Hematology

1. GENERAL HEMATOLOGY

2. RED CELL DISORDERS BONE MARROW FAILURE SYNDROMES BLEEDING DISORDERS HEMATOLOGY PRIMARY DECREASE PRODUCTION INCREASED DESTRUCTION POLYCYTHEMIA ANEMIA SECONDARY LEUKEMIAS CHRONIC ACUTE MYELOID MYELOID LYMPHOID LYMPHOID DIAMOND BLACKFAN APLASTIC ANEMIA PLATELET DISORDERS COAGULATION DEFECTS VASCULAR BLOOD LOSS

3. PRIMARY DECREASED PRODUCTION INCREASED DESTRUCTION POLYCYTHEMIA ANEMIA SECONDARY BLOOD LOSS NUTRITIONAL ANEMIAS FOLIC ACID DEF IRON VITAMIN B12 DEF HEMOLYTIC ANEMIAS MEMBRANE DEFECTS INFECTION IMMUNE RED CELL DISORDERS

5. Etiopathogenesis of Anemia Iron, folic acid, proteins . . . Bone Marrow DEFICIENCY ANEMIA MARROW FAILURE Circulation BLOOD LOSS HEMOLYSIS Acute Chronic Intravascular Extravascular 1 2 4 3

6. Hematologic Values During Infancy and Childhood 47 (42-52) 16 (14.0-18.0) Adult male 42 (37-47) 14 (12.0-16.0) Adult female 38 (34-40) 13 (11.0-16.0) 7-12 yr 37 (33-42) 12.0 (10.5-14.0) 6 mo -6 yr 36 (31-41) 12.0 (9.5-14.5) 3 months 50 (42-66) 16.5 (13-20.0) 2 weeks 55 (45-65) 16.8 (13.7-21.1) Cord Blood HEMATOCRIT HEMOGLOBIN AGE

7. Classification of Anemia based on Red Cell MCV Aplastic anemia Leukemia Folate deficiency Vitamin B12 deficiency Liver disease Normal Chronic Disease Hereditary Spherocytosis Blood loss Early iron deficiency Marrow infiltration Thalassemias Iron Deficiency Lead poisoning Chronic Diseases MCV High MCV Normal MCV low

8. Which of the RBC’s in the foll. blood smears is considered- 1. Normocytic, normochromic 2. hypochromic, microcytic 3. macrocytic B A C

15. Physiologic increase in iron requirements FEMALE infancy menopause Adolescence pregnancy childhood male

17. IRON DEPLETION IRON DEFICIENT ERYTHROPOIESIS IRON DEFICIENCY ANEMIA

24. Repletion of iron stores 1-3 mo Increase in hemoglobin level 4-30 days Reticulocytosis (peak at 5-7 days) 48-72 hour Initial bone marrow response: erythroid hyperplasia 36-48 hour Replacement of intracellular iron enzyme 12-24 hour Response Time after iron administration Response to iron therapy in iron deficiency anemia

26. BONE MARROW A B

34. THE HEMOGLOBINS 2 α 2 γ Hemoglobin F (Fetal) 2 α 2 δ Hemoglobin A2 2 α 2 β Hemoglobin A1 (Adult) Polypeptides Hemoglobin

44. G6PD Deficiency

47. Glutathione anti-oxidant system 2GSH + H2O2 GSSG + 2 H2O Reaction 1 GSSG + NADPH 2 GSH + NADP Reaction 2 GLU PEROXIDASE GLU REDUCTASE G6PD Deficiency

50. CHRONIC ACUTE MYELOID MYELOID LYMPHOID LYMPHOID LEUKEMIAS AML M0-M7 ALL L1-L2 CML CLL

51. CLASSIFICATION OF ACUTE LEUKEMIAS (FAB) assoc. with difficulty in aspirating the marrow megakaryoblastic AML M7 Erythroleukemia AML M6 Monocytic AML M5 Granulocytic and monocytic AML M4 Commonly associated with DIC Promyelocytic AML M3 With granulocytic maturation AML M2 Without maturation AML M1 Undifferentiated AML M0 ACUTE MYELOGENOUS LEUKEMIA

52. CLASSIFICATION OF ACUTE LEUKEMIAS (FAB) LEUKEMIAS Mature B cell (burkitt’s lymphoma)-bad prognosis T-cells (bad prognosis) Best prognosis (pre-B cell lineage) Large, finely stippled chromatin, mod. cytoplasm, deeply basophilic cytoplasm with vacuolations ALL L3 Large cells, cleft nucleus, prominent nucleoli, mod. cytoplasm ALL L2 Small cells predominate, homogenous nuclear chromatin, inconspicuous nucleoli, scanty basophilic cytoplasm ALL L1 ACUTE LYMPHOCYTIC LEUKEMIA

54. PLATELET DISORDERS COAGULATION DEFECTS VITA K DEF BLEEDING DISORDERS HEMOPHILIAS QUALITATIVE QUANTITATIVE TRAUMA VASCULAR PURPURA VITAMIN DEF VASCULAR VWD CONN. TISS. DSE ITP INFECTIOUS SCURVY EHLER DANLOS SYNDROME DIC DIC THROMBASTHENIAS

56. Normal hemostasis Vessel injury Collagen exposure TXA2, ADP Platelet aggregation 1  hemostatic plug Stable hemostatic plug Vasoconstriction  blood flow Tissue thromboplastin Blood coag. Fibrin

61. Prothrombin Time Intrinsic Surface XII Prekallikrein HMW -K XI XIa IX IXa VIIIa Phospoholipid Ca++ Extrinsic VII-VIIa Tissue Factor Phospholipid Ca++ X Xa Va Phospholipid Ca++ Prothrombin(II) Thrombin(IIa) Fibrinogen(I) Fibrin

62. Activated Partial Thromboplastin Time Intrinsic Surface XII Prekallikrein HMW -K XI XIa IX IXa VIIIa Phospoholipid Ca++ Extrinsic VII-VIIa Tissue Factor Phospholipid Ca++ X Xa Va Phospholipid Ca++ Prothrombin(II) Thrombin(IIa) Fibrinogen(I) Fibrin

74. BLACKFAN-DIAMOND ACQUIRED APLASTIC ANEMIA BONE MARROW FAILURE FANCONI’S ANEMIA CONGENITAL APLASTIC ANEMIA TRANSIENT ERYTHOBLASTOPENIA OF CHILDHOOD (TEC)