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Flashcards in Hematology Deck (100)
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1

most sensitive assay for IDA

transferrin receptor index (TRI)

2

if Hb 10 g/dL, MCV 85, TIBC low, transferrin saturation 22%, ferritin 120, what will BM bx show?

ACD: INCREASED Fe2+ in macrophages (RES) and decreased sideroblasts

3

70 yo male or post-menopausal female w/ Hb 9.5 g/dL, MCV 70, decreased ferritin, wtd?

GI w/u

4

young pt, < 40 yoa w/ Hb 9.5 g/dL, MCV 70, decreased ferritin, wtd?

EGD

5

older pt, > 50 yoa w/ Hb 9.5 g/dL, MCV 70, decreased ferritin, wtd?

colonoscopy first

6

45 yo pt w/ LEFT supraclavicular LAD w/ Hb 9.5 g/dL, MCV 70, decreased ferritin, wtd?

EGD to r/o stomach CA

7

25 yo female w/ Hb 9 g/dL, MCV 63, decreased ferritin, RDW 17%

- smear: hypochromic microcytic, anisocytosis, target cells, pencil/cigar cells

- dx

either menstrual loss or pregnancy w/ increased need

8

25 yo female w/ Hb 9 g/dL, MCV 63, decreased ferritin, RDW 17%

- smear: hypochromic microcytic, anisocytosis, target cells, pencil/cigar cells

- tx

ferrous sulfate PO

9

pt started on tx for IDA w/ Fe2+ and vitamin C, what to check for response and how soon?

- reticulocyte count

- 5-7 days

10

60 yo female w/ h/o DM and CKD p/w fatigue, Hb is 9 g/dL, stool guaiac negative, serum EPO is 10 mg/dL, is started on EPO tx, 4 weeks later Hb is 9.2 g/dL, wtd?

start supplemental ferrous sulfate

11

pregnant female in 2nd trimester, Hb 10.5 g/dL, MCV 80, RDW 14%

increased plasma volume

12

pregnant female in 2nd trimester, Hb 10.5 g/dL, MCV 75, RDW 17%

IDA

13

elderly male p/w nausea, abd pain and diarrhea, on exam, slight confusion, gait abnormality, and decreased vibration sensation, Hb 9 g/dL, MCV 78, wtd?

urine heavy metal screening

14

elderly pt works at factory that makes batteries, or lives in an old building, or is a chronic alcoholic, p/w h/o anemia, and gout, Hb 9 g/dL, MCV 80, dx?

lead poisoning

15

young pt presents for regular check up, Hb 12.2 g/dL, MCV 70, RDW 13.5%, smear shows hypochromic microcytic cells, target cells, how to establish dx?

Hb electrophoresis

16

Asian pt (India/Vietnam/Laos/Cambodia) p/w Hb 12 g/dL, MCV 75, blood refused when trying to donate, smear shows target cells, dx?

alpha thalassemia trait

17

black male p/w SC anemia w/ arthralgia, fever, Hb 8 g/dL, increased LDH, increased reticulocyte count, normal ferritin, dx?

painful vaso-occlusive crisis

18

painful vaso-occlusive crisis tx

hydration, analgesics, O2

19

painful vaso-occlusive crisis, best way to prevent

hydroxyurea

20

black male p/w SC anemia w/ arthralgia, fever, Hb 8 g/dL, increased LDH, increased reticulocyte count, normal ferritin, supportive tx started, next day Hb drops, wtd?

don't transfuse, c/w current management

21

Hb level to transfuse pt

< 7 g/dL

22

how many units PRBC to transfuse in pt NOT bleeding?

ONE unit and recheck

23

pt w/ chronic IDA scheduled for surgery, Hb 8 g/dL, wtd?

iron

24

black male w/ SC disease p/w right hip pain, no h/o recent trauma, XR hip shows diffuse articular sclerosis and patches of decalcification, dx?

avascular necrosis of femoral head

25

pt w/ SC anemia w/ CP, fever, sputum negative for PMNs, CXR shows infiltrate, IV morphine given, dx?

acute chest syndrome

26

acute chest syndrome tx

IV abx, O2 if hypoxic, PRBCs if severe anemia

27

acute chest syndrome tx if hypoxia persists despite O2 and PRBCs

EXCHANGE transfusion

28

pt w/ SCT w/ LUQ pain, enlarging spleen and dropping H/H, BP 100/80 and HR 96 supine, SBP 80 and HR 114 sitting up, dx?

splenic sequestration crisis

29

splenic sequestration crisis tx after IVF

PRBCs

30

school teacher w/ arthralgias, Hb 8 g/dL, no h/o bleeds, no rash, reticulocyte count 0.2%, dx?

aplastic anemia 2/2 parvovirus B19