Title: Big Ol' Bonewizardry Deck / Hex Clues / Heme
Tags: hex-clues hex-clues::heme

Q: Ecchymoses
A: bruise >1cm 🎯
extravasated blood 💜

Q: Petechiae
A: pinpoint 🎯
platelet problem 🟥

Q: What is MetHb?
A: Fe3+ useless 🎯
chocolate blood 🍫
methylene blue 🔵

Q: What is RHOGAM?
A: anti-D IgG mops up fetal RBCs 🩸🔴
prevents HDN 🛡️

Q: MCC of Polycythemia
A: Secondary polycythemia 🎯
chronic hypoxia 🎯
COPD, altitude, smokers 🚬

Q: Purpura
A: palpable 3mm-1cm 🎯
vasculitis or platelet dz 🌸

Q: What is a Band?
A: immature neutrophil 🛡️⚪
left shift = bacterial 🦠

Q: What is a Stomatocyte?
A: mouth-shaped RBC 🩸🔴
liver disease 🍺

Q: What is the RBC lifespan?
A: 120 days 🎯
four months of duty 🪖

Q: What is INR?
A: standardized PT 🎯
warfarin monitor 💊

Q: What diseases have low LAP?
A: ↓ Low LAP ⬇️📉
CML + PNH 🎯
leukocytes lacking 🫥

Q: What has high LAP?
A: ↑ Leukemoid reaction 🎯
high LAP rules out CML ⬆️📈
severe infection 🦠

Q: What is the platelet lifespan?
A: 7-10 days 🎯
short and sticky 🍯

Q: What is Anisocytosis?
A: variable RBC size 🩸🔴
↑RDW 📊

Q: Striae
A: linear bruise lines 🎯
Cushing’s or rapid growth 🏃

Q: What does Rh + tell you?
A: Rh positive 🎯
has D antigen 🎯
no anti-D risk 🛡️

Q: Aplastic Anemia w/ Myelofibrosis
A: Marrow fibrosis 🎯
CML blast crisis or mets 🎯
marrow replaced 🚫

Q: What does -cytosis tell you?
A: ↑ -cytosis 🎯
more cells 🎯
suffix code 🔤

Q: What is a Blast?
A: immature precursor 🎯
>20% = acute leukemia ☠️

Q: What is type and match?
A: ABO/Rh only 🎯
no crossmatch yet 🤝

Q: What is Poikilocytosis?
A: variable shapes 🎯
sickle, target, schisto 🎨

Q: What does -cythemia tell you?
A: ↑ -cythemia 🎯
high blood cell count ⬆️📈
poly, thrombo, etc 🔤

Q: Hemophilia C
A: Factor XI deficiency ⬇️❌
Ashkenazi, AR, mild 📿

Q: What is a Drepanocyte?
A: Sickle cell 🎯
HbS polymerizes deoxygenated 🎯
crescent moon RBC 🌙

Q: What is the most common transplant?
A: Blood transfusion 🩸💉
the OG transplant 🎯
done millions daily 🌍

Q: What are plasmacytomas?
A: Plasmacytoma 🎯
solitary plasma tumor 🎗️💀
myeloma precursor 📈

Q: What disease has a long philtrum?
A: Williams syndrome 🎯
elfin face + supravalvular AS 🎯
chr 7 deletion 🧚

Q: What is Rouleaux formation?
A: RBC coin stacks 🩸🔴
multiple myeloma 💰

Q: What disease has 6 fingers?
A: Trisomy 13 (Patau) 🎯
polydactyly + cleft + holopros 🎯
lethal 💀

Q: What is a Syngeneic transplant?
A: identical twin 🎯
no GvHD, no rejection ✅

Q: What is backward typing?
A: Reverse typing 🎯
known antigen + patient serum 🎯
detects antibodies 🔍

Q: What is an Autograft?
A: self to self 🎯
zero immune fight ✅

Q: What is an Allograft?
A: same species, diff person 🎯
immunosuppression 💊

Q: What does Rh - tell you?
A: Rh negative 🎯
no D antigen 🎯
can make anti-D 🚨

Q: What is a Xenograft?
A: cross-species 🎯
porcine valves etc 🫀

Q: What is a Lymphocyte?
A: T, B, NK 🎯
adaptive immunity 🎯

Q: What does acute hypoxia cause?
A: dyspnea + tachypnea 🫁😤
confusion + tachycardia 😵

Q: What does blood type A tell you?
A: A antigen on RBC 🩸🔴
anti-B in serum 🅱️❌

Q: What is the Clotting Cascade?
A: factors → fibrin 🎯
intrinsic + extrinsic → common 🕸️

Q: What does high WBC and >5% blasts tell you?
A: Acute leukemia 🎯
≥20% marrow blasts 🎯
aggressive 🔥

Q: What disease has painful fingers?
A: Sickle dactylitis 🎯
hand-foot syndrome 🎯
vaso-occlusion 😖

Q: What is forward typing?
A: known antibody + patient RBC 🩸🔴
detects antigens 🔍

Q: What defines AML?
A: Auer rods, MPO+ 🎯
t(15,17) = APL 🎂

Q: What is Waldenstrom Macroglobulinemia?
A: IgM hyperviscosity 🛡️🎯
B-cell lymphoma 🩸

Q: What is a Pencil cell = Cigar cell?
A: Iron deficiency ⚙️🩸
elongated RBC 🩸🔴
microcytic + hypochromic 🪶

Q: What is Hyperacute rejection?
A: minutes 🎯
preformed antibodies type II HSR ⚡

Q: What disease has a smooth philtrum?
A: Fetal alcohol 🤰👶
thin lip + small fissures 🎯
smooth philtrum + MR 🚫

Q: What is Cabot's ring body?
A: nuclear membrane remnant 🎯
megaloblastic + lead ⚫

Q: What is a Platelet?
A: megakaryocyte fragment 🎯
primary hemostasis 🩹

Q: What does high WBC and B cells tell you?
A: B-cell rise 🎯
bacterial infection 🦠🌡️
or B-cell leukemia 🧪

Q: What is Acute rejection?
A: days to months 🎯
immunosuppression 💊

Q: What is Heavy Chain Disease?
A: IgA → bowel 🛡️🎯
Mediterranean lymphoma 🌊

Q: What defines ALL?
A: TdT+ PAS+ CALLA+ 🎯
t(12,21) good Px 🦴

Q: What do platelet problems cause?
A: Platelet bleeding 🩸🟣
mucocutaneous 🤚🟡
petechiae + epistaxis + gums 👃

Q: What is an Eosinophil?
A: parasites + allergy 🪱🦠
major basic protein 🌸

Q: What do clotting factor problems cause?
A: Factor bleeding 🩸💧
deep 🎯
hemarthrosis + intramuscular 💪

Q: What does NADPH oxidase deficiency cause?
A: CGD 🎯
catalase+ infections 🦠🌡️
abnormal NBT/DHR ❌

Q: What does high WBC and high PMNs tell you?
A: PMN-osis 🎯
stress demargination or bacterial 🎯
steroids/exercise 🏃

Q: What is a Schistocyte?
A: DIC, TTP, HUS, valves 📡🔬
microangiopathic ⚙️

Q: What is a Helmet cell?
A: schisto variant 🎯
MAHA 💔

Q: What does blood type O tell you?
A: universal RBC donor 🩸🔴
no A/B, anti-A + anti-B 🤝

Q: What does high WBC and bands tell you?
A: Left shift 🎯
bands = immature PMNs 🎯
bacterial 🦠

Q: What is a Döhle body?
A: cytoplasmic RER 🎯
infection, burns, pregnancy 🤰

Q: What defines Hodgkin's lymphoma?
A: Reed-Sternberg owl eyes 🎯
CD15+ CD30+, EBV 🦉

Q: What do high retics (>1%) tell you?
A: marrow responding 🎯
hemolysis or bleed 💧

Q: What does Ca-EDTA bind?
A: lead chelator 🎯
binds divalent metals 🧲

Q: What does -penia tell you?
A: ↓ -penia 🎯
low cell count ⬇️📉
drug or virus 💊

Q: Aplastic anemia w/ autoimmune attack suggests
A: Thymoma / Fanconi 🎯
pure RBC aplasia 🩸🔴
immune attack on marrow ⚔️

Q: What is Erythrocytic Protoporphyria?
A: EPP 🎯
ferrochelatase deficiency ⬇️❌
photosensitivity ☀️

Q: What is a Pappenheimer body?
A: iron inclusion ⚙️🩸
sideroblastic, post-splenectomy 🧲

Q: What is Graft vs. Host disease?
A: GvHD 🎯
donor T-cells attack host 🎯
skin + gut + liver 🔥

Q: What is a Neutrophil?
A: most abundant WBC 🛡️⚪
first responder 🚒

Q: What does HAM'S test diagnose?
A: PNH 🎯
CD55/CD59 deficient ⬇️❌
complement-mediated lysis 🩸

Q: What do low retics tell you?
A: ↓ Marrow failure 🎯
iron/B12/folate def 🥬💊
aplastic 🚫

Q: What does blood type AB tell you?
A: universal plasma recipient 🎯
both antigens, no antibodies 🤝

Q: What is a Target cell = Codocyte?
A: bull’s-eye RBC 🩸🔴
thal, HbC, liver, asplenia 🏹

Q: What is a Basophil?
A: IgE-bound histamine + heparin 💉🩸
↑ in CML 📈

Q: What is Basophilic Stippling?
A: ribosome aggregates 🎯
lead, sidero, thal ⚫

Q: What is Essential Thrombocythemia?
A: plts >450k 🎯
JAK2/CALR/MPL 🧬

Q: What are the Vitamin K clotting factors?
A: Vit K factors 🎯
II, VII, IX, X + C + S 🎯
warfarin targets 💊

Q: What does the indirect Coombs test tell you?
A: antibodies in serum 🛡️🎯
pre-transfusion + prenatal 🤰

Q: What organ can make RBCs if the long bones are damaged?
A: Spleen + liver 🟫🫀
extramedullary hematopoiesis 🎯
hepatosplenomegaly 📈

Q: What does myeloperoxidase deficiency cause?
A: MPO deficiency ⬇️❌
Candida infections 🍄🦠
normal NBT ✅

Q: Pyruvate kinase deficiency
A: PK deficiency ⬇️❌
no ATP, rigid RBCs 🩸🔴
AR, neonatal hemolysis 👶

Q: What disease has sausage digits?
A: Dactylitis 🎯
psoriatic + reactive arthritis 🎯
sausage finger 🌭

Q: What causes both increased PTT and bleeding time?
A: vWD 🎯
most common inherited bleed 🩸💧
platelet adhesion + Factor VIII carrier 🩹

Q: What is a Monocyte?
A: largest WBC, kidney nucleus 🛡️⚪
→ tissue macrophage 🏠

Q: What is type and cross?
A: crossmatch with patient serum 🎯
reserves the unit 🏷️

Q: What is Hemophilia B?
A: Hemophilia B (Christmas) 🎯
Factor IX def, X-linked 🎯
hemarthrosis 🦵

Q: How does Cyanide poison Hb?
A: blocks complex IV ETC 🔒🚫
almond breath + lactic acidosis 🌰
amyl nitrite + thiosulfate 🎯

Q: What defines CML?
A: t(9,22) BCR-ABL 🎯
Philadelphia chromosome 🔔
imatinib 🎯

Q: What is Monoclonal Gammopathy of Undetermined Significance?
A: MGUS 📡🔬
M-spike 🎯
1%/yr → myeloma ⏳

Q: What is Hb C disease?
A: HbC disease 🎯
Glu→Lys at β6 🎯
crystals + target cells 🎯

Q: What defines CLL?
A: smudge cells CD5+ CD20+ 🎯
warm AIHA + hypogammaglobulinemia 🐝

Q: What is a Burr cell = Echinocyte?
A: evenly spiculated 🎯
uremia, PK def, liver 🫘

Q: How does fibrin stabilization factor deficiency present
A: Factor XIII deficiency ⬇️❌
delayed umbilical bleed 🩸💧
normal PT/PTT ✅

Q: What does the direct Coombs test tell you?
A: antibody on patient RBCs 🩸🔴
AIHA + HDN 🍼

Q: How does CO poison Hb?
A: CO poisoning 🎯
binds 200× tighter than O2 🎯
cherry-red skin 🚗

Q: What is Factor V Leiden?
A: resistant to protein C 🎯
#1 inherited thrombophilia 🥇

Q: What is a Tear drop cell = Dacrocyte?
A: myelofibrosis 🎯
squeezed through fibrotic marrow 🪨

Q: What is extravascular hemolysis?
A: spleen macrophages eat RBC 🩸🔴
hereditary spherocytosis 🟡

Q: How does Factor 13 deficiency present?
A: Factor XIII deficiency ⬇️❌
delayed cord stump bleed 🩸💧
normal PT/PTT/INR ✅

Q: What are Immunoprivileged sites?
A: brain, cornea, thymus, testes, placenta 🧠⚡
no lymphatics 🚫

Q: What is intravascular hemolysis?
A: ↓haptoglobin + ↑LDH + hemoglobinuria 🎯
PNH + valves ⚙️

Q: Anticonvulsive drugs that cause Megaloblastic/Macrocytic anemia
A: Anticonvulsant megaloblastic ⚡🧠
phenytoin, valproate, carbamazepine 🎯
folate antagonism 🥬

Q: What disease has 2-jointed thumbs?
A: Diamond-Blackfan 🎯
triphalangeal thumbs 🎯
pure RBC aplasia 🔴

Q: What is a Heinz body?
A: denatured Hb precipitate 🩸🧬
G6PD def → bite cell 🍪

Q: What drugs cause hemolytic anemias?
A: HIPPPE mnemonic 🎯
oxidative stress ⚠️

Q: What is Hemolytic Disease of the Newborn?
A: HDN 🎯
IgG anti-D crosses placenta 🛡️🎯
prevent RhoGAM 💉

Q: What is a Spur cell = Acanthocyte?
A: irregular spikes 🎯
abetalipoproteinemia + liver 🍺

Q: What is Sickle cell trait?
A: Sickle trait HbAS 🎯
painless hematuria 🎯
malaria resistance 🦟

Q: What is Glanzmann's?
A: GpIIb/IIIa deficiency ⬇️❌
no aggregation 🤝❌

Q: What is present in Chronic rejection that clearly differentiates it from acute rejection?
A: fibrosis + vascular thickening 🎯
refractory to immunosuppression 🚫

Q: What is a Bite cell = Basket cell?
A: G6PD deficiency ⬇️❌
spleen bites Heinz bodies 🦷

Q: What does extremely high WBC count and <5% blasts tell you?
A: Leukemoid reaction 🎯
↑LAP rules out CML 🎯
severe infection 🦠

Q: What is Chronic Granulomatous Disease?
A: CGD 🎯
NADPH oxidase def 🎯
catalase+ bugs, NBT neg ❌

Q: What is Bernard Soulier?
A: GpIb deficiency ⬇️❌
big platelets, low count 🍔

Q: What is Fanconi Anemia
A: pancytopenia + short + thumb anomalies 🎯
AR DNA repair ☕

Q: What is Hemophilia A?
A: Factor VIII def, X-linked 🎯
hemarthrosis, ↑PTT 📏