Hematology Flashcards

(32 cards)

1
Q

Iron deficiency

A
Low Fe
Low ferritin
High TIBC
High RDW**
Low Fe sat
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2
Q

AOCD

A

Low Fe
high ferritin
Low TIBC
Low to high Fe sat

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3
Q

Iron deficiency

Most accurate

A

Bone marrow biopsy

Don’t do on ccs though

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4
Q

Anemia blue box about HgH

A

HgH has beta 4 tetrads with 3 gene deleted alpha thal

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5
Q

What’s the only mictocytic anemia with high retic count?

A

HgH

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6
Q

B12 deficiency

A

MC: Peripheral neuropathy
Least common: dementia

High LDH
High indirect bilirubin 
Low retic ct
Oval cells
Hypersegmented neutrophils
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7
Q

PE for sickle cell

*** very important

A
Neurological 
Heent
Chest
Cv
Abdominal 
Extremities
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8
Q

When you answer exchange transfusion in sickle cell

A

Eye: retinal infarction
Lung: pulmonary infarction
Penis: priapism
Brain: stroke

Goal: decrease HbS to 30-40%

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9
Q

Sudden drops in Hct in sickle cell patients is due to what

A

Parvovirus B19

 - Best initial : 
 - most accurate; pcr for dna of parvovirus 

Also parvovirus gives low retic ct and aplasia in bm

Folate deficiency
- All sickle cell pts need to be on folate replacement

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10
Q

Parvovirus b19 Tx

A

Transfusions and immunologlobulin

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11
Q

The mcc death in PNH

A

Large vessel venous thrombosis … like portal vein thrombosis

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12
Q

Aplastic anemia

Main feature
Tx

A

Pancytopenia

Tx
Young patients bm tx

Older patients :
antithymocyteglobulin
Cyclosporine

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13
Q

Ccs pcv

A
Order:
 CBC
Abg 
heme consultation
Nuclear rbc mass test
Epo
B12 and lap elevated!!!
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14
Q

MM

Tx
Most effective therapy

A

Melphalan and steroids

Add lanilodimide, thalidomide
Bortezomib ( revèrses renal dysfunction)

Most effective: autologous stem cell transplant … but have to be <70

(-) AG is due to paraproteinemia because proteins are cationic (+) aCl- and Hco3- increase to compensate … same with albumin does the same thing. Every 1 point decrease in albumin; 2 point decrease in AG

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15
Q

VWD

Tx

A

Desmopressin

Or…
VIII replacement

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16
Q

Thrombopoietin analogs

A

Romiplostim
Eltrombopag

They treat chronic ITP
They stimulate megakaryocytes

No response to splenectomy

17
Q

Mixing study

A

Correct ptt to normal—> clotting factor deficiency

Does not correct to normal —> factor inhibitor antibody

18
Q

APL syndrome

Presents

Dx
Tx

A

Venous thrombosis
Spontaneous abortion
Increased ptt, normal pt
Fp VDRL

Dx
Mixing study first
Then Russell viper venom test

Tx
Heparin then warfarin

19
Q

Anemia Dx testing

A

On top of all the others you know also do UA with microscopic analysis.

20
Q

PNH can transform into

A

Aplastic anemia
Best initial
Most accurate tx: bone marrow transplant
Tx: antithymocyte globulins and cyclosporine

AML
Best initial : smear
   Most accurate 
   Tx: idarubicin
Cytosine arabinoside
21
Q

Acute intermittent porphyria

A

Motor and sensory neuropathy
Recurrent abdominal pain

Red colored urine with a negative dipstick

Brought on by fasting, alcohol, and phenobarbital

22
Q

Myelofibrosis

Features
Tx

A

Normal TRAP

Smear shows teardrops
Marrow shows fibrosis
JAK2 mutation

Tx
Best initial therapy lenalidomide or thalidomide
ruxolitinib inhibits jam 2

23
Q

CLL Tx

A

Fludarabine + rituxomab And cyclophosphamide m

Alemtuzumab (anti cd 52)when fludarabine fails

24
Q

CML Tx

A

Imatinib (gleevec), dasatanib, nilotinib

Bone marrow transplant is curative but rarely needed

25
MM Dx tests
SPEP- MONOclonal hypergammaglibenemia usually IgG UPEP BUN and creatinine qq_ renal failure Hypercalcemia Bone scan Peripheral smear - rouleax, inc MPV B2 microglobulim- prognostic indicator!!! … neg alk phosp and neg bone scan
26
Hereditary spherocytosis
Recurrent hemolysis Splenomegaly Elevated MCHC Bilirubin gallstones Dx Osmotic fragility test Tx Splenectomy
27
PNH. Can transform into … Dx Tx
Aplastic anemia AML ( auer rods, idarubicin or daunorubicin and cytosine arabinoside) Most accurate test cd55 and cd59 Tx glucocorticoids tx dependent with severe disease —> eculizumab!
28
Waldenstroms macroglobulinrmia
Hyperviscosity from IgM overproduction Best initial test is serum viscosity level and SPEP Tx Best initial therapy plasmapharesis Furtherther treatment add the same agents used in CLL like fludarabine ands rituximab Or chloramvucil
29
HD and NHL. Best initial test
Excisional lymph node Bx
30
HD And NHL staging tests Tx
Cxr Ct with contrast Bm biopsy Stage 1 and 2 without B symptoms are treated with radiation and low dose chemo Advanced stage, 3 and 4 are treated just with chemo HD: ABVD ( adriamycin, bleomyocin, vinblastine, dacarbazine NHL: CHOP Cyclophosphamide, hydroxyadriamycin, oncovin. ( vincristine, prednisone add rituximab!
31
ITP Dx Tx
The preriphersl smear shows LARGE platelets U/S to look for a normal spleen You need a BM Biopsy Antibodies to gp 2b/3a receptor Tx: first steroids then IvIg when platelet < 20000
32
HIT therapy
Stop heparin and switch to a direct thrombin inhibitor like fondaparinoux, lepirudin, argatroban