Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MKSAP - Internal > hematology > Flashcards

hematology Flashcards

1
Q

what might a serum ferritin level lower than 100-120 ng/ml in a pt with inflammatory disease suggest?

A

iron deficiency concomitant with anemia of chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

changes in iron studies seen in anemia of chronic disease

A

decreased transferrin and TIBC level

increased serum ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

changes in iron studies seen in iron deficiency anemia

A

increased transferrin and TIBC levels

decreased ferritin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

characteristic finding on BM biopsy in aplastic anemia

A

hypoplastic BM (<20% cellularity) with normal maturation of all cell lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

initial management in pts with aplastic anemia (after BM biopsy)…

A

withdrawl of any causative agents

CT scan of chest to R/O thymoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in a question stem, what should you look for to dx. aplastic anemia?

A

look at all 3 cell lines - all will be decreased
reticulocytes will be decreased
should have hypocellular BM biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do you supplement iron in iron deficiency anemia?

A

oral ferrous sulfate, 325 mg three times daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

who should receive parenteral iron therapy?

A

those pts with iron deficiency anemia who have problems with malabsorption ex. celiac dz, Crohn’s dz, small bowel dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are “bite” cells in G6PD deficiency caused by?

A

produced when accumulated oxidized Hb remains adherent to the RBC mb with an adjacent mb bound clear zone; spleen takes a “bite” out of these RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how can you tell a pt apart with hereditary spherocytosis and warm-AIHA?

A

direct Coomb’s test is positive in warm AIHA and negative in spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

characteristic findings in a pt with thalassemia

A

1 low MCV

  1. target cells on PBS
  2. normal results on iron studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

common lab findings in hemolytic anemia

A

elevated LDH
decreased haptoglobin
reticulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

schistocytes are associated with ? (4)

A

mechanical/prosthetic heart valves
TTP
HUS
DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

peripheral blood smear findings in iron deficiency anemia

A

microcytosis
hypochromia
anisocytosis - diff. sizes
poikilocytosis - diff shapes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what types of cell characterize warm-AIHA on peripheral blood smear?

A

spherocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does it mean when a “mixing corrects to normal”

A

pt likely has a factor deficiency

- it will remain abnormal if a factor inhibitor is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how can you make the dx. of DIC?

A 
prolonged PT, aPTT and thrombin time
positive D-dimers
decreased fibrinogen
decreased platelet count
microangiopathic hemolytic anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what disease do you suspect in a pt who has a personal/family history of bleeding tendency, prolonged bleeding time, elevated aPTT and a low factor VIII level?

A

von willebrand disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

in someone with a low factor VIII level, how can you distinguish vWD from hemophilia A?

A

vWD causes prolonged bleeding time, while hemophilia A does not

20
Q

best screening test for bleeding disorder

A

clinical history

21
Q

what risk factors of bleeding require further screening (PT, aPTT, plt count) pre-operatively?

A 
personal/family history of bleeding
liver disease
significant alcohol use
malabsorption
anticoagulation therapy
22
Q

a pt with sickle cell dz presents with transient aplastic crises – what should you consider?

A

acute infection with parvovirus B19

  • dx. with serum IgM abs
  • recovery is usually spontaneous
23
Q

management of acute chest syndrome

A

exchange transfusion

24
Q

best test to diagnose osteonecrosis (avascular necrosis) in pt with sickle cell dz?

A

MRI of the hip

25
Q

where is pain typically located in avascular necrosis?

A

groin

26
Q

reflex sympathetic dystrophy

A

complex regional pain syndrome

  • localized osteoporosis
  • pain in extremities with swelling, limited ROM, vasomotor instability and skin changes
27
Q

therapy of pt with sickle cell dz who developed stroke

A

chronic blood transfusion therapy to maintain peripheral blood HbS level < 50%

28
Q

what should you consider in any pt with an otherwise unexplained decrease in platelet count and/or new thrombotic event 5-10 days after initiation of heparin therapy? how should you tx. them?

A
  1. heparin induced thrombocytopenia

2. stop heparin and administer argatroban

29
Q

gold standard dx. test for HIT

A

C14-serotonin release assay

- but negative assay does not exclude HIT

30
Q

TTP is due to deficiency of what?

A

ADAMST13

31
Q

pentad of TTP

A 
neurological symptoms
fever
renal failure
thrombocytopenia
micropathic hemolytic anemia
32
Q

Tx. of TTP

A

plasma exchange

33
Q

Evans syndrome

A

combination of warm AIHA and ITP

34
Q

condition in which platelets clump together and cannot be counted properly

A

pseudothrombocytopenia

35
Q

how can you dx. pseudothrombocytopenia

A

finding clumps of platelets (can occasionally adhere to neutrophils) on stained blood film

36
Q

what do you do if you find pseudothrombocytopenia?

A

redraw pts blood using alternative anticoagulant to EDTA, such as heparin or sodium citrate

37
Q

gestational thrombocytopenia

A

usually have platelet levels around 70 000

38
Q

first line tx. for pts with ITP

A

steroids

39
Q

indications for steroid tx. in ITP

A

symptomatic bleeding and plt count < 50 000 OR plt counts < 15 000

40
Q

Tx of pt diagnosed with antiphospholipid syndrome

A

indefinite anticoagulation

41
Q

how do you confirm the diagnosis of antiphospholipid syndrome?

A

2 positive lab tests (anticardiolipid ab or lupus inhibitor assay) ATLEAST 12 weeks apart - this is to ensure the findings were not transient

42
Q

what are the antiphospholipid ab?

A

IgG anti-cardiolipin

B2-glycoprotein I abs

43
Q

how can you diagnose antiphospholipid syndrome?

A

history of a thrombotic event (ex. recurrent pregnancy loss) in association w/ persistent lupus anticoagulant or persistently elevated ab

44
Q

who is antiphospholipid syndrome common in?

A

SLE pts

- can also be been in cancer, infections (HIV) or drugs

45
Q

decreased AG in the presence of anemia, proteinuria, hypercalcemia and renal failure suggests…

A

multiple myeloma

46
Q

what is MGUS characterized by?

A

monoclonal spike < 3 g/dL
< 10% plasma cells in BM
absence of lytic bone lesions, anemia, hypercalcemia or renal failure

MKSAP - Internal (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions