Download Fundamentals of Pathology by Husain A. Sattar PDF
By Husain A. Sattar
USMLE STEP 1 AND scientific direction REVIEW
*218-page full-color Pathoma™ text.
*Integration of key thoughts from linked disciplines.
*Over three hundred often-tested, full-color images.
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Sample text
L . Proteins C and S normally inactivate factors V and VIII. 2 . Increased risk for warfarin skin necrosis i. Initial stage of warfarin therapy results in a temporary deficiency of proteins C and S (due to shorter half-life) relative to factors II, VII, IX, and X ii. In preexisting C or S deficiency, a severe deficiency is seen at the onset of warfarin therapy increasing risk for thrombosis, especially in the skin. D. Factor V Leiden is a mutated form of factor V that lacks the cleavage site for deactivation by proteins C and S.
Iron is transferred to erythroid precursors and enters the mitochondria to form heme. If protoporphyrin is deficient, iron remains trapped in mitochondria. 1 . Iron-laden mitochondria form a ring around the nucleus o f erythroid precursors; these cells are called ringed sideroblasts (hence, the term sideroblastic anemia, Fig. 2) . D . Sideroblastic anemia can b e congenital o r acquired. 1 . Congenital defect most commonly involves ALAS (rate-limiting enzyme). 2. Acquired causes include i. Alcoholism-mitochondrial poison ii.
RBC lifespan is 120 days; each day roughly 1 -2% of RBCs are removed from circulation and replaced by reticulocytes. C. A properly functioning marrow responds to anemia by increasing the RC to >3%. D. RC, however, is falsely elevated in anemia. 1 . RC is measured as percentage of total RBCs; decrease i n total RBCs falsely elevates percentage of reticulocytes. E. RC is corrected by multiplying reticulocyte count by Hct/45. 1 . Corrected count > 3 % indicates good marrow response and suggests peripheral destruction.