Hematology (3%) Flashcards

1
Q

Lead poisoning anemia (plumbism) is a _____ _____ anemia, most commonly seen in (children/adults)

A

Acquired sideroblastic anemia

children

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2
Q

What are the clinical manifestations of lead poisoning anemia?

A

Abd pain w/ constipation, neurologic sx (ataxia, fatigue, learning disabilities, coma, shock), anemia sx, metabolic acidosis

± Asymptomatic

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3
Q

What labs will be elevated in a pt with lead poisoning anemia (plumbism)?

A

Increased serum lead and increased serum iron

looks similar to anemia of chronic disease except lead poisoning is associated with increased serum Fe, ACD is associated with decreased serum Fe

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4
Q

What will be seen on peripheral smear of pts with lead poisoning anemia (plumbism)?

A

Microcytic, hypochromic anemia w/ BASOPHILIC STIPPLING (dots of denatured RNA seen in RBCs) & RINGED SIDEROBLASTS in bone marrow (iron accumulation in mitochondria due to failure of incorporation of iron into Hgb)

May be normocytic

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5
Q

What may be seen on XR in patients with lead poisoning anemia?

A

“lead lines” linear hyperdensities at the metaphyseal plates

Lead lines in gums (adults)

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6
Q

What is the recommended managment for lead poisoning anemia?

A

Remove source of lead

Chelation therapy may be needed if severe (ex. Succimer, CaNa2EDTA)

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7
Q

There are two forms of CNS lymphoma, primary and secondary.

Which one is more common?

Which one is a variant of extranodal Non-Hodgkins lymphoma?

Which one is a result of metastasis from another site, especially large B cell lymphoma (90%) and Burkitt’s lymphoma (10%)?

A

Secondary

Primary

Secondary

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8
Q

What virus is found in 90% of patients with CNS lymphoma?

A

Epstein Barr virus

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9
Q

What is the most common sx in a patient with CNS lymphoma?

A

Focal deficits

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10
Q

What will be seen on CT or MRI of a pt with CNS lymphoma?

A

hypointense RING-ENHANCING LESION in deep white matter on CT

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11
Q

What is the most effective chemotherapy for CNS lymphoma?

A

Methotrexate

Radiation therapy and corticosteroids have a partial response

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12
Q

Acute Myelogenous Leukemia (AML) associations

A

Adults

Immature granulocytic cells seen in the peripheral blood (myeloblasts, promyelocytes)

Auer rods (clumps of azurophilic granular material that form elongated needles seen in the cytoplasm of myeloid leukemic blasts)

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13
Q

Loss of position and vibratory sense are assoicated with what type of anemia?

A

Pernicious anemia (a decrease in red blood cells when the body can’t absorb enough vitamin B-12)

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14
Q

Hepatosplenomegaly is associated with _______ anemia

A

Hemolytic

(a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over)

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15
Q

Petechiae and ecchymosis are assoicated with what condition?

A

Thrombocytopenia

a condition characterized by abnormally low levels of thrombocytes, also known as platelets, in the blood

<em>A normal human platelet count ranges from 150,000 to 450,000 platelets per microliter of blood</em>

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16
Q

Multiple myeloma is a cancer of the _____ cells

A

plasma

17
Q

ALL, AML, CLL, or CML?

MC in kids, presents with blasts in peripheral blood

A

ALL

18
Q

ALL, AML, CLL, or CML?

Pancytopenia, blasts in peripheral blood

A

AML

19
Q

ALL, AML, CLL, or CML?

Increased WBC, Left shift in myeloid series of cells, (+) Philadelphia chromosome

A

CML

20
Q

ALL, AML, CLL, or CML?

WBC > 20,000, Absolute lymphocyte count >5,000

A

CLL

21
Q

____ anemia is caused by a lack of intrinsic factor

A

pernicious

22
Q

__________ is a normocytic normochromic anemia with many spherocytes

How is this condition dx’d?

A

Hereditary spherocytosis

(+) osmotic fragility test

23
Q

Pts with ______ ______ have elevated Hgb/Hct and on PE will have plethora, engorged retinal veins, and splenomegaly

A

Polycythemia vera

Plethroa = ruddy complexion

24
Q

A pt with _______ will have a prolonged PTT and a normal platelet count and funciton.

They should be treated with factor VIII or cryoprecipitate

A

Hemophilia A