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86 Cards in this Set

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intrinsic pathway tested with
PTT
extrinsic pathway tested with
PT
extrinsic pathway starts with factor __ getting activated by ___
factor VII activated by tissue factor
intrinsic pathway starts with factor ___ getting activated by ___
factor XII activated by collagen, basement membrane, activated platelets, or kininogen
proteins C and S inhibit factor ___
VIIIa, Va
thrombomodulin activates ___ forming ___, which then combines with ___
thrombomodulin activates protein C, forming APC, which then combines with protein S
in addition to initiating the intrinsic pathway of the coagulation cascade, factor XIIa (Hageman factor) does what?
converts prokallikrein to kallekrein
kallokrein has 2 anticoagulant effects. name them
activates plasminogen to plasmin; converts kininogen to bradykinin
mechanism of heparin
activation of antithrombin, which degrades thrombin (factor IIa)
intrinsic and extrinsic pathways merge at...
X to Xa
plasminogen is activated to plasmin by ...
tPA
mechanism of abciximab
inhibits GpIIb/IIIa
mechanism of clopidigrel & ticlopidine
inhibit ADP receptor on platelets, preventing insertion of GpIIb/IIIa into the membrane
Glanzmann's thrombasthenia is a deficiency of...
GpIIb/IIIa
Bernard-Soulier syndrome is a deficiency of...
GpIb, which binds platelets to vWF on the basement membrane
thrombomodulin, vWF, thromboplastin, tPA, and PGI2 are synthesized by...
endothelial cells
hemophilia A/B
PTT increased, otherwise normal
vitamin K deficiency
PT, PTT increased, PC and BT normal
Bernard-Solier disease
PT, PTT normal; PC decreased; BT increased
Glanzmann's thrombasthenia
PT, PTT normal; PC normal; BT increased
coagulation studies in ITP and TTP
PT, PTT normal; PC decreased; BT increased
coagulation studies in von Willebrand's disease
PT normal; PTT high; PC normal; BT high
coagulation studies in DIC
PT, PTT high; PC low; BT increased
characterized by anti-GpIIb/IIIa antibodies
ITP
characterized by a deficiency of ADAMTS13 (vWF metalloprotease), leading to large vWF multimers that increase platelet aggregation
TTP
mix the patient's RBCs with anti-IgG antibodies and see whether RBCs agglutinate
direct Coomb's test
mix the patient's serum with normal RBCs and see whether RBCs agglutinate
indirect Coomb's test
tests for anti-RBC abs on patient's RBCs
direct Coomb's test
tests for anti-RBC abs in patient's serum
indirect Coomb's test
characterized by low serum iron, high TIBC/transferrin, low ferritin, and low % transferrin saturation
iron deficiency anemia
characterized by low serum Fe, low transferrin/TIBC, high ferritin, and normal % transferrin sat
anemia of chronic disease/inflammation
characterized by high serum Fe, low transferrin/TIBC, high ferritin, and high % transferrin saturation
hemochromatosis
characterized by normal serum Fe, high transferrin/TIBC, normal ferritin, and high % transferrin sat
pregnancy or OCP's
what is the % transferrin sat?
serum Fe over TIBC
characterized by high serum Fe, low transferrin/TIBC, normal ferritin, and high % tranferrin saturation
lead poisoning
acanthocyte (spur cell)
liver disease, abetalipoproteinemia
basophilic stippling due to aggregation of ribosomes (hint: TAIL)
thal, ACD, iron deficiency, lead poisoning
bite cell
G6PD deficiency
elliptocyte
hereditary elliptocytosis
you have iron available but cannot synthesize heme
sideroblastic anemia, where the ring is the nucleus and the basophilic granules are Fe in mitochondria
schistocyte or "helmet cell"
DIC, TTP, HUS, traumatic hemolysis (eg heart valve)
tear drop cell
bone marrow infiltration (myelofibrosis, myelophthisis)
target cell (hint: HALT)
HbC, Asplenia, Liver disease, Thal
Howell-Jolly bodies
asplenia/hyposplenia. Basophilic nuclear remnants in RBCs
defective in X-linked sideroblastic anemia
ALA synthase
inhibited by lead
ALA dehydratase, ferrochelatase
defective in acute intermittent porphyria
porphobilinogen deaminase
builds up in acute intermittent porphyria
porphobilinogen
defective in porphyria cutanea tarda
uroporphyrinogen decarboxylase
builds up in porphyria cutanea tarda
uroporphyrinogen III
CD30+, CD15+
Reed-Sternberg cells
t(11;14)
mantle cell lymphoma
CD5+
poor prognosis mantle cell lymphoma
t(12;21)
good prognosis ALL
S100+, CD1a+ cells in skin with Birbeck granules
Langerhans cell histiocytosis
mutated in chronic myeloproliferative disorders
JAK2
antidote for heparin
protamine sulfate
monitor this if you are on heparin
PTT (intrinsic)
monitor this if you are on warfarin
PT (extrinsic)
used as anticoagulants in heparin-induced thrombocytopenia
lepirudin, bivalirudin
inhibited by warfarin
eposide reductase
streprokinase, urokinase, tPA (alteplase) are examples of...
fibrinolytics
mechanism of tPA
convert plasminogen to plasmin, which cleaves fibrin
mechanism of antiplatelets cilostazol and dipyridamole
inhibit phosphodiesterase III, increasing cAMP in platelets, inhibiting aggregation; also vasodilators
folic acid analog that inhibits DHF reductase
methotrexate
pyrimidine analogue that inhibits thymidylate synthase
5-fluorouracil
purine analogue activated by HGPRTase
6-mercaptopurine, 6-thioguanine
pyrimidine analogue that inhibits DNA polymerase
cytarabine (ara-C)
direct DNA intercalator
dactinomycin
indirect DNA intercalators that generate free radicals to noncovalently intercalate and break DNA
doxorubicin, daunorubicin
generates free radicals leading to breaks in DNA
bleomycin
inhibit DNA topoisomerase II
etoposide, teniopside
alkylating agent that covalently cross-links DNA at guanine N7; require bioactivation by liver
cyclophosphamide, ifosfamide
alkylating agents that penetrate the CNS
nitrosureas like carmustine, lomustine, semustine, streptozosin
alkylating agent that can cause pulmonary fibrosis
busulfan
microtubule inhibitors that bind tubulin in M-phase and block microtubule polymerization, inhibiting formation of the mitotic spindle
vincristine, vinblastine
microtubule inhibitors that inhibit breakdown of the mitotic spindle, preventing anaphase
paclitaxel and other taxols
DNA cross-linkers that can cause nephro/ototoxicity
cisplatin, carboplatin
inhibits ribonucleotide reductase
hydroxyurea
chemo causing dilated cardiomyopathy
doxorubicin, daunorubicin
chemo causing pulmonary fibrosis
bleomycin, busulfan
chemo causing hemorrhagic cystitis preventable with mesna
cyclophosphamide
chemo causing peripheral neuropathy
vincristine
chemo causing nephro/oto preventable with amifostine and Cl- diuresis
cisplatin, carboplatin
toxicity of trastuzumab
cardiotoxicity
toxicity of imatinib
fluid retention