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Clin Med Final > Heme > Flashcards

Heme Flashcards

1
Q 
microcytic anemia (↓ MCV)
↓Serum Fe 
↓Transferrin 
↓Ferritin 
↑TIBC 
↑RDW
A

Iron deficiency

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2
Q

Iron deficiency tx

A

ferrous sulfate 325 mg QD with vit C

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3
Q 
microcytic, hypochromic
↑Serum Fe 
↑Serum Lead
↓TIBC
↑Ferritin
A

Lead Poisoning Anemia

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4
Q 
microcytic
↓Serum iron
↓TIBC 
↑Ferritin 
↑Transferrin
A

anemia of chronic inflammation

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5
Q 
African American
Normocytic
↓Hb 
↓Hematocrit 
↑Reticulocytes 
±Howell-jolly bodies
Hb electrophoresis: HbS
A

sickle cell

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6
Q

sickle cell tx

A

pain control: IV hydration & oxygen, NSAIDs, opioids

Hydroxyurea: ↑RBC water & ↓RBC sickling and ↑HbF Folic Acid

±RBC transfusion: severe only

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7
Q 
microcytic ↓MCV
↑ or nrml RBC 
↑Serum Fe & ferritin 
↓Hb
Target cells
Heinz bodies
A

α-Thalassemia

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8
Q

α-Thalassemia tx

A

Mild: no treatment

Moderate: folate, avoid
oxidative stress, AVOID Fe supplementation

Severe: weekly blood transfusions, Vit C, folate, Iron chelation, Splenectomy, bone marrow transplant

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9
Q 
Mediterranean
↓MCV
↑ or nrml RBC 
↑Serum Fe and ferritin 
↓Hb
Target cells
frontal bossing
hepatosplenomegaly
A

β-Thalassemia

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10
Q

β-Thalassemia tx

A

Minor: No med care, genetic counseling

Major: Perodic blood transfusions, Vit C, folate, avoid excess Fe intake, Iron chelating agents, splenectom

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11
Q

How do you dx pernicious anemia?

A

schilling test

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12
Q

What are the hemolytic anemias with enzyme disorders?

A

G6PD deficiency

Pyruvate kinase deficiency

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13
Q

What are hemolytic anemias with erythrocyte membrane

disorders?

A

Hereditary Spherocytosis
Hereditary Pyropoikilocytosis
Hereditary Elliptocytosis
AIHA

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14
Q

What are indications for splenectomy?

A

splenomegaly, hypersplenism, gallstones, jaundice, growth, transfusion
dependence

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15
Q

What are the microcytic anemias?

A

Fe deficency
Anemia of Chronic Inflammation
Lead posioning

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16
Q

What are the normocytic anemias with decreased

reticulocytes?

A 
accute hemorrhage
anemia of chronic inflammation
renal dx
liver dx
marrow infiltration
myelodysplastic syndrome
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17
Q

What are the normocytic anemias with increased

reticulocytes?

A

hemolyitc anemia

post-hemorrhagic anemia

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18
Q

What are sx of leukopenia/neutropenia?

A

fever, sx of infections

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19
Q

What are sx of thrombocytopenia?

A

purpura, petechiae, prolonged bleeding, excessive bruising

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20
Q

What are the general signs of anemia?

A

fatigue, dyspnea, syncope, pallor, postural hypotension, CHF

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21
Q

What are the macrocytic anemias?

A

vit B12

Folate

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22
Q

What is pancytopenia?

A

all 3 cell lines decreased

23
Q

What is thrombocytopenia?

A

low platelet count

24
Q

How do you treat
acquired
neutropenia?

A

G-CSF

25
Q

How do you treat
acute myeloid
leukemia?

A

chemo

26
Q

How do you treat
anemia of chronic
inflammation?

A

Eradicate underlying disease

IV Fe

27
Q

How do you treat

Aplastic anemia?

A

HSCT

28
Q 
How do you treat
autoimmune
neutropenia (AIN)?
A

observation

29
Q

How do you treat
Autoimune Hemolytic
Anemia (AIHA)?

A

Warm: Stabilize, Glucocorticoids 1-2
mg/kg QD, Splenectomy or,
Rituximab

Cold: avoid cold, Rituximab,
plasmapheresis

30
Q

How do you treat

BMF?

A

HSCT curative but not always

indicated

31
Q

How do you treat
chronic lymphocytic
leukemia (CLL)?

A

watch & wait, if sx present treat with

Rituximab

32
Q

How do you treat
chronic myeloid
leukemia (CML)?

A

imatinib

33
Q

How do you treat

DIC?

A

Treat underlying cause Hydration
RBC transfusion
If bleeding:
platelets, FFP, cryoprecipitate

34
Q

How do you treat
dimond-blackfan
anemia?

A

supportive care with RBC

transfusions

35
Q

How do you treat

Fanconi anemia?

A

support with transfusion or HSCT

36
Q

How do you treat Fe

deficiency?

A

Ferrous sulfate 325 mg po QD witth

vit C

37
Q

How do you treat

folate deficiency?

A

Folic acid 1 mg po QD

38
Q

How do you treat

G6PD deficency?

A

Self limited
Avoid offending food/drugs
Hydrate

39
Q

How do you treat
Hemolytic Uremic
Syndrome (HUS)?

A

Supportive tx: observation, IV fluids
Severe: plasmapheresis, dialysis as
needed
ABX will WORSEN condition

40
Q

How do you treat

hemophilia A

A

DDAVP/stimate

41
Q

How do you treat

hemophilia B?

A

factor IX infusion

42
Q

How do you treat
hereditary
spherocytosis (HS)?

A

Splenectomy & folic acid to help

not cure

43
Q

How do you treat

hodgekins lymphoma?

A

Involved field radiotherapy,

chemotherapy

44
Q

How do you treat
inherited
thrombophillia?

A

LMW heparin IV Vondaoarinux,
UFH Warfarin (oral once ontrolled)
plus vit K

45
Q

How do you treat ITP?

A 
Children: observation,shore course
steroids, ±IVIG or anti-D
Adults: corticosteroids, IVIG, anti-D,
platelet transfusion if <30K
Chronic: splenectomy, Rituximab,
immunosuppressant agents
46
Q

How do you treat
lymphoblastic
leukemia (ALL)?

A

chemo

47
Q

How do you treat
pyruvate kinase
deficiency?

A

Splenectomy

48
Q

How do you treat
severe congenital
neutropenia?

A

G-CSF

49
Q

How do you treat

sickle cell?

A 
Pain control: IV hydration &amp; oxygen,
NSAIDs, opioids
Hydroxyurea: ↑RBC water &amp; ↓RBC
sickling &amp; ↑HbF
Folic Acid
50
Q

How do you treat TTP?

A 
Plasmapheresis: remove Ab daily
1.5 L plasma vol exchange
Immunosuppression:
corticosteroids, ±splenectomy if
refractory to tx
Platelet transfusion
CONTRAINDICATED unless likethreatening
bleeding
51
Q

How do you treat vit B

deficiency?

A

IM B12 (100 mcg daily then weekly
then monthly)
Orabl B12 1mg QD (mild)
Folic acid for first several months

52
Q

How do you treat von willebrand

disease?

A

DDAVP/stimate

53
Q

How do you treat α-Thalassemia?

A

Mild: no treatment
Moderate: folate, avoid oxidative stress, AVOID Fe supplementation
Severe: weekly blood transfusions, Vit C, folate, Iron chelation, Splenectomy, bone marrow
transplant

54
Q

How do you treat β-Thalassemia?

A

Minor: No med care, genetic counseling
Major: Perodic blood transfusions, Vit C, folate, avoid excess Fe intake, Iron chelating agents,
splenectomy

Clin Med Final (3 decks)

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