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HandL Final > Anemia - Hubbard > Flashcards

Anemia - Hubbard Flashcards

1
Q

What is the word for wanting to eat ice all the time?

A

Pagophagia

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2
Q

What is the cause of paroxysmal cold hemoglobinuria (PCH)?

A

Tertiary syphilis (Donath-Landsteiner hemolytic anemia)

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3
Q

When do symptoms of AIP occur?

What is the most common sx?

How often are attacks?

A

After puberty

Abdominal pain

Intermittent

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5
Q

PCT pts are at increased risk for what?

May occur in what?

A

Hepatoma

ESRD

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7
Q

Prognosis for AIP minimally affected pt?

Severely?

A

Normal

Chronically debilitated

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8
Q

What are the following lab values in G6PD?

Reticulocyte count?
Haptoglobin?
LDH?
Bilirubin?

A

Inc
Dec
Inc
Inc

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10
Q

Major CF in PCT?

What is not seen?

Occurs in what setting?

A

Cutaneous photosensitivity

No neurologic effects

Alcohol drinking

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12
Q

Warm agglutinin reaction to what?

Cold?

A

IgG

IgM

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14
Q

Tx of PV?

A

Phlebotomy (every 1-2 weeks)

hydroxyurea

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16
Q

Tx for ACD if mild?

Severe?

What is NOT helpful?

A

Supportive (10-12 Hb)

Transfusion

Fe supplementation

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19
Q

What is the reticulocyte count in immune mediated hemolytic anemia?

A

Elevated

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20
Q

MOA in Bartonellosis (Carrion)?

What special CF?

Vector?

Tx?

A

Adheres to rbc membrane

Oriya fever

Sand flea

Antibiotics and support

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22
Q

Acute intermittent porphyria (AIP) is most common in whom?

Due to what?

More common in whom?

A

Scandinavia, British, eastern Europe

Def. of porhobilinogen deaminase (PBG)

Psychiatric pts

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23
Q

Does folate or B12 have minimal body stores?

What condition can deplete it faster?

A

Folic acid

Pregnancy

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24
Q

What are the bolded clinical features in PV?

Acc CF?

A

Facial rubor, pruritis w/hot shower

Hyperviscosity, splenomegaly in 70%

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25
Q

CFs of N/V/C, tachycardia, HTN, and neurologic changes are common in what?

A

AIP

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27
Q

What disease is from a parasite in rodents and has a slow gradual course, myalgia with darker urine?

A

Babesia microti

Or he could just give it away w/Maltese cross

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28
Q

What is reticulin?

A

RNA that is generating hemoglobin

29
Q

W/out tx, prognosis of PV?

Been linked to what?

Usual cause of death in treated pts?

A

50% mortality w/in 18 months

Budd-Chiari syndrome

Progressive marrow fibrosis w/pancytopenia aka spent phase

30
Q

What is the most common of the porphyria?

Due to what defect?

A

Porphyria cutanea Garda (PCT)

No uroporphyrinogen decarboxylase in liver

33
Q

Tx for PCT?

A

Chloroquine
Phlebotomy
Stop drugs/alcohol

34
Q

What causes cardiac anemia?

Severity of anemia?

A 
Severe AS (valve gradient > 50 mmHG)
Prosthetic valves

Mild

35
Q

What random chemicals can induce hemolytic anemia?

A

Copper
Pure oxygen –> astronauts
Bee/spider venom

36
Q

What are common causes of GI bleeding leading to Fe def anemia?

A

PUD
Angiodysplasia
Inflammatory states
Tumors

39
Q

How does Lead fuck up rbcs?

A

Interferes w/cation pump leading to shortened rbc survival time

42
Q

Pseudoscleroderma occurs in what?

What else present?

A

PCT

After minor trauma, sun exposed skin gets gross

43
Q

What 3 medicines should pts w/sickle cell take?

A

Hydroxyurea
PCN
folic acid

44
Q

Lab features of PCT?

A

Increased liver enzymes, iron in liver, porphyrins in urine and stool (ALA)

46
Q

Treatment of cold antibody hemolytic anemia?

A

Supportive
Avoid cold
Tx infections

47
Q

What is the mainstay of tx for warm antibody hemolytic anemia?

What else may be used?

What if disease is chronic over a long time?

A

Steroids in high doses

Immunosuppressives -> cyclophosphamide and azathioprine

Splenectomy

49
Q

Tx of acute attacks in AIP?

A

Hydration w/D5 or D10
Hemin infusion
Beta blocker
Analgesic

51
Q

What chemicals can cause aplastic anemia?

A

Toluene

Glue

53
Q

What are the precipitating factors of AIP?

A 
Hormones 
Drugs - anticonvulsants, barbiturates, sulfonamides, alcohol
Low calorie intake
Surgery 
Infection

Mark Fagala has AIP at SABA in the Caribbean

56
Q

What drugs can cause aplastic anemia?

What infections?

A

Chloramphenicol, quinacrine

Hepatitis, EBV, Erythrovirus (parvovirus), HIV

57
Q

Refractory megaloblastic anemia may occur in what?

A

Myelodysplasia

58
Q

Tx for malaria?

A

Antimalarials and supportive care

61
Q

What is characterized by loss of hematopoietic stem cells, fatty replacement of marrow, and pancytopenia?

A

Aplastic anemia

62
Q

What drug can cause megaloblastic anemia?

What toxin?

A

Methotrexate

Arsenic

64
Q

What is the genetic acquired malabsorption that leads to Fe def anemia?

A

nRAMP2 which codes for DCT1/DMT1 in the brush border

65
Q

Describe labs in ACD?

Fe?
TIBC
Ferritin?

A

Dec
Dec
Inc

68
Q

Tx for cardiac anemia?

A

New prosthesis

Fe replacement

70
Q

What chronic condition produces acantholytic on peripheral smear and can cause erythroid progenitor proliferation defects?

A

Chronic kidney disease

75
Q

What dose given for supplemental folate tx?

A

1 mg po qd

HandL Final (8 decks)

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