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Flashcards in Hubbard Deck (45):
1

TTP - treatment

Plasmapheresis

2

vWD presents as ____

Mucocutaneous bleeding

3

Treatment for vWD

Cryoprecipitate (vWF) + DDAVP (release vWF)

4

Vitamin K deficiency - labs

Prolonged PT, deficient factors 2, 7, 9, 10, C, S

5

Treatment for vitamin K deficiency

Normal liver fxn -- vitamin K supplements

Liver disease or acute hemorrhage -- FFP

6

Hereditary hemorrhagic telangiectasia - gene deficiency

Endoglin (CD 105)

7

Function of antithrombin 3

Serine protease - inhibits thrombin activation

8

AT3 requires what?

Heparin

9

AT3 deficiency causes increased risk of _____

Clotting (via thrombin activation)

10

AT3 deficiency - presentation

Recurrent LE thrombophlebitis, DVT, leg ulcers, PE

11

AT3 deficiency - treatment

Refractory?

Anticoagulants (heparin)

AT3 replacement

12

Protein C/S deficiency - treatment

Warfarin

13

Factor V Leiden - risk?

Treatment?

Thromboembolism

No episodes = monitor, etc.

Prior episode(s) = lifelong anticoagulation

14

Prothrombin 20210

Risk?

G-A mutation, causing increased prothrombin activity

Thrombosis

15

Common occurrences w/ antiphospholipid syndrome

- Thromboembolism
- Miscarriage
- Thrombocytopenia
- Cerebral ischemia/stroke
- UBOs on MRI

16

Diagnosis of antiphospholipid syndrome (3)

- Prolonged PTT
- No correction using normal plasma
- Neutralization w/ excess phospholipid

17

Specific diagnostic test for antiphospholipid syndrome

Dilute Russell viper venom time (DRVVT)

18

Treatment for antiphospholipid syndrome

Hx of thromboembolism --> lifelong anticoagulation

19

ITP - treatment

Prednisone

20

Reactive leukocytosis, thrombocytopenia, prolonged PT and PTT, no RBC fragments on smear

How to diagnose?

DIC - from infection

Dx = D-dimer level

21

DIC treatment

Treat the cause, FFP, cryoprecipitate, platelet transfusions

22

Hyaline thrombi that occlude the capillaries of basically every organ

TTP

23

Patient on prolonged antibiotics, PT starts to get longer

Vitamin K deficiency - no microbial production

24

Connective tissue disease, prolonged PTT that doesn't correct, valvular heart disease, recurrent stroke, thrombocytopenia

Antiphospholipid syndrome

25

Superficial venous thrombosis - risk?

DVT, PE

26

Oral contraceptives - risk (when combined w/ other disorders)?

Thrombosis

27

Erythromelalgia - treatment

Aspirin

28

SPEP gamma spike w/ hump after

Treatment?

MGUS

NO treatment, just monitor

29

Solitary plasmacytoma - treatment

Local radiation

30

Multiple myeloma - diagnosis

What not to do?

Skeletal survey

NOT A BONE SCAN

31

Multiple myeloma - treatment

Thalidomide/lenolidamide + dexamethasone

32

Sausage-linking of fundoscopic veins

Waldenstrom's hyperviscosity

33

Waldenstrom's - treatment

Plasmapheresis, hydration, bisphosphonate

34

Fat pad = green birefringence on congo red

Amyloidosis

35

Joint pain, infections, anemia, bleeding, pedal edema
Multinucleate plasma cells w/ Dutcher bodies in BM

Amyloidosis (AL - light chain)

36

Temporal muscle wasting, chronic diarrhea, pre-renal disease, malabsorption

Treatment?

Alpha heavy chain disease

Antibiotics

37

Aplastic anemia - treatment

Cyclosporin + anti-thymocyte globulin

38

Diffuse rash, hemolytic anemia, elevated ESR, Gimsa stain

Classic finding?

Babesiosis

Maltese cross

39

Oral contraceptives + Factor V Leiden

35x increased risk of hypercoaguability

40

Hydroxyurea

Increased HbF in sickle cell

41

Acute chest syndrome - treatment

Transfusion

42

Treatment for PCV and ET

IFN-alpha, phlebotomy

43

Black water fever

RBC burst into blood (malaria complication) - hemoglobinuria and bilirubinuria (direct and indirect)

44

Neuropathy, HSM, endocrine issue, M spike, skin and skeletal lesions

POEMS syndrome - osteosclerotic myeloma

45

Male, eczema, thrombocytopenia, bloody diarrhea, recurrent infections

Wiskott-Aldrich (congenital thrombocytopenia)