Hematology Flashcards
(182 cards)
1
Q
anemic patients with reticulocyte count > 2 indicates
A
working marrow, RBC loss is either from bleeding or hemolysis
2
Q
anemic patients with reticulocyte count > 2 indicates
A
working marrow, RBC loss is either from bleeding or hemolysis
3
Q
anemic with retic cound
A
bone marrow failure from lack of epo or nutrients
4
Q
why does renal failure cause anemia
A
lack of EPO production
5
Q
what does high indirect bilirubin mean?
A
hemolysis or glibert syndrome
6
Q
high indirect bilirubin, high LDH, and high corrected retic count all point to?
A
hemolysis
7
Q
everyone has a least _____types of hemoglobin
A
3
8
Q
a decrease is what 2 type of hemoglobin leads to thalassemia?
A
alpha and beta
9
Q
normal white blood cell count
A
4.5 -11
10
Q
normal platelet count
A
150-400
11
Q
normal recticulocyte count
A
25-85
12
Q
Burr cells =
A
uremia (too much urea in the blood) kidney’s are not doing well
13
Q
Spur cells=
A
postsplenectomy
14
Q
Schistocytes =
A
DIC, vasulitis, and thrombotic thrombocytopenia
15
Q
Tear drop
A
iron deficiency
16
Q
target cells
A
thalassemias
17
Q
basophilic stippling
A
lead toxicity
18
Q
bite cells
A
G6PD deficiency
19
Q
rouleaux formation
A
Multiple myeloma
20
Q
increased recticulocyte count =
A
hemolysis or hemorrhage
21
Q
type of cells found in sideroblastic lead
A
dimorphic stippling
22
Q
who gets alpha thalassemia and who gets beta
A
Alpha; asian and Beta is meds and africans
23
Q
life long anemia and positive iron stores think….
A
thalassemia
24
Q
what determines the severity of alpha thalassemia
A
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
