CIS Pales Flashcards
definition lymphadenopathy
feel abnormal
painful to touch
what fungi can cause lymphadenopathy
histoplasmosis, coccidiodes
supraclavicular nodes drain from where
thorax and abdomen
what is panniculitis
inflammation of abdominal fat
heterophile test
mono
one very suspicious lymph node on neck
what imaging is gold standard
CT
factor VII intrinsic or extrinsic
intrinsic
14 y.o F heavy menstruation, weakness lack concentration, Sx 7-8 mo periods heavy and last 7-9 days easy bruising, bleed after tooth extraction age 7 normal vital signs WN/WD, pale, no bruises Hb 9.5 MCV 69 ddx?
Fe deficiency anemia
bleed disorder- vwD, hemophilia
14 y.o F heavy menstruation, weakness lack concentration, Sx 7-8 mo periods heavy and last 7-9 days easy bruising, bleed after tooth extraction age 7 normal vital signs WN/WD, pale, no bruises Hb 9.5 MCV 69 Labs to order?
CBC PT PTT platelet count PS Iron panel PFA platelet function analyzer
14 y.o F heavy menstruation, weakness lack concentration, Sx 7-8 mo periods heavy and last 7-9 days easy bruising, bleed after tooth extraction age 7 normal vital signs WN/WD, pale, no bruises Hb 9.5 MCV 69 normal PTT PT platelet count elevated bleeding time, elevated PFA
not problems in coagulation cascade
qualitative problem with platelets
medicaitons that can cause qualitative problems with platelets
aspirin, NSAIDs
clopidogrel, abcixumab (IIa/IIIB inhibitor)
What is type 2N vwD
normal levels vWF, RIPA and multimer pattern
low factor VIII (prolongs PTT)
how will low VIII change PT PTT
prolonged PTT
20 mo boy with Hx joint swelling and bruising
deep hematomas in thigh mm, not walking on own
no Hx bleeding problems in parents, or 3 siblings
pale wd/wn
tenderness around ankles dec ROM b/l
no petechial rashes
ddx?
hemophilia
ITP
single factor deficiency
what do you have to check with rashes
blanching or not?
20 mo boy with Hx joint swelling and bruising
deep hematomas in thigh mm, not walking on own
no Hx bleeding problems in parents, or 3 siblings
pale wd/wn
tenderness around ankles dec ROM b/l
no petechial rashes
tests to order?
platelet count bleedting time PT PTT PFA CBC
20 mo Hx hematomas
elevated PTT normal PT
ddx?
inherited deficiency VIII, IX, XI deficiency facotr XII vwD acquired: heparin, inhibitor VIII, IX XI XII acquired vwD
normal PTT long PT
ddx?
inherited factor VII deficiency
acquired: factor VII def, vit K def, liver disease, coumadin/warfarin, inhibitor factor VII
prolonged PT and PTT
ddx?
liver disease
DIC!!!
heparin and warfarin
inherited: combined def, def prothrombin etc…
how can you differentiate between factor deficiency and factor inhibitor problems?
mixing study: mix plasma with normal plasma
if corrects PTT then was deficiency
if does not correct there is an inhibitor
factor VII shows deficiency and when mixed with normal plasma PTT was corrected
what 2 diseases need to check for
Hemophilia A
vwD
boy with hemophilia, what family Hx do you look into
males on mothers side
bleeding in minor cuts more likely platelets or hemophilia?
platelets
large subcutaneous soft tissue hematomas more likely in hemophilia or platelet deficiency
hemophilia
