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Flashcards in Hem/Onc Deck (30):
1

What is t(4;11) associated with?

ALL

2

What is t(9;22) associated with?

CML
Philadelphia chromosome

3

What is t(8;14) associated with?

Burkitt's Lymphoma
EBV
Non Hodgkin's Lymphoma
B cell

4

What are the features of osteosarcoma?

- lesion at proximal or distal end of long bone
- lesion shows a SUNBURST PATTERN

5

What are the features of Ewing sarcoma?

- lesion has a LAMELLATED "ONION SKIN" appearance

6

What are the features of osteoid osteoma?

X-ray will show a central radiolucency with thickened bone around it.

7

When does ABO incompatibility usually occur?

In a mother with type O blood during first (or subsequent) pregnancy. She will have anti-A and anti-B antibodies that can cause hemolytic anemia in a baby with type A or type B blood.

8

What are the features of erythema infectiosum?

- Parvovirus B19
- Slapped cheek
- Rash on extremities will appear later (lacy rash, macular, morbilliform)
- Diagnose with IgM titers
- Can cause aplastic crisis
- Intrauterine infection can cause hydrosphere fetalis

9

What are the features of paroxysmal nocturnal hemoglobinuria (PNH)?

- Dark colored urine in the mornings
- Complement mediated hemolysis
- Coombs negative auto hemolytic anemia
- Diagnosis: flow cytometry for CD59, DF assay, Ham's test

10

What are the encapsulated organisms?

"Some Nasty Killers Have Some Capsule Protection."
S = Streptococcus pheumoniae
N = Neiserria meningitidis
K = Klebsiella pneumoniae
H = Haemophilus influenzae
S = Salmonella typhi
C = Cryptococcus neoformans
P = Pseudomonas aeruginosa

11

What are the four features of iron deficiency anemia?

- Low transferrin saturation
- High RDW
- Low reticulocyte count
- Ferritin level < 15

12

What is transferrin?

Transports iron.

Saturation level will be low if there is no iron available to transport.

13

How do you calculate the Mentzer Index?

MCV/RBC

>12 = iron deficiency anemia
<11 = thalassemia

14

What is seen on the blood smear for beta thalassemia major?

Microcytosis
Target cells
Basophilic stippling

15

How do you differentiate lead toxicity from iron deficiency anemia?

RBCs will have basophilic stippling.

16

At what lead level is chelation therapy indicated?

Level > 45

Chelate with EDTA, dimercaprol, or d-penicillamine.

17

What is pernicious anemia?

The lack of intrinsic factor, a protein produced by the stomach to help absorb vitamin B 12.

18

What are the symptoms of vitamin B 12 deficiency?

Macrocytic anemia
Neurologic issues (paresthesias, ataxia, decreased reflexes)
In pregnant women, spina bifida

19

What are the features of Fanconi anemia?

MACROCYTIC ANEMIA/ APLASTIC ANEMIA - everything else is small (small head, short stature)

F = Facial (microcephaly)
A = Abnormal testes and kidneys (hypogonadism, renal abnormalities)
N = No thumbs/radius
C = Cafe au lait spots
O = Ocular abnormality
N = Neutropenia
I = Increased risk of AML

20

What are the features of diamond Blackfan anemia?

MACROCYTIC ANEMIA

- Pure red cell aplasia
- Present around 3 months of age
- Low reticulocyte count
- Physical: triphalangeal thumb, craniofacial abnormalities

21

What is maternal immune thrombocytopenic Purpura?

Thrombocytopenia in neonates that lasts for weeks.

Mother forms antibodies against fetal platelet antigens inherited from the father.

aka, neonatal alloimmune thrombocytopenia (NAIT)

22

What are the vitamin K dependent coagulation factors?

2, 7, 9, 10

23

What are the features of von Willebrand disease?

"Factor eight on a plate to go on a date with von Willebrand."
- Factor 8 and platelets need vWF to function.

- Autosomal dominant
- Elevated PTT
- Prolonged bleeding time

24

How is von Willebrand deficiency treated?

- Minor bleed: give DDAVP (to increase plasma factor 8 and vWF
- Severe bleed: Factor 8 concentrate (Humate P); cryoprecipitate (has factor 8 and vWF
- Aminocaproic acid: for mucosal bleeding (helps to inhibit fibrinolysis)

25

What are the lab features of DIC?

Thrombocytopenia
Low fibrinogen
Elevated fibrinogen split products (D-dimer)
Elevated thrombin time
Elevated PT
Elevated PTT

26

How is DIC treated?

- Thrombocytopenia: platelets
- Anemia: pRBCs
- Low fibrinogen: cryoprecipitate (has fibrinogen, factor 8, vWF)
- Low clotting factors: FFP (has most of the clotting factors)

27

What is an osteochondroma?

- Common, benign bony tumor
- Usually located near growth plates
- Has a cartilaginous cap

28

Which causes more severe anemia: alpha or beta thalassemia?

Beta thalassemia

29

What are the 3 types of beta thalassemia?

- Beta thalassemia trait: mild microcytosis
- Beta thalassemia intermedia: obvious microcytosis; occasional blood tx after illness
- Beta thalassemia major: Cooley's anemia; frequent tx

30

What are the clinical features of Beta thalassemia major?

- Frequent tx
- Hemochromatosis
- Smear: microcytes, target cells, basophillic stippling
- Requires chelation (tx with desferoximine)