Flashcards in Hematology Deck (51)
What conditions will you see basophilic stippling with?
Treatment of lead poisoning?
-Adults: EDTA or succimer
-Kids: Dimercaprol (iron chelation)
If a peripheral blood smear shows microcytic, hypo chromic anemia with basophilic stippling, what should you suspect?
What medication can be given to sickle cell patients to decrease vasoocclusive crises?
hydroxyurea (increases the hemoglobin F production)
What medication are children with sickle cell given until the age of 5?
Penicillin (as prophylaxis for pneumococcal infection)
What vaccines are important for kids with Sickle Cell?
"Please Hit My Infection"
What drugs can cause hemolysis in G6PD patients?
"Spleen Purges Nasty Inclusions From Damaged Cells"
Howell-jolly bodies are seen in what condition?
Bite cells and Heinz bodies?
Heinz bodies (oxidative stress --> clumps of hemoglobin)
-bite cells (from splenic removal heinz bodies)
Transfusion reaction where IgE antibodies attack soluble antigens in donor plasma? Tx?
(can continue reaction if urticaria resolves)
If a patient with IgA deficiency receives blood with IgA antigens, what reaction is likely to occur?
-Anaphylaxis (2/2 anti-IgA IgG antibodies in recipient)
What is the cause of non hemolytic febrile reaction? When is this seen?
-cytokines produced by stored donor cells cause fever, chills, malaise 1-6 hours after transfusion
What is the most common cause of acute hemolytic reaction? What are the symptoms?
-ABO incompatibility (2/2 clerical error)
-hemolysis, fever, chills, tachycardia, tachypnea, hypotension
What is the cause of fever, hemolysis or elevated indirect bilirubin 2-10 days after a blood transfusion?
-Anti-kidd or and-D(Rh) antibodies
-"delayed hemolytic reaction"
-No treatment needed
Findings in hemolytic anemia?
inc LDH, inc indirect bili, Dec haptoglobin, inc reticulocyte count
What can a parvovirus B19 infection lead to? What patients are more likely to experience this?
Aplastic anemia (pancytopenia)
-sickle cell and hereditary spherocytosis
What is the diagnostic test for aplastic anemia? What will it show?
bone marrow biopsy--> hypocellularity and fatty infiltration
What labs are elevated in a B12 deficiency? How does this differ from folate deficiency?
Methylmalonic acid and homocysteine
-folate deficiency will have an elevated homocysteine and normal methymalonic acid
Microcytic anemia + neuro symptoms?
What is the cause of ITP?
anti-platelet IgG antibodies
treatment is normally glucocorticoids and IVIG or platelet transfusion if bleeding
What are the clinical features of HUS?
-hemolysis, uremia (renal failure) and thrombocytopenia
What are the clinical features of TTP?
Hemolysis, uremia (renal failure), thrombocytopenia, neurological sequelae (AMS, seizures, coma) and fever
What is the treatment for HUS and TTP?
Plasma exchange and glucocorticoids
What other 2 less critical disorders should be considered as differentials in a patient with thrombocytopenia?
Alcoholism and B12 deficiency
What are the causes of DIC?
"STOP Making Thrombi"
Treatment for von Willebrand Disease?
How does hemophilia A affect PT and PTT?
How does von willebrand affect PT, PTT, platelet count and bleeding time?
Normal platelet count, increases bleeding time, normal PT, increases PTT
How does DIC affect platelet count, PT, PTT and bleeding time? Fibrinogen?
Decreases platelet count. Increases bleeding time, PT and PT. Decreases fibrinogen