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Flashcards in Hematology Deck (295):
1

What are sx of anemia based on

Severity of disease

2

Sx w/ HCT >30-35

None

3

Sx w/ HCT 25-30

Dyspnea worse on exertion
Fatigue

4

Sx w/ HCT 20-25

Lightheadedness
Angina

5

Sx w/ HCT

Syncope
CP

6

What kills you in anemia

MI

7

What conditions are indistinguishable for myocytes in the heart

Anemia
Hypoxia
CAD
Carbon monoxide poisoning

8

First clue to etiology of anemia

MCV

9

Causes of low MCV

Fe def
Thalassemia
Sideroblastic anemia
AOCD

10

Only microcytic anemia with elevated retic count

Alpha-thalassemia

11

Causes of high MCV

B12/Folate def
Sideroblastic anemia
Alcohol
Azathioprine, 6-MP, hydroxyurea
Liver disease/hypothyroidism
Zidovudine, phenytoin
MDS

12

2 main causes of normocytic anemia acutely

Blood loss
Hemolysis

13

Retic count in normocytic anemia

Elevated when there is hemolysis

14

Treatment for severe anemia

pRBCs

15

When do you transfuse anemic pt

Symptomatic
HCT 25-30 in elderly pt or one w/ heart disease

16

What is symptomatic anemia

SOB
Lightheadedness, confusion, syncope
Hypotension, tachy
CP

17

What to transfuse for IgA def pts

IgA def donor FFP

18

HCT of pRBCs

70-80%
Whole blood w/ 150mL plasma removed

19

Effect of pRBC on HCT

Each unit raises HCT by 3 points

20

Who doesn't get FFP

Hemophilia A, B
Von Willebrand

21

What does FFP replace

Clotting factors

22

What does cryoprecipitate replace

Fibrinogen (for DIC)
Has high VIII and VWF

23

MCV in microcytic anemia

Decreased

24

What is the main reason for Fe def anemia

Blood loss

25

Body needs for Fe

Normal - 1-2mg/day
Menstruating - 2-3
Pregnant - 5-6

26

What is the suspected etiology of AOCD

Fe trapped in macrophages or ferritin so Hb synth doesn't occur

27

How does renal failure cause AOCD

Deficiency of EPO

28

When is sideroblastic anemia macrocytic

MDS

29

MCC sideroblastic anemia

Alcohol

30

Less common causes of sideroblastic anemia

Pb poisoning
Isoniazid
B6 def

31

Most likely anemia with GI bleeding

Fe def

32

Most likely anemia with menstruation

Fe def

33

Most likely anemia with cancer/chronic infection

AOCD

34

Most likely anemia with RA

AOCD

35

Most likely anemia in alcoholics

Sideroblastic

36

Most likely anemia with Asx pts

Thalassemia

37

Best initial test for microcytic anemia

Fe studies

38

MC microcytic anemia with target cells

Thalassemia

39

Which anemia has low ferritin

Fe def

40

Which anemia has high Fe

Sideroblastic

41

Which anemia has normal Fe studies

Thalassemia

42

Fe def iron studies

Low ferritin
High TIBC

43

AOCD Fe studies

High ferritin
Low TIBC

44

Unique lab features of Fe def

Increased RDW
Increased platelets

45

Single most accurate test for Fe def

Bone marrow Bx for stainable Fe
NEVER done

46

Unique lab features for sideroblastic anemia

Prussian blue staining for ringed sideroblasts (most accurate)
Basophilic stippling

47

Type of anemia in Chronic renal failure

Normocytic

48

Most accurate test for Thalassemia

Hb electrophoresis

49

Most accurate test for alpha-thalassemia

Genetic studies

50

Thalassemia with HbH and increased retics

3-del
HbH are beta tetrads

51

1 gene deletion features of B-thal

Increased HbF, HbA2

52

2 gene deletion features of a-thal

Mild anemia
Normal electrophoresis

53

3 gene deletion features of B-thal

Normal HbF

54

4 gene deletion features of a-thal

gamma-4 tetrads (Hb Bart)
CHF causes death in utero

55

RDW in thalassemia

Normal

56

Rx Fe def

Oral ferrous sulfate
IM Fe if insufficient

57

Rx AOCD

Fix underlying problem
Only Anemia from ESRD responds to EPO

58

Rx Sideroblastic anemia

Correct cause
B6/pyridoxine replacement

59

Rx Thalassemia

B - Lifelong chronic transfusions (NOT 3-del)
Fe overload - Deferasirox, deferiprone, defereoxamine

60

First step in Macrocytic Anemia

Peripheral smear

61

What is macrocytic anemia

Presence of hypersegmented neutrophils

62

What does B12/Folate defiency do that alcoholism cannot

Hypersegmented neutrophils

63

Causes of B12 deficiency

Pernicious anemia
Pancreatic insufficiency
Vegan
Crohn's/Celiac/Sprue/Radiation/Terminal ileum damage
Blind loop syndrome/Gastrectomy/Gastric bypass
Diphyllobothrium latum/HIV

64

Causes of B9 deficiency

Goat's milk, Celiac
Psoriasis and skin loss/turnover (sickle cell)
Phenytoin, Sulfa
MTX usage in RA

65

MC neuro abnormality in B12 deficieny

Peripheral neuropathy

66

Classic neuro loss in B12 defiency

Posterior column damage (position and vibratory)
AKA Subacute combined degeneration

67

Which deficiency is associated with increased methylmalonic acid levels

B12

68

LAb values common to B12 and folate deficiency

Megaloblastic anemia
Increased LDH and indirect bili
Decreased retic
Hypercellular marrow
Macroovalocytes
Increased homocysteine

69

Why is B12 NL in 1/3 of pts with B12 def

Carrier protein transcobalamin is acute phase reactant and may be elevated

70

Confirmatory test for pernicious anemia

Anti-intrinsic factor
Anti-parietal cell

71

Why is retic count low in macrocytic anemia

RBCs destroyed as they leave the marrow

72

Why does pancreatic insufficiency cause macrocytic anemia

Pancreatic enzymes are needed to absorb B12

73

What can result from B12/folate replacement

Hyperkalemia

74

What is common in all hemolysis

Decreased HCT
Increased LDH, indirect Bili, retics
Decreased haptoglobin
NL/Increased MCV
Hyperkalemia
Folate deficiency

75

What does haptoglobin do

Transfers Hb from intravascular to extravascular

76

What is chronic hemolysis always associated with

Bilirubin gallstones

77

Why is urine dark in hemolytic anemia

Increased Hb

78

What can prolongued hemoglobinuria lead to

Renal failure/ATN

79

MCC hemolysis

Sickle cell

80

Retic count in sickle cell

Always High

81

Precipitants of vasoocclusive crisis

Hypoxia
Dehydration/Contrast
Infection/Fever
Cold Temperatures

82

Common features of sickle cell pts

African american
Pain in chest, back, thighs +/- fever

83

Common manifestations of sickle cell

Bilirubin gallstones
Infection from autosplenectomy
Osteomyelitis
Retinopathy
Stroke
Cardiomegaly
Leg skin ulcers
Avascular necrosis

84

Best initial test sickle cell

Peripheral smear

85

Most accurate test sickle cell

Hb electrophoresis

86

What is the only Sx in sickle cell trait

Hematuria
Isosthenuria

87

Large volume HCT drop in pt with sickle cell

Parvovirus B19
Dx - PCR (best) or IgM
Rx - IVIG

88

Seen in neutrophils in Ehrlichia infections

Morulae

89

Cause of Howell-Jolly bodies

Splenectomy

90

Rx Sickle cell

O2/Hydration/Analgesia
Folate chronically
Pneumococcal vaccine

91

Prophylaxis for sickle cell crisis

Hydroxyurea

92

Rx if fever/white count in sickle cell

Ceftriaxone
Levofloxacin
Moxifloxacin

Don't wait for culture

93

When to use exchange transfusion in severe vasoocclusive crisis

Acute chest
Priapism
Stroke
Visual disturbance from retinal infarction

94

What is hereditary spherocytosis

Defect in RBC cytoskeleton leading to loss in flexibility

95

Most common features in hereditary spherocytosis

Recurrent hemolysis
Intermittent jaundice
Splenomegaly
FHx anemia/hemolysis
Bilirubin gallstones

96

Dx tests hereditary spherocytosis

Low MCV
Increased MCHC
Neg Coombs

97

Most accurate test for hereditary spherocytosis

Osmotic fragility

98

Rx hereditary spherocytosis

Folate replacement
Splenectomy

99

Causes of Autoimmune hemolysis

50% Idiopathic
CLL
Lymphoma
SLE, RA
PCN, alpha-methyldopa, rifampin, phenytoin, quinidine

100

Most accurate test autoimmune hemolysis

Coombs

101

Best initial therapy autoimmune hemolysis

Steroids

102

Other Rx for autoimmune hemolysis

Splenectomy (if reccurent)
IVIG (if not responding to steroids)
Rituximab, azathioprine, cyclophosphamide, cyclosporine (if splenectomy doesn't control)

103

Alternative drugs to steroids in autoimmune hemolysis

Azathioprine
Cyclophosphamide
Cyclosporine
Mycophenolate mofetil

104

What is cold agglutinin disease

IgM Abs against RBC

105

What is cold agglutinin disease associated with

EBV
Waldenstrom
Mycoplasma pneumoniae

106

Where does cold agglutinin disease present

"Cold" body parts
- Nose, ears, fingers, toes

107

Most accurate test for cold agglutinin disease

Cold agglutinin titre

108

Rx cold agglutinin disease

Stay warm
Rituximab or plasmapheresis
Cyclophosphamide, cyclosporine

109

What are cryoglobulins associated with

Hep C
Joint pain
Glomerulonepheritis

110

Who gets G6PD def

Men (XR)

111

What is the MCC oxidative stress in G6PD def

Infection

112

Causes of oxidative stress in G6PD def

Dapsone
Quinidine
Sulfa drugs
Primaquine
Nitrofurantoin
Fava beans

113

MC features in G6PD def

African American/Mediterranean
Sudden anemia and jaundice
Normal spleen

114

Best initial test for G6PD def

Heinz bodies and bite cells

115

Most accurate test for G6PD def

G6PD level 1-2mos after hemolytic episode

116

Stain used for heinz bodies

Methylene blue

117

Rx G6PD def

Avoid oxidative stress

118

Cause of HUS/TTP

Deffiency of ADAMTS 13 (metalloproteinase)

119

HUS associated with

Kids
E. coli 0157:H7

120

TTP associated with

Ticlopidine
Clopidogreal
Cyclosporine
AIDS
SLE
Adults - neuro sx and fever

121

Similar features in TTP/HUS

Intravascular hemolysis - schistocytes
Thrombocytopenia
Renal insufficiency

122

Rx TTP/HUS

Plasmapheresis
FFP if there is delay
NEVER give platelets
Dialysis if BUN > 80

123

What is PNH

Clonal stem cell defect increasing RBC sensitivity to complement in acidosis

124

Defect in PNH

DAF - CD 55 and 59
Gene - PIG-A

125

Mechanism in PNH

↑ resp → ↑pCO2 → ↓pH → Hemolysis + Thrombosis

126

Features of PNH

Dark urine with first urination of the day
Pancytopenia and Fe def anemia

127

MCC death in PNH

Mesenteric and Hepatic vein Thrombosis

128

Most accurate test for PNH

Decreased CD 55+59 (Flow cytometry)

129

Best initial therapy for PNH

Predisone

130

Only cure for PNH

BM transplant

131

Complement inhibitor for PNH

Eculizumag (inactivates C5)

132

Other Rx PNH

Folate
Transfusions

133

What is aplastic anemia

Pancytopenia of unknown origin

134

Causes of pancytopenia

Radiation
Toxins: Toluene, DDT, Benzene
Drugs: Phenytoin, Carbamazepine, Chloramphenicol, EtOH, Chemo
SLE
PNH
HIV, Hep, CMV, EBV
B12, Folate def
PTU, Methimazole

135

Presentation for Aplastic Anemia

Fatigue
Infections
Bleeding

136

Most accurate test for aplastic anemia

BM Bx

137

Supportive therapy for aplastic anemia

Transfusions
ABX
Platelets

138

Rx for true aplastic anemia

Allogenic BM transplant

139

Rx for true aplastic anemia >50 or unmatched

Antithymocyte globulin (ATG)
Cyclosporine or Tacrolimus (inhibit T cells)

140

Suspected mechanism of aplastic anemia

Autoimmune destruction of marrow by T cells

141

What is polycythemia vera

Unrestricted proliferation of all 3 cell lines but mainly RBCs

142

Mutation in PV

JAK2

143

Sx in PV

Hyperviscosity
- HA, blurred vision, tinnitus
- HTN
- Fatigue
- Splenomegaly
- Bleeding
- Thrombosis

144

Lab values in PV

HCT > 60
Red cell mass elevated
O2 NL
Low EPO
B12 elevated
Low Fe
Low MCV

145

Most accurate test for PV

JAK2 mutation

146

What can PV convert to

AML

147

Compare PV to RCC

RCC has elevated EPO

148

Rx PV

Phlebotomy and aspirin
Hydroxyurea
Allopurinol and Rasburicase
Antihistamines

149

What is essential thrombocytosis

Platelets > 1 million causing thrombosis and bleeding

150

What must be excluded in a dx of essential thrombocytosis

Stress induced thrombocytosis
- Cancer
- Infection
- Fe def

151

50% pts with essential thrombocytosis have what mutation

JAK2

152

When is Rx not necessary in essential thrombocytosis

153

What is erythromelalgia

Painful red hands in ET

154

Best initial therapy ET

Hydroxyurea

155

Rx ET w/ RBC suppression from hydroxyurea

Anagrelide

156

Rx erythromelalgia

Aspirin

157

What is myelofibrosis

Pancytopenia in older pt with BM fibrosis

158

Blood smear features in myelofibrosis

Teardrop cells

159

Rx myelofibrosis

Thalidomide and Lenalidomide (TNF-inhibitors)

160

Allogenic BM transplant in myelofibrosis

161

Sx suggesting acute leukemia

Pancytopenia
- Fatigue, infection, bleeding
Hx MDS

162

Translocation in AML M3

15, 17

163

Association with M3 AML

DIC

164

Best initial test in AML

Blood smear showing blasts

165

Most accurate test for AML

Flow cytometry

166

What is characteristic of AML

Myeloperoxidase (MPO)
Auer rods (M3)

167

Who gets acute leukemia in general

AML - Adults
ALL - Children

168

Mortality in acute leukemia w/o chemo

6-12mos

169

BMT mortality in acute leukemia

Matched + related = 20%
Matched + unrelated = 30%

170

Initial therapy with AML/ALL

Chemo to remove blasts from peripheral smear

171

Rx acute leukemia if prognosis is poor after chemo

BMT

172

Best indicator of prognosis in acute leukemia

Cytogenetics

173

What is added to chemo for M3

All-trans retinoic acid (induces myelocyte maturity)

174

What is added to ALL chemo

Intrathecal MTX

175

Chemo drugs in acute leukemia

Doxorubicin
VIncristine
Prednisone

176

Function of Rasburicase

Prevents tumor lysis related to uric acid rise

177

Differentiate CML from Reactive leukocytosis

↑ LAP Reactive
↓ LAP CML

178

Common features of CML

High WBC w/ >90% neutrophils
Pruritis after hot baths/showers
Splenomegaly (early satiety, ABD fullness, LUQ pain)
B Sx

179

Most accurate test for CML

BCR-ABL on PCR/FISH

180

Best initial therapy CML

Tyrosine kinase inhibitors (Gleevec) 90% improvement

181

Only cure for CML

BMT

182

Rate of transformation of CML to AML

Blast crisis
20% of pts per year

183

Most important step in leukostasis reaction

Leukopheresis
- Remove excess WBCs
- Hydroxyurea not as fast

184

Characteristic abnormality in MDS

5q deletion

185

Who gets MDS

>60 w/ pancytopenia despite hypercellular BM

186

What can MDS conver to

AML
Most die of complications of infection or bleeding first

187

Presentation of MDS

ASx pancytopenia on CBC
Fatigue + Wt loss
Infection
Bleeding
Sometimes Splenomegaly

188

Dx tests in MDS

CBC anemia w/ ↑MCV, nucleated RBCs, few blasts
Hypercellular marrow
Ringed sideroblasts w/ prussian blue

189

What determines severity of MDS

# of blasts

190

Most distinct lab abnormality in MDS

Pelger-Huet cells

191

Rx MDS

Transfusion
EPO (20% response)
Lenalidomide (5q deletion pts)
Azacitidine reduces transfusion dependence but not survival

192

What is CLL

Abnormal functioning normal appearing B cells

193

MC Sx in CLL

Fatigue

194

Other Sx in CLL

Lymphadenoma (80%)
Spleen/Liver enlargement (50%)
Infection

195

What is the Richter phenomenon

Conversion of CLL to high grade lymphoma (5% pts)

196

Dx tests in CLL

WBC > 20,000 w/ 80-98% lymphocytes
50% pts are hypergammaglobulinemic
Anemia and thrombocytopenia
Smudge cells

197

Stages of chronic leukemia

Stage 0 - ↑WBCs (CLL only)
Stage 1 - +nodes
Stage 2 - Spleen
Stage 3 - Anemia
Stage 4 - ↓platelets

198

Chronic leukemia prognosis by stage w/o rx

0-1 = 10-12yrs
2 = 5 years
3-4 = 1-2yrs

199

Rx CLL stage 2-4

Fludarabine
Refractory - cyclophosphamide
Mild - Chlorambucil
Severe - IVIG
Autoimmune thrombocytopenia or hemolysis - Prednisone

200

Best initial therapy CLL

Fludarabine + Rituximab (advanced or sx)

201

Who gets hairy cell leukemia

Middle aged men

202

Presentation of hairy cell leukemia

Pancytopenia
Massive splenomegaly
Monocytopenia
Dry tap

203

Best initial testof hairy cell leukemia

Smear showing hairy cells (B-cells with filamenous projections)

204

Most accurate test for hairy cell leukemia

Immunotyping by Flow cytometry

205

Rx Hairy cell leukemia

Cladribine or Pentostatin

206

Best initial test for any lymphoma

Excisional Bx

207

Presentation of NHL

Painless lymphadenopathy (firm, rubbery, NT)
B Sx

208

CBC in NHL

NL

209

Determine severity of NHL

High LDH = more severe

210

Staging procedures of NHL

CT chest, ABD, pelvis
BM Bx

211

Staging Lymphoma

1 - Lymph node group (95% remission)
2 - 2 or more groups on same side of diaphragm
3 - Both sides of diaphragm
4 - Widespread

212

Rx Lymphoma

1,2 - Local radiation and chemo
3-4 +/- B Sx - CHOP and rituximab (anti CD20)

213

CHOP

Cyclophosphamide
Adriamycin (doxorubicin or hydroxydaunorubicin
Vincristine (Oncovin)
Prednisone

214

MALT associated with

H. pylori

215

Rx MALT

Clarithromycin and amoxicillin

216

Hodgkin's Disease specific cells

Reed-Sternberg

217

Which lymphoma presents earlier

HD - stage 1-2
NHL - stage 3-4

218

Best prognosis in HD

Lymphocyte predominant

219

Worst prognosis in HD

Lymphocyte depleted

220

Worst prognosis in NHL

Burkitt and immunoblastic

221

Rx stage 1-2 HD

Local radiation and chemo

222

Rx stage 3-4 HD

Adriamycin (doxorubicin)
Bleomycin
Vincristine
Dacarbazine

223

Complications of radiation in HD

Breast, Thyroid, Lung tumors
Premature CAD

224

Complications of chemo in HD

Acute leukemia, MDS, NHL 1% per year

225

Doxorubicin AE

Cardiotoxicity

226

Vincristine AE

Neuropathy

227

Bleomycin AE

Pulm fibrosis

228

Cyclophosphamide AE

Hemorrhagic cystitis

229

Cisplatin AE

Renal/Ototoxicity

230

What is myeloma

Abnormal proliferation of plasma cells which make IgG and A that don't fight infection and clog up kidneys

231

MC presentation of myeloma

Bone pain 2/2 hypercalcemia and lytic bone lesions

232

What causes lytic bone lesions on myeloma

OAF

233

What causes hyperuricemia in myeloma

Increased cell turnover of plasma cells

234

What causes anemia in myeloma

Infiltration of BM by plasma cells

235

What causes renal failure in myeloma

Accumulation of IGs and Bence-Jones
Hypercalcemia
Hyperuricemia

236

First dx test for myeloma

XR showing lytic lesions

237

MCC death in myeloma

Renal failure and infection

238

Serum protein electrophoresis in Myeloma

IgG (60%) or IgA (25%) spike

239

Lab values in myeloma

15% have bence jones protein only
Hypercalcemia
Decreased anion gap
Beta 2 microglobulin
Rouleaux
Elevated BUN/Cr
Elevated total protein and NL albumin

240

Best dx feature of myleoma

>10% plasma cells on BM Bx

241

Why is radionuclide (technetium) scan normal in myeloma

Lytic lesions don't pick up the isotope

242

What detects bence-jones

Urine immunoelectrophoresis

243

Best initial therapy for myeloma

Dexamethasone with lenalidomide, bortezomib or both

244

Who gets Melphalan in myeloma

Older, fragile pts

245

Most effective therapy

Autologous BMT w/ stem cell support after induction with chemo (lenalidomide and steroids)

246

SPEP in MGUS

IgG or IgA spikes

247

What percentage of MGUS converts to Myeloma

1% per year

248

What is Waldenstrom Macroglobulinemia

Overproduction of IgM from malignant B cells leading to hyperviscosity

249

Presentation of Waldenstrom

Lethargy
Blurry vision and vertigo
Engorged vessels in the eye
Mucosal bleeding
Raynaud
Anemia

250

Best initial therapy for Waldenstrom

Plasmapheresis

251

Long-term rx Waldenstrom

Rituximab or Prednisone cyclophosphamide

252

Decrease production of B cells

Bortezomib
Lenalidomide

253

Features of platelet bleeding

Superficial
Epsitaxis, gingival, petechiae, purpura, mucosal

254

Features of factor bleeding

Deep
Joints and Muscles

255

Which organs can have both platelet or factor bleeding

Brain
GI

256

What to look for in ITP

Isolated thrombocytopenia
Normal-sized spleen

257

Best initial therapy for ITP

Prednisone

258

Dx tests for ITP

Antiplatelet Abs
U/S or CT for spleen
Megakaryocytes are elevated

259

Rx for no bleeding, plts >30,000 ITP

Nothing

260

Rx for mild bleeding, plts

Steroids

261

Rx for severe bleeding, plts

IVIG, Anti-Rho

262

Rx recurrent episodes, steroid dependent ITP

Splenectomy

263

Rx splenectomy, steroid not effective ITP

Romiplostim
Eltrobopag, Rituximag, Azathioprine, Cyclosporine, Mycophenolate

264

Fastest way to increase platelet count in ITP

IVIG

265

What vaccines to give before splenectomy

N. meningitidis
H. influenzae
Pneumococcus

266

Most common inherited bleeding disorder

Von Willebrand Disease (AD)

267

What to look for in VW disease

Platelet bleeding with NL count

268

What worsens VWD

Aspirin

269

Dx tests for VWD

Decreased VWF
Ristocetin cofactor assay shows VWF dysfunction
Factor VIII activity
Bleeding time (NEVER done)

270

Best initial therapy for VWD

DDAVP
Factor VIII replacement or VWF concentrate if it doesn't work

271

What to look for in suspected hemophilia

Delayed joint/muscle bleeding in male child

272

Lab values in hemophilia

NL PT
Prolongued PTT
Mixing studies correct PTT

273

Most accurate test for hemophilia

Factor VIII or IX assay

274

Rx mild hemophilia

DDAVP

275

Rx Severe bleeding in hemophilia

Factor replacement

276

Is there an increase in bleeding in Factor XI deficiency

No - only in trauma/surgery

277

Stop bleeding in factor XI deficiency

FFP

278

Features of Factor XII deficiency

Elevated PTT
No bleeding
NL platelets
No therapy

279

Definite risks of DIC

Sepsis
Burns
Abruptio placentae
Amniotic fluid embolus
Snake bites
Trauma
Cancer

280

Dx tests in DIC

Elevated PT and PTT
Low platelets
Elevated D-dimer and fibrin split products
Decreased fibrinogen

281

Rx DIC

Platelets

282

MCC thrombophilia

Factor V Leiden

283

Rx Factor V Leiden

Warfarin till INR 2-3 for 6mos

284

Causes of HIT

Unfractionated > LMWH

285

When does HIT present

5-10 days after starting heparin

286

How does HIT present

Platelets drop by 30%
Venous clots > arterial clots

287

Dx tests for HIT

ELISA for platelet factor 4 abs or serotonin release assay

288

Rx HIT

Stop all heparin products
Direct thrombin inhibitors - Agatroban, Lepirudin, Bivalrudin
Warfarin after inhibitors

289

2 main syndromes in Antiphospholipid syndromes (APL)

Lupus anticoagulant
Anticardiolipin Ab

290

Anticardiolipin association

Spontaneous abortions

291

Only abnormality in APL

PTT

292

Best initial test in APL

Mixing study

293

Most accurate test for APL

Russell viper venom test for lupus anticoagulant

294

Rx APL

Heparin and warfarin
May be lifeling

295

What makes ITP worse

Aspirin