Heme

Question 1

TIBC (transferrin saturation)

Answer 1

evaluateion and dx of iron def anemia, chronic dz anemia, and thalassemias

• Increased in Fe def anemia, PG
• decreased in anemia of chronic dz and hemochromatosis

Question 2

red cell mass

Answer 2

hematocrit

Question 3

blood concentration

Answer 3

hemoglobin

Question 4

red cell size

Answer 4

RDW

Question 5

platelets are increased ___ and decreased ___

Answer 5

increased in malignancy, leukemia, polycethemia vera

decreased in itp, chemo

Question 6

WBC count increased in _____ and decreased in ____

Answer 6

increased in infection, leukemia, malignancy

decreased in viral infections, bone marrow depression

Question 7

neutrophils increased in and decreased in

Answer 7

increased in bacterial infection, inflammation, leukema

decreased in drugs, chemicals, radiation

Question 8

right shift

Answer 8

B12 or folate def

Question 9

severe anemia that begins at 4-6 months

pronounced wasting, jaundice, slow growth, delayed onset of secondary sex features

Answer 9

beta-thalassemia maor

Question 10

B-12 def (megaloblastic)
alcohol and hypothyroid (non-megaloblastic)
elevated MCV
low reticulocyte count
low methylmalonic acid

Answer 10

Macrocytic anemia

Question 11

G6PD def
bite cells or heinz bodies
mediterranean ancestry
jaundice
hepatosplenomegaly
dark urine

Answer 11

hemolytic anemia

Question 12

high fever
chills
thrombocytopenia
abdominal pain, diarrhea, headache, myalgia
recent travel

Answer 12

malaria

Question 13

etiology and workup of lymphangitis

Answer 13

cellulitis caused by strep pyogenes
CBC - leukocytosis
blood culture

Question 14

tx hemolytic anemia

Answer 14

corticosteroids
immunosuppressive
splenectomy
IV immunoglobulin

Question 15

where is B12 absorbed

Answer 15

terminal ileum

Question 16

where is iron absorbed and what enhances absorption

Answer 16

dietary iron absorbed in duodenum
Cit C
absorption reduced by tea and calcium

Question 17

alpha vs beta thallasemia

Answer 17

alpha: african and southeast asian
- hypochromic microcytic
beta: mediterranean
- palpable spleen
- increased RBC
beta thallasemia major: severe anemia and jaundice, stunted growth, iron overload

Question 18

x-linked recessive

bite cells and heinz bodies

Answer 18

G6PD def

Question 19

workup for hemochromotosis

Answer 19

CBC with iron studies

liver biopsy

Question 20

stem cell disorder characterized by panhyperplastic, decreased EPO, malignant, neoplastic, marrow disorder.
increased RBC, WBC, and paltelets
plethora

Answer 20

polycythemia vera

Question 21

tx hemophilia A

Answer 21

Desmopressin

Question 22

tx hemophilia B

Answer 22

Recombinant factor IX and anti-fibrinolytic

Question 23

palpable purpura
abdominal pain
arthritis

Answer 23

henoch-schonlan purpura
resolves within 4 weeks
NSAIDs
corticosteriods for edema

Question 24

sudden onset petechiae, easy bruising, epistaxis 1-3 weeks after viral illness in 2-6 year old

Answer 24

ITP

Question 25

increased bleeding time and PTT decreased factor VIII normal platelet

Answer 25

Von Willebrand

Question 26

abnormality of Philadelphia chromosome Ph1 | increased WBC

Answer 26

CML

Question 27

rapid progressive malignancy with DIC, Aurer rods

Answer 27

AML

Question 28

most common leukemia of children

Answer 28

ALL "All Little Leauguers"

Question 29

most common form of leukemia in western world occurs over 60 yo accumulation of virgin B cells smudge cells seen

Answer 29

CLL (cranky late lifers)

Question 30

tx CLL

Answer 30

corticosteroids | chemo

Question 31

Reed Sternberg cells bimodal age distribution association with EBV lymphadenopathy

Answer 31

Hodgkin Lymphoma

Question 32

workup for hodgkin lymphoma

Answer 32

CBC, CT for lymph nodes, lymph node biopsy (see Reed S cells)

Question 33

``` proliferation of monoclonal plasma large amount so IgG or IgA bone pain/bony lesions increased ca renal failure Rouleaux fomration of RBCs ```

Answer 33

Multiple Myeloma

Question 34

workup MM

Answer 34

serum or urinary monoclonal protein | end organ damage

Question 35

drugs for anemia

Answer 35

Epoetin alfa

Question 36

anti-platelet drugs

Answer 36

aspirin | clopidogrel

Question 37

pentoxifylline

Answer 37

decreases blood viscosity | use: peripheral vascular disease

Question 38

vitamin K antagonist

Answer 38

Warfarin | *monitor INR

Question 39

what vitamin deficiencies are associated with chelosis and paresthesias

Answer 39

B12 and Riboflavin

Question 40

what can inhibit iron absorption

Answer 40

black tea tannins

Question 41

homeopathic for heavy bleeding, craving cold drinks and ice cream, hypersensitivity, colds go to chest

Answer 41

phosphorus

Question 42

workup for fever of unknown origin

Answer 42

CBC

Question 43

mild anemia, thrombocytopenia, leukocytosis, lymphoblasts in young child with fever

Answer 43

ALL