Hematology Flashcards by Alice Richards

leukemias to know

ALL
AML
CLL
CML

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child
LAD
bone pain
fever, bleeding

ALL

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if the vignette is leukemia in a kid it’s

ALL

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hallmark bx finding of ALL

> 20% blasts

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tx for ALL

chemo

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middle aged pt w. fatigue, LAD. splenomegaly

CLL

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mc leukemia in adults

CLL

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hallmark findings of CLL

smudge cells on peripheral smear (mature lymphocytes)

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management of CLL

lymphycytes > 10,000: obs
symptomatic: chemo

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2 hallmark findings of AML

blasts
auer rods

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3 sx of AML

splenomegaly
gingival hyperplasia
WBC > 100,000

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hallmark finding of AML

auer rods
>20% blasts

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2 sx of CML

WBC > 100,000
hyperuricemia
splenomegaly

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hallmark finding of CML

philadelphia chromosome (translocation of chromosomes 9 and 22)

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lab findings of anemia of chronic dz

normal vs decreased MCV
decreased TIBC
increased ferritin

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mcc causes of anemia of chronic dz

CKD
connective tissue d.o
RA
SLE
HIV
ca
cirrhosis
chronic infxn

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hallmark finding of anemia of renal failure

decreased serum erythropoietin

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pharm for anemia of chronic dz if Hgb < 10

EPO analog (epogen, procrit)

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2 bleeding disorders to know

VWD
hemophilias A and B

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clotting factor deficiencies associated w. hemophilias a and b

a: VIII
b: IX

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moa for von willebrand factor

found on plasma, platelets, and walls of BV -> helps PLTs adhere to vessel wall at the site of injury

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mc genetic bleeding d.o

VWD

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common presentation for VWD

excessive bleeding after a cut or menstrual bleeding

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how is VWD differentiated form hemophilia

w. hemophilia:
hemarthrosis
small amt of superficial bleeding
common w. minor injury
petechiae

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tx for VWD

DDAVP severe: transfusion containing VW factor

how is hemophilia passed on

x-linked recessive

hallmark presentation of hemophilas

hemarthrosis

lab findings of hemophilias

increased PTT normal PT/PLT

tx for hemophilias

replace factor VIII or IX

anemia post infxn or medication

G6PD

G6PD is a _ anemia

hemolytic

what 3 populations are mc affected by g6pd

african middle eastern asian

3 triggers for g6pd

fava beans antimalarials sulfonamides

2 hallmark dx findings of g6pd

on smear: heinz bodies bite cells

4 genetic causes of hypercoagulable state

protein C def. protein S def. antithrombin III def. factor V leiden

6 acquired heme causes of hypercoagulable states

polycythemia vera DIC antiphospholipid syndrome TTP HUS HIT

what acquired clotting disorder is often associated w. SLE

antiphospholipid abs syndrome

AI rxn to PLT's usually after viral illness

ITP

4 conditions associated w. ITP

HIV HCV SLE CLL

2 hallmark lab findings of ITP

CBC normal except for low PLT (+) direct coombs

tx for ITP

kids: supportive vs IVIG adults: prednisone

5 s/sx of IDA

target cells pica nail spooning angular cheilitis glossitis

mcc of IDA

blood loss

tx for IDA

FeSO4 325 mg TID 6 weeks to replete recheck q 3 mos x 1 year

causes of microcytic anemia

IDA sideroblastic thalassemia late anemia of chronic dz lead poisoning -> basophilic stippling

lymphomas to know

hodgkin's non hodgkin's

hallmark dx of hodgkin's lymphoma

reed sternberg cells - owl eye appearance

s/sx of hodgkin's lymphoma

painless upper body LAD: neck axilla shoulder mediastinum

what are 3 B sx associated w. hodgkin's lymphoma

fever wt loss night sweats

what condition is highly associated w. hodgkin's lymphoma

EBV

HIV pt + painless LAD + GI/skin sx

non hodgkin lymphoma

hodgkin lymphona affects _ cells non hodgkin lymphoma affects _ cells (2)

hodgkin: B non hodgkin: B and T

4 sx of non hodgkin lymphoma

SOB intussusception bowel obstruction abdominal masses

cancer of monoclonal plasma cells

multiple myeloma

hallmark presentation of multiple myeloma

older pt bone/back pain refractory to tx

what does CRAB stand for

**multiple myeloma:** calcium elevation renal failure anemia bone lesions

dx for multiple myeloma

UA: bence jones protein smear: rouleaux formation (stacked RBC) XR: lytic punched out bone lesions electrophoresis: monoclonas M protein spike bone marrow bx: >10% clonal plasma cells

definitive tx for multiple myeloma

bone marrow transplant

chronic hemolytic anemia that occurs almost exclusively in AA's

SSA

s/sx of SSA

hemolysis jaundice splenomegaly priaprism poor healing pain/swelling in hands/feet acute chest syndrome pigmented gallstones

what causes SSA crises

sickle-cell shaped RBCs clot capillaries -> end organ ischemia

what lab value can be used to monitor SSA crises

**reticulocytes** - decrease a pt improves

definitive dx for SSA

HgbS on Hgb electrophoresis

2 hallmark blood smear findings of SSA

sickled RBCs howell-jolly bodies also target cells

what type of anemia is SSA

normochromic normocytic

Hb SS vs Hb SA

HbSS: disease HbSA: trait

2 parents w. a sickle cell trait have a _ chance of having a child w. HbSS dz

25%

management of SSA crisis

high flow O2 pain control Hgb < 6: transfusion

what med may reduce the frequency of SSA crises

hydroxyurea

what type of anemia is thalassemia

microcytic hypochromic

3 types of thalassemia

beta major beta trait alpha

most severe form of thalassemia

beta major

electrophoresis findings associated with each form of thalassemia

beta major: Hgb A2 and F beta trait: Hgb A2 alpha: Hgb H, Hgb Bart's, Hgb A

Hgb _ is associated w. hydrops fetalis

bart's

which thalassemia is minor and often misdiagnosed as IDA

beta trait

tx for beta thalassemia major

transfusion deferoxamine (iron chelation)

acute febrile disease with multi-organ thrombosis

TTP

decreased PLT anemia schistocytes

TTP

3 precipitants of TTP

quinidine cyclosporine pregnancy

TTP is caused by inhibition of what gene

ADAMTS13

how to remember typical presentation of TTP

FAT RN: fever anemia thrombocytopenia renal failure neuro sx

tx for TTP

steroids plasmapheresis

3 causes of hemolytic uremic syndrome

e.coli 0157:h7 shigella diarrheal illness in a child

common presentation of HUS

anemia decreased PLT renal failure

2 types of macrocytic anemia

vitamin B12 folic acide deficiency

hallmark finding of vit b12 deficiency

hypersegmented neutrophils

3 rf for b12 deficiency

pernicious anemia gastrectomy vegan

pernicious anemia is caused by abs to

intrinsic factor

2 sx of b12 deficiency

glossitis poor balance/low proprioception

what is the schilling test for pernicious anemia

<10% radiolabeled b12 in urine -> administer intrinsic factor -> results normalize

presentation of folate deficiency

mimics b12 but no neuro sx

folate deficiency makes you think what pt pop

alcoholics

folate deficiency anemia is same same

megaloblastic anemia

what dx finding is pathognomonic for folate deficiency

hypersegmented PMNs

3 folic acid antagonists

bactrim phenytoin sulfasalazine

Hematology Flashcards

(95 cards)