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HemeOnc Flashcards

1
Q

High TIBC

A

Iron deficiency

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2
Q

> 24oz/d cow’s milk + anemia, pica, fatigue, inc RDW

A

Iron deficiency –> oral iron therapy

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3
Q

Iron deficiency tx in baby

A

Cows milk b4 9mo

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4
Q

High Ferritin

A

Chronic disease –> EPO

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5
Q

Low iron, Low TIBC anemia

A

Chronic disease

- high ferritin

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6
Q

Low TIBC

Everything else normal or high

A

Thalessemias (Inc A1)

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7
Q

High Hb A2

A

B-Thal trait

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8
Q

MCV <75, normal RDW, Target cells, Normal iron, ferritin, no response to iron

A

B-Thal trait (inc A2), alpha-thal (normal)

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9
Q

Target cells anemia

A

Thal minor

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10
Q

Hct >30, RDW NORMAL, RBC count normal to Inc, normal to inc iron, Ferritin, anemia

A

Thal minor

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11
Q

Basophilic stippling

A

Thalessemia & heavy metal poisoning

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12
Q

RUQ pain w/ inspiration, splenomegaly, same thing in brother

A

Hereditary spherocytosis –> Ca-bilirubin gall stones –> folate & splenectomy

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13
Q

Tx for hereditary spherocytosis

A

Folate & tranfusions –> 30+ yr strep risk = vaccination b4 splenectomy + daily PCN

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14
Q

Multiple small round dense, hyperchromic (no pallor) RBCs, RUQ pain, Coombs -

A

Hereditary spherocytosis = ankyrin defect –> high MCHC & RDW

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15
Q

High retic, hyperUNconjugated bilirubinemia, spherocytes, schistiocytes, osmotic fragility

A

Hereditary spherocytosis

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16
Q

High retic, inc MCHC, normal or low MVC, anemia, jaundice

A

Hereditary spherocytosis

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17
Q

Thrombocytopenia –> pancytopenia, absent radius/thumb, café-au-lait, microcephaly

A

Fanconi anemia (TAR)

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18
Q

Pancytopenia, hypopigmented spots, short, abn thumbs, deafness, strabismus, 7 y/o

A

Fanconi anemia = DNA breaks –> stem cell transplant

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19
Q

Swelling of hand/feet, fever, pale, poor feeding

A

Hand-foot syndrome = Sickle Cell

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20
Q

85% HbS, 15% HbF

A

Sickle cell disease

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21
Q

Management of Sickle cell

A

Vaccinations, PCN until 5, folic acid, HU for vasoocclusive events

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22
Q

Sickle cell disease complications

A

ACS, dacylitis, stroke, osteomyelitis, splenic infarction

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23
Q

Hx severe arm pain, now weakness, clumsy in right hand, 3 y/o A.A boy

A

Sickle cell stroke = get peripheral smear, retic

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24
Q

40%HbS, 60% HbA

A

Sickle cell Trait –> Hematuria, can’t concentrate urine –> polyuria, nocturia, inc UTIs

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25
Q

Anemia + high retic, A.A boy, hx hematuria, Abd pain, no vaccines –> death

A

Sickle cell –> bacterial infection d/t asplenia = PCN until 5 y/o

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26
Q

1 bacteremia bug in sickle cell

A

Strep pneumo (encapsulated)

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27
Q

Howell-Jolly bodies

A

Sickle cell - sign of aplenia

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28
Q

Severe drop in Hb, retic <1%, sudden onset fatigue, dyspnea, NO HSM

A

Aplastic crisis

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29
Q

Retic <1%, BM HYPOCELLULAR, fatty infiltrate, bleeding, petechiae, lethargy, weakness

A

Acquired aplastic anemia - drugs, chemicals, CCl4, insecticides

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30
Q

Hypoplastic, fat-filled marrow

A

Aplastic Anemia

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31
Q

High F Hb (HU increases this)

A

Sickle cell, beta thal, aplastic anemia

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32
Q

Reticulocytosis w/ sickle cell

A

Hyperhemolytic crisis

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33
Q

African American 17 y/o male w/ painless hematuria

A

Sickle cell trait - d/t papillary ischemia

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34
Q

Heinz bodies & bite cells

A

G6PD deficiency and thalessemias = Hb precipitation

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35
Q

Bite cells, RBC inclusions (Heinz bodies), inc indirect bili, inc LDH, dec haptoglobin, jaundice, back pain, DARK urine

A

G6PD deficiency

- activity level may be NORMAL during an attack

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36
Q

Inc marrow cellularity + megakaryocyte hyperplasia

A

Essential thrombocytosis

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37
Q

Shiny tongue, palmar crease, Hb 7.5, WBC 3500, Hx gastric bypass

A

B12 deficiency d/t bypass/no IF

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38
Q

Everything inc but TIBC dec

A

Hemochromatosis

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39
Q

Absent CD55

A

Paroxysmal Nocturnal Hemoglobinuria

- destruction by complement

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40
Q

Hemarthroses, epistaxis, joint swelling, young age, family bleeding disorder

A

Hemophilia A (VIII) or B (IX)

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41
Q

Easy bruising, knee swelling after fall, skin ecchymoses, bruising at waistband

A

Hemophilia (A = VIII, B= IX) –> platelet count and Coag

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42
Q

Cause of hemophilia arthropathy

A

Iron/hemosiderin deposition –> synovitis & fibrosis

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43
Q

Normocytic, normochromic anemia, low retic, Hb 7-10, normal platelet, WBC, bilirubin

A

Anemia of prematurity - FTT, tachypnea, lethargy, cyanosis, tachycardia

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44
Q

Weak, abd pain, inc urine prophobilinogen

A

Acute intermittent porphyria

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45
Q

Purpura, large joint arthritis, N/V, melena, normal PT, PTT, Comp & IgA N-Inc

A

Anaphylactoid purpura

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46
Q

Bruising, bloody stool, IVH, baby born at home, inc PT

A

Hemorrhagic disease of newborn = vit K def (II, VII, IX, X)

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47
Q

Venous Hct >65 risk

A

NEC –> partial exchange transfusion

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48
Q

Washing cells/removing WBCs

A

Prevent febrile transfusion

49
Q

HPT w/ acute monoarthritis, chondrocalcinosis

A

Pseudogout - CPPD = rhomboid crystal, +

50
Q

Helmet cells

A

Trauma - DIC, HUS, TTP

51
Q

Drugs that cause folic acid deficiency

A

TMP-SMX, MTX, Phenytoin, phenobarbital

52
Q

Platelet dysfunctions

A

vWD, renal failure (uremic coagulopathy)

53
Q

Inc PT (INR)&raquo_space; aPTT

A

Vit K deficiency

54
Q

CF + prolonged PT deficiency

A

Vit K –> low factor VII

55
Q

Lupus anti-coagulant prolongs?

A

PTT

56
Q

Drop of >50% platelets on heparin

A

HIT –> stop all heparin & use direct thrombin inhibitor + serotonin release assay

57
Q

Absent Ib-IX-V, mild thrombocytopenia but profuse bleeding, giant platelets

A

Bernard-soulier

58
Q

Anemia, thrombocytopenia, HS megaly, BONE PAIN/erosions, PAS+ inclusions

A

Gaucher’s

59
Q

Blood transfusions before 1986 and 1992 screened for what?

A

HBV and HCV, respectively

60
Q

Paresthesias & hypoCa, hypoMag after receiving several PRBC units

A

Citrate anti-coagulant in whole blood chelates serum Ca

61
Q

Pancytopenia, young A.A female, joint pain, rash, 1+ proteinuria, FPGN

A

SLE –> peripheral immune destruction of all 3 cell lines

62
Q

Isolated thrombocytopenia, no infections

A

Immune thrombocytopenia (ITP) —> steroids then splenectomy or rituximab

BM shows inc MEGAkaryocytes

63
Q

URI weeks ago –> sudden petechiae, epistaxis, thrombocytopenia >30,000

A

ITP –> Observation; steroids if <30,000

64
Q

Hemolytic anemia, thrombocytopenia, renal failure, HA, fragmented RBCs

A

TTP-HUS (ADAMTS-13) —> plasma exchange

65
Q

Painless blisters on dorsal hand (sun-exposed area),fragility, facial hyperpigment, hypertrichosis, inc uroporphyrins, HCV, estrogen use or iron overload

A

Porphyria cutanea tarda –> phlebotomy, hydroxychloroquine or IF-a

66
Q

Deficiency in urobilinogen decarboxylase –> urine porphyrin inc

A

Porphyria cutanea tarda

67
Q

1 inherited disorder causing hypercoagulability

A

Factor V Leiden

68
Q

HCV, palpable purpura, hematuria, proteinuria, low complement

A

Mixed cryoglobulinemia = Hep C

69
Q

Palpable purpura on butt of kid

A

Henoch-Schonlein

70
Q

Purpura, normal platelet count, arthralgia, abd pain/bleeding, scrotal swelling

A

Henoch-Schonlein purpura –> intussusception = IVFs, NSAIDs or steroids –> SURGERY

71
Q

Hematuria, abd pain, purple non-blanching rash on lower legs, normal platelets

A

Vasculitis/HSP

72
Q

Senile purpura

A

Perivascular CT atrophy

73
Q

Therapy for iron overload in B-thal or sickle cell

A

Deferoximine

74
Q

Ruby papules on lips, high Hct, recurrent nosebleeds, digital clubbing

A

Osler-Weber-Rendu –> AVMs (lungs –> shunt –> polycythemia, hemoptysis)

75
Q

Delayed clamping of umbilical cord –> ?

A

Polycythemia –> Resp distress

76
Q

Resp distress, poor feeding, neuro sx

A

Polycythemia

77
Q

Pruritus after warm shower, ulcers, facial plethora, Low EPO

A

PCV

78
Q

JAK2 mutation

A

PCV

79
Q

PNA sx but lymphocytosis, smudge cells, how to confirm Dx?

A

CLL –> flow cytometry

80
Q

Most common leukemia in Western countries

A

CLL

81
Q

Elderly, lymphocytosis, smudge cells (breakdown/inc fragility)

A

CLL

82
Q

Reed-Sternberg cells

A

Hodgkins lymphoma

83
Q

Leukocytosis with neutrophilia, marked splenomegaly, low leukocyte alkaline phosphatase

A

CML

84
Q

Pt got chemo & rad for Hodgkin lymphoma –> CXR density dx?

A

Secondary malignancy - also breast, bone, thyroid, GI cancers

85
Q

Numerous infections, weight loss, HSM, LAD, petechiae

A

ALL = higher in boys, Down

86
Q

Pale, petechiae, fever, fatigue, rubbery non-tender LNs, anemia, widened mediastinum

A

ALL –> BM Bx

87
Q

LAD, splenomegaly, 80% blasts, Inc prolymphocytes, (-) PAS (+) Tdt

A

ALL

88
Q

Starry sky appearance

A

Burkitt lymphoma

89
Q

Tx for acute limb ischemia

A

Heparin –> surgery –> intra-arterial fibrinolysis

90
Q

Anti-cardiolipin Abs, recurrent thromboses

A

Antiphospholipid Ab syndrome

91
Q

Poor prognostic indicator in CLL

A

Thrombocytopenia

92
Q

Cause of death in CLL pts

A

Infection

93
Q

Temp 101.3, neutrophils 850

A

Neutropenic fever –> PA –> Zosyn

94
Q

Dry tap, TRAP stain, CD11c

A

Hairy cell leukemia (B) –> Cladribine (purine)

95
Q

NHL Tx

A

CHOP

96
Q

CLL tx

A

Chlorambucil & Prednisone

97
Q

BCR/ABL

A

CML

- Hx of radiation exposure

98
Q

9;22 activity

A

TK in CML, tx = Imatinib

99
Q

Hypocellular + Fibrotic marrow

A

Myelofibrotic disorders

100
Q

Retinoic Acid receptor

A

AML (promyelocytic)

101
Q

Excess bone resorption in cancer

A

PTHrP - Breast CA

102
Q

Excess Ca reabsorption in cancer

A

Lymphoma (Vit D)

103
Q

Anterior mediastinal masses

A

Thymoma - Teratoma - Thyroid - Terrible lymphoma

104
Q

Mediatinal mass w/ high b-HCG, normal AFP

A

Seminoma

105
Q

Mediastinal mass w/ elevated b-HCG, elevated AFP

A

Mixed germ cell/Non-seminomatous - yolk, chorio

106
Q

Back pain, anemia, renal dysfxn, elevated ESR, constipation

A

MM –> hyperCa

107
Q

Plasmacytosis, monoclonal proteins, lytic lesions

A

MM (IgG or IgA)

108
Q

High serum protein, normal albumin (gamma gap) disorders

A

MM, amyloidosis, waldenstroms, MGUS

109
Q

Gamma gap, anemia, pancytopenia, hyperCa, renal disease

A

MM

110
Q

MM SPEP

A

> 3g M protein, >10% plasma cells in BM

111
Q

MGUS SPEP

A

need sketelal x-rays to monitor for –> MM

112
Q

IgM spike, anemia, bruises, night sweats, dizzy, blurry vision, numbness

A

Waldenstroms

113
Q

Metabolic/electrolyte abnormalities w/ tumor lysis syndrome

A

HypoCa, HyperPhos, Uric acid, K

114
Q

Frequency of brain mets by cancer type

A

Lung > Breast > Melanoma > Colon

115
Q

Solitary brain mets

A

Breast, Colon, RCC

116
Q

Multiple brain mets

A

Lung, Melanoma

117
Q

Pappenhiemer bodies

A

Sideroblastic anemia - phagocytes ingest excessive iron

118
Q

LOW Hb and haptoglobin
Inc LDH and bilirubin
Portal vein thrombosis

A

PNH

  • no GP1 –> cant bind CD55 or 59 –> destruction by complement
  • Dx by flow cytometry
119
Q

Signs and sx of polycythemia in newborn

A

RESPIRATORY DISTRESS
Poor feeding, hypoglycemia, hypoCa

Tx = hydration or partial exchange transfusion

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