Hematology Flashcards
(113 cards)
1
Q
MC cause of iron deficiency in the US?
A
Chronic blood loss
2
Q
MC cause of iron deficiency in the world?
A
diet
3
Q
Sx of iron defiency?
A
pic, pagophagia, koilonychia, glossitis, angular cheilitis, pallor
4
Q
CBC seen in iron deficiency?
A
microcytic hypochromic anemia
5
Q
Iron study seen in iron deficiency anemia?
A
decreased ferritin
decreased serum iron
increased TIBC
6
Q
Txt for iron deficiency anemia?
A
ferrous sulfate
7
Q
Adv effects of iron?
A
constipation, GI, dark stools
8
Q
Txt for severe iron deficiency anemia
A
RBC transfusion
9
Q
MC cause of B12 deficiency?
A
pernicious anemia
10
Q
Who are at risk for B12 deficiency?
A
vegans, chronic alcoholics
11
Q
Sx of B12 defiency?
A
neurologic abnormalities
12
Q
MC initial sx of B12 deficiency?
A
symmetric paresthesias
13
Q
Blood smear for B12 defiency?
A
macrocytic anemia, hypersegmented neurtophils
14
Q
What can be used to distinguish B12 deficiency from folate?
A
increased methylmalonic acid, neurologic sx
15
Q
Txt for B12 deficiency?
A
oral, IM cynaobalamin
16
Q
Txt for B12 deficiency due to pernicious anemia?
A
lifelong monthly IM B12 injections
17
Q
Where is B12 absorbed?
A
distal ileum
18
Q
What is needed for B12 absorption?
A
intrinsic factor
19
Q
What cells make intrinsic factor?
A
parietal cells
20
Q
MC cause of folate deficiency?
A
inadequate intake
21
Q
Sx of folate deficiency?
A
no neurologic abnormalities, normal methylmalonic acid
22
Q
Txt for folate deficiency?
A
oral folic acid
23
Q
CBC seen in anemia of chronic dx?
A
normocytic normochromic anemia
24
Q
Iron studies seen in chronic anemia?
A
normal or increased ferritin
decreased TIBC
decreased serum iron
25
Txt for anemia of chronic dx?
treat underlying cause
| erthyropoietin alpha if renal dx
26
Sickle cell trait is what type of genetic disorder?
autosomal recessive
27
Sx of pts w/ sickle cell trait?
asymptomatic. May develop sx if exposed to factors
28
Dx of sickle cell?
hemoglobin electrophoresis
29
Txt for sickle cell trait?
none
30
MC presenting sx of sickle cell dx?
dactylitis
31
Pts with sickle cell dx are at risk for?
infection w/ encapsulated organisms
Osteomyeltis
Stroke
32
MC organism in patients w/ sickle cell dx?
Salmonella spp.
33
Dx of sickle cell dx?
peripheral smear
34
What is seen on peripheral smear for sickle cell dx?
Howell-jolly bodies, target cell, sickled erythrocytes
35
What is seen on hemoglobin electrophoresis for sickle cell dx?
HbS, little to no HbA, increased HbF
36
What is the definitive dx for sickle cell dx?
DNA analysis
37
Txt for sickle cell dx?
IV hydration and oxygen
38
Med for sickle cell dx?
Hydroxyurea
39
Definitive cure for sickle cell?
bone marrow transplant
40
What supplement is need in sickle cell dx?
folic acid
41
What drug reduces the frequency and severity of pain episodes and prolongs survival in sickle cell dx?
Hydroxyurea
42
Adverse effects of Hydroxyurea?
Myelosupression, GI upset
43
What is the prophylactic for sickle cell dx?
Penicillin given at 2-3 mo till 5yrs
| Pneumococcal and influenza vaccine
44
What's the problem in Thrombotic thrombocytopenic purpura?
ADAMTS13 deficiency
45
Pentad seen in Thrombotic thrombocytopenic purpura?
```
Fever
Anemia
Thrombocytopenia
Renal failure
Neuro sx
```
46
Txt for Thrombotic thrombocytopenic purpura?
plasmapheresis
| glucocorticoids and/or Rituximab
47
What txt should not be done in Thrombotic thrombocytopenic purpura?
platelet transfusions
48
MC primary bone malignancy in adults?
Multiple myeloma
49
Sx of multiple myeloma?
```
bone pain
recurrent infections
elevated calcium
anemia
kidney injury
```
50
What proteins are seen in multiple myeloma?
Bence jones proteins
51
What is seen on CBC for multiple myeloma?
Rouleaux formation
52
Txt for multiple myeloma?
stem cell transplant
53
MC leukemia in children?
ALL (acute lymphocytic leukemia)
54
Children who have ?? are at risk for ALL?
Down syndrome
55
What symptoms are associated with ALL?
Pancytopenia, fever & infections, bleeding, anemia
56
Findings on PE for ALL?
hepatomegaly or splenomegaly
57
Txt for ALL?
chemo
58
MC form of leukemia in adults?
CLL (chronic lymphocytic leukemia)
59
MC sx of CLL?
fatigue
60
MC sx on PE for CLL?
lymphadenopathy, splenomegaly
61
Characteristic of CLL?
Smudge cell
62
MC acute leukemia in adults?
AML (acute myeloid leukemia)
63
Characteristic of AML?
Auer rods
64
Characteristic of CML?
Philadelphia chromosome
65
Leukemia associated w/ pruritus after hot baths?
CML
66
Txt for CML?
Tyrosine kinase inhibitors Imatinib
67
Risk factor for Hodgkin lymphoma?
Epstein Barr virus
68
Sx of Hodgkin lymphoma?
asymptomatic painless lymphadenopathy (painful w/ Etoh ingestion)
69
MC site for Hodgkin lymphoma?
neck (cervical and supraclavicular)
70
Systemic B symptoms?
fever, night sweats, weight loss, Pel Ebstein fever
71
Dx of Hodgkin lymphoma?
excisional whole lymph node biopsy
72
How to differentiate Hodgkin from Non-Hodgkin?
Reed Sternberg cell (Hodgkin)
73
What does Reed Sternberg cells look like?
owl eyes
74
Txt for Hodgkin lymphoma?
chemo + radiation
| advance- combo chemo
75
MC type of Non-Hodgkin?
diffuse large b cell
76
MC site of extranodal Non-Hodgkin?
GI tract
77
What type of genetic disorder is G6PD?
X-linked recesive
78
Seen on peripheral smear for G6PD?
schistocytes "bite cells", heinz bodies- hallmark
79
Txt for G6PD defeciency?
avoid offending food and drugs
80
What can exacerbate G6PD deficiency?
infection, fava beans
| meds: dapsone, primaquine, methylene bluse, nitrofurantoin
81
What type of genetic disorder is Hemophilia A and B?
X-linked recessive
82
Sx seen in Hemophilla A and B?
hemathrosis, delayed bleeding, swelling in joints- ankles, excessive hemorrhage
83
What coagulation is is messed up in hemophilia?
prolonged aPTT
84
1st line Txt for hemophilia A acute or prophylaxis?
factor VIII
85
Mild txt of Hemophilia A?
Desmopressin (DDAVP)
86
1ST Txt and prophylaxis for hemophilia B?
Factor IX
87
What type of genetic disorder is Von Willebrand?
autosomal dominant
88
MC hereditary bleeding disorder?
von willebrand
89
Sx of Von Willebrand disorder?
mucocutaneous bleeding
90
What coagulation is messed up in Von Willebrand?
prolonged PTT and BT
91
Txt for Von Willebrand?
DDAVP
92
MC inherited cause of hypercoagulability?
Factor V Leiden
93
What sx are seen in Factor V Leiden?
increased DVT, PE, hepatic vein , cerebral thrombosis
94
Txt for Factor V?
indefinite anticoag
95
Patho of immune throbocytopenic purpura?
autoantibodies against platelets, leading to splenic destruction of platelets
96
ITP is most common after what?
viral infection
97
Sx seen in ITP?
mucocutaneous bleeding, NO SPLENOMEGALY
98
1st Txt for ITP?
Glucocorticoids
99
2nd Txt for ITP?
IVIG
100
Txt for children with no bleeding or mild bleeding in ITP?
observation
101
What should make you think of Thalassemia?
microcytic anemia w/ normal or increase serum Fe with no response to Iron treatment
102
Who is Alpha Thalassemia most common in?
SE Asians
103
Sx of alpha thalessemia?
sx present at birth
| frontal bossing
104
Definitive txt for thalassemia?
bone marrow transplant
105
Txt for alpha thalassemia?
episodic blood transfusion
| iron chelating agents
106
Risk factor Beta thalassemia?
Mediterranean
107
MC type of beta thalassemia?
minor
108
Sx of beta thalassemia?
sx present after >6mo
hemolytic anemia
chronic anemia
hepatosplenomegaly
109
Txt for Beta thalassemia?
frequent transfusions
iron chelating
Vit C & folate
110
Antiphospholipid syndrome is associated with what dx?
systemic lupus erythematosus
111
Sx of antiphospholipids?
increased risk of arterial & venous thromboses
recurrent DVT or PE
recurrent miscarriages
112
What type of anticoag is seen in antiphospholipid syndrome?
lupus anticoagulant
113
Txt for antiphospholid syndrome?
asymptomatic no txt
lifelong Warfarin
LMHW- preggo
