2024-02-08T08:06:17+03:00[Europe/Moscow] en true <p>G6PD (Glucos-6-phosphate dehydrogenase deficiency</p><p>)</p>, <p>G6PD exacerbators</p>, <p>Transferrin</p>, <p>Ferritin</p>, <p>Rhabdomyosarcoma</p>, <p>Breast Cancer</p>, <p>Organs relationship w/ blood</p>, <p>Nutrients needed for RBC synthesis</p>, <p>Types of Anemia</p>, <p>Carcinoma</p>, <p>Squamous cell tumors</p>, <p>Adenocarcinoma</p>, <p>Small Cell Carcinoma</p>, <p>Sarcoma</p>, <p>Lynch Syndrome</p>, <p>Cancer causing viruses</p>, <p>Hematopoietic cancers (leukemia)</p>, <p>Melanoma</p>, <p>proto-onco v oncogenes</p>, <p>Chronic Kidney Disease and blood</p>, <p>P53 Tumor Suppressor Gene</p>, <p>Neonatal Hemoglobin</p>, <p>Telomerase</p>, <p>Hemoglobin S mutation</p>, <p>Osteosarcoma</p>, <p>Liposarcoma</p>, <p>Chondrosarcoma</p>, <p>Leiomyosarcoma</p>, <p>Angiosarcoma</p>, <p>Tertoma</p>, <p>Lymphoma</p>, <p>Vascular endothelial growth factor (VEGF)</p>, <p>Example of commonly mutated tumor suppressor gene</p>, <p>Von Willebrand Disease</p>, <p>Virchow's Triad</p>, <p>Role of Endothelium in anticlotting</p>, <p>Prothrombin Time</p>, <p>Partial thromboplastin time</p>, <p>Reticulocyte count in anemia</p>, <p>Schistocytes</p> flashcards

Module 4- Neoplasia, Blood and Clotting

Advanced Pathophysiology

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  • G6PD (Glucos-6-phosphate dehydrogenase deficiency

    )

    Abnormal amount or function of G6PD, RBCs have inadequate protection from oxidative stress

  • G6PD exacerbators

    Foods (like fava beans) or Oxidizing drugs (antimalarial drugs, sulfas and nitrofurantoin)

  • Transferrin

    Iron binding protein in the plasma. Transports iron from gut or spleen to bone marrow for use in new RBC synthesis

  • Ferritin

    Iron storage protein

  • Rhabdomyosarcoma

    Cancer of skeletal muscle

  • Breast Cancer

    Genetic Testing- BRCA 1&2, HER and ER

  • Organs relationship w/ blood

    Liver-Makes clotting factors and thrombopoietin. Also makes bile salts-important in absorbing vit K and B12)

    Kidney- Makes erythropoietin

    Bone marrow- creates platelets and RBCs

    Spleen- Where old RBCs are recycled. Iron is released by RBCs and carried by transferrin to bone marrow

  • Nutrients needed for RBC synthesis

    Iron, Folate and Vitamin B12

  • Types of Anemia

  • Carcinoma

    Epithelial origin. Ductal carcinoma in situ of the breast

  • Squamous cell tumors

    Squamous cell origin

  • Adenocarcinoma

    Glandular epithelial cell origin

  • Small Cell Carcinoma

    neuroendocrine cell origin

  • Sarcoma

    Mesenchymal tissue (cartilage, smooth muscle, skeletal muscles, blood vessels)

  • Lynch Syndrome

    Non-polyposis colorectal cancer (can have polyps, but not required)

  • Cancer causing viruses

    Epstein bar virus- burtcell lymphoma or burkitt lymphoma

    Hep B & C- he;ptocellular carcinoma

    HPV- head and neck cancer, anal and genital cancer

  • Hematopoietic cancers (leukemia)

    Bone marrow, peripheral blood, lymph node, spleen, or liver origin

  • Melanoma

    Originates in the skin

  • proto-onco v oncogenes

    Proto-oncogenes- Normal. Active in embryonic and early childhood development.

    Oncogenes- mutation in proto-oncogenes. Cancer causing.

  • Chronic Kidney Disease and blood

    Reduced erythropoietin synthesis, fluid and electrolyte imbalances can also inhibit erythropoiesis. Iron deficiency is also common. Hemodialysis also reduces RBC lifespan.

  • P53 Tumor Suppressor Gene

    Need mutation on both alleles. Inhibits gene expression of p21

  • Neonatal Hemoglobin

    Fetal RBCs only live 45 to 70 days (adult RBCs are around 120 days) and are macrocytotic

    Hgb drops to its nadir at about 60 DoL, erythropoiesis relatively low until then

    Premature infants have a lower nadir

  • Telomerase

    An enzyme that maintains chromosome length. Responsible for making cancer cells essentially immortal

  • Hemoglobin S mutation

    Replacement of hydrophilic amino acid Valine with hydrophobic amino acid Glutamate, as in sickle cell anemia.

  • Osteosarcoma

    Bone

  • Liposarcoma

    adipose tissue

  • Chondrosarcoma

    cartilage

  • Leiomyosarcoma

    Smooth muscle

  • Angiosarcoma

    Blood

  • Tertoma

    Germ cell

  • Lymphoma

    B and T lymphocytes

  • Vascular endothelial growth factor (VEGF)

    Helps tumors create enough of a blood supply to feed rapid growth in tumors and opens the doorway for cancer cells to metastasis to other parts of the body

  • Example of commonly mutated tumor suppressor gene

    P53- the mutation keeps it from "turning on" P21. Without being activated, P21 cannot suppressor tumor growth

  • Von Willebrand Disease

    Autosomal dominant, but incomplete penetrance. Reduces platelet adherence to damaged endothelium (longer clotting time). Common presentation mucosal bleeding, nose bleeds (epitaxis), excessive bruising and menorrhagia

  • Virchow's Triad

    Endothelial injury (HTN, DM, cancer, other inflammatory diseases), Venous stasis (not moving), Hypercoagulability (cancer, smoke)

  • Role of Endothelium in anticlotting

    When intact the endothelium releases platelet aggregation inhibitors i.e. nitric oxide and prostacyclin

  • Prothrombin Time

    PT with INR (international normalized ratio). Tissue factor added to anticoagulated blood. Time to clot is measure. Test for for coagulation pathway defects and efficacy of warfarin treatment

  • Partial thromboplastin time

    Tests for coagulation pathway defects (including hemophilia A and B) and efficacy of unfractionated heparin treatment

  • Reticulocyte count in anemia

    Decreased- Anemia of chronic inflammation

    Increased- Hemolytic anemia

  • Schistocytes

    RBC fragments