Hema Flashcards Preview

CanQB > Hema > Flashcards

Flashcards in Hema Deck (80):
1

Abnormal labs in hemochromatosis

High transferrin saturation
High ferritin

2

Best screen for hemochromatosis

Transferrin

3

Acute phase reactants

ESR
CRP
PLTs

4

Mechanism of aspirin

Permanent acetylation of platelet enzyme cyclooxygenase > inhibit PG

5

When to stop aspirin prior to surgery?

5 days

6

Labs in hemolytic anemia

High retic
High LDH
High unconjugated bilirubin

Low haptoglobin

7

Pathophysiology of HIT

Platelet aggregation from heparin induced antibodies

8

Rx of HIT

Stop heparin
Start lepirudin, argatroban, or desirudin

9

Healthy + clumped platelets ?

Repeat
Usually antibodies to anti coagulant in CBC tube

Repeat w/ citrate in tube.

10

Warfarin antidote

Vit K

11

Oral iron absorption is better w/ acidic or alkalic environment?

Acidic

12

Improve oral iron supplement?

Give Vit C

Take on empty stomach

13

Lower oral iron absorption?

PPI
H2 blockers

14

When to stop iron supplement? Why?

Months after reaching target Hgb

To replenish iron store

15

Causes of B12 deficiency

Strict vegetarian diet

Chronic pancreatitis

Pernicious anemia

Tapeworm (diphyllobothrium)

Ileum disease + gasterectomy / bypass

16

Hemochromatosis triad

Skin hyper pigmentation
DM
Cirrhosis

+ Cardiac disease
+ infertility
+ joint pain

17

Hemochromatosis pathophysiology

Single gene mutation (HFR)

Increased iron absorption > deposition in heart, liver, skin, pituitary, genitalia

18

What accelerate the expression of hemochromatosis

Hep C

19

Normal transferrin saturation

14-50%

20

Hemochromatosis gene

HEF gene Ch 6

21

Dx of iron deficiency anemia

Low ferritin

22

Rx of sickle cell crisis

IVF
Oxygen
Pain control (IV opiates)
If fever => Abx

23

Hgb electrophoresis in thalassemia trait

Hgb A2

24

MOA of warfarin

Inhibits epoxide reductase > low K > alters factors 2, 7, 9, 10

25

Dx low B12?

High methylmalonic acid

26

Dx HIT

PLT low w/in 5-15 day oh heparin

27

In HIT antibodies are against what

Heparin-platelet factor 4 complex

28

Complication of HIT?

Thrombosis > bleeding albeit low platelet count

29

HIT Rx

Stop heparin
Start danaparoid or fondaparinux

If warfarin started = stop + add Vit K

30

Hemophilia A inheritance

XL

31

Serum iron in hemochromatosis

300 mg/dL

32

Indication of response to iron supplement in iron deficiency

Increase retic after 1 wk of replacement

33

Aplastic anemia labs

Normocytic anemia
Low retic

34

Dx aplastic anemia

Bone marrow biopsy

35

Type of ab in HIT

IgG

36

PLT level in HIT

< 50

37

Contraindicated in HIT

LMWH

38

T/F: 2-3 drinks / day of alcohol don't alter INR

True

39

Effect of alcohol on warfarin

Reduce its metabolism = increase INR

40

Active bleeding on warfarin

Stop warfarin
5-10 mg Vit K
FFP
Till INR < 5

41

High INR on warfarin + no bleeding

Stop warfarin
INR q24hr
Resume warfarin when INR is therapeutic range.

42

Risk of tea and toast diet

Low vitamin C

43

What's Vit C

Ascorbic acid

44

What's amyloidosis?

Extra cellular deposition of insoluble proteins

45

Dx amyloidosis

+ve Congo red dye

Pink in H+E stain

Apple green birefringence under polarized light.

46

What's Rivaroxban?

Factor Xa inhibitor

47

Advantages of rivaroxban

Fixed dose
Acts in hours
No monitoring
No drug or food interaction
Not metabolized by liver = not affected by P450 inducers / inhibitors.

48

Daily maintenance of Vit B12

1000 mg

49

Is Vit B12 supplement effective in pernicious anemia, gastrectomy, terminal ileum damage?

Yes

50

TTP classic

Easy bruising
Fever
Dark urine

Low PLT
High Bleeding time
High bilirubin

51

Marker of liver dysfunction in bleeding

Abnormal INR + aPTT

52

Dx polycythemia Vera (1ry)

Erythropoietin low
O2 low

53

G6PD enzyme function

Catalyze the oxidation of glucose-6-phosphate to glucose-6-phosphogluconate

And reduce NADP+ to NADPH

(Nicotinamide adenine dinucleotide phosphate)

54

G6PD Dx

No fluorescent on rapid fluorescent spot test.

55

Drugs avoided in G6PD

Dapsone
Sulfa
TMP-SMX

56

MCC of anemia in elderly

Chronic disease esp renal

57

Normal Hct

40-50%

58

Normal MCv

80-100

59

Dx spherocytosis

Osmotic fragility

60

Coombs test in spherocytosis

Negative

61

Normal retic count

<2%

62

Rx of vW disease

Desmopressin
Transfusion of factor VIII or vW concentrate

63

Pathophysiology of TTP

Low ADAMS 13
Plasma protease for vW factor.

64

TTP Rx

Plasmaphoresis
FFP transfusion

65

Advantage of LMWH

No monitor needed

66

aPTT used in monitoring what drug

Unfractionated heparin

67

TMP/SMX + warfarin

Bleeding risk

68

Criteria for polycythemia Vera

2 major or 1 major + 2 minor.

Major:
1. Hgb >18.5 M or >16.5 F and RBC mass >25%
2. JAK2 mutation

Minor:
1. Low erythropoietin (<30)
2. BM biopsy = hypercellularity + prominent erythroid, granulocyte, megakaryocyte
3. Endogenous erythroid colony formation

69

Normal PLT

130-400

70

Normal ESR

M: 1-13
F: 1-20

71

Serum albumin

35-50

72

Normal ferritin

15-200

73

Normal iron

60-160 ug/L or 11-29 umol/L

74

TIBC

250-460 ug/L or 45-82 umol/L

75

Most accurate Dx of iron deficiency anemia

Bone marrow aspiration for staining of iron

76

Complication of hemochromatosis

Liver cirrhosis (Portal HTN)

77

Dx portal HTN

Transjugular cath (dangerous)
US or CT

78

Bleeding when on warfarin?

Hold warfarin
FFP transfusion
Vit K IV

79

Antidote of heparin, warfarin, ASA

Heparin = protamine

Warfarin = FFP + Vit K

ASA = platelet transfusion

80

Antidote of heparin, warfarin, ASA

Heparin = protamine

Warfarin = FFP + Vit K

ASA = platelet transfusion