Hematology

Question 1

Causes of microcytic anemias

Answer 1

iron deficiency
thalassemias
Pb 
B6 deficiency
EtOH

Question 2

Causes of macrocytic anemia

Answer 2

folate/B12

liver disease

Question 3

Causes of normocytic anemia

Answer 3

hemolytic anemia
anemia of chronic disease
myelodysplastic syndromes
renal failure

Question 4

Dx and tx for beta thalassemia

Answer 4

dx=electrophoresis

tx=pRBCs transfusions

Question 5

Causes of sideroblastic anemias (6)

Answer 5

chloramphenicol
INH
Pb/excess Zinc
EtOH
B6 deficiency

Question 6

Tx for sideroblastic anemia

Answer 6

B6 (pyridoxine)

Question 7

Causes of aplastic anemia

Answer 7

radiation
chloramphenicol/sulfas/gold
parvovirus/HIV/EBV/CMV
benzenes

Question 8

Source of B12

Answer 8

fish and meats

absorbed in ileum with intrinsic factor

Question 9

Causes of B12 deficiency (5)

Answer 9

pernicious anemia
EtOH
Crohn's
diphyllobothrium latum
bacterial overgrowth

Question 10

Sx of B12 deficiency

Answer 10

anemia
glossitis
loss of position and vibratory sense
dementia
urinar/fecal incontinence

Question 11

Source of folate

Answer 11

green veggies

Question 12

Causes of folate deficiency

Answer 12

tea and toast diet
EtOH
long term abx
MTX
phenytoin

Question 13

Sx of hemolytic anemias (5)

Answer 13

jaundice
dark urine
elevated reticulocytes (>2%)
hepatosplenomegaly
cholelithiasis

Question 14

Tx for hemolytic anemias

Answer 14

folate due to depletion

tx underlying cause

Question 15

Complications of Sickle-Cell (8)

Answer 15

gallstones
high output heart failure
aplastic crisis with parvo B19
Hand-foot syndrome
Acute chest syndrome
avascular necrosis of bones
priapism
renal papillary necrosis

Question 16

Dx for Sickle-Cell

Answer 16

electrophoresis

Question 17

Tx for Sickle-Cell

Answer 17

increased fluid intake
morphine for pain
hydroxyurea

Question 18

Dx for hereditary spherocytosis

Answer 18

Direct Coombs (-)
osmotic fragility test (+)
spherocytes
tx=splenectomy

Question 19

Dx of G6PD deficiency

Answer 19

bite cells and Heinz bodies
G6PD levels can be normal during hemolytic phase
otherwise deficient NADPH assay

Question 20

Dx of autoimmun hemolytic anemia

Answer 20

Warm is Coombs test (+)
Cold is (+) for cold agglutinins
spherocytes seen with warm as well

Question 21

Dx of paroxysmal nocturnal hemoglobinuria

Answer 21

Ham’s test
sugar water test
flow cytometry for CD55 and CD59

Question 22

Dx of idiopathic thrombocytopenic purpura

Answer 22

plateletes< 20,000

increased megakaryocytes on marrow tap

Question 23

Tx of idiopathic thrombocytopenic purpura

Answer 23

corticosteroids
IV immunoglobulin
romiplastim/eltrambopag

Question 24

Dx of TTP

Answer 24

schistocytes on peripheral smear
thrombocytopenia
ARF

Question 25

Tx for TTP

Answer 25

plasmapheresis

Question 26

Dx of HIT

Answer 26

decrease in platelets by 50% | serotonin release assay

Question 27

Dx of von Willibrand disease

Answer 27

increased bleeding time and PTT | ristocetin platelet aggregation decreased

Question 28

Dx of DIC (5)

Answer 28

``` elevated PT, PTT and bleeding time D-dimer (+) thrombocytopenia schistocytes decreased fibrinogen ```

Question 29

Tx for DIC

Answer 29

FFP | cryoprecipitate

Question 30

Inherited hypercoagulopathies (6)

Answer 30

``` Factor V Leiden AT III deficiency Protein C/S deficiency Hyperhomocysteinemia Prothrombin mutation Antiphospholipid Ab syndrome ```

Question 31

Adverse effects of heparin (4)

Answer 31

HIT osteoporosis alopecia rebound hypercoagulability

Question 32

Heparin consideration with pts

Answer 32

renal insufficiency due to renal excretion

Question 33

Drug interaction with clopidogrel

Answer 33

PPI's, decrease effectiveness

Question 34

Lab for hemolytic anemia

Answer 34

Haptoglobin decreased