Gen Med > Hematology > Flashcards

Hematology Flashcards

(99 cards)

Start Studying
0
Q

Causes for iron def

A

Menstration
Nutrition
Aspirin it NSAID use
GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Common signs of anemia

A 
Tachycardia
Orthostatic hypotension 
Pallor
Jaundice (hemolysis)
Smooth tongue
Koilonychia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Of the iron we ingest we absorb…

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Of the iron we absorb…

A

75% hemoglobin
10-20% ferritin
5-15% other
No excretion occurs!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which protein allows macrophages to recycle iron back into circulation?

A

Ferroportion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What protein slows iron absorption & cycling?

A

hepicidin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hallmark symptom of iron deficiency

A

pica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Serum ferritin def

A

<12 mcg/dl

1st sign of iron def

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TIBC metaphor

A

Seats on the bus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

% saturation metaphor

A

Seats full

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anemia of chronic disease labs

A

Normal ferritin level

Serum Iron low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thallesemia

A

MCV very low

RBC count normal or high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sideroblastic Anemia

A

Increased serum iron

% saturation increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Drug therapy for iron def

A

350 mg po tid

3 wks halfway normal
2 mos back to baseline
6 mos minimum txt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s the concern w paraenteral Fe?

A

Anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why does inflammatory disease cause anemia?

A

Reduced BM response to EPO

Ex: RA, Chronic inf, cancer, chronic kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most common cause of chronic disease anemia?

A

T cell mediated suppression on hematopoesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What cytokines contribute to ACD?

A

IL-6 and IL-1b (hepcidin produced in liver & inhibits iron absorption) (hepcidin binds to intestinal ferropotion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chronic renal insufficiency can result in…

A

Iron def
Folate deg
(Due to hemodialysis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ACD

A

Serum iron dec
TIBC dec
Serum ferritin normal or increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Drugs that can cause ACD

A

DMARDs

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Thalasemia

A

Reduced glob chain synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Alpha Thallesemia

A

Gene deletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Beta thal

A

Gene mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Only 1 normal alpha allele
Hgb H disease Splenomegaly Hemolytic anemia
25
Beta thal major
At 6 mos old severe anemia requires transfusion and folate supp Eventual chelation, transfusions Hgb F dominates Low hct
26
Beta thal minor
Clinically fine, Microcytic anemia
27
Thalasemia labs
Markedly dec MCV | Normal iron studies
28
Target cells indicate
Thalasemias
29
Txt for Hgb H disease
Folic acid
30
Sideroblastic Anemia
Inability to incorporate heme into protoporhyrin | Iron accumulates into mitochondria
31
Causes of sideroblastic anemia
Lead poisoning ethanol abuse Myelodysplasia
32
Sideroblastic anemia labs
Basophilic stippling of RBC Serum iron increased Ringed sideroblasts in BM Erythronium hyperplasia in BM
33
Anemia defined as
Hgb < 39% Males Hgb <37%
34
Intrinsic factor is made in
parietal cells of gastric mucosa
35
The biggest fear w B12 def
Irreversible neurological damage
36
Most common cause of B12 def
Pernicious Anemia
37
Sign of B12 def
Stocking glove Glossitis Loss of sensation Clumsiness/ataxia
38
Macrocytic Anemia lab
MCV> 100 fL
39
B12 def lab
``` Hypersegmented neutrophils MCV> 100 Anisocytosis (varied cell size) Poikilocytosis (varied cell shape) Howell jolly bodies ```
40
B12 def TXT
1000 mcg IM/ month (more initially) Oral cobalamin 6 wks 18 mos for full improvement
41
Folic acid signs
Same as B12 without neurological symptoms | Plus GI complaints
42
Folic acid antagonists
methotrexate Trimethoprim sulfate Phenytoin (Dilantin)
43
Microcytic anemia
MCV <80 fl
44
What test confirms thal?
Hgb electrophoresis
45
Where does B12 absorption occur?
Terminal Illeum (IF needed)
46
other causes for B12 def
Vegan duet, Gastric bypass, crowns or celiac
47
Alcoholics more commonly associated w
Folic acid def
48
Intrinsic hemolytic anemias
Cell membrane disorders Enzyme system dis Hgb disorders
49
Extrinsic hemolytic anemia
autoimmune Microangiopathic Malaria
50
Hemolytic anemia labs
Decreased haptoglobin Increased bilirubin Increased LDH
51
Spherocytosis signs
jaundice RUQ (Gallstones) palpable spleen
52
Hallmark lab for hereditary spherocytosis
Microcytosis w increased mean corpuscular hgb conct MCHC > 36 g/dl Positive osmotic fragility test
53
Txt for spherocytosis
Folic acid | Splenectomy
54
G6PD Def smear
Bite cells and Heinz bodies
55
G6PD stats
Only men | 10-15% of black men
56
Oxidative stressors (G6PD)
Infection, hypoxia, quinidine, sulfa drugs, nitrofurantonin
57
Do not do thus during a hemolytic episode
g6PD assay
58
What molecularly is goin on with Sickle Cell
Valine substitutes for glutamine on B chain
59
sickle cell disease stats
1/400 black kids in US
60
Life expectancy with sickle cell
40-50 yrs
61
Sickle cell Hgb
hgb f decreases Hgb S increases Usually presents by age 2, always by 8
62
Signs of sickle cell
``` Jaundice Hepatomegaly Pigmented gallstones Splenomegaly in kids Ulcers overlying tibia Acute pain during vaso-occlusive episodes in long bones chest & spine ```
63
Sickle cell labs
``` Nucleated rbcs Inc WBC Inc bilirubin Sickle cells, target cells, Howell jollys Hct dec 20-30% In cretic ```
64
Worries during acute vaso-occlusive episode
``` CVA Priapism MI PE Ischemic necrosis of organs Osteomyelitis-staph ```
65
Txt sickle cell crisis
Narcotics Oxygen hydration Blood transfusions if hgb < 5mg/dl
66
Txt of chronic sickle cell
Folic acid Pneumococcal vaccine Hydroxyurea (hgb f) Stem cell transplant
67
Sickle cell trait electrophoresis
60% hgb A 40% hgb S
68
Autoimmune hemolytic anemia
IgG antibody binds to RBC RBC membrane removed by spleen macrophages Spherocytes form
69
Associated with autoimmune HA
CLL SLE Lymphomas
70
Hallmark lab for autoimmune GA
Pos Coombs
71
Other labs Autoimmune HA
Inc retics Inc bilirubin Spherocytes Indirect Coombs +\-
72
TxT autoimmune HA
Prednisone 1-2 mg/kg daily Blood transfusion if hct< 30% Splenectomy if refractory to pred 2nd line Cyclosporine Retuxamib
73
Microangiopathic Anemias
RBC fragmentation | Coagulopathy and thrombocytopenia
74
Associated with microangiopathic anemia
Malfunctioning cardiac valve prosthesis TTP DIC HUS
75
Aplastic Anemia causes
``` SLE Chemo/rad Insecticides and "enes" Carbamazine, phenytoin, sulfonamides, chloramphenicol Pregnancy ```
76
Aplastic anemia labs
Pancytopenia | Dec retics & immature forms
77
Leukemia labs
Inc immature blasts
78
Pancytopenia could also be...
SLE, hypersplenism, disseminated infection
79
txt of choice for aplastic anemia for ppl <50
Allogenic BM transplant
80
Txt of choice for aplastic anemia for ppl over 50
Cyclosporine and antithymocyte globulin
81
Risk factors for leukemia
Cyclophosphamide Benzene Ionizing radiation Family hx
82
ALL stats
80% childhood leuks 20% adult leuks 70% remission rate
83
ALL signs
``` Lymphadenopathy Hepatomegaly Splenomegaly Pallor Bone pain Joint pain Malaise ```
84
Confirms dx of ALL
> 20% blasts in BM
85
AML stats
Median 60 y old 80-90% remission if under 50 50-60% if over
86
AML signs
``` Gingival hyperplasia Purpura Petechiae Lymphadenopathy Pallor Epistaxis Bone & joint pain ```
87
Confirms dx of AML
20% myeloblasts | Auer Rods
88
CML stats
55 y/old median
89
CML phases
Chronic- normal BM function Accelerated- neutrophil differentiation Impaired Acute- "Blast crisis"
90
Signs of CML
Sternal tenderness Splenomegaly Night sweats Weight loss
91
CML Dx
50,000 + WBCs Bcr/abl gene Philadelphia chromosome
92
Txt CML
Imantinib dasatinib BM transplant
93
What's the most peeve leant leukemia?
CLL
94
CLL stats
Median 70 y/old | 6 yr survival median
95
CLL Dx
Smudge cells | +\- anemia thrombocytosis
96
Indications to treat CLL
Progressive fatigue | Symptomatic lymphadenopathy, anemia or thrombocytopenia
97
Txt of CLL
Fludarabine | rituxan
98
Reactive or atypical lymphs are associated with...
Infectious mono

Gen Med (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions