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EOR - Internal Med > Hematology > Flashcards

Hematology Flashcards

1
Q

leukemias to know

A

ALL
AML
CLL
CML

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2
Q

child
LAD
bone pain
fever, bleeding

A

ALL

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3
Q

if the vignette is leukemia in a kid it’s

A

ALL

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4
Q

hallmark bx finding of ALL

A

> 20% blasts

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5
Q

tx for ALL

A

chemo

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6
Q

middle aged pt w. fatigue, LAD. splenomegaly

A

CLL

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7
Q

mc leukemia in adults

A

CLL

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8
Q

hallmark findings of CLL

A

smudge cells on peripheral smear (mature lymphocytes)

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9
Q

management of CLL

A

lymphycytes > 10,000: obs
symptomatic: chemo

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10
Q

2 hallmark findings of AML

A

blasts
auer rods

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11
Q

3 sx of AML

A

splenomegaly
gingival hyperplasia
WBC > 100,000

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12
Q

hallmark finding of AML

A

auer rods
>20% blasts

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13
Q

2 sx of CML

A

WBC > 100,000
hyperuricemia
splenomegaly

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14
Q

hallmark finding of CML

A

philadelphia chromosome (translocation of chromosomes 9 and 22)

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15
Q

lab findings of anemia of chronic dz

A

normal vs decreased MCV
decreased TIBC
increased ferritin

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16
Q

mcc causes of anemia of chronic dz

A

CKD
connective tissue d.o
RA
SLE
HIV
ca
cirrhosis
chronic infxn

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17
Q

hallmark finding of anemia of renal failure

A

decreased serum erythropoietin

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18
Q

pharm for anemia of chronic dz if Hgb < 10

A

EPO analog (epogen, procrit)

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19
Q

2 bleeding disorders to know

A

VWD
hemophilias A and B

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20
Q

clotting factor deficiencies associated w. hemophilias a and b

A

a: VIII
b: IX

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21
Q

moa for von willebrand factor

A

found on plasma, platelets, and walls of BV -> helps PLTs adhere to vessel wall at the site of injury

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22
Q

mc genetic bleeding d.o

A

VWD

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23
Q

common presentation for VWD

A

excessive bleeding after a cut or menstrual bleeding

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24
Q

how is VWD differentiated form hemophilia

A

w. hemophilia:
hemarthrosis
small amt of superficial bleeding
common w. minor injury
petechiae

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25
Q

tx for VWD

A

DDAVP
severe: transfusion containing VW factor

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26
Q

how is hemophilia passed on

A

x-linked recessive

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27
Q

hallmark presentation of hemophilas

A

hemarthrosis

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28
Q

lab findings of hemophilias

A

increased PTT
normal PT/PLT

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29
Q

tx for hemophilias

A

replace factor VIII or IX

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30
Q

anemia post infxn or medication

A

G6PD

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31
Q

G6PD is a _ anemia

A

hemolytic

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32
Q

what 3 populations are mc affected by g6pd

A

african
middle eastern
asian

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33
Q

3 triggers for g6pd

A

fava beans
antimalarials
sulfonamides

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34
Q

2 hallmark dx findings of g6pd

A

on smear:
heinz bodies
bite cells

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35
Q

4 genetic causes of hypercoagulable state

A

protein C def.
protein S def.
antithrombin III def.
factor V leiden

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36
Q

6 acquired heme causes of hypercoagulable states

A

polycythemia vera
DIC
antiphospholipid syndrome
TTP
HUS
HIT

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37
Q

what acquired clotting disorder is often associated w. SLE

A

antiphospholipid abs syndrome

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38
Q

AI rxn to PLT’s usually after viral illness

A

ITP

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39
Q

4 conditions associated w. ITP

A

HIV
HCV
SLE
CLL

40
Q

2 hallmark lab findings of ITP

A

CBC normal except for low PLT
(+) direct coombs

41
Q

tx for ITP

A

kids: supportive vs IVIG
adults: prednisone

42
Q

5 s/sx of IDA

A

target cells
pica
nail spooning
angular cheilitis
glossitis

43
Q

mcc of IDA

A

blood loss

44
Q

tx for IDA

A

FeSO4 325 mg TID
6 weeks to replete
recheck q 3 mos x 1 year

45
Q

causes of microcytic anemia

A

IDA
sideroblastic
thalassemia
late anemia of chronic dz
lead poisoning -> basophilic stippling

46
Q

lymphomas to know

A

hodgkin’s
non hodgkin’s

47
Q

hallmark dx of hodgkin’s lymphoma

A

reed sternberg cells - owl eye appearance

48
Q

s/sx of hodgkin’s lymphoma

A

painless upper body LAD:
neck
axilla
shoulder
mediastinum

49
Q

what are 3 B sx associated w. hodgkin’s lymphoma

A

fever
wt loss
night sweats

50
Q

what condition is highly associated w. hodgkin’s lymphoma

A

EBV

51
Q

HIV pt + painless LAD + GI/skin sx

A

non hodgkin lymphoma

52
Q

hodgkin lymphona affects _ cells
non hodgkin lymphoma affects _ cells (2)

A

hodgkin: B
non hodgkin: B and T

53
Q

4 sx of non hodgkin lymphoma

A

SOB
intussusception
bowel obstruction
abdominal masses

54
Q

cancer of monoclonal plasma cells

A

multiple myeloma

55
Q

hallmark presentation of multiple myeloma

A

older pt
bone/back pain refractory to tx

56
Q

what does CRAB stand for

A

multiple myeloma:
calcium elevation
renal failure
anemia
bone lesions

57
Q

dx for multiple myeloma

A

UA: bence jones protein
smear: rouleaux formation (stacked RBC)
XR: lytic punched out bone lesions
electrophoresis: monoclonas M protein spike
bone marrow bx: >10% clonal plasma cells

58
Q

definitive tx for multiple myeloma

A

bone marrow transplant

59
Q

chronic hemolytic anemia that occurs almost exclusively in AA’s

A

SSA

60
Q

s/sx of SSA

A

hemolysis
jaundice
splenomegaly
priaprism
poor healing
pain/swelling in hands/feet
acute chest syndrome
pigmented gallstones

61
Q

what causes SSA crises

A

sickle-cell shaped RBCs clot capillaries -> end organ ischemia

62
Q

what lab value can be used to monitor SSA crises

A

reticulocytes - decrease a pt improves

63
Q

definitive dx for SSA

A

HgbS on Hgb electrophoresis

64
Q

2 hallmark blood smear findings of SSA

A

sickled RBCs
howell-jolly bodies

also target cells

65
Q

what type of anemia is SSA

A

normochromic
normocytic

66
Q

Hb SS vs Hb SA

A

HbSS: disease
HbSA: trait

67
Q

2 parents w. a sickle cell trait have a _ chance of having a child w. HbSS dz

A

25%

68
Q

management of SSA crisis

A

high flow O2
pain control
Hgb < 6: transfusion

69
Q

what med may reduce the frequency of SSA crises

A

hydroxyurea

70
Q

what type of anemia is thalassemia

A

microcytic
hypochromic

71
Q

3 types of thalassemia

A

beta major
beta trait
alpha

72
Q

most severe form of thalassemia

A

beta major

73
Q

electrophoresis findings associated with each form of thalassemia

A

beta major: Hgb A2 and F
beta trait: Hgb A2
alpha: Hgb H, Hgb Bart’s, Hgb A

74
Q

Hgb _ is associated w. hydrops fetalis

A

bart’s

75
Q

which thalassemia is minor and often misdiagnosed as IDA

A

beta trait

76
Q

tx for beta thalassemia major

A

transfusion
deferoxamine (iron chelation)

77
Q

acute febrile disease with multi-organ thrombosis

A

TTP

78
Q

decreased PLT
anemia
schistocytes

A

TTP

79
Q

3 precipitants of TTP

A

quinidine
cyclosporine
pregnancy

80
Q

TTP is caused by inhibition of what gene

A

ADAMTS13

81
Q

how to remember typical presentation of TTP

A

FAT RN:
fever
anemia
thrombocytopenia
renal failure
neuro sx

82
Q

tx for TTP

A

steroids
plasmapheresis

83
Q

3 causes of hemolytic uremic syndrome

A

e.coli 0157:h7
shigella
diarrheal illness in a child

84
Q

common presentation of HUS

A

anemia
decreased PLT
renal failure

85
Q

2 types of macrocytic anemia

A

vitamin B12
folic acide deficiency

86
Q

hallmark finding of vit b12 deficiency

A

hypersegmented neutrophils

87
Q

3 rf for b12 deficiency

A

pernicious anemia
gastrectomy
vegan

88
Q

pernicious anemia is caused by abs to

A

intrinsic factor

89
Q

2 sx of b12 deficiency

A

glossitis
poor balance/low proprioception

90
Q

what is the schilling test for pernicious anemia

A

<10% radiolabeled b12 in urine -> administer intrinsic factor -> results normalize

91
Q

presentation of folate deficiency

A

mimics b12 but no neuro sx

92
Q

folate deficiency makes you think what pt pop

A

alcoholics

93
Q

folate deficiency anemia is same same

A

megaloblastic anemia

94
Q

what dx finding is pathognomonic for folate deficiency

A

hypersegmented PMNs

95
Q

3 folic acid antagonists

A

bactrim
phenytoin
sulfasalazine

EOR - Internal Med (13 decks)

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