Flashcards in Heme Onc_UW Deck (54)
What confirms dx of leukemia?
bone marrow biopsy with greater than 25%
Most common pediatric renal malignancy?
Wilms tumor is aka
Burr cells are seen in?
Spiculated RBCs of similar size with regularly spaced projections. Seen in uremia or artifact of preparation
Seen in sideroblastic anemia. Results from phagosomes that engulf excessive amounts of iron.
Heinz bodies seen in
Heinz bodies are
when Hb oxidizes in GPD deficiency, they precipitate into these heinz bodies.
Universal screening for iron deficiency anemia
complete CBC 9-12 months
Tx for iron deficiency anemia
empiric oral iron therapy. Recheck Hg in 4 weeks, if it has risen by 1g/dL, continue for 2-3 months.
Tx for ITP
If only skin manifestations: observe, regardless of platelet count. If bleeding, then regardless of platelet count give IVIG or glucocorticoids
S pneumo, H influenze and N. meningitidis have what in common?
Common vaccinations of childhood that use live attentuated viruses?
Measles, mumps, rubella and chicken pox
What can prevent pneumococcal sepsis in sickle cell pateints
Pneumococcal vaccine and pencillin propylaxis (kids should get it till age 5)
Common vaccinations of childhood with bacterial toxoids
Tetanus and diptheria
Epistaxis, visible nasal mass, nasal obstruction
Side effects of hydroxyurea treatment
Suppresses the bone marrow. Can cause thrombocytopenia, leukopenia and anemia. but these effects are generally temporary and reversible but can predispose patient to infection.
MOA of hydroxyurea
Increases proportion of fetal hemoglobin so that the proportion of HgS is reduced and chances of sickling reduce
What bones are frequently affected in osteonecrosis due to sickle cell anemia?
Humeral and femural heads
What is anistocytosis
Blood cells of unequal size
Lab findings for iron deficiency anemia
Decreased MCV, decreased transferrin, anistocytosis => increased RDW, decreased MCH, decreased trasnferrin saturation, increased TIBC. Smear shows small hypochromic rbcs.
MCHC is elevated or depressed in hereditary spherocytosis? Why?
It's elevated. Due to cellular dehydration and membrane loss, the MCHC is high.
What are the diagnostic tests for hereditary spherocytosis?
Osmotic fragility test with acidified glycerol lysis test and abnormal eosin-5-maleimide binding test (flow cytometry)
What is the typical manifestation of hereditary spherocytosis
Coombs negative hemolytic anemia, jaundice and splenomegaly
Genetic pattern of hereditary spherocytosis
75% A/D, 25% spontaneous
What are lab findings/diagnostic tests for hereditary spherocytosis
Imp finding is elevated MCHC. Due to cell dehydration and lower cell volume, this is elevated. Spherocytes on peripheral blood smear, coombs negative. Diagnostically do the acidfied glycerol lysis test and the eosin 5 maleimide binding test.
How is vitamin K related to factors 2,7,9,10 and factors C and S.
Vitamin K is a cofactor for the enzyme gamma glutamyl carboxylase that adds carboxyl groups to the glutamate residues of several coagulation factors such as 2, 7, 9, 10 and C and S. These extra carboxyl groups add the factors affinities for platelets
Most common primary bone tumor in children
Osteosarcomas are found most commonly in
Metaphyses of long bones: proximal humerus, distal femur, proximal tibia.
PE findings and X -ray findings for osteosarcoma
Large tender mass. X-ray finding: sun-burst periosteal pattern and "codman" triangle.