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ICM - Hematology > Hematology Case Day > Flashcards

Hematology Case Day Flashcards

1
Q

Normal Number for Iron

A

50

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2
Q

Normal number for TIBC

A

200-350

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3
Q

Normal number for Ferratin

A

10-200

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4
Q

What is PICA?

A

Strange craving to chew on things common in iron deficiency anemia
(Pagophagia – chewing on ice)

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5
Q

Pertinent past medical and surgery examples given for diagnosis of anemia

A

IBD – Decreased B12 reabsorption

Gastric Bypass

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6
Q

What does Hepcidin do

A

Decreases the transport of Iron

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7
Q

Important anemia signs to look for on physical exam

A 
Vital Sign Changes
Pallor
Splenomegaly
Neurologic Signs
Guiac Check in Rectal Exam
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8
Q

Three crucial initial anemia labs

A

Reticulocyte Count
MCV
Peripheral Smear

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9
Q

How to calculate absolute reticulocyte count (ABR)

A

(% retic count) * (RBC count)

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10
Q

MCV= ______/________

A

Hct / RBC

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11
Q

Low Retic. Count. Low MCV – Heme Defect – Name them

A

Iron Deficiency
Anemia of inflammation
Congenital Sideroblastic Anemia
Lead poisoning

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12
Q

Low Retic Count, Low MCV – Globin Defect – Name them

A

Thalassemias

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13
Q

What do you see on a peripheral smear with Iron Deficiency

A

Poikilocytosis

Thrombocytosis

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14
Q

What do you see on a peripheral smear with Thalassemias

A

Target RBCs

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15
Q

What do you see on a peripheral smear with Lead Poisoning

A

Basophillic stippling

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16
Q

What do you see on a peripheral smear with Anemia of Inflammation

A

Toxic Granulation in neutrophils

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17
Q

Iron Deficiency. Serum Iron, TIBC, Ferratin?

A

Iron – Low
TIBC – High
Ferritin – Low

18
Q

Anemia of Inflammation. Serum Iron, TIBC, Ferratin?

A

Iron – Low
TIBC – Low
Ferratin – Normal/High

19
Q

Thalassemia. Serum Iron, TIBC, Ferratin?

A

Iron – Normal
TIBC – Normal
Ferratin – Normal/High

20
Q

Def. megaloblastois if MCV is over

A

115

21
Q

Cause of megaloblastosis? non-megaloblastic anemias w/ low retic and high mcv?

A

Mega – DNA synth problem

Non-mega – Cholesterol membrane defects

22
Q

Two meds that may cause megaloblastic anemias

A

Hydroxyurea

Methotrexate

23
Q

What is seen in peripheral smears in B12/Folate Deficiency?

A

HYPERSEGMNETED NEUTROPHILS
Leukopenia
Thrombocytopenia

24
Q

What is seen in peripheral smears in MDS?

A

Pelger-Huet Anomaly of PMNs
Basophilic Stippling
Varying RBC Shapes

25
Q

What is a Pelger-Huet anomaly of PMNs?

A

Bilobed Neutrophil

26
Q

What might a low retic. count with a normal MCV mean

A

Primary BM failure (aplastic anemia, BM infiltration)

Secondary BM failure (Low EPI, Meds, Parvo, HIV)

27
Q

Describe the peripheral smear of a patient with marrow infiltration

A

Leukoerythroblastic (not enough room in the marrow to finish maturing, so imature RBCs and WBCs are released into the blood)

28
Q

Describe the peripheral smear of an aplastic anemia patient

A

Leukopenia and thrombocytopenia

29
Q

Describe the peripheral smear of a secondary marrow failure patient

A

Normal

30
Q

Anemia with a high reticulocyte count means,,,

A

Shortened RBC survival (Hemolysis or Blood Loss)

31
Q

General lab findings commonly seen in hemolytic anemia

A

High Retic, LCH, Bilirubin
Low Haptoglobin
Urine hemosiderin

32
Q

What is haptoglobin?

A

Its the guy that carries Iron back to the marrow

33
Q

If you do a Coombs test on a hemolytic anemia, what antibodies do you use?

A

IgG – Warm

IgM – Col

34
Q

What peripheral smear finding is associated with autoimmune hemolysis?

A

spherocytosis

35
Q

Common causes of mechanical hemolysis

A

TTP/HUS (Microangiopathic Hemolytic Anemia)

Prosthetic Valve Hemolysis

36
Q

Hereditary conditions associated with non-immune hemolysis?

A 
Hemoglobinopathies (Sickle Cell)
Enzyme defects (G6PD)
Membrane Defects (hereditary spherocytosis)
37
Q

Spur cell anemia is found in…

A

Liver Failure

38
Q

Infection related hemolysis is foudn in…

A

malaria and babesiosis

39
Q

Difference between a B12 and a folate deficiency

A

B12 has neuro symptoms and folate does not

40
Q

Test for hereditary spherocytosis

A

Osmotic Fragility Test

ICM - Hematology (6 decks)

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