Exam 1 - Hematology + Abx Intro Flashcards
(190 cards)
1
Q
Describe the difference between low and high anysocytosis
A
Anysocytosis = variation in blood cell size (RDW)
Low = uniform size = normal
High = variance, can imply more than one cause of anemia
2
Q
Which two substances inhibit platelet aggregation?
A
Prostacyclin and nitrous oxide
3
Q
In which thrombocytopenia is bleeding rare, despite a low platelet count, due to platelets being large and hyperfunctional?
A
ITP (immune mediated thrombocytopenia)
4
Q
How to confirm a diagnosis of G6PD deficiency?
A
G6PD lab assay
(not during acute hemolysis though, will give a false negative)
5
Q
Heatstroke treatments
A
- Lower temperature with spray mist and fans or ice packs to groin/axillae
- Correct dehydration, usually IV fluids
6
Q
True or False.
If a patient has had a previous anaphylactic reaction to penicillin, they should avoid carbapenems.
A
False.
They should avoid using cephalosporins, a different b-lactam.
7
Q
Which leukemia is associated with particularly high neutrophils and basophils?
A
CML (chronic myeloid leukemia)
8
Q
Most common causes of secondary polycythemia
A
- Smoking
- COPD
- OSA
- Obesity
- High altitude
9
Q
Three things that may be seen on peripheral smear of a patient with a hemolytic anemia
A
- Spherocytes
- Sickle cells
- Schistocytes
10
Q
An anemic patient in their 60s presents with complaints of fatigue, weakness, infections, and bleeding/bruising.
CBC reveals pancytopenia and macrocytic RBCs. The patient has a low reticulocyte count.
What is your next step to confirm a diagnosis?
A
Could be myelodysplastic syndrome or aplastic anemia, both need bone marrow biopsy to confirm
11
Q
In iron deficiency anemia, what must always be confirmed before giving an iron supplement?
A
The cause!
12
Q
Three common (broad) reasons for neutrophilia (>10,000)
A
- Inflammation
- Splenectomy
- Serious bacterial infections
13
Q
Most patients with hemolysis get this supplement as part of their treatment
A
Folate
14
Q
Is the leukemia associated with the Philadelphia chromosome more common in men or women?
A
CML is more common in men
15
Q
Which medications can cause drug induced hemolytic anemia?
A
- Penicillin or cephalosporin antibiotics
- NSAIDs
- Acetaminophen
- Hydrochlorothiazide
16
Q
Name and describe the three (broad) types of polycythemia
A
- Relative: normal RBC, fluid down
- Secondary: elevated EPO due to hypoxia
- Primary: bone marrow disorder
17
Q
You suspect hemolysis in a patient.
Characteristic lab findings are present, including low Hgb, high LDH, low haptoglobin, and high indirect bilirubin.
You order a peripheral smear and see schistocytes
What is your likely diagnosis?
A
Microangiopathic hemolysis
(TTP, HUS, DIC, etc.)
18
Q
Which, RBC or Hgb count, is a better indicator of health/O2 carrying capacity?
A
Hemoglobin (Hgb)
19
Q
On peripheral smear of a patient with sickle cell trait/disease you may see sickle shaped RBCs as well as ….
A
Howell-Jolly bodies
20
Q
Describe the basic pathophysiology of heat exhaustion
A
Inadequate cardiac output as peripheral vessels vasodilate due to strenuous exercise and/or environmental heat stress
21
Q
Down syndrome is linked with this leukemia in adulthood
A
AML (acute myeloid leukemia)
(ALL = childhood)
22
Q
In immune mediated thrombocytopenia (ITP), would you expect to see more severe symptoms in a younger or older patient?
A
Younger: “child, following a cold, wakes up with bruises all over”
(Elderly are often asymptomatic)
23
Q
True or False.
DIC (disseminated intravascular coagulopathy) is always a primary process.
A
False.
DIC is always a secondary process
(secondary to a disease state that causes a person to run out of clotting proteins)
24
Q
Celiac disease is associated with this type of anemia
A
Iron deficiency anemia (due to malabsorption)
25
Most common cause of neuroleptic malignant syndrome
Haloperidol (psych medication)
26
Treatment for neutrophilia
Fix the cause
27
HIT (heparin induced thrombocytopenia) usually occurs 4-10 days after heparin is given in these two types of procedures
Cardiovascular or orthopedic surgeries
28
Which thrombocytopenia is unique in that it can cause bleeding *or* clotting?
DIC (disseminated intravascular coagulopathy)
29
Symptoms of multiple myeloma
CRAB criteria
- Hypercalcemia
- Renal failure
- Anemia
- Bone pain
(also neurologic symptoms, infections, hyperviscosity)
30
Name two causes for each of the following anemias:
- Microcytic
- Normocytic
- Macrocytic
- Microcytic
Iron deficiency, thalassemia
- Normocytic
Anemia of chronic disease, acute blood loss
- Macrocytic
Vitamin B12 or folate deficiency
31
Prophylactic antibiotics should be given this long before a surgery
Within two hours prior to incision
32
This syndrome can be thought of as a "pre-AML"
Myelodysplastic syndrome
(AML also listed as a complication of erythrocytosis)
33
Treatment for antiphospholipid antibody syndrome
Warfarin
- *not* DOACs!
34
Erythropoietin stimulates the growth of ...
Red blood cells
35
You perform a peripheral smear on a patient who has suffered from an acute hemolytic episode with significant anemia. You see spherocytes, but schistocytes are absent. You perform a Coombs test that is positive for IgG.
What is your diagnosis?
Warm autoimmune hemolytic anemia (WAIHA)
36
Age and gender demographics most affected by anemia
- Women of reproductive age
- Children and elderly
37
Where does extravascular hemolysis typically occur?
Bone marrow, liver, spleen
38
What is the role of interleukin 3?
Stimulates the early phase of hematopoesis
39
This blood cancer is associated with Rouleaux formations (clumps of red blood cells)
Multiple myeloma
40
Name some common (broad) causes of neutropenia (<1500)
- Drug-induced (most common)
- Chemotherapy
- Autoimmune
- Splenic sequestration
- Cirrhosis
41
Most common cause of lymphocytosis (>4000)
Viral infection
42
What abnormalities would you expect to see on labs for a patient with heatstroke?
- High WBCs (stress)
- Elevated LFTs and bilirubin, low platelets due to liver stress
- Hematuria, myoglobinuria, proteinuria, BUN, creatinine due to renal stress
43
Causes of eosinophilia (>500)
NAACP
- Neoplasm
- Allergy/Atopy
- Asthma
- Connective tissue disorders
- Parasites
44
Which generation of cephalosporins is good for treating CNS infections as it covers Neisseria (meningitis and gonorrhea too)?
3rd generation
45
First line treatment for warm autoimmune hemolytic anemia (WAIHA)
High dose prednisone
46
In a patient with iron deficiency anemia, what are the expected findings for the following:
- Hgb and Hct
- MCV and MCH
- Ferritin
- TIBC
- Hgb and Hct - LOW
- MCV and MCH - LOW
- Ferritin - LOW
- TIBC - HIGH
47
Which antibiotic medications have the broadest coverage of any beta-lactam?
Carbapenems
(imipenem, meropenem, ertapenem, daripenem)
48
Name the growth factor that is produced by T cells and stimulates the formation of neutrophils, monocytes, and eosinophils
GM-CSF
49
What are the four key treatments for managing a patient in sickle crisis?
- Adequate hydration
- Supplemental oxygen
- Rest
- Pain control
50
How to diagnose HIT (heparin induce thrombocytopenia)?
PF4 Ab (ELISA test)
51
Describe the differences between sickle cell *trait* and sickle cell *disease*
Trait
- Heterozygous
- <50% HbS
- Asymptomatic unless triggered
Disease
- Homozygous
- >50% HbS
- Chronic hemolysis, frequent infections, and risk of sickle crisis
52
Treatment for von Willebrand's disease
DDAVP
53
This hemoglobinopathy is x-linked and so affects men much more than women
G6PD deficiency
54
Apart from knowing the medication that caused the condition, how else might you differentiate serotonin syndrome from neuroleptic malignant syndrome?
Timeframe
- NMS = within 10 days of treatment
- SS = within 24 hours
Symptoms
- SS = less hyperthermia and rigidity, more likely to see shivering, hyperreflexia, myoclonus, n/v/d
55
In which extracorpuscular damage/defect condition are steroids an ineffective treatment, and what is used instead?
Cold agglutinin disease
- Use rituximab/IVIG/plasmapheresis
56
True or False.
Both clindamycin and vancomycin have MRSA coverage
True
Although 20-25% of MRSA strains in USA are resistant to clindamycin
57
Which antibiotic is the drug of choice for mastitis?
Dicloxacillin
58
Common symptoms of hemolytic anemias
- Jaundice
- Dark urine
- Splenomegaly (more in inherited than acquired)
59
This blood cancer is possibly caused by agent orange exposure
CLL (chronic lymphoid leukemia)
60
Hepcidin and inflammation are associated with this anemia
Anemia of chronic disease
61
What does thrombin time measure?
The function of thrombin in converting fibrinogen to fibrin
62
Which hemoglobinopathy is associated with childhood osteoporosis?
Beta thalassemia major
63
Patients taking this antibiotic should be cautioned to avoid alcohol due the disulfiram-like effect
Metronidazole
64
Common side effects of oral iron supplementation
Gastrointestinal
65
Name the growth factor that is specific for neutrophils
G-CSF
66
This hemoglobinopathy is confirmed by the presence of HbS on hemoglobin electrophoresis
Sickle cell trait/disease
67
Do earlier or later generation cephalosporins typically offer broader antimicrobial coverage?
Later generations cover more
68
Which anemia is the only one where measuring *serum* iron is useful?
Anemia of chronic disease
(it will be low)
69
Elliptocytosis, spherocytosis, and stomatocytosis are all examples of this type of hemolysis
Hereditary caused hemolysis
70
In a sentence, describe hemostasis
Tightly regulated process of continual thrombosis (clotting) and fibrinolysis (breakdown of clots)
71
A patient with iron deficiency anemia due to celiac disease should be treated with ...
IV iron supplementation - since they can't absorb oral
72
Symptoms of iron deficiency anemia
- Pallor
- Fatigue
- Glossitis
- Koilonychia
- Irritable
- Leg cramping
73
The one (need to know) cause of warm autoimmune hemolytic anemia (WAIHA) is ...
Chronic lymphocytic leukemia (CLL)
74
Risk factors for multiple myeloma
- Black
- Farmers
- Wood/leather workers
- Petrol exposure
75
This blood cancer is a cancer of the plasma cells
Multiple myeloma
76
What does PTT measure?
Time from factor XII to fibrin
Intrinsic pathway
77
Is a D-dimer test more sensitive or specific?
Sensitive
Normal d-dimer = no clot
Good at ruling *out*
78
Where is the growth factor for platelets produced?
Thrombopoietin is produced in the liver
79
A patient with megaloblastic anemia is given supplemental B12/folate. How can you quantitatively measure their response to treatment?
Reticulocyte count
(also clinical improvement)
80
In which, von Willebrand's disease or hemophilia, would you expect to see more bleeding and bruising?
Hemophilia - much more bleedy and bruisy (hemarthrosis = bleeding into joints) than platelet issues like vWF
81
Broadly, how does pregnancy affect anemia?
Worsens due to dilutional effect
(and increased iron requirement)
82
All of the leukemias are common in middle aged to older adults except for [blank], which typically occurs in children aged 3-4
ALL (acute lymphocytic leukemia)
83
True or False.
Heatstroke is a life-threatening emergency.
True
84
This leukemia is associated with "B-symptoms" such as fever, night sweats, and lymphadenopathy as well as abdominal pain, weight loss, and hype-rviscosity events
CML (chronic myeloid leukemia)
85
These antibiotics can be used to treat group A strep and syphilis
Penicillin G/V
86
Erythropoietin comes from this organ
Kidneys
(Decreased EPO with chronic renal failure)
87
Stem cells primarily mature in the ....
Bone marrow
88
In which of the leukemias might you see leukemia cutis as well as mental status changes (confusion)?
AML (acute myeloid leukemia)
89
What are the three most common causes of fever of unknown origin, in order
1. Infections
2. Autoimmune
3. Neoplasms
90
Which thrombocytopenia is associated with a defect in ADAMTS 13?
TTP (thrombotic thrombocytopenic purpura) - platelet aggregation due to long von Willebrand strands
91
What is the next step in the workup of a patient who has an prolonged PTT?
Assess with mixing study (1:1 mix patient blood with normal blood)
- Corrects = likely deficient factor
- Remains prolonged = likely inhibitor (antibody)
92
Describe what happens when there is vascular endothelial damage and adhesion occurs
Vessel damage causes immediate vasoconstriction to slow blood
Collagen exposure allows contact between platelets and Von Willebrand factor (adhesion)
Adhesion activates platelets to stick to collagen better, platelets stick to the wall of blood vessels
93
Complications of medications for CLL (chronic lymphoid leukemia)
Wound healing and bleeding problems
94
An anemic patient complains of fatigue, chronic infections, and bleeding. Labs show pancytopenia as well as reticulocytopenia. How might you expect their bone marrow biopsy to look?
Pancytopenia with reticulocytopenia = aplastic anemia
Bone marrow biopsy would be *hypocellular with fatty infiltration*
95
How is the activation of thrombin limited to the site of injury?
Thrombin itself activates Protein C, which breaks down thrombin
96
Which clotting factor is most directly involved in platelet aggregation
Fibrinogen - forms a bridge between platelets
97
Main factor that increases release of erythropoeitin
Hypoxia
98
Which drug is associated with causing TTP (thrombotic thrombocytopenic purpura)?
Clopidogrel
99
Which two body systems are most affected in TTP (thrombotic thrombocytopenic purpura)?
- Neurologic
- Renal
100
Name the first and the definitive tests for thalassemia
- First = hemoglobin electrophoresis
- Definitive = globulin gene testing
101
Patients with this type of hemolysis are typically asymptomatic until there is a triggering illness or inflammatory event
Hereditary caused hemolysis
(Sickle cell trait is a hemoglobinopathy, not hemolysis. Same triggers though)
102
This leukemia is a disease of mature b-lymphocytes
CLL (chronic lymphoid leukemia)
103
Nitrofurantoin (Macrobid) is used to treat uncomplicated UTIs. What is a side effect from this drug that women in their 60s and 70s should be warned about?
Interstitial pneumonitis
104
Which immune mediated hemolyses are associated with the presence of IgG?
- Warm autoimmune hemolytic anemia (WAIHA)
- Drug induced hemolysis
105
Stephen-Johnson's syndrome is associated with this antibiotic
Bactrim (trimethoprim-sulfamethoxazole)
106
Treatments for *beta* thalassemia
Minor
- no treatment needed
Major
- blood transfusion as required
- iron chelation (deferoxamine or deferasirox)
- pneumococcal vaccination
- stem cell transplant is only curative option
107
Name and describe the different types of *beta* thalassemia
Minor
- heterozygous
- asymptomatic or mild anemia
- CBC and peripheral smear can look like iron deficiency
Major
- homozygous
- symptoms begin at 6-9 months of age
- significant anemia, jaundice, hepatosplenomegaly, iron overload secondary to hemoptysis
- childhood osteoporosis
108
Rank the following body areas from most to least accurate body temperature measurement:
- Axillary
- Forehead
- Rectal
- Sublingual
- Tympanic
1. Rectal
2. Forehead
3. Sublingual
4. Tympanic
5. Axillary
109
What would you expect to see on peripheral smear of a patient with microangiopathic hemolysis?
Schistocytes
110
This condition is associated with Richter's transformation
CLL (chronic lymphoid leukemia)
111
In a patient with thalassemia, what are expected findings for the following:
- MCV
- MCH
- Ferritin
- MCV = LOW
- MCH = LOW
- Ferritin = NORMAL TO INCREASED
(+/- anemia)
112
How to differentiate myelodysplastic syndrome from AML?
MDS = <20% myeloblasts
AML = 20% + myeloblasts
113
Treatment for multiple myeloma
Stem cell transplant most common and effective
114
Cause of basophilia (>150)
Myeloproliferative disorders (something's wrong with the bone marrow) such as CML
115
Below this neutrophil level, a healthy person is at risk of bacterial infections and it is a severe medical emergency
Below 500
(neutropenia though is just <1500)
116
Most common cause of anemia (worldwide and US)
Worldwide = malnutrition
USA = bleeding
117
Treatment for CLL (chronic lymphoid leukemia)
Only treat if symptomatic!
118
How to differentiate between low and high risk myelodysplastic syndromes
- Low risk = <5% myeloblasts
- High risk = 5 to 20% myeloblasts
119
On a peripheral smear, irregular densities at the edge of RBCs are seen, consistent with Heinz bodies. Bite cells are absent. What is the likely diagnosis?
Alpha thalassemia (3/4 deletions)
(Heinz *with* bite cells = G6PD)
120
Who is most at risk for heatstroke?
Elderly, women, infants
- due to lower ability to sweat
121
Symptoms of erythrocytosis
Headaches and itchiness
(neuropathy = polycythemia vera
waking at night = OSA)
122
In diagnosing a patient with hereditary caused hemolysis you would see these types of RBCs on a peripheral smear
Abnormally shaped
- elliptocytes
- spherocytes
- stomatocytes
123
What does PT measure?
Time from factor VII to fibrin
Extrinsic pathway
124
Name and describe the different types of *alpha* thalassemia
Named based on number of genes deleted
1/4 = silent carrier
- Asymptomatic
2/4 = trait
- Mild microcytic, hypochromic anemia
3/4 = hemoglobin H (HbH) disease
- HbH and Heinz bodies
- Increased RBC destruction in the spleen
- Significant microcytic, hypochromic anemia
4/4 = Hydrops fatalis (Hemoglobin Barts)
- No alpha chains produced
- O2 can't be released causing death in utero
125
What is the half life of red blood cells?
120 days
126
What is the half life of platelets?
7-10 days
127
Apart from large (macrocytic) RBCs, what else might be noted on a peripheral smear of a patient with megaloblastic anemia?
Hyper-segmented neutrophils
128
Auer rods seen on peripheral smear are indicative of this disease
AML (acute myeloid leukemia)
129
This macrolide should not be given to cardiac patients as it can kill them
Clarithromycin
130
Infections are the most common complication of this blood cancer and so live vaccines should be avoided
CLL (chronic lymphoid leukemia)
131
Causes of myelodysplastic syndrome
DNA damage
(radiation, chemo, benzene/tobacco, mercury/lead)
132
Name some causes of lymphocytopenia (<1000)
- Viral infections
- Some bacterial infections
- Marrow disorders
- Autoimmune
- Renal failure
- Immunosuppressants
133
This blood cancer can be diagnosed with flow cytometry alone
CLL (chronic lymphoid leukemia)
(can confirm with bone marrow biopsy if inconclusive)
134
What is the half life of neutrophils?
6-8 hours
135
Which antibiotic family do gentamicin, streptomycin, and tobramycin belong to, and what is their notable side effect?
- Aminoglycosides
- Renal damage and ototoxicity
136
Elevated uric acid is seen in this leukemia
AML (acute myeloid leukemia)
137
First line treatment for ITP (immune mediated thrombocytopenia)
Steroids
138
What is seen on a peripheral smear of a patient with G5PD deficiency?
- Heinz bodies
- Bite cells
139
Name two natural anticoagulants that help limit clotting to the site of injury
- Antithrombin
- Protein C
140
Treatments for primary polycythemia
- Hydroxyurea
- Phlebotomy
- JAK inhibitors
141
Temperature threshold for a fever
>100.4f
142
Inheritance pattern of malignant hyperthermia of anesthesia
Autosomal dominant
143
This test is done to confirm paroxysmal nocturnal hemoglobinuria (PNH)
Flow cytometry
144
Three causes of hemolytic anemias are:
- Autoimmune
- Hereditary spherocytosis
- Sickle cell disease
How would you treat each one?
- Autoimmune: steroids
- Hereditary spherocytosis: splenectomy
- Sickle cell disease: hydroxyurea
145
What result would you expect from a patient with hemophilia A in a PTT mixing study?
Hemophilia A = deficient in factor 8
Expect result to be a *corrected* PTT
146
Test to confirm an autoimmune cause of hemolytic anemia
Coombs test
147
Tetracyclines cover MRSA, h. influenzae, and atypicals, but should not be used in these patients, or in conjunction with these substances ...
- Do not use in pregnant women or children <9 years old
- Avoid taking with milk or antacids ( limits absorption)
148
Extramedullary hematopoiesis occurs in the ...
Spleen and liver
(extramedullary = outside the bone marrow)
149
Which immune mediated hemolyses are associated with the presence of IgM?
Cold agglutinin disease
150
In which thrombocytopenia would it be appropriate to check a lupus anticoagulant level?
Antiphospholipid Ab syndrome
(autoimmune antibodies against natural anticoagulants)
151
Three pathways (broad) leading to anemia
- Reduced RBC production
- Increased RBC destruction
- Blood loss
152
Which condition is associated with Waldenstrom's macroglobulinemia?
Cold agglutinin disease
153
True or False.
RBC lifecycle can be shortened but not prolonged.
True
154
This hemoglobin is associated with the abnormal production of chains in the hemoglobin complex
Thalassemia
155
Antipyretics should always be used to treat fevers in these types of patients
- Young children
- Elderly
- Debilitated patients
- Cardiopulmonary patients
- Stroke victims
- Temp >104f
156
Treatment for TTP (thrombotic thrombocytopenic purpura)
Plasmapheresis (or death!)
157
Patients whose RBCs lack CD55 and CD59 proteins are at risk of these types of blood clots
CD55 and CD59 missing = PNH
*Venous* clots in unusual places (brain, liver, IVC, skin)
158
This macrolide can be given to cystic fibrosis patients as it has an anti-inflammatory effect
Azithromycin
159
Haptoglobin is produced by the ...
Liver
160
Three most common symptoms associated with von Willebrand's disease
- Epistaxis
- Gingival bleeding
- Bruising
(typical of platelet issues)
161
In a patient with anemia of chronic disease, what are the expected findings for the following:
- Serum iron
- TIBC
- Ferritin
- Serum iron - LOW
- TIBC - LOW
- Ferritin - NORMAL TO HIGH
162
What is seen on the peripheral smear of a patient with CLL (chronic lymphoid leukemia)?
Smudge cells
163
Name the four cardinal symptoms of neuroleptic malignant syndrome
- Severe muscular rigidity
- Hyperthermia (>104f)
- Autonomic instability (tachycardia, labile BP, diaphoresis)
- Altered sensorium
164
Name some oxidative stressors that can trigger hemolysis in patients with G6PD deficiency
- Fava beans
- Nitrofurantoin
- Fluoroquinolones
- Dapsone
- Infections
- Renal failure
- DKA
165
This macrolide has the notable side effect of copious diarrhea
Erythromycin
166
Heat exhaustion treatments
- Rest in shade
- Supine with feet above head
- Cool with water/shower/hose
- Rehydrate with cold water
167
Symptoms of heat exhaustion
- An obvious difficulty continuing with exercise
- Temp 101-104f
- *No* seizure/altered consciousness/delirium
168
The oral from of this antibiotic medication can be given to treat a patient with c. difficile as it is poorly absorbed and makes it all the way to the gut
Vancomycin
169
Heatstroke symptoms
- Temperature >104f
- With neurologic symptoms
170
This condition has a classic triad of:
- Hemolysis with hemoglobinuria
- Pancytopenia
- Unexplained thrombosis
Paroxysmal nocturnal hemoglobinuria (PNH)
171
You suspect hemolysis in a patient.
Characteristic lab findings are present, including low Hgb, high LDH, low haptoglobin, and high indirect bilirubin.
You order a peripheral smear and see microcytic and hypochromic RBCs.
What is your likely diagnosis?
Thalassemia
172
Which cephalosporin generation is good for skin conditions as it covers staph and strep?
1st generation
173
Most common type of anemia worldwide
Iron deficiency anemia
174
True or False.
In HIT (heparin induced thrombocytopenia) platelets drop significantly but this leads to clotting
True
175
You suspect hemolysis in a patient.
Characteristic lab findings are present, including low Hgb, high LDH, low haptoglobin, and high indirect bilirubin.
You order a peripheral smear and see spherocytes.
What is your next step?
Order a Coombs test
176
Criteria for diagnosis of fever of unknown origin
>100.9f for at least 3 weeks with no known cause
177
This type of anemia is defined as pancytopenia due to bone marrow failure
Aplastic anemia
178
Patients diagnosed with this leukemia must get a lumbar puncture due to the likelihood of spread to the spine and also receive their medications intrathecally
ALL (acute lymphoblastic leukemia)
179
Complications of a fever
- Increased O2 consumption (arrythmia, ischemia, CHF)
- Febrile seizures
- Stupor, delirium (>104f)
- Worse if very young or old
180
An anemic patient has the following lab values:
- High LDH and bilirubin
- Low haptoglobin
- High reticulocytes
What type of anemia does this patient have?
Hemolytic anemia
181
Describe the role of beta-lactamase inhibitors such as tazobactam (in Zosyn) and clavulanate (in amoxicillin)
Beta-lactamase inhibitors stop bacteria from breaking down the beta-lactam rings in the antibiotic they're combined with to allow it work
Beta-lactamase inhibitors themselves are not antibiotics, but facilitate antibiotics to work
182
This antibiotic class has a risk of tendon rupture in the elderly
Fluoroquinolones
(ciprofloxacin, levofloxacin, moxifloxacin)
183
Which, blastic or clastic lesions, show up on a bone scan?
Blastic (uptake) only
(not clastic, lytic lesions)
184
Describe the role of hydroxyurea in managing sickle cell disease
Increases production of HbF (fetal hemoglobin) which reduces the relative amount of HbS
185
A patient with anemia mentions that they are having neurologic symptoms. Based on this, how would you expect their RBCs to look on a peripheral smear?
Large (macrocytic due to B12 deficiency)
186
Most common side effect of penicillins
Hypersensitivity reactions (rash, nausea, diarrhea)
(often delayed 7 to 10 days into treatment and reaction more common if given parenterally)
187
Which two blood cancers have symptoms of bone pain?
- ALL (acute lymphoblastic leukemia)
- Multiple myeloma
188
Which growth factor stimulates megakaryocyte and platelet formation?
Interleukin 11
189
Which of these is NOT a cause of ITP (immune mediated thrombocytopenia)?
- Quinine
- HIV
- Nitrofurantoin
- Pregnancy
Nitrofurantoin (goes with G6PD deficiency)
190
What antibiotic family does linezolid belong to and how should a patient being started in linezolid be counselled?
- Oxazolidinone
- Avoid decongestants
- No tyramine containing foods (aged cheese, dried meats, tap beer, red wine, soy sauce, sauerkraut)
