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CMPP > Anemias > Flashcards

Anemias Flashcards

1
Q

Four things that people with sickle cell trait are at increased risk for

A

VTE
Ckd
Renal medullary carcinoma
Hematuria

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2
Q

When does sickle cell trait start to have the risk of sudden-death with physical activity

A

Without a dehydration rhabdo or heat exposure

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3
Q

Two tests to detect sickle cell disease

A

Hemoglobin electrophoresis and peripheral smear

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4
Q

What deficiency do sickle cell disease patients have and what does expose them to

A

Folate for megaloblastic macrocytic anemia

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5
Q

Nine causes of vaso-occlusive crisis

A 
Nothing 
hypoxia 
dehydration
 acidosis 
Fatigue
 cold-weather 
alcohol 
pregnancy
 emotional stress
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6
Q

Six associated symptoms with vaso-occlusive crisis

A 
Fever 
swelling 
tenderness 
tachypnea  
HTN  
nausea and vomiting
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7
Q

How long do vaso-occlusive crisis last

A

2 to 7 days

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8
Q

How do you diagnose vaso-occlusive crisis

A

Clinically

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9
Q

How do you treat vaso-occlusive crisis

A

NSAIDs the narcotics

always hydrate

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10
Q

For indications to use hydroxyurea

A

More than three episodes a year
history of ACS
history of vaso-occlusive events
history of symptomatic anemia

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11
Q

The side effect of hydroxyurea

A

Suppress all lines

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12
Q

Presentation of ACS

A

Chest pain
fever
cough
low O2 sat

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13
Q

What is ACS

A

New infiltrate with the pulmonary symptoms in a patient with SCD

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14
Q

Three ways to get increased cycling in the pulmonary vascular in ACS

A

Fat embolism
pulmonary infarct
infection by pneumonia or mycoplasma

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15
Q

Four steps of treating ACS

A

Hydrate with caution
oxygen support
antibiotics
transfusion

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16
Q

Three neurologic complications of sickle cell disease

A

Stroke seizures narrow cognitive decline

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17
Q

How do we determine children’s risk for stroke and SCD

A

Transcranial Doppler

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18
Q

Describe aplastic crisis and SCD

A

Parovirus B 19 causes an infection of red blood cell progenitors in the marrow which impairs cellular division for a few days this causes a rapid drop in hemoglobin with the reticulocyte count less than one

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19
Q

How soon do aplastic crisis patients get better

A

7 to 10 days

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20
Q

When does splenic sequestration usually happen in sickle cell disease patients

A

Within the first five years but can occur anytime

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21
Q

What bacteria’s are especially harmful to kids with sickle cell disease

A

strep pneumo

H flu

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22
Q

Which bacteria most dangerous two adults with sickle cell disease

A

E. coli
Samonella
Strep pneumo

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23
Q

What to viruses or more virulent in SCD

A

Parovirus

H1n1

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24
Q

What cardiovascular event are SCD patients more prone to

A

Myocardial infarction because likely secondary increased 02 demand

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25
Q

Deficiency and hereditary spherocytosis

A

Spectrin

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26
Q

Three clinical manifestations of hhereditary spherocytosis

A

Anemia jaundice splenomegaly

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27
Q

Clinical picture of mild hereditary spero-cytosis

A

No anemia modest reticulocytosis little splenomegaly or Jandus not diagnosed until adulthood

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28
Q

When do you need regular transfusions and hereditary spherocytosis

A

When is severe

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29
Q

Seven key diagnostic features of hereditary spirit cytosis

A 
Reticulocytosis 
microcytic anemia 
hyperchromic cells 
elevated RDW 
spherocytes on peripheral smear pseudohyperkalemia 
osmotic fragility test
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30
Q

For complications of hereditary spherocytes cytosis

A

Lego ulcers
hypertrophic cardiomyopathy
movement disorders
gallstones

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31
Q

Three treatments for hereditary spherocytosis

A

Folic acid
blood transfusions
splenectomy

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32
Q

Six causes of autoimmune hemolytic anemia warm

A 
Idiopathic 
viral infection 
systemic lupus 
immune deficiency 
malignancy of the immune system 
drugs
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33
Q

Six drugs that cause warm hemolytic anemia

A

Sulfas cephalosporins rifampin ibuprofen penicillins fluroquinolones

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34
Q

Drug to use for a long-term treatment of warm autoimmune hemolytic anemia

A

Azothioprine(imuran)

35
Q

What drug can’t you use and warm hemolytic anemia

A

Methotrexate

36
Q

Is warm or cold hemolytic anemia more severe

A

Warm

37
Q

Two most common infections that cause cold hemolytic anemia

A

Pneumonia

mono

38
Q

Most common neoplasm to cause cold hemolytic anemia

A

Lymphoma

39
Q

Is hereditary hemachromatosis dominant or recessive

A

Recessive

40
Q

For places the iron deposits and hereditary hemachromatosis

A

Heart liver pituitary pancreas

41
Q

Seven manifestations of hereditary hemachromatosis

A 
Liver disease 
Hepatocellular carcinoma 
diabetes mellitus 
joint pain 
dilated cardiomyopathy 
hypogonadism 
skin changes
42
Q

The only definitive test to diagnose hereditary hemachromatosis

A

Liver biopsy

43
Q

When don’t we treat hereditary hemachromatosis

A

Ferritin less than 1000

asymptomatic

44
Q

Best way to treat hereditary hemachromatosis if you have to

A

Phlebotomy

45
Q

Most common population of sickle cell

A

Sub-Saharan Africans

46
Q

Three populations most at risk for taco

A

Young old and surgical ICU settings

47
Q

Best noninvasive test to determine total Iron body stores

A

Ferritin

48
Q

Two things that affect TIBC

A

Pregnancy OCP

49
Q

How much elemental iron does one need for supplementation a day

A

150 to 200 mg

50
Q

How soon should hemoglobin be back to normal with treatment of iron deficiency anemia

A

6 to 8 weeks

51
Q

What is often mistaken for a vitamin B12 deficiency

A

Sideriblastic anemia

52
Q

Transferrin level in sideroblastic anemia

A

Low

53
Q

RDW in sideroblastic anemia

A

High

54
Q

Treatment for anemia of chronic disease if you must

A

EPO

55
Q

Seven causes of a plastic anemia

A 
Idiopathic 
cytotoxic radiation
drugs 
 viral 
immune disorder 
pregnancy 
Anorexia
Dancing anemia
56
Q

6 categories of clinical manifestations in aplastic anemia

A 
Cardiopulmonary compromise
 fatigue 
recurring infection 
mucosal hemorrhage 
Pallor and petechiae rash 
no lymphadenopathy 
No hepatosplenomegaly
57
Q

Four characteristics of sudden onset cute hemolytic anemia

A

Jaundice
Pallor
dark urine
with or without abdominal or back pain

58
Q

Hemoglobin reaction to a cute hemolytic anemia

A

Hg fall of 3 to 4

59
Q

Drugs that cause hemolytic Anemia in g6pd

A 
Fluoroquinolones 
antimalarial's 
nitro 
sulfa drugs 
Tylenol 
aspirin 
methylene blue 
INH
60
Q

What chains are excess in a thalassemia

A

Gamma in newborns

Beta on adults

61
Q

Where is a thalassemia the most common

A

Southeast Asia

62
Q

3 Severe lifelong problems in HbH disease

A

Microcytic hemolytic anemia
infective erythropoeisis
splenomegaly

63
Q

What are four beta chains bound together that are soluble and formed from Alpha thalassemia intermedia

A

Hemoglobin h

64
Q

What are four gamma chains bound together called

A

Hb Bart’s

65
Q

What has a higher affinity for oxygen and then HBA but cannot release it

A

HB Barts

66
Q

What is the MCV in a thalassemia and why?

A

Well because hemoglobin makes up 35% of the cell volume

67
Q

What are target cells associated with

A

A thalassemia

68
Q

Reason behind target sells

A

The KCL cotransporter is broken in a Palastine yeah and allows fluid to leak out causing dehydration

69
Q

When do you see basophilic stippling

A

Hemolytic anemia and a and B thalassemia

70
Q

Iron transferrin and ferritin levels in a thalassemia

A

All higo

71
Q

Treatment for a thalassemia minima and minor

A

None

72
Q

Treatment for h BH disease

A

Follow bloodwork support with transfusion avoid oxidative stress but no bone marrow transplant

73
Q

What exacerbates hemolysis in HbH dz

A

Oxidation (same as g6pd)

74
Q

What percent is hemoglobin H in Alpha thalassemia intermedia

A

5 to 30%

75
Q

Is Alpha thalassemia intermedia symptomatic at birth

A

Yes with neonatal jaundice and anemia

76
Q

What population is beta thalassemia common in

A

Mediterranean descent

77
Q

Presentation of beta thalassemia minor

A

Asymptomatic mild anemic discovered incidentally

78
Q

Presentation of Beta thalassemia intermedia

A

Varies

79
Q

Synonym for beta thalassemia major

A

Cooley’s anemia

80
Q

Eight characteristics of beta thalassemia major

A 
Abdominal swelling 
growth retardation 
irritability 
Jaundice
 Pallor
skeletal abnormalities 
splenomegaly
 life long transfusion dependent
81
Q

What anemia gets an altered protein synthesis of spectrum in addition to their problems

A

Beta thalassemia

82
Q

Which thalassemia has premature a pop ptosis

A

Beta

83
Q

M HC and MCHC of beta thalassemia

A

Microcytic hypo chronic but some will be very dense

CMPP (17 decks)

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