Heme Review

Question 1

Normocytic anemias

Answer 1

Anemia of chronic disease

thallassemias

Question 2

What diseases can cause anemia of chronic disease?

Answer 2

Rheumatoid conditions
Inflammatory Bowel Disease
Cancer
Chronic infections
Chronic liver disease

Question 3

Best lab finding for iron deficiency

Answer 3

iron to TIBC ratio of less than 10%

Question 4

Causes of cold hemolytic anemia

Answer 4

Post mono or post mycoplasmal infection

Question 5

Difference in immunoglobulins between warm and cold hemolytic anemias

Answer 5

IgG- warm

IgM- cold

Question 6

Disease where sulfa drugs causes hemolytic anemia

Answer 6

G6PD deficiency

Question 7

difference in symptoms between B12 and folate deficiencies

Answer 7

B12- neurologic findins

Folate- no neurologic findings

Question 8

Mechanism of thallassemias

Answer 8

reduction in synthesis of globin genes

Question 9

Best lab test of B12 deficiency

Answer 9

elevated methylmalonic acid and homocysteine

Question 10

High iron:TIBC
Low MCV
Target cells

Answer 10

Thallassemia

Question 11

Mechanism of anemia of chronic disease

Answer 11

Sequestration of iron in the reticuloendothelial system

Question 12

Antibody produced in pernicious anemia

Answer 12

Anti-intrinsic factor

Question 13

Mild anemia
High MCHC
splenomegaly
family history

Answer 13

Hereditary spherocytosis

Question 14

Sickle cell patient

profound anemial

Answer 14

hyperhemolytic crisis

Question 15

What infection causes sickle cell patients to have aplastic anemia

Answer 15

parvovirus B19

Question 16

Three sickle cell complications

Answer 16

Acute chest syndrome
Salmonella ostetomyolitis
avascular necrosis of femoral head

Question 17

What vaccines should be given to a patient after a splenectomy

Answer 17

Encapsulated bacteria:
pneumoccocal
meningitis
Hib

Question 18

ruddy skin
itching
cyanosis of finger tips
splenomegaly
high platelets

Answer 18

Polycythemia vera

Question 19

Mutation present in polycythemia vera

Answer 19

JAK2

Question 20

Complication of heparin induced thrombocytopenia

Answer 20

PE and DVT-> makes patient hypercoagulable

Question 21

AE after being on heparin for several days

Answer 21

heparin induced thrombocytopenia

Question 22

Mechanism of Paroxysmal Nocturnal Hemaglobinuria

Answer 22

Loss of GPI linked proteins on the cell surface (CD55, 59)

Question 23

History of bleeding
Elevated PTT
Increased bleeding time

Answer 23

von Willebrand’s disease

Question 24

Recent URI
petechiae on legs, arma, and trunk
profound thrombocytopenia
Normal WBC and HCT

Answer 24

Idiopathic thrombocytopenic purpora

Question 25

Mechanism of Bernard-Soulier

Answer 25

platelets can't clump

Question 26

Mechanism of Idiopathic thrombocytopenic purpora

Answer 26

Autoantibodies against platelets

Question 27

``` bruises on upper and lower extremities palatal petechiae fever low HCT elevated LDH thrombocytopenia schistocytes on blood smear ```

Answer 27

TTP

Question 28

``` Vertebral compression fracture high calcium kindey failure anemic high protein/albumin narrow anion gap ```

Answer 28

multiple myeloma

Question 29

defect in TTP

Answer 29

ADAM TS-13

Question 30

Older pt massive lymphadenopathy palpable spleen WBC 30k with lymph

Answer 30

CLL

Question 31

``` High WBC (all cell lines) mild illness ```

Answer 31

CML

Question 32

What is the mutation of CML

Answer 32

9:22 translocation of BCR-ABL proteins

Question 33

Treatment for CML

Answer 33

imantinib

Question 34

What is the mutation in acute promyelocytic leukemia

Answer 34

15:17, retinoic acid receptor

Question 35

Treatment for APL

Answer 35

ATRA: all-trans-retinoic-acid

Question 36

Why is calcium high in Multiple Myeloma

Answer 36

Osteoclase Activating factors

Question 37

Bone biopsy finding in ITP

Answer 37

megakaryocytes on bone marrow biopsy

Question 38

child bloody diarrhea followed by AKI thrombocytopenia anemia

Answer 38

HUS

Question 39

Pentad of TTP

Answer 39

``` Microangiopathic Hemolytic Anemia Thrombocytopenia Decreased renal function Disturbed NEUROLOGICAL function: Fever ```