Hematology Flashcards
(124 cards)
1
Q
What are the 5 causes of low MCV anemia?
A
- Iron deficiency
- Thalassemia
- Sideroblastic
- Anemia of chronic dz
- Spherocytosis
2
Q
What are the 4 causes of normocytic anemia?
A
- Blood loss
- Hemolysis
- Anemia of chronic dz
- Aplasia
3
Q
What are the 6 causes of macrocytic anemia?
A
- Vit B12 & folate deficiency
- Alcoholism
- Liver disease
- Drugs
- Mydelodysplastic syndrome
- Sideroblastic
4
Q
If reticulocytes are high, what type of anemia is it (only 2 options)?
A
Hemolytic or chronic blood loss (both normocytic)
5
Q
What does cryoprecipitate replace?
A
Fibrinogen, Factor 8, VWF
6
Q
What can cryoprecipitate aid?
A
DIC
7
Q
What is FFP used for?
A
Elevated PTT, aPTT, or INR
8
Q
When is the platelet count low enough to transfuse platelets?
A
<50,000
9
Q
What common condition can cause sideroblastic anemia?
A
Alcoholism
10
Q
Which type of anemia has: Serum iron: low Ferritin: low TIBC: high Transferrin %: low
A
Iron deficiency
11
Q
Which type of anemia has high iron?
A
Sideroblastic anemia
12
Q
Which type of anemia has normal iron studies?
A
Thalassemia
13
Q
Which type of anemia has: Serum iron: high Ferritin: high TIBC: low Transferrin %: high
A
Hemochromatosis
14
Q
Which type of anemia has: Serum iron: low Ferritin: high TIBC: low Transferrin %: low
A
Chronic dz
15
Q
Which type of anemia has: Serum iron: high Ferritin: high TIBC: low Transferrin %: high
A
Hemolytic anemia
16
Q
Which type of anemia has: Serum iron: high Ferritin: high TIBC: low Transferrin %: high
A
Sideroblastic anemia
17
Q
When you see increased HbF, what dx’s might be possible?
A
Thalassemia, sickle cell
18
Q
What does megaloblastic mean?
A
Presence of hypersegmented neutrophils
19
Q
Only ___ and _____ deficiency cause megaloblastic anemia?
A
B12 and folate
20
Q
Only ___ deficiency is associated with an increased MMA level?
A
B12
21
Q
How is pernicious anemia confirmed (2 Ab’s)?
A
- Anti-intrinsic factor
2. Anti-parietal cell
22
Q
What electrolyte abnormality is associated with B12 or folate replacement?
A
Hypokalemia
23
Q
Chronic hemolysis is associated with which type of gallstone?
A
Bilirubin
24
Q
Does sickle cell have a high reticulocyte count?
A
Yes
25
Sickle cell is caused by a point mutation at position __ of the __ globin chain, causing ____ to replace _____ ___?
Position 6 of the B-globin chain; valine replaces glutamic acid
26
What's the most common type of gallstone in sickle cell?
Bilirubin
27
What can be found on the smear of sickle cell or splenectomy patient?
Howell-Jolly bodies
28
What's the best initial test for sickle cell?
Peripheral smear
29
What's the most accurate test for sickle cell?
Electrophoresis
30
What 2 medications lower mortality in sickle cell patients?
1. Hydroxyurea
| 2. Abx with fever
31
What virus causes an aplastic crisis in sickle cell anemia?
Parvovirus B-19
32
When is exchange transfusion used (4)?
1. Acute chest syndrome
2. Priapism
3. Stroke
4. Visual disturbance from retinal infarction
33
What's the only symptom of sickle cell trait?
Inability to concentrate urine
34
What type of gallstones are seen in hereditary spherocytosis?
Bilirubin
35
What's the most accurate test for hereditary spherocytosis?
Eosin-5-maleimide flow cytometry
36
What's the tx for hereditary spherocytosis?
Folic acid supplementation, splenectomy
37
What is warm hemolysis?
Autoantibodies (IgG) against RBCs, often unknown cause but can be from penicillin and other drugs
38
What's the best initial tx for warm hemolysis?
Glucocorticoids
39
What is cold agglutinin?
IgM antibodies against RBCs "Mm it's cold in here" often showing mottled extremities in the cold
40
What's the tx for cold agglutinin?
Warmth and rituximab
41
What's the inheritance pattern of G6PD?
XLR
42
```
What can the following all precipitate:?
Dapsone
Quinidine
Sulfa drugs
Primaquine
Nitrofurantoin
Fava beans
```
Oxidative crisis in G6PD (sudden anemia and jaundice)
43
What does a smear show in G6PD (2)?
1. Heinz bodies
| 2. Bite cells
44
What are HUS and TTP?
Intravascular hemolysis with schistocytes, thrombocytopenia, renal insufficiency
45
What are low ADAMST13 associated with?
TTP
46
What is HUS associated with?
E. Coli 157:H7
47
What is TTP associated with?
Ticlopdipine, clopidogrel, cyclosporine, AIDS, SLE
48
What's the tx for severe HUS or TTP?
Plasmapharesis
49
What dx causes episodic dark urine, pancytopenia, iron deficiency anemia, and clots in unusual places, due to a clonal stem cell defect with increased RBC sensitivity to complement in acidosis?
Paroxysmal Nocturnal Hemoglobinuria (PNH)
50
What markers are associated with PNH (4)
1. CD55
2. CD59
3. DAF
4. PIG-A
51
What's the best tx for PNH?
Prednisone
52
What's the only cure for PNH?
BM transplant
53
What's the most common cause of death in PNH?
Thrombosis
54
What is aplastic anemia?
Autoimmune pancytopenia of unknown origin
55
Which leukocyte is involved in aplastic anemia?
T cells
56
What 2 medications can be used for aplastic anemia?
Cyclosporine, tacrolimus
57
What dx is due to a JAK2 mutation?
Polycythemia Vera
58
What are the following levels in Polycythemia Vera?:
O2:
EPO:
Vit B12:
O2: normal
EPO: low
Vit B12: high
59
What cancer can Polycythemia Vera turn into?
AML
60
What's the tx for Polycythemia Vera?
Phlebotomy, aspirin, hydroxyurea, allopurinol, and antihistamines
61
What's the tx for hypereosinophilic syndrome?
Steroids (otherwise death from cardiomyopathy or thromboembolism!)
62
What dx presents with itchy skin lesions and abdominal pain, nausea, urticaria pigmentosa, Darier sign (hives at point of touch), and is triggered by NSAIDs, aspirin, narcotics?
Systemic Mastocytosis
63
What's the best diagnostic test for Systemic Mastocytosis?
Serum tryptase
64
What's the best treatment for Systemic Mastocytosis?
Antihistamines, steroids, montelukast
65
Which dx presents with pancytopenia, teardrop-shaped clels, and nucleated RBC's on smear?
Myelofibrosis
66
What's the best tx for Myelofibrosis?
Thalidomide (TNF-inhibitors)
67
Which type of leukemia is associated with DIC?
PML
68
What type of cancer is myeloperoxidase characteristic of?
AML
69
What cancer are Auer rods associated with?
AML
70
Are AML and ALL treated with chemotherapy?
Yes
71
What are Auer rods?
Azurophilic rods composed of lysosomes
72
What dx presents with itchiness in the shower?
Polycythemia Vera
73
Which blood cancer presents age <13?
ALL
74
Which blood cancer presents age 13-40?
AML
75
Which blood cancer presents age 40-60?
CML
76
Which blood cancer presents age >60?
CLL
77
Does CML have splenomegaly?
Yes
78
What can CML turn into?
AML
79
What dx presents with pancytopenia, often asymptomatic, with ringed Pelger-Huet cells (bilobed nucleus) on smear?
Myelodysplastic syndrome
80
Which blood cancer shows smudge cells?
CLL
81
What prophylaxis is indicated in CLL?
PCP
82
What dx presents in middle aged and presents with pancytopenia, splenomegaly, dry tap, and monocytopenia?
Hairy Cell Leukemia
83
What's the tx for Hairy Cell Leukemia?
Cladribine
84
What's the best way to dx Non-Hodgkin's Lymphoma?
Excisional lymph node biopsy
85
What dx presents with painless LAD?
Non-Hodgkin Lymphoma
86
What is "CHOP" therapy for stage III and IV Non-Hodgkin Lymphoma?
Cyclophosphamide
Hydroxydaunorubicin
Ovincristine
Prednisone
87
What's "ABVD" therapy for stage III and IV Hodgkin Lymphoma?
Adriamycin
Bleomycin
Vinblastine
Dacarbazine
88
Which form of lymphoma has Reed-Sternberg cells?
Hodgkin
89
Which form of lymphoma often presents with Stage III or IV disease?
Non-Hodgkin Lymphoma
90
Which 2 types of lymphoma present with B symptoms?
Hodgkin and Non-Hodgkin Lymphoma
91
What's the adverse effect of doxorubicin?
Cardiomyopathy
92
What's the adverse effect of vincristine?
Neuropathy
93
What's the adverse effect of bleomycin?
Lung fibrosis
94
What's the adverse effect of cyclophosphamide?
Hemorrhagic cystitis
95
What's the adverse effect of cisplatin?
Renal toxicity, ototoxicity, neurotoxicity
96
What's the most common presenting symptom of Multiple Myeloma?
Bone pain from fractures
97
What dx presents with hyperuricemia, anemia, renal failures, bone pain, and hypercalcemia?
Multiple Myeloma
98
What will a bone x-ray show in Multiple Myeloma?
Punched out "lytic" lesions
99
What does the SPEP show in Multiple Myeloma?
Monoclonal "M" spike
100
What are the two most common Ig's that produce monoclonal proliferation in Multiple Myeloma?
IgG and IgA
101
What dx has Bence-Jones protein?
Multiple Myeloma
102
What dx has rouleaux?
Multiple Myeloma
103
What's the most accurate test for myeloma?
BM biopsy (shows >10% plasma cells)
104
What do you need to give prophylaxis against when using thalidomide or lenalidomide?
Clotting prophylaxis
105
What dx is associated with serum free light chain ratio of 100:1?
Myeloma
106
What's a precurser dx that can lead to MM in 1% of cases and presents with spike of IgA or IgG as well?
MGUS
107
What dx presents with an overproduction of IgM from malignant B cells, leading to hyperviscosity and presenting with engorged BV's in eye, mucosal bleeding, Raynaud, and blurry vision?
Waldenstrom Macroglobulinemia
108
What's the best initial therapy for Waldenstrom Macroglobulinemia?
Plasmapharesis
109
What can present similarly to vWF deficiency but is sudden onset, shows elevated megakaryocytes, and is treated with prednisone?
ITP
110
What 3 vaccines do splenectomy patients need prior to surgery?
1. N. meningitidis
2. H. influenzae
3. Pneumococcus
111
Does vWFd present with normal platelet count?
Yes
112
What is the aPTT in vWFd?
Elevated in half of the patients
113
What assay detects vWFd?
Ristocetin
114
What's the best initial therapy for vWFd?
DDAVP (desmopressin)
115
Which diagnosis has giant platelets?
Bernard-Soulier
116
What's the tx for Glanzmann Thrombasthenia and Bernard-Soulier?
DDAVP (desmopressin)
117
What are the PT and aPTT in hemophilia?
PT: normal
aPTT: prolonged
118
How do you treat mild cases of hemophilia?
DDAVP
119
How do you treat severe cases of hemophilia?
Factor replacement
120
```
What are the following labs in DIC?:
PT:
aPTT:
D-dimer:
Fibrin split:
Fibrinogen:
```
```
PT: prolonged
aPTT: prolonged
D-dimer: elevated
Fibrin split: elevated
Fibrinogen: decreased
```
121
How do you treat factor V Leiden?
Warfarin to INR 2-3 for 3-6 months
122
What dx appears 5-10 days after starting heparin, and has a marked drop in platelet count?
HIT
123
What does the serotonin release assay test?
HIT
124
What's the tx for HIT?
Stop heparin, start fondaparinux, then do warfarin
