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COMAT - IM > Heme/Onc Part 1 > Flashcards

Heme/Onc Part 1 Flashcards

1
Q

What will be seen on peripheral smear with a Macrocytic Anemia?

A

Hypersegmented Neutrophils (>5 lobes)

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2
Q

What can differentiate a folate and B12 deficiency on lab value?

A

Methylmalonic Acid
– High with B12 deficiency

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3
Q

Which occurs faster, Folate or B12 deficiency?

A

Folate

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4
Q

Where is B12 found?

A

Animal products

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5
Q

What 3 conditions may have a Vitamin B12 deficiency?

A

Vegan
Crohn’s
Gastric Bypass

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6
Q

How is Vitamin B12 absorbed?

A

Parietal cells in the stomach secrete IF which binds B12 and helps it be absorbed in the terminal ILEUM

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7
Q

What test can be used to assess if a Vitamin B12 deficiency is nutritional or an absorption problem?

A

Schilling’s Test

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8
Q

Following a Schilling’s Test, if Vitamin B12 IS in the urine, what kind of deficiency does the patient have?

A

Nutritional deficiency

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9
Q

If a patient has impaired absorption of Vitamin B12 due to Crohns or Gastric Bypass, what is the treatment?

A

IM Vitamin B12

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10
Q

Vitamin B12 deficiency will have what symptoms that a Folate deficiency will not have?

A

Neuro Sx – loss of proprioception/vibratory/etc.
= Subacute Combined Degeneration

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11
Q

What are the levels of Iron, Ferritin and TIBC with Iron Deficiency Anemia?

A

LOW iron and ferritin
HIGH TIBC

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12
Q

What causes Anemia of Chronic Disease?

A

Chronic inflammation with cytokines, often autoimmune or malignancy

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13
Q

What are the levels of Iron, Ferritin and TIBC with Anemic of Chronic Disease?

A

LOW iron and TIBC
HIGH Ferritin

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14
Q

If you see a Microcytic Anemia with normal iron studies and a significantly low MCV, what may be the condition?

A

Alpha Thalassemia

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15
Q

What are 3 Microcytic Anemias?

A

Iron deficiency
Anemia of Chronic Disease
Thalassemias

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16
Q

If a Hemolytic Anemia is occurring, what 3 lab changes will be present?

A

Low Haptoglobin
HIGH LDH and bilirubin

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17
Q

If a Hemolytic Anemia is occurring, what 3 lab changes will be present?

A

LOW Haptoglobin
HIGH LDH and bilirubin

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18
Q

What are the signs of a Febrile Non-hemolytic transfusion reaction?

A

Fever, chills and malaise following transfusion

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19
Q

What causes a Febrile Non-hemolytic transfusion reaction? What do you do?

A

Cytokines in the transfused blood
– Give Acetaminophen and stop the transfusion

20
Q

What are the signs of an Acute Hemolytic transfusion reaction?

A

Fever and chills
Hypotension
Flank pain and possible renal failure

21
Q

What causes an Acute Hemolytic transfusion reaction?

A

ABO incompatibility where recipient antibodies attack donor blood

22
Q

What will be seen with a Delayed Hemolytic transfusion reaction?

A

A week after a transfusion, the patient may have a fever

23
Q

If a patient has an allergic reaction with a transfusion it will occur in minutes. Why does it occur?

A

Recipient antibodies to plasma proteins
Ex. IgA Deficiency

24
Q

Signs of an Allergic reaction following a transfusion?

A

Urticaria and itching
Anaphylaxis

25
Q

What is the mutation with Sickle Cell Disease?

A

Glutamic acid replaced by Valine on Beta globin gene Chr. 16

26
Q

Under conditions of acidosis and hypoxemia, RBCs will sickle with sickle cell disease. In general, what 2 things does that cause?

A

Clot/Ischemia
Hemolysis

27
Q

If you believe a Sickle Cell patient is having an Acute Chest Syndrome or a Cerebral infarction, what is the treatment?

A

Exchange transfusion

28
Q

If you believe a Sickle Cell patient is having a vaso-occlusive pain crisis, what are 3 things that they should be given?

A

IVF
Oxygen
Pain control

29
Q

If a Sickle Cell patient comes in with abdominal pain, what could be the cause?

A

Pigmented gallstones from chronic hemolysis

30
Q

Due to autoinfarction of the spleen, what should children with Sickle Cell be given until age 5? After that?

A

Penicillin until age 5
Pneumococcal vaccine after that

31
Q

Following the initiation of chemotherapy treatment, what may occur if patients are now sick or having arrhythmias?

A

Tumor Lysis syndrome

32
Q

Pneumonic to remember Tumor Lysis Syndrome electrolyte changes?

A

PUKE Calcium

33
Q

Electrolyte changes with Tumor Lysis Syndome?

A

PUKE Calcium
- phosphorus
- uric acid
- potatssium
= ELEVATED
- Calcum LOW

34
Q

What is the treatment of Tumor Lysis Syndrome?

A

Normal saline and Uric acid inhibitors

35
Q

What is a Myelodysplastic Syndrome?

A

Disorder of the formation of 1 or more myeloid lines

36
Q

What will be seen with a Myelodysplastic Syndrome?

A

Cytopenias
BM is < 20% blasts!

37
Q

What may be seen on peripheral smear with a Myelodysplastic Syndrome?

A

Oval Macrocytes

38
Q

What is the result of a BM biopsy with a Myelodysplastic Syndrome?

A

< 20% blasts!

39
Q

Side effect of Vincristine and Vinblastine?

A

Peripheral Neuropathy

40
Q

Side effects of Cisplastin/Carboplatin?

A

Ototoxicity
Nephrotoxicity

41
Q

Side effect of Cyclophosphamide

A

Hemorrhagic Cystitis

42
Q

Side effect of Bleomycin?

A

Pulmonary Fibrosis

43
Q

Side effect of Adriamycin, Doxorubicin, Daunorubicin?

A

Cardiomyopathy

44
Q

How do you differentiate mature cells from blasts?

A

Mature cells have very little cytoplasm
– BLASTS = CYTOPLASM

45
Q

Exposed collagen on injured vasculature will expose vWF, which binds what platelet antigen?

A

GP1B

COMAT - IM (17 decks)

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