterozygous}} autosomal codominant mutation of HBB gene causes misshapen B-globinSubstitution of {{c3::Val…
Published	12/13/2023	{{c1::Hemolysis}} results in the release of {{c4::LDH}} and hemoglobin, where the excess heme is converted to {{c2::bilirubin}} and excreted in {{c3::…
Published	12/13/2023	{{c1::Haptoglobin}} binds free hemoglobin, allowing them to be digested by {{c2::macrophages}}
Published	12/13/2023	{{c1::Hemoglobin}}uria will cause a {{c2::red-purple}} colored urine, while {{c1::hemosiderin}}uria will cause a {{c2::brown}} colored urine
Published	12/13/2023	A reticulocyte index greater than {{c1::2}}% is indicative of hemolytic anemia
Published	12/13/2023	{{c1::Intravascular}} hemolytic anemia has decreased {{c2::haptoglobin}} and {{c3::hemoglobin}}, {{c3::hemosiderin}}, and {{c3::urobilin}} in the urin…
Published	12/13/2023	{{c1::Extravascular}} hemolytic anemia has {{c2::spleno}}megaly and {{c3::urobilin}} in the urine without hemoglobinuria or hemosiderinuria
Published	12/13/2023	Iron from hemoglobin is stored as {{c1::hemosiderin}} in {{c2::PCT}} cells
Published	12/13/2023	Cold Autoimmune Hemolytic Anemia unique clinical sign: {{c1::Raynaud's phenomenon}}
Published	12/13/2023	Warm autoimmune hemolytic anemia clinical signs: {{c1::DVTs}} and {{c1::PE}}
Published	12/13/2023	Thrombotic thrombocytopenic purpura clinical symptom: {{c1::headache}}/{{c1::confusion}}
Published	12/13/2023	Hemolytic-uremic syndrome clinical signs: {{c1::diarrhea}}, {{c1::GI}} symptoms
Published	12/13/2023	Erythroblastosis fetalis clinical sign: {{c1::hyperbilirubin}}emia within first 24 hours, {{c2::kernicterus}} after birth, {{c3::heart}} failure, {{c4…
Published	12/13/2023	Sickle cell anemia clinical signs: {{c1::dactyl}}itis, {{c2::Moyamoya}} disease, {{c3::splenic}} sequestration
Published	12/13/2023	Pyruvate kinase deficiency clinical signs: {{c2::kernicterus}}/{{c2::fetal hydrops}} if severe, poor {{c1::growth}}, {{c1::premature}} birth
Published	12/13/2023	Warm autoimmune hemolytic anemia diagnostics on imaging: {{c1::spherocytes}}
Published	12/13/2023	Cold agglutinin disease treatment: {{c1::sutimlimab}} (monoclonal antibody against complement subunit {{c2::C1s}})
Published	12/13/2023	Thrombotic thrombocytopenic purpura treatment: {{c1::plasma}} exchange (removes {{c2::ADAMTS13}} antibodies)
Published	12/13/2023	Disseminated intravascular coagulation treatment: {{c1::heparin::medication}}, {{c2::plasma}}/{{c2::platelet}} transfusion
Published	12/13/2023	Erythroblastosis fetalis diagnosis: positive DAT/IAT causing {{c1::maternal}} antibodies on {{c1::neonate}} RBCs
Published	12/13/2023	Erythroblastosis fetalis treatment:Rh: {{c2::RhoGAM}} to Rh- motherABO: {{c1::phototherapy}} (reduces serum bilirubin)
Published	12/13/2023	Hereditary spherocytosis/ellipsocytosis diagnosis: {{c1::Eosin 5 maleimide (EMA)}} test, {{c2::osmotic fragility}} test
Published	12/13/2023	Pyruvate kinase deficiency diagnosis: presence of {{c1::echinocytes (burr cells)}} on blood smear
Published	12/13/2023	Hemoglobin C disease diagnosis: hexagonal/tetragonal {{c1::crystals}} and {{c2::target}} cells on blood smear
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