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Steep 2 CK hematology > heamatology 3 > Flashcards

heamatology 3 Flashcards

(87 cards)

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1
Q

What do we do for a patient with DVT for C/I for anticoagulant?

A

Inferior venaca filiter

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2
Q

proximal/massive/limb ischemia risk Dvt with PE or life tret?

A

Thrombolitic

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3
Q

If C/I thrombolytic therapy?

A

Thrombectomy

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4
Q

a common cause of b12 deficincy?

A

Gastrectomy

Autoimmune gastritis

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5
Q

did megaloboastic animia cause jaundice?

A

yes (intramedullary mechanical hemolysis)

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6
Q

mutation in JAK 2?

A

polycythemia vera

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7
Q

A complication of PV?

A

Thrombosis
myelofibrosis
leukemia

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8
Q

a common cause of anemia after erythropoietin administrasion?

A

IDA(especially microcytic anemia)

B/C depletion of Iron store by erythropoiesis and chronic disease

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9
Q

management?

A

Intravenous IRON

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10
Q

ITP management in children?

A

only mucocutaneous bleeding –observe

if bleeding-corticosteroid,anti D and Iv Ig

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11
Q

Role of anti-D in ITP?

A

Anti-D therapy appears to inhibit macrophage phagocytosis by a combination of both FcR blockade and inflammatory cytokine inhibition of platelet phagocytosis within the spleen. Anti-RhD treatment is associated with mild to moderate infusion toxicities.

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12
Q

hereditary spherocytosis lab finding?

A

Increase MCHC
small, hypochromic, round RBC w/o central pallor
Negative coombs test
Increase osmotic fragility by acidic glycerol lytic test
Abnormal eosin 5 maleimide binding test

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13
Q

Treatment?

A

Folic acid
Transfusion
Splenectomy(reduce hemolysis and gall stone risk)

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14
Q

why MCHC?

A

RBC dehydration

Membrane loss

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15
Q

Inheritance?

A

Autosomal dominant

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16
Q

Calcium (serum) normal level?

A

8.6-10.3 mg/dL

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17
Q

APL CM?

A

common in young and middle-aged adult

Pancytopenia

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18
Q

laboratory?

A

pancytopenia
myeloblast with our road
15:17 muchation-APL gene to retinoic acid receptor alpha

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19
Q

management?

A

ALTRA-induce lukocyte diferenciation

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20
Q

complication?

A

DIC by inducing TF release and plasmin release-CVS and pulmonary hemorrhage

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21
Q

IDA in older patients require?

A

endoscopic evaluation

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22
Q

Investigation for pernicious anemia?

A

Esophagogastroduodenoscopy. especially when they have suspicious symptoms for gastric ca.

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23
Q

A complication of atrophic gastritis?

A

gastric ca

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24
Q

Pica?

A

excessive appetite for non-food particles like paper products, ice, clay, or dirt.

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25
what does it indicate?
IDA(it may precede the anemia)
26
Role of bisphosphonate therapy in hypercalcemia?
Inhibit osteoclastic activity | Also, Prevent complications of bone metastasis I.E # and malignant hypercalcemia.
27
what do things indicate polycythemia is due to OSA?
Presence of OSA complication - HF - HTN - Erectile dysfunction - Arrhythmia
28
How does OSA cause polycythemia?
Increase erythropoietin production
29
Hereditary hemorrhagic telangiectasis?
Osler-weber-rendu syndrome
30
CM?
Autosomal dominant Telagectaiss AV malformation Recurent epistaxix
31
AV malformation common location?
``` Skin Mucous membrane GI tract Brain Liver Lung ```
32
Telaegctasia CM?
Telangiectasia is a condition in which widened venules (tiny blood vessels) cause threadlike red lines or patterns on the skin Ruby colored vision that Blanche with pressure
33
a complication of AVM with a right to left shunt?
chronic hypoxia Clubbing Polycythemia
34
Pulmonary AVM?
Can present with massive hemoptysis
35
acanthocyte?
spur cell | projection with varying interval and size
36
cause?
Liver disease Abetalipoproteinemia Vit-E deficiency
37
echinocyte?
burr cell | symmetric projection
38
cause?
Liver disease ESRD PKD
39
Scleroderma renal crisis mechanism?
``` Acute renal failure Increase vascular permeability Activation of the coagulation system Increase renin release Proteinuria on urinalysis ```
40
Symptoms related to the complication?
HTN Shistocotes and thrombocytopnia RF
41
sideroblastic anemia?
anemia due to impaired heme synthesis
42
cause?
Congenital sidroblastic anemia Acquired clonal sideroblastic anemia Acquired reversible sideroblastic anemia
43
Congenital sidroblastic anemia?
X-linked sideroblastic anemia: Autosomal recessive sideroblastic anemia? Genetic syndromes:
44
X-linked sideroblastic anemia?
This is the MC congenital cause Involves a defect in ALAS2 Although X-linked, approximately one-third of patients are women due to skewed X-inactivation (lyonizations).
45
Autosomal recessive sideroblastic anemia?
Involves mutations in the SLC25A38 gene. The function of this protein is involved in the mitochondrial transport of glycine. Is typically severe in presentation.
46
Genetic syndrome?
Rarely, maybe part of a congenital syndrome and present with associated findings, such as ataxia, myopathy, and pancreatic insufficiency
47
Acquired clonal sideroblastic anemia?
Fall under the broader category of myelodysplastic syndromes (MDS). These anemias are associated with an increased risk for leukemic evolution.
48
Diagnosis?
On the peripheral blood, smear can be found erythrocytes with basophilic stippling (cytoplasmic granules of RNA precipitates) and Pappenheimer bodies (cytoplasmic granules of iron) Microcytic hypochromic /microcytic normochromic In BM sideroblasts(ringed sideroblasts with nuclus)
49
Acquired reversible sideroblastic anemia?
Excessive alcohol use(MCC) pyridoxine deficiency (vitamin B6 is the cofactor in the first step of heme synthesis), lead poisoning copper deficiency Excess zinc(cause by decreasing absorption and increasing excretion of copper). Isoniazid (which interferes with pyridoxine metabolism), chloramphenicol (which, by inhibiting the synthesis of mitochondrial membrane protein, impairs mitochondrial respiration. cycloserine linezolid
50
Anemia of chronic disease treatment?
Treat the underlying cause If not respond erythropoietin/dabaproitin If not still respond-packd RBC
51
G6PD deficiency pheripherial sign?
Bite cell | Hienze bodie
52
cause of spherocytosis?
Autoimmune Immune hemolytic anemia | Hereditary spherocytosis
53
How to D/T?
AIHA posetive comb test absent family history
54
How to D/T warm from cold AIHA?
Cause CM Treatment complication
55
cause?
``` WARM viral infection drugs SLE(autoimmune disease) CLL(lymphoproliferative disease0 Immunodeficiency state COLD Infn(Mycoplasma,I mononuclosis) Lymphoproliferative diasese ```
56
CM?
``` Warm asymptomatic to life treating anemia positive for IgG and anti C3 COLD symptom of anemia acrocyanosis(cold exposure) anti C3 and IgM comb posetive ```
57
treatment?
``` WARM Corticosteroid Splenectomy for refractory case Cold Avoid cold environment Rituximab Fludarabine ```
58
Complication?
``` WARM" TE Lymphoproliferative disease COLD Ischemia and pheripherial gangren Lymphoproliferative disease ```
59
aplastic anemia?
BM failure due to hematopoietic stem cell deficiency(CD34)
60
cause?
autoimmune DRUG Infection Radiation and toxin exposures(benzen)
61
Autoimmune
lupus | eosinophilic fascitis
62
Drug?
Carbamazepine Chloroamphinicol Sulphonamide
63
Infection?
HBV HIV EPV parvo
64
diagnosis?
pancytopenia no abnormal cell in pheripherial morphology BM biopsy; BM filled with FAT
65
chemotherapy-induced vomiting tx?
first-line-5HT3 blocker(ondasetron) | dopamin receptor antagonist 2nd/3rd line
66
Direct factor 10 inhibitors?
Apixaban/Rivaroxaban
67
the D/C between warfarin?
M.Action Onset Overlap needed LAB monitoring
68
M.Action?
FxaI-directly inhibit factor xa | warfarin--Vit Kmetabolism
69
The onset of therapeutic action?
FXaI-2-4 Hr | W-5-7 day
70
Did overlap need with UH?
FXaI-No | W-yes
71
Follow up with INR needed?
FXaI-No | W-Yes/2-3 wk interval)
72
Thrombolytic TX in DVT?
PE with hemodynamic instability | Proximal DVT with sever symptom
73
IV filter indication?
Anticoagulation failure | Anticoagulation C/I
74
HIT CM?
occur 5-7 day after heparin(H/L) initiation thrombocytopenia arterial/venous thrombosis
75
management?
stop heparin immediately | start non-heparin anticoagulant(enoxaparin)
76
pathophysiology?
heparin bind with plasmaPP4 protein-attach to platelet membrane-Ab formation --Platelet destruction--venous/arterial thrombosis from factor release by platelet
77
Diagnosis?
Serotonin release assay | Antibody titer
78
Tumour lysis syndrome risk?
Tumor with high burden/turnover | Initiation of chemotherapy/radiotherapy
79
manifestation?
High Phosphorous, K and uric acid, and low Ca AKI(uric acid,Ca stone) Cardiac arrhythmia
80
treatment?
continue chemotherapy aggressive fluid/electrolyte monitoring prophylaxis: allopurinol, rasburicase, and feboxitat
81
Hairy cell leukemia feature?
Clonal B cell neoplasm Middle/older age BRAF gene mutation
82
clinical future?
``` agranulocytosis anemia thrombocytopenia mild lymphocytosis splenomegaly(tumor infiltration) hepatomegaly/LND/B symtom is rare ```
83
Diagnosis?
hairy cell in pheripherial smear | flow cytometry in BM biopsy(All cases were bright positive for CD11c and negative for CD5.)
84
management?
Chemotherapy | life expectancy is mainly normal
85
sign of glossitis?
smooth shiny tongue
86
mechanism?
defect in epithelium proliferation
87
cause?
B12 deficiency Iron deficiency Riboflavin deficiency Folic acid deficiency

Steep 2 CK hematology (4 decks)

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