Hematology Flashcards
(133 cards)
1
Q
leukemias to know
A
ALL
CLL
AML
CML
2
Q
which acute leukemia is associated w. kids
A
ALL
3
Q
3 sx of ALL
A
LAD
bone pain
bleeding
in a kid
4
Q
bone marrow bx findings of ALL
A
20% blasts
5
Q
mc childhood malignancy
A
ALL
6
Q
tx for ALL
A
chemo -> 90% remission
7
Q
what acute leukemia is found in adults
A
AML
8
Q
2 sx of AML
A
splenomegaly
gingival hyperplasia
9
Q
lab findings of AML
A
thrombocytopenia
neutropenia
leukostasis: WBC > 100,000
10
Q
bone marrow bx findings of AML
A
auer rods
> 20% blasts
adults
11
Q
mc leukemia in adults
A
CLL
12
Q
CLL is often asymptomatic, but what are 3 possible sx
A
fatigue
LAD
splenomegaly
13
Q
bx findings of CLL (2)
A
smudge cells
mature lymphocytes
14
Q
tx for CLL
A
obs
lymphocytes > 100,000 chemo
15
Q
what type of leukemia is associated w. blastic crisis
A
CML
16
Q
2 lab findings of CML
A
WBC > 100,000
hyperuricemia
17
Q
dx for CML (2)
A
-philadelphia chromosome (translocation of 9 and 22)
-splenomegaly
18
Q
anemias to know
A
anemia of chronic dz
aplastic
folate/B12 deficiency
hemolytic
IDA
SSA
thalasseimia
19
Q
only anemia where WBC/RBC/platelets are decreased
A
aplastic
20
Q
what anemias are associated w. elevated MCV
A
B12
folate
21
Q
what pt pop does macrocytic anemia make you think of
A
alcoholics
22
Q
what is pathognomonic for folate deficiency
A
hypersegmented PMNs
23
Q
what sx differentiates folate deficiency from B12 deficiency
A
neurologic deficits w. B12
24
Q
what anemia occurs after infxn or oxidative stress from meds
A
G6PD
25
what pt pop does G6PD deficiency make you think of
**african american male**
also middle eastern, s. asian
x linked
26
2 peripheral smear findings of G6PD
bite cells
heinz bodies
27
fxn of G6PD play
protects RBC membrane -> deficiency = hemolytic anemia
28
3 triggers associated w. G6PD deficiency
fava beans
antimalarials
sulfonamides
29
5 types of hemolytic anemia
autoimmune
G6PD
SSA
thalassemia
hereditary spherocytosis
30
lab findings of hemolytic anemia
**increased:**
reticulocytes
LDH
indirect bilirubin
**decreased:**
haptoglobin
31
what coombs test is associaated w. hemolytic anemia
direct
32
what anemia is associated with a positive osmotic fragility test
hereditary sphreocytosis
33
what type of anemia is associaated with very high reticulocytes
SSA
34
dx for SSA:
hallmark finding:
electrophoresis -> hemoglobin S
peripheral smear -> howell jolly bodies, target cells
35
what anemia is associated w. very low MCV and fam hx blood cell d.o
thalassemia
36
most sensitive test for IDA
ferritin
37
peripheral smear findings of IDA
target cells
38
2 PE findings associated w. IDA
pica
nail spooning
39
mc anemia in US
IDA
40
tx for IDA
FeS04 325 mg tid
Hgb < 8: transfusion
41
PE findings of SSA
jaundice
splenomegaly
priapism
poor healing
pain/swelling in hands/feet
acute chest syndrome
42
tx for SSA
hydroxyurea
43
3 types of thalassemia
beta major
beta trait
alpha
44
most severe thalassemia
mediterranean descent
ftt
beta thalassemia major
45
electrophoresis findings of beta thalassemia major
hemoglobin A2 and F
46
tx for beta thalassemia major
transfusion
iron cheation - deferoxamine
47
mild anemia
electrophoresis shows hemoglobin A2
often misdiagnosed as IDA
beta thalassemia trait
48
thalassemia associated w. chinese and southeast asians
alpha thalassemia
49
what does hemoglobin bart's make you think of
hydrops fetalis
50
hypersegmented neutrophils
normal folate
decreased vibratory/position sense
B12 deficiency
51
B12 anemia is same same
pernicious anemia
52
3 causes of pernicious anemia
abs to intrinsic factor
gastrectomy
vegans
53
3 PE findings of pernicious anemia
smooth beefy, sore tongue
poor balance
low proprioception
54
peripheral smear finding of pernicious anemia
hypersegmented neutrophis
55
elevated serum MMA
elevated homocysteine
pernicious anemia
56
what is schilling test
< 10% radiolabeled B12 in urine
normal when given intrinsic factor
**pernicious anemia**
57
3 causes of aplastic anemia
drugs/toxins
xrt
chemo
58
3 drugs associated w. aplastic anemia
ACEI
sulfas
phenytoin
59
6 sx of aplastic anemia
severe pallor
weakness
petechiae
ecchymosis
mucosal bleeding
severe infxn
60
gs dx for aplastic anemia
bone marrow bx
61
2 clotting factor d.o Smarty PANCE wants us to know
von willebrand (vWD)
hemophilias A/B
62
vWD is associated w. missing
protein for platelet fxn (von willebrand factor)
factor VIII
63
hemophilia a = decreased _
hemophilia b = decreased _
a: VIII
b: IX
64
30 yo woman w. recurrent nosebleeds and heavy menses - has been taking ASA and getting more nosebleeds - has fam hx nosebleeds - labs show increased PTT, normal PT, increased bleeding time
vWD
65
mc genetic bleeding d.o
autosomal dominant
vWD
66
pathology of wWD
missing VW factor in plasma -> platelets can not adhere to vessel wall after injury -> increased bleeding
67
how to differentiate vWD from hemophilias
vWD does not involve hemarthrosis
68
tx for vWD
DDAVP (dasmopressin)
transfusion w. concentrated VW factor
69
3 yo M - prolonged nosebleeds - right elbow swollen and ttp - maternal uncle has hx unexplained bleeding - labs show increased PTT - imaging shows blood accumulation in knee joint
hemophilia
70
mc type of hemophilia
A
71
hemophilia B is same same
christmas dz
72
hemophilia is _ linked
x recessive
73
labs associated w. hemphilia
increased PTT
normal PT
normal platelets
decreased factor VIII or IX
74
ddx for easy bruising (3)
platelet dysfxn
coag deficiency
meds
75
3 genetic causes of easy bruising
vWD
hemophioia
ITP
76
what labs reflect clotting factor deficiency
prolonged PT/PTT
77
hypercoagulable states to know
**PVCs:**
platelets elevation
vascular injury
clotting factor antagonists not working
stasis/surgery
78
what conditions are associated w. elevated platelets
TTP
HIT (heparin induced thrombocytopenia)
HUS
HELLP
79
3 anti clotting factors to know
protein C
protein S
antithrombin III
80
what is virchow's triad
blood stasis
hypercoagulable state
vascular injury
81
6 genetic causes of hypergoaculable states
antithrombin III deficiency
factor V leiden (protein C resistance)
protein C deficiency
protein S deficiency
dysfibrinogenemia
abnormal plasminogen
82
protein C resistance -> increased DVT/PE
common in young pt
factor V leiden
83
mc genetic hypercoagulation d.o
factor V leiden
84
tx for factor V leiden
LMWH bridge -> warfarin
85
-vitamin K dependent anticoagulant liver protein that stimulates fibrinolysis and clot lysis
-inactivates factors V and VIII
protein C
86
pt w. protein C deficiency are at increased risk for _ on warfarin
skin necrosis
87
tx for protein C deficiency
LMWH
DOACs fo life
no warfarin!
88
vitamin K dependent anticoagulant that inactivates factors Va and VIIIa -> reduces thrombin
protein S
89
tx for protein S deficiency
LMWH
DOAC fo life
90
recurrent VTE/PEm repetitive intrauterine fetal death
antithrombin III deficiency
91
what anticoagulant inhibits thrombin IIa and Xa
antithrombin III
92
-autoimmune clotting d.o associated w. SLE
-thromboses and recurrent spontaneous abortions
antiphospholipid antibody syndrome
93
antiphospholipid antibody syndrome involves _ mediated thrombosis
complement
94
dx for antiphospholipid antibody syndrome
lupus anticoagulant
anticardiolipin
DRVVT test
prolonged PTT
95
2 lymphomas to know
hodgkin
non hodgkin
96
painless enlarged posterior cervical and supraclavicular lymph nodes (virchow's nodes)
hodgkin's lymphoma
97
what are B symptoms associated w. lymphoma
fever
chills
night sweats
98
CXR finding of hodgkin lymphoma
mediastinal adenopathy
99
what is this showing
**reed sternberg cells:** abnormal multinucleated lymphocyte
**hodgkin's lymphoma**
100
immunocompromsed pt w. GI sx and painless peripheral LAD
non hodgkin lymphoma
101
age distribution for hodgkin's lymphoma
bimodal:
peaks in 20's and 50's
102
bx findings of non hodgkin lymphoma
diffuse large B cells
T cell
natural killer cells
103
lymph nodes associated w. non hodgkin's lymphoma (6)
peripheral
axillary
abdominal
pelvic
inguinal
femoral
104
B sx are common w. _ lymphoma
and uncommon w. _ lymphoma
common: hodgkin
uncommon: non hodgkin
105
which lymphoma is associated w. EBV
hodgkin's lymphoma
106
malignancy of the bone marrow -> overproduction of RBC
can also increase platelets and WBC
polycythemia vera
107
hallmark sx of polycythemia vera
**pruritis after hot shower** -> elevate histamines
swelling
burning pain
rubor of hands and feet (erythromelalgia)
108
comorbidity associated w. polycythemia vera
gout
109
4 h's of polycythemia vera
hypervolemia
histaminemia
hyperviscosity
hyperuricemia
110
dx for polycythemia vera
1. positive jak2
2. bone marrow bx
111
lab elevations w. polycythemia vera (6)
RBC/hgb,hct
thrombocytes
leukocytes
B12
uric acid
histamine
112
tx for polycythemia vera
-phlebotomies
goal:
113
causes of secondary polycythemia (6)
**altitude**
COPD
sleep apnea
bloodletting
genetic
neoplasms (pheo, liver)
114
important consideration in management of SSA pt
**immunizations:**
meningococcal
PNA
h.flu
influenza
115
3 thrombotycopenias to know
ITP
TTP
HIS
DIC
116
-autoimmune rxn to platelets
-insidious, chronic onset after viral infxn
ITP
117
ITP is associated w. (4)
HIV
HCV
SLE
CLL
118
lab findings of ITP
low platelets (CBC otherwise nl)
positive direct coombs
119
tx for ITP
kids: supportive vs IVIG
adults: prednisone
120
acute febrile dz involving multi organ thrombosis
thrombotic thrombocytopenia (TTP)
121
lab findings of TTP
thrombocytopenia
anemia
122
peripheral smear finding of TTP
schistocytes (RBC fragments)
123
causes of TTP
quinidine
cyclosporine
pregnancy
124
inhibition of what gene is associated w. TTP
ADAMTS13
125
sx of TTP
**FAT RN:**
fever
anemia
thrombocytopenia
renal failure
neuro sx
126
dx for TTP
-thrombocytopenia (CBC otherwise nl)
-schistocytes on smear
negative coombs
127
tx for TTP
steroids
plasmaphoresis
128
-what thromboytopenia is associated w. e.coli 0157:H7
-think diarrheal illness in kids
HUS
129
presentation of HUS (4)
post e.coli or shigella
kids
anemia + thrombocytopenia
severe renal failure
130
abnormal activation of coagulation sequene -> microthrombi throughout microcirculation -> low platelets, fibrin, and coag factors -> **hemorrhage and thrombosis simultaneously**
DIC
131
5 causes of DIC
infxn
obtetric complications
trauma
malignancy
shock
132
lab findings of DIC
**decreased:** platelets
**increased:**
bleeding time
PT/PTT
d dimer
133
tx for DIC (4)
cryoprecipitate
FFP
platelet transfusion if < 30,000
LMWH
