Awesome Review Flashcards by Alpa Patel

Difference btwn MCV and RDW?

MCV- measure of RBC size
RDW- measure of variation of red cell size

Note: if RDW is high, it’s a mixed anemia

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Bite Cell

G6PD deficiency

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Too much Erythropoietin can cause what 4 major problems?

Lymphoma, VTE, CVA, HTN

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Most sensitive assay for IDA

Serum Transferrin receptor level/log ferritin which is
Transferrin receptor index

> 2.0 is IDA

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IDA: 
Transferrin saturation 
Serum ferritin 
TIBC
Transferrin receptor index

Transferrin saturation 2.0

Note: transferrin saturation is also low in AOCD

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What would you see on hemoglobin electrophoresis for beta thalassemia?

Increased A2 levels
Increased fetal Hgb levels
Must have Both!

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How to diagnose alpha thalassemia?

DNA PCR analysis

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What will you see on XRAY of hip for Avascular necrosis of femur head

Diffuse articular sclerosis and patches of decalcification

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Treatment algorithm for acute chest syndrome in sickle cell anemia patient?

Abx
Oxygen
PRBCs
Exchange transfusion if still hypoxic!!

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Diagnose and Treat a schoolteacher with anemia and arthalgias- Parvovirus B19

IgM Antibodies or PCR assay

Treat with IVIg

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MC cause of osteomyelitis in Sickle Cell Disease

Salmonella

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If MCV is > 110, what are you thinking?

Vitamin B12 deficiency

Folate deficiency

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Difference btwn B12 and folate deficiency?

B12 deficiency will have both increased MMA and Increased Homocysteine

Folate deficiency will only have increased homocysteine

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Metformin and PPI can cause what macrocytic anemia?

B12 deficiency due to decreased absorption of Vitamin B12

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5 causes of folic acid deficiency

Alcohol
Folic acid antagonist (MTX) 
OCP
Low dietary intake of folate 
Infection 
Celiac Sprue 
Dilantin/Phenytoin
Relative Folate deficiency (chronic hemolysis or hereditary spherocytosis)
Old 
Pregnancy

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Treat Myelodysplastic Syndrome

If 55 yo, Azacitidine

If erythropoietin level > 500, antithymocyte globulin and cyclosporine
If 5q gene deletion or can’t tolerate antithymocyte globulin- Lenalidomide

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Transferrin saturation is >45%

Hemochromatosis with HFE gene

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Treat Aplastic Anemia

50 give antithymocyte globulin and cyclosporine
If can’t tolerate or doesn’t work, give
Alemtuzumab

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Name 5 causes of Pancytopenia

MDS
B12 deficiency
Fanconi Syndrome 
Viral hepatitis 
HIV
Hypersplenism 
Hairy cell Leukemia
Bactrim
Copper Deficiency

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Name etiology of warm AIHA

SLE
CLL
Lymphoma 
Methyldopa
PCN
Procainamide

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Etiology of Cold AIHA

Quinidine 
Lymphoma 
Infectious Mononucleosis
Influenza
Mycoplasma

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Treatment of Warm AIHA

Steroids 
Danazol
Rituximab 
Splenectomy
Immunosuppressive drugs

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Treatment of Cold AIHA

Cyclophosamide
Chlorambucil
Rituximab
NOT STEROIDS

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Diagnose and Treat Hereditary Spherocytosis

Study These Flashcards

Osmotic Fragility Test

Tx: folate supplement or splenectomy in severe cases

Screening and Specific Test for Hereditary Spherocytosis

Screening- fluorscent spot for G6PD activity in men | Specific- quantitative level of G6PD enzyme (but not during acute hemolysis)

Name 4 conditions you see schistocytes

DIC HUS HELLP TTP

After massive blood transfusion, patient has seizure due to?

Citrate toxicity

What causes acute hemolytic transfusion reaction?

ABO incompatibility

What causes delayed Hemolytic transfusion reaction?

Rh incompatibility | 2-10 days after transfusion

Prevent febrile nonhemolytic transfusion reaction, give what kind of PRBC

Leukoreduced (remove contaminating WBCs)

Give what kind of PRBC if IgA deficiency

Washed (removes protein) | Especially if urticaria and recurrent allergic reaction

Etiology for Transfusions Related Acute Lung Injury

Anti leukocyte antibody from donor | Stop donating!

Etiology and treatment of | Post transfusion Purpura

PLA-1 Antibodies | Tx: IVIg

What primary hemostasis disorder gas giant platelets?

Bernard Soulier disease | Normal PTT

Diagnose VonWilibrand Disease

Decreased Ristocetin factor assay Increased bleeding time Increased PTT

Treat VonWilibrand Disease

Mild- DDAVP | Severe- factor 7 concentrate contains vWD

Treatment for Idiopathic/Immune Thrombocytopenic Purpura

If bleeding or platelet

You need to anticoagulate someone with HIT

Argatoban or Bilavirudin | Direct thrombin inhibitor

How to determine factor 13 deficiency?

Clot Retraction Test

What are the Factor Xa inhibitors?

Rivaroxaban Apixaban Fondaparinux Edoxaban

What are Low Molecular Weight Heparin?

Dalteparin Enoxaparin Tinzaparin (Inhibit thrombin and Xa)

What are direct thrombin Inhibitors?

Hirudin, bivalirudin, lepirudin, desirudin Argatroban Dabigratan

Russel Viper Venom Time Test for..?

Lupus anticoagulant syndrome

How long do you treat provoked cause of DVT or post surgically? How long do you treat Leiden factor V defect or protein C deficiency DVT?

3 months | 6 months

Cause of Warfarin Skin Necrosis | How to treat?

Protein C deficiency | FFP

Treat Polycythemia Vera

Low dose Aspirin with phlebotomy to get Hct 60, give hydroxyurea Or consider Ruxolitinib (JAK2 inhibitor)

In Essential Thrombocytosis, | What are the 2 associated mutations?

JAK2 | CALR

Diagnose CML

FISH for t(9:22) Or PCR analysis for abl/bcr fusion gene

3 diseases you see decreased leukocyte alkaline phosphatase

CML PNH Wilson's disease

Long standing history of PV | Blood smear is tear drop cells, uncleared RBC, giant platelets

Myelofibrosis

Translocation and treatment of | Acute Promyelocytic leukemia

T(15:17) Auer rods! Tx: All trans retinoic acid and arsenic trioxide

Signs/Symptoms and Treatment of ATRA differentiation syndrome

ATRA- all trans retinoic acid Dyspnea, pulmonary infiltrate, fever, weight gain, hypotension Give Dexamethasone

Mutation for Hairy Cell Leukemia

BRAF V600E

What ethnicity is common in alpha thalassemia?

SE Asia like Vietnam, Cambodia, Laos

What ethnicity is common in beta thalassemia?

Mediterranean/Asian like Italian, Greek, Indian

Spurr cell OR acanthocyte

Liver Disease

Burr Cell OR Echinocyte

Anemia of Uremia

Smear shows Tear Drop, nucleated RBC and giant platelets

Myelofibrosis

Side Effect of Lenalidomide

VTE/PE

Awesome Review Flashcards

(59 cards)