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Hematology Flashcards

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1
Q

What are sx of anemia based on

A

Severity of disease

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2
Q

Sx w/ HCT >30-35

A

None

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3
Q

Sx w/ HCT 25-30

A

Dyspnea worse on exertion

Fatigue

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4
Q

Sx w/ HCT 20-25

A

Lightheadedness

Angina

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5
Q

Sx w/ HCT

A

Syncope

CP

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6
Q

What kills you in anemia

A

MI

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7
Q

What conditions are indistinguishable for myocytes in the heart

A

Anemia
Hypoxia
CAD
Carbon monoxide poisoning

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8
Q

First clue to etiology of anemia

A

MCV

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9
Q

Causes of low MCV

A

Fe def
Thalassemia
Sideroblastic anemia
AOCD

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10
Q

Only microcytic anemia with elevated retic count

A

Alpha-thalassemia

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11
Q

Causes of high MCV

A 
B12/Folate def
Sideroblastic anemia
Alcohol
Azathioprine, 6-MP, hydroxyurea
Liver disease/hypothyroidism
Zidovudine, phenytoin
MDS
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12
Q

2 main causes of normocytic anemia acutely

A

Blood loss

Hemolysis

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13
Q

Retic count in normocytic anemia

A

Elevated when there is hemolysis

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14
Q

Treatment for severe anemia

A

pRBCs

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15
Q

When do you transfuse anemic pt

A

Symptomatic

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

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16
Q

What is symptomatic anemia

A

SOB
Lightheadedness, confusion, syncope
Hypotension, tachy
CP

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17
Q

What to transfuse for IgA def pts

A

IgA def donor FFP

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18
Q

HCT of pRBCs

A

70-80%

Whole blood w/ 150mL plasma removed

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19
Q

Effect of pRBC on HCT

A

Each unit raises HCT by 3 points

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20
Q

Who doesn’t get FFP

A

Hemophilia A, B

Von Willebrand

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21
Q

What does FFP replace

A

Clotting factors

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22
Q

What does cryoprecipitate replace

A

Fibrinogen (for DIC)

Has high VIII and VWF

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23
Q

MCV in microcytic anemia

A

Decreased

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24
Q

What is the main reason for Fe def anemia

A

Blood loss

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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

Step 2 CK (21 decks)

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