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PANRE > Heme > Flashcards

Heme Flashcards

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1
Q

Diseases with macrocytosis

A

B12 def
folate def
liver dz
aplastic anemia

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2
Q

diseases with microcytosis

A

fe def
thalassemia
lead poisoning

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3
Q

“howell jolly bodies”

A

splenectomy or asplenism

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4
Q

“Heinz bodies” and “bite cells” (2)

A

thalassemia

G6PD def

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5
Q

“target cells” (2)

A

thalassemia

sickle cell

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6
Q

“basophilic stippling”

A

lead poisoning

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7
Q

“burr cells” (echinocytes)

A

uremia

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8
Q

“bands” seen

A

bacterial infx

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9
Q

Fe def anemia: high or low ferritin?

ACD: high or low ferritin?

A

Fe def: low ferritin

ACD: high ferritin

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10
Q

RBC life span

A

120 days

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11
Q

list (non-obvious) lab values for hemolytic anemia (5)

A 
inc reticulocytes
inc LDH
inc indirect bili
dec haptoglobin
\+ schistocytes
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12
Q

Hgb S on electophoresis

A

sickle cell

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13
Q

microcytic anemia
normal Fe
electrophoresis normal

A

alpha thalassemia

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14
Q

microcytic anemia
normal Fe
electrophoresis with low HgbA, high HgbF

A

beta thalassemia

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15
Q

MC presentation of alpha thalassemia major?

A

stillbirth

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16
Q

When do sx appear for beta thalassemia major

A

6 months

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17
Q

treatment for beta thalassemia major?

A

deferoxamine (chelating agent)
bone marrow transplant
weekly transfusions

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18
Q

what will iron labs show in ACD (3)

A

low iron
low TIBC
high ferritin

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19
Q

treatment of ACD in addition to treating underlying disease?

A

epo

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20
Q

management for someone with G6PD symptoms

A

self-limiting, remove offending agent if possible

supplement or transfuse if severe

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21
Q

if someone is a carrier of the sickle cell trait, what is the only symptom they might have

A

episodic hematuria

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22
Q

when do sx start for sickle cell anemia and what are the sx

A

6 months, dactylitis MC 1st presentation

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23
Q

other than dactylitis, what are 3 other presentation of sickle cell anemia

A
  1. dactylitis
  2. infections (salmonella osteo, asplenia)
  3. hemolytic anemia
  4. thrombotic sx (chest pain syndrome, splenic crisis, AVN)
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24
Q

what pain med can you NOT use in sickle cell dz

A

meperidol (demerol)

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25
management of sickle cell crisis
1st step IV hydration and O2* Hydroxyurea Folic acid Vaccinate for spneumo, hinf, nmeningitis
26
diagnostic tests for hereditary spherocytosis
microspherocytes that are hyperchromic + osmotic fragility test - coombs test
27
diagnostic tests for autoimmune hemolytic anemia
microspherocytes + coombs test smear w/ agglutination of rbcs
28
tx for hereditary spherocytosis
folic acid | splenectomy TOC
29
warm v cold autoimmune hemolytic anemia
warm - caused by SLE, malignant IgG Ab cold- caused by the cold, infx IgM Ab
30
tx for autoimmune hemolytic anemia
warm- steroids | cold - warm up
31
"cola cola urine in early am"
paroxysmal nocturnal hemoglobinuria
32
best test for paroxysmal nocturnal hemoglobinuria
flow cytometry
33
best tx for paroxysmal nocturnal hemoglobinuria
ecluzimab (anti complement ab)
34
list the extrinsic factors (PT)
1, 2, 5, 10 | 7
35
list the intrinsic factors (PTT)
1, 2, 5, 10 | 8, 9, 11, 12
36
which med prolongs PT
warfarin
37
which med prolongs PTT
heparin
38
happens to kids, following a viral illness, with mucocutaneous bleeds and petechiae. labs show thrombocytopenia, PT/PTT normal dx and treatment
ITP | tx kids by observing x 6 mos +/- ivig adults needs ivig/steroids
39
a patient with s/s of mucocutaneous bleeds, hemolytic anemia, kidney failure. labs show thrombocytopenia, normal PT/PTT, increased ind bili, decreased haptoglobin what 2 disease should you suspect
TTP and HUS
40
what is the major symptom difference between TTP and HUS
TTP will have near symptoms and fever | HUS more likely to have kidney sx
41
what is the major patient population difference between TTP and HUS
TTP: females 20-50yo HUS: kids after a diarrheal prodrome
42
what is the tx for TTP versus HUS
TTP: plasmapheresis and steroids HUS: observe kids, +/- plasmapheresis
43
hemophilia a what factor intrinsic or extrinsic
factor 8 | intrinsic
44
hemophilia b what factor intrinsic or extrinsic
factor 9 | intrinsic
45
what is the treatment of hemophilias
A: Factor 8 replacement and DDAVP B: Factor 9 replacement only
46
does VWD increase PT or PTT
increased PTT | due to decreased factor 8 associated with it
47
gold standard test for VWD
risotecin activity test | no platelet aggregation with risocetin
48
tx for mod to severe VWD
DDAVP | Cryoprecipitate (with factor 8, fibrinogen, vwf)
49
which lymphoma - peaks in 20s and again in 50s - peaks 50+ with hx immunosuppression
1. hodgkins | 2. non hodg
50
which lymphoma - is peripheral with noncontiguous LAD - is upper body with localized LAD
1 non hodg | 2 hodgkins
51
which lymphoma has reed sternberg cells with owl eye appearance
hodgkins
52
which lymphoma shows diffusely large b cells or follicular
non hodgkins
53
which lymphoma commonly has b sx
hodgkins
54
which lymphoma is assoc with the "pel ebstein fever" 1-2 weeks of cyclical fevers
hodgkins
55
which lymphoma is more assoc with EBV
hodgkins | also Burkitt's which is a NHL
56
leukemia assoc with kids with >30% blasts
ALL
57
auer rods
AML
58
+ philadelphia chromosome
CML
59
indolent chemo that doesn't need treatment until there is a crisis
CLL
60
"smudge cells"
CLL
61
how do you treat a blastic crisis
like AML - combo chemo and BMT
62
"rouleaux formation" on CBC
multiple myeloma
63
tx for multiple myeloma
stem cell transplant | chemo, bisphosphonates
64
other than phlebotomy, what is med tx for polycythemia vera?
hydroxyurea
65
extra-liver sx of hemochromatosis (4)
heart failure hypogonadism pancreatic insufficiency bronze skin

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