USMLE Hematology

whatever's version from 2016-05-31 17:16


Eosinophilia causesCTD/Cortisol deficiency/Helminths/Idiopathic hypereosinophilia/Neoplasia/Allergies/Asthma6 CCHINAA
Sickle Cell ComplicationsAutosplenectomy/Renal papillary and Femoral Head necrosis/Encapsulated organism infection SKHPNSCALPCP/Aplastic anemia (Parvovirus B19)/Salmonella osteomyelitis/Splenic sequestration with low Volume/Hg and shock6 AREASS
Cold agglutinationIgM/Mycoplasma/Mononucleosis3 Ms and Maine colder than Georgia
Relative WBC populationsNeutrophils/Lymphocytes/Monocytes/Eosinophils/Basophils5 Neutrophils Like Making Everything Better
Lead poisoning Sx/TxLead Lines/Encephalopathy/Erythrocyte basophilic stippling/Abdominal colic/sideroblastic Anemia/Drops (wrist/foot)/Dimercaprol/eDta/Succimer (in kids)10 LLEEAADDDS
PorphyriaPainful abdomen/Port wine urine/Polyneuropathy/Psychological disturbances/Precipitated by drugs5 Ps
DIC causesSepsis/Trauma/Ob complications/Pancreatitis/Malignancy/Nephrotic/Transfusion7 STOP Making New Thrombi
Multiple MyelomaCalcemia/Renal insufficiency/Anemia/Bone lytic lesions/Back pain/Infections6 CRABBI
Warfarin affectsExtrinsic pathway/increases PT Block epoxide reductase needed to reduce (oxidized) Vit K after it prepares factors2 EXPresidenT went to War(farin)
Target cellHbC disease/Asplenia/Liver disease/Thalassemia4 HALT target
Vit K dependentX/IX/VII/II/C/SX Pres Couldn't Save from 1972 War
PTX/VII/V/II/I (extrinsic pathway)1752
PTTAll but XIII and VII (intrinsic pathway)1307


Dacrocyte (teardrop)Myeloid metaplasia/fibrosis1
Acanthocyte (spur cell)Thalassemas/Anemia of chronic disease/Lead poisoning3
Bite cellG6PD deficiency1
ElliptocyteHereditary elliptocytosis1
MacroovalocyteMegaloblastic anemia/marrow failure2
Ringed sideroblastsIron overload anemia1
Schistocyte (helmet cell)DIC/TTP-HUS/traumatic hemolysis3
Sickle cellSickle cell anemia1
SpherocyteHereditary spherocytosis/autoimmune hemolysis2
Target cellHbC disease/Asplenia/Liver disease/Thalassemia4
Heinz (-like) bodiesG6PD deficiency/alpha thalassemia2
Howell Jolly bodies (basophilic nuclear remnants)Functional hyposplenia/asplenia/napthalene mothball ingestion3
Reed-Sternberg cells (owl's eyes)Hodgkin's disease (required)1
Starry sky appearance (lymphocytes w/interspersed macrophages)Burkitt's Lymphoma1
Fried egg cellMultiple myeloma whole cell1
Rouleax (stacked RBCs)Multiple myeloma RBC1
Clock face chromatinMultiple myeloma Nuclei1
White intracytoplasmic inclusionsMultiple myeloma Ig1
Filamentous projectionsHairy cell leukemia (Mature B cell)1
Birbeck granules (tennis rackets on EM)Langerhans cell histiocytosis1
Auer rods (peroxidase positive cytoplasmic inclusions)AML (granulocytes and myeloblasts) particularly M3 (APML) subtype1
Smudge cellsSLL/CLL1
Fibrous bands/lacunar (RS variant) cellsNodular sclerosing Hodkin's Lymphoma1


Folate deficiencyHigh homocysteine/MMA normal1
B12 deficiencyHigh homocysteine/MMA1
Reed Sternberg cells of Hodgkin'sCD30/CD152
Mantle cell lymphomaCD5 (CD19/CD20)3
Waldenstrom's macroglobulinemiaHyper IgM1
Multiple myelomaHyper IgA1
Multiple myelomaHyper IgG1
Hairy cell leukemiaStains TRAP (tartrate resistant acid phosphatase) positive1
Langerhans cell histiocytosisS-100 (neural crest origin)1
Langerhans cell histiocytosisCD1a1
Normally on RBCs/missing in paroxymal nocturnal hemoglobinuriaCD55/CD592
Follicular B cell lymphomaCD10 (CALLA)/BCL2/BCL6 (CD19/CD20)5
CLLCD5/CD23 (CD19/CD20)4
B-ALLCD10 (CALLA)/CD22 (CD19/CD20)4
Mycosis fungoides/Sezary syndromeCD41

Molecular Biology

Hereditary spherocytosisAnkyrin/band 3/protein 4.2/spectrin4
HbCBeta globin residue 6 glutamic acid to lysine1
HbSBeta globin residue 6 glutamic acid to valine1
Hb Bartsgamma4 (4 alpha genes deleted-hydrops fetalis)1
HbHbeta4 (3 alpha genes deleted)1
Sideroblastic anemiaX linked/dALA synthase (glycine/succCoA to dALA)2
Paroxysmal nocturnal hemoglobinuriaGPI anchor (X chromosome) for CD55-CD59/decay accelerating factor (degrades complement)2
Lead poisoningdALA deH2ase (dALA to porphobilinogen)/ferrochelatase (protoporphyrin to heme)2
Hemophila AXLR/factor VIII2
Hemophila B/Christmas DiseaseXLR/factor IX2
Vitamin K deficiencyII/VII/IX/X/C/S6
Acute intermittent porphyriaPorphobilinogen deaminase (porphobilinogen to HO/Me/bilane)1
Porphyria cutanea tardaUroporphyrinogen deCO2ase (uroporphyrinogen III to coproporphyrinogen III)1
Bernard Soulie syndromelow GpIb1
Glanzmann's thrombasthenialow GpIIb/IIIa1
ITPanti GpIIb/IIIa antibodies1
TTPADAMTS 13 (vWF metalloprotease-degrades vWF multimers)1
vWF diseaselow vWF (indirectly VIII)2
LeidenFactor V resistant to degradation by protein C1
ProthrombinIncreased production causes clots1
AntithrombinDecifiency causes clots1
Protein C/SUnable to inactivate V/VIII1
Adult T cell lymphomaHTLV-11
Polycythemia veraJAK2 on chromosome 91
Myelofibrosis/myeloid metaplasiaJAK2 on chromosome 91
Essential thrombocythemiaJAK2 on chromosome 91
EBVBurkitt's lymphoma/DLBCL/CNS lymphoma3
HCVB cell lymphoma1
Burkitt's lymphomat(8;14) (conjoins c-myc on 8 and heavy chain Ig on 14)1
Mantle cell lymphomat(11;14) (conjoins cyclin D1 11 and heavy chain Ig on 14)1
Follicular lymphomat(14;18) (conjoins heavy chain Ig on 14 and bcl-2 on 18)1
ALLt(12;21) in some gives better prognosis1
AML M3 (responds to ATRA)t(15;17)1
CMLt(9;22) (bcr-abl)1
CLLChromosomal translocations are rare1

Transpositions in Cancers

Burkitt's lymphoma8/c-mycLow2
Burkitt's lymphoma14/heavy chain IgHigh2
Burkitt's lymphomat(8;14) (conjoins c-myc on 8 and heavy chain Ig on 14)t(x;x)2
Mantle cell lymphoma11/cyclin D1Low2
Mantle cell lymphoma14/heavy chain IgHigh2
Mantle cell lymphomat(11;14) (conjoins cyclin D1 11 and heavy chain Ig on 14)t(x;x)2
Follicular lymphoma14/heavy chain IgLow2
Follicular lymphoma18/bcl-2High2
Follicular lymphomat(14;18) (conjoins heavy chain Ig on 14 and bcl-2 on 18)t(x;x)2
ALLt(12;21) in some gives better prognosist(x;x)3
AML M3t(15;17) responds to ALTRAt(x;x)3
CML22/bcr (breakpoint cluster region)High2
CMLt(9;22) (bcr-abl tyrosine kinase)t(x;x)3
Philadelphia chromosomet(9;22) (bcr-abl tyrosine kinase)t(x;x)3
CLLChromosomal translocations are raret(x;x)2


Hodgkin'sYoung adults/>55/M>F except nodular sclerosingEpidemiology3
Hodgkin'sLow grade fever/night sweats/weight loss/pruritus/nontender lymphadenopathySx5
Hodgkin'sEBV in 50%Association1
Hodgkin'sNodular sclerosing better than lymphocyte mixed/depletedPrognosis3
NonHodgkin'sLow grade fever/night sweats/weight loss (fewer than Hodgkin's)Sx4
Burkitt's (NH) lymphomaAdolescent-young adultEpidemiology1
Burkitt's (NH) lymphomaJaw lesion in endemic African/pelvis or abdomen in sporadicSx2
Burkitt's (NH) lymphomaEBVAssociation1
Diffuse large B cell (NH) lymphomaUsually adults/20% in childrenEpidemiology2
Diffuse large B cell (NH) lymphomaRapidly enlarging mass anywhere in the bodySx1
Mantle cell (NH) lymphomaOlder malesEpidemiology1
Mantle cell (NH) lymphomaPoor (avg survival 3 years)Prognosis1
Follicular (NH) lymphomaAdultsEpidemiology1
Follicular (NH) lymphomaDifficult to cure/indolentPrognosis1
Adult T cell (NH) lymphomaAdults (esp Japan/West Africa/Carribean)Epidemiology1
Adult T cell (NH) lymphomaCutaneous lesionsSx1
Adult T cell (NH) lymphomaAggressivePrognosis1
Mycosis fungoidesIndolentPrognosis1
Sezary syndromeIndolentPrognosis1
Mycosis fungoidesCutaneous rash/patches/nodulesSx1
Sezary syndromeCutaneous rash/patches/nodulesSx1
Mycosis fungoidesAdultsEpidemiology1
Sezary syndromeAdultsEpidemiology1
Multiple myelomaCRABBI/hyperCalcemia/Renal insufficiency/Anemia/Bone lytic lesions/Back Pain/InfectionsSx6
Multiple myelomaPunched out lytic lesions on X ray/M spike on protein electrophoresis/Ig light chain Bence Jones proteins in urineTests/Imaging3
MGUS/Monoclonal Gammopathy of Undetermined SignificanceAsymptomatic (precursor to multiple myeloma)Sx1
MGUS/Monoclonal Gammopathy of Undetermined Significance1-2% progress to multiple myelomaPrognosis1
LeukemiasAnemia (RBC)/infections (WBC)/hemorrhage (platelets)Sx3
ALLT cell ALL may present as mediastinal mass (thymus infiltration)Sx1
ALLMost responsive leukemia to therapy/t(12;21) betterPrognosis2
CLL/SLLOften asymptomatic/autoimmune hemolytic anemiaSx2
Hairy cell leukemiaAdultsEpidemiology1
Hairy cell leukemiaCladribine/adenosine analogTreatment1
AMLMedian 65Epidemiology1
AMLall trans retinoic acid in M3 subtype indcues myeloblast differentiationTreatment1
CMLHighest incidence 30-60Epidemiology1
CMLVery low leukocyte alkaline phosphatase (immature granulocytes)Tests/Imaging1
CMLMay accelerate into AML/ALL (blast crisis)Prognosis1
CMLimatinib (small molecule bcr-able tyrosine kinase inhibitor)Treatment1
Langerhans cell histiocytosisLytic bone lesions/skin rashSx2
Langerhans cell histiocytosisChildrenEpidemiology1
Myelodysplastic syndromesRefractory anemia/w or wo ringed sideroblasts/chronic myelomonocytic leukemia/refractory anemia with excess blasts in transformationSx4
Myelodysplastic syndromesM>50Epidemiology2

GF and Granules

BasophilsGM-CSF/IL-3/TGF-Beta (also suppresses eosinophils)3GF
NKIL-15 (commitment)/IL-18/IL-2 (maturation)3GF
Neutrophils primary/azurophilicMyeloperoxidase/bactericidal-permeability increase protein/defensins/SERPs4Granule
Neutrophils secondary/specificAlkaline phosphatase/lysozyme/NADPH oxidase/collagenase/lactoferrin/cathelicidin6Granule
EosinophilsMajor basic protein/eosinophil cationic protein/peroxidase/neurotoxin4Granule


USMLE Hematology Pharmacology