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Flashcards in Hematology Deck (182):
1

anemic patients with reticulocyte count > 2 indicates

working marrow, RBC loss is either from bleeding or hemolysis

2

anemic patients with reticulocyte count > 2 indicates

working marrow, RBC loss is either from bleeding or hemolysis

3

anemic with retic cound

bone marrow failure from lack of epo or nutrients

4

why does renal failure cause anemia

lack of EPO production

5

what does high indirect bilirubin mean?

hemolysis or glibert syndrome

6

high indirect bilirubin, high LDH, and high corrected retic count all point to?

hemolysis

7

everyone has a least _____types of hemoglobin

3

8

a decrease is what 2 type of hemoglobin leads to thalassemia?

alpha and beta

9

normal white blood cell count

4.5 -11

10

normal platelet count

150-400

11

normal recticulocyte count

25-85

12

Burr cells =

uremia (too much urea in the blood) kidney's are not doing well

13

Spur cells=

postsplenectomy

14

Schistocytes =

DIC, vasulitis, and thrombotic thrombocytopenia

15

Tear drop

iron deficiency

16

target cells

thalassemias

17

basophilic stippling

lead toxicity

18

bite cells

G6PD deficiency

19

rouleaux formation

Multiple myeloma

20

increased recticulocyte count =

hemolysis or hemorrhage

21

type of cells found in sideroblastic lead

dimorphic stippling

22

who gets alpha thalassemia and who gets beta

Alpha; asian and Beta is meds and africans

23

life long anemia and positive iron stores think....

thalassemia

24

what determines the severity of alpha thalassemia

how much chains are deleted

25

another name for beta thalassemia?

Cooley's anemia

26

tx for thalassemia?

transfusions, but must be careful not to overload

27

iron overloading may result in

hemosiderosis, heart failure, cirrhosis.

28

what medication can be given to postpone hemosiderosis

deferoxamine or oral deferasirox

29

what are iron store and hemoglobin levels like in thalassemia?

hemoglobin is low 3-6 and iron is normal

30

definitive tx for thalassemia

bone marrow transplant or spenectomy

31

what is the hallmark of Fe deficiency?

Pica

32

what is plummer vinson syndrome

formation of esophageal webs due to severe iron deficiency

33

what plasma ferritin level indicates iron insufficiency

34

what if serum iron is decreased to

dx = iron deficiency

35

what can be taken with iron to help with absorption

vitamin c

36

treatment for iron defiency

325mg of ferrous sulfate, therapy should be continued for 6 months

37

anemia can be caused by chronic inflammation, what labs should you get

CRP and ESR

38

what type of screening is used for sideroblastic anemia and what are the causes

prussian blue stain show rings. lead, etoh

39

treatment for lead poisoning

chelation therapy

40

anemia of chronic disease have what size cells

normocytic

41

anemia due to renal failure can be tx with?

Recombinant epo

42

name a couple of folate acid antagonist

phenytoin, trimethoprim-sulfamethoxazole and sulfasalazine

43

lacking folic acid will you have neurologic symptoms?

no. but you may have a sore tongue

44

Macro-ovalocytes and hyper segmented polymorphonuclear cells are path gnomonic for ?

Folic acid deficiency (macrocytic anemia), keep in mind that B12 deficiency can also have this

45

Howell jolly bodies =

folic acid deficiency

46

name the buzz words for b12 deficiency of pernicious anemia

smooth tongue, stocking-glove paresthesia, dementia (neurologic problems)

47

tx pernicious anemia

lifelong b12 injections

48

tx pernicious anemia

lifelong b12 injections

49

anemic with retic cound

bone marrow failure from lack of epo or nutrients

50

why does renal failure cause anemia

lack of EPO production

51

what does high indirect bilirubin mean?

hemolysis or glibert syndrome

52

high indirect bilirubin, high LDH, and high corrected retic count all point to?

hemolysis

53

everyone has a least _____types of hemoglobin

3

54

a decrease is what 2 type of hemoglobin leads to thalassemia?

alpha and beta

55

normal white blood cell count

4.5 -11

56

a what age do sickle cell problems start

6 months when Hgb F starts to fall

57

normal recticulocyte count

25-85

58

Burr cells =

uremia (too much urea in the blood) kidney's are not doing well

59

Spur cells=

postsplenectomy

60

Schistocytes =

DIC, vasulitis, and thrombotic thrombocytopenia

61

Tear drop

iron deficiency

62

target cells

thalassemias

63

basophilic stippling

lead toxicity

64

bite cells

G6PD deficiency

65

rouleaux formation

Multiple myeloma

66

increased recticulocyte count =

hemolysis or hemorrhage

67

type of cells found in sideroblastic lead

dimorphic stippling

68

who gets alpha thalassemia and who gets beta

Alpha; asian and Beta is meds and africans

69

life long anemia and positive iron stores think....

thalassemia

70

what determines the severity of alpha thalassemia

how much chains are deleted

71

another name for beta thalassemia?

Cooley's anemia

72

tx for thalassemia?

transfusions, but must be careful not to overload

73

iron overloading may result in

hemosiderosis, heart failure, cirrhosis.

74

what medication can be given to postpone hemosiderosis

deferoxamine or oral deferasirox

75

what are iron store and hemoglobin levels like in thalassemia?

hemoglobin is low 3-6 and iron is normal

76

definitive tx for thalassemia

bone marrow transplant or spenectomy

77

what is the hallmark of Fe deficiency?

Pica

78

what is plummer vinson syndrome

formation of esophageal webs due to severe iron deficiency

79

what plasma ferritin level indicates iron insufficiency

less than 20

80

what if serum iron is decreased to

dx = iron deficiency

81

what can be taken with iron to help with absorption

vitamin c

82

treatment for iron defiency

325mg of ferrous sulfate, therapy should be continued for 6 months

83

anemia can be caused by chronic inflammation, what labs should you get

CRP and ESR

84

what type of screening is used for sideroblastic anemia and what are the causes

prussian blue stain show rings. lead, etoh

85

treatment for lead poisoning

chelation therapy

86

anemia of chronic disease have what size cells

normocytic

87

anemia due to renal failure can be tx with?

Recombinant epo

88

name a couple of folate acid antagonist

phenytoin, trimethoprim-sulfamethoxazole and sulfasalazine

89

lacking folic acid will you have neurologic symptoms?

no. but you may have a sore tongue

90

Macro-ovalocytes and hyper segmented polymorphonuclear cells are path gnomonic for ?

Folic acid deficiency (macrocytic anemia), keep in mind that B12 deficiency can also have this

91

Howell jolly bodies =

folic acid deficiency

92

name the buzz words for b12 deficiency of pernicious anemia

smooth tongue, stocking-glove paresthesia, dementia (neurologic problems)

93

are MMA and homocystenine levels increased in anemia due to vitamin b12?

YES

94

tx pernicious anemia

lifelong b12 injections

95

Acronym for hemolytic anemia

HIT

96

what does HIT stand for

hereditary, immune attack and trauma

97

Hereditary causes of hemolytic anemai

G6PD, thalassemia, sickle cell

98

Immune attack causes of hemolytic anemia

TTP, HUS, DIC

99

The direct coombs test id antibodies on______

the RBC

100

the indirect test id antibodies in the______

patient's serum

101

Test for G6DP hemolysis

Heinz body test

102

who does sickle cell affect in the US

blacks

103

a what age do sickle cell problems start

6 months when Hgb F starts to fall

104

what causes a sickle cell crisis

dehydration, altitude, acidosis, hypoxemia, stress, menses

105

sickle cell patients are at an increased risk for

strep pneumo infection, ulcer, spleen and gallbladder issues

106

what ortho issue is more common in sickle cell patients

AVN of the femoral and humeral head

107

that method demonstrates the level of different hemoglobin in the red cells

electrophoresis

108

findings of sickle cells on peripheral smear

Howell jolly bodies

109

preventative tx for sickle cell

low dose penicillin daily from birth to 6 years old, pneumo vaccines and screening to prevent stroke. daily hydroxyurea should also be considered.

110

what type of a genetic disorder is G6PD

X-linked (black males)

111

what causes episodic hemolysis in G6PD

Fava beans and oxidative drugs like aspirin

112

Coomb's test results: Warm IgG positive = what causes?

CLL, NHL, Hodgkin, SLE

113

Coomb's test results: Cold IgM positive/ positive complement C3d =

infection, EBV, CMV, mono

114

polycythemia vera is known to have what mutation

JAK2

115

Poly..Vera might convert to...

myelofibrosis or chronic myeloid leukemia

116

Upper GI issue associated with poly, vera

PUD

117

what is the most commen complication of poly. vera

thrombosis

118

signs of primary poly, vera

HTN, splenomegaly, thrombosis

119

who is affected by AML

all mature lions (ADULTS) over 60 years old

120

who is affected by ALL

all little lions 3-7 years old

121

CBC for leukemia

pancytopenia, circulating blasts >20%

122

Auer rods are seen in what type of leukemia

AML

123

Terminal deoxynucleotidyl transferase is diagnostic for

ALL

124

what are 3 stages of CML

chronic, accelerated and acute (blast crisis >30% blasts)

125

tx for ALL

chemo (50% of children will be cured

126

what should be contained on a hyper coagulation panal

protein S and C, antithrombin III, factor V leiden, HIT essay

127

what test is used to defect lupus anticoagulant

russell's viper venom

128

treatment for lupus anti autoimmune causes

prednisone

129

hallmark leukocytosis number > 20,000

CLL

130

hallmark is leukocytosis with a WBC of 150,000

CML

131

what replaced the search for the philly gene in CML

BCR-ABL

132

a smudge cell are pathognomics for

CLL

133

Reed strenberg cells found, associated with epstein barr virus and incident peaks in 20s and 50s

Hodgkins lymphoma

134

B lymphocytes associated with HIV and occurs in 20-40 year olds

NON-hodgkins lymphoma

135

treat for NON- hodgkins lymphoma if only 1-2 nodes involved

radiation

136

treatment for NON-hodgkins lymphoma involves more than 1 node?

chemo

137

treatment for hodgkins

chemo or chemo + radiation

138

What are rouleaux formations

spike on serum protein electrophoresis, positive multiple myeloma

139

bence jones, lytic lesions, replacement of bone marrow?

MM

140

monoclonal paraprotein

MM

141

most common bleeding disorder

vWD

142

what clotting factor is missing in vWD

8

143

PET vs PITT

extrinsic vs intrinsic

144

next step if either PT or PTT is long?

Thrombin time (TT)

145

what does thrombin time measure

conversion of fibrinogen to fibrin

146

thrombocytopenia, post viral infection, autoimmune IgG disorder

ACUTE immune thrombocytopenia purpura (ITP)

147

thrombocytopenia more common in females, associated with HIV, autoimmune and hep C

CHRONIC immune thrombocytopenia purpura

148

Rare but fatal thrombocytopenia associated with HIV, pregnancy, and anti-clotting drugs

TTP

149

thrombocytopenia that causes hemorrhage in pt w/ severe illness, sepsis, burns, and cancer

DIC

150

thrombocytopenia similar to TTP, but found in children with toxicgenic e.coli

HUS

151

if platelet count is below 50,000 symptoms include?

petecitea, purpura, bleeding gums

152

Will PT/PTT be normal or abnormal in TTP, HUS, DIC and HIT

abnormal in DIC and HIT

153

tx for HIT

stop heparin

154

tx for TTP

FFP and plasma exchange, no platelets

155

tx for HUS

support, no platelets

156

tx for DIC

FFP cryo platelets

157

dx study for TTP

autoantibodies against ADAMTS 13 lead to excessive platelet aggregation

158

dx for HIT

ELISA is positive, PF4 heparin antibody enzyme

159

tx for ITP

support, steroids or take out spleen

160

what is more common acquired or congenital platelet dysfunction

acquired, due to aspirin and NSAIDS

161

test for platelet function

platelet function testing (PFT) problems even though the platelet number is normal

162

dx test for vWD

PT is normal and PTT may be prolonged & PFA prolonged, factor VIII is low, vWD is low

163

abnormal pt and ptt

got to think DIC

164

tx for vWD

desmopressin (DDAVP) nasal spray for prevention before procedures and Factor VIII concentrates

165

is PTT or PT increased with hemophilia A

PTT, everything else is normal

166

what is more common hemophila A or B

A

167

most common acquired cause of inability to clot?

Vitamin K deficiency

168

what studies are prolonged in Vit K deficiency?

PT and PTT, vita K level and factors II, VII, IX, and X (2.7,9,10)

169

is Hyperhomocysteinemia venous of arterial

arterial

170

What is the best treatment for hemophilia A?

Factor 8

171

Which of the following thrombophilias may result from B 6 , B 12 , or folate deficiency?

Homocysteine is broken down in the body by Vit B 6 , B 12 , and folate. Thus, hyperhomocysteinemia may result from a deficiency in any of these compounds.

172

A 65 year old female presents to your office with an acute onset of gingival bleeding, frequent epistaxis, and fatigue. She denies having night sweats. Physical exam reveals a slight fever, without lymphadenopathy. Complete Blood Count demonstrates WBC 50,000; hemoglobin 8.9; platelets 20,000; and peripheral smear shows myeloblasts. Which of the following findings is consistent with the likely diagnosis?

This patient is presenting with acute myeloid leukemia (AML). A CBC will show leukocytosis with anemia/thrombocytopenia. Bone marrow biopsy is the definitive test, which will reveal Auer rods, which is pathognomic for AML.

173

Which of the following signs of metastatic disease is characterized by palpable pelvic nodes on pelvic or rectal exam?

Palpable pelvic nodes on pelvic or rectal exam are termed Blumer’s shelf, and may be a sign of metastatic cancer.

174

Which of the following venous thrombophilias may lead to heparin resistance?

Can lead to heparin resistance since heparin activates on Antithrombin III.

175

Which of the following is the most common cause of B 12 deficiency?

Atrophic gastritis, the autoimmune destruction of gastric parietal cells leads to a lack of intrinsic factor. Vitamin B 12 absorption is dependent on adequate levels of intrinsic factor.

176

what two coag-pathies are people really sick?

TTP and DIC

177

Do not give platelets in what 3 coag-pathies

TTP, HUS, and HIT

178

the only coag-pathy with true venous and arterial clots?

HIT

179

two coag-pathy with hemolytic anemia

TTP & HUS

180

what is more serious ITP or TTP

TTP (may be CNS findings)

181

what type of leukemia has the exam finding of Spenomegaly

CML

182

Antithrombin III deficiency causes clots and is complicated by its possible resistance to _____

heparin