Common presentation of hematological malignancies Flashcards Preview

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Flashcards in Common presentation of hematological malignancies Deck (34):
1

What are the microcytic anemias?

Fe deficiency
Thalassemia
Anemia of chronic disease
Hemoglobinopathies
Sideroblastic anemia

2

What does ferritin measure?

Body Fe stores

3

What does TIBC measure?

Number of open spots on transferritin

4

What does retic count measure? What is normal?

Reticulocyte count (immature RBCs)

0.5-1.5%

5

What does urea breath test check for?

H.pylori infection

6

What are the three common causes of Fe deficiency anemia?

Inadequate absorption
Inadequate utilization
Excessive loss

7

What is the treatment for a gastric ulcer?

PPIs

8

What vitamin increases the absorption of Fe?

Vitamin C

9

What mineral suppresses the absorption of Vitamin C?

Ca

10

How long does it take for the retic count to rise in response to Fe therapy? Hb?

Fe = 1 week
Hb = 2 weeks

11

How long should you continue fe therapy?

Until serum Fe normal

12

What drug interferes with vit b12 absorption?

PPIs

13

What are the causes of megaloblastic macrocytic anemia?

Vit B12 deficiency
Folate deficiency

14

What are the causes of non-megaloblastic macrocytic anemia? (4)

myelodysplastic syndrome
Liver disease
Hypothyroidism
Alcoholism

15

What condition are multilobed neutrophils found in? What are these called?

Macrocytic anemia
Hypersegmented neutrophils

16

What happens to the reticulocyte count in pernicious anemia?

Goes down

17

What disease has high methylmalonic acid and total homocysteine levels? Which has just high homocysteine levels?

Both high = B12
Just homocysteine = folate

18

How long does it take retic count to increase with B12 administration?

End of first week

19

How long does the megaloblastic anemia take to correct with B12 supplementation?

6-8 weeks

20

What is the general ddx for normocytic anemia?

Hemolytic anemia

21

What are the causes of intrinsic hemolytic anemia? (3)

Membrane defects
Enzyme deficiencies (G6PD)
Hemoglobinopathies

22

What are the causes of extrinsic hemolytic anemia? (3)

Autoimmune
Alloimmune
Non-immune (trauma, infx)

23

What is the test used to identify immune mediated hemolytic anemia?

Coombs test

24

What is the reticulocyte count like in hemolytic anemia?

high

25

What type of anemia is LDH high in?

extrinsic hemolytic anemia

26

What does an elevated indirect bilirubin indicate? Direct?

Indirect = liver problem
Direct = obstruction

27

BIte cells on PBS = ?

G6PD deficiency

28

What are the triggers for G6PD deficiency?

Fava beans
Infections
Drugs (antimalarials and sulfa)

29

What are the two types of drugs that pts with G6PD deficiency should avoid?

Sulfa drugs
Antimalarials

30

What happens to BUN with GI bleeds?

Can increase, but not incredibly sensitive

31

Itchy after showering = what disease?

Polycythemia vera

32

What hematological diseases should you be concerned about with skin changes?

Hemochromatosis (gray)
Polycythemia vera
PCT

33

What are the secondary causes of polycythemia vera? How can you differentiate this from primary polycythemia vera?

COPD, pulmonary HTN, CHF (lung issues where you need more oxygen carrying capacity)


EPO will be low in primary polycythemia vera

34

What is the treatment for polycythemia vera?

Phlebotomy
ASA to prevent clots