misc heme

Question 1

severe hypochromic, microcytic anemia with chronic hemolysis… splenomegaly, jaundice, cholelithiasis;
1/3 pts have skeletal changes due to expanded erythopoiesis

Answer 1

alpha thal major

Question 2

poikilocytes in what

Answer 2

alpha and beta majors

Question 3

severe microcytic anemia in 1st year of life

-what do they need for treatment

Answer 3

beta thal major

-need chronic tranfusions for marrow transplant to survive

Question 4

produces more marked microcytosis for degree of anemia than iron def anemia

Answer 4

thalasemia

Question 5

how to treat or postpone hemosiderosis

Answer 5

deferoxamine or deferasirox

Question 6

cooley begins when

Answer 6

beta thal begins 4-6 months of age

Question 7

born with severe anemia, growth retardation, abn facial structure, pathologic fx, hepatosplenomegaly

Answer 7

beta thal

Question 8

serum iron and ferritan nml or elevated;

hgb usually 3-6

Answer 8

think thalasemia

Question 9

3 maintenance things for sickle cell anemia

Answer 9

low dose PCN from birth to 6 years
pneumococcal vaccine
daily lifelong oral hydroxyurea

Question 10

most common hypercoagulable state

Answer 10

factor V leiden

Question 11

may result from B6, B12, folate

Answer 11

homocysteine

Question 12

isolated lymphocytosis with leukocytosis over 20,000

Answer 12

CLL

Question 13

anemia and thromobocytosis

Answer 13

CML

Question 14

increased granulocytes-MATURE neutrophils and low blast cells

Answer 14

CML

Question 15

coombs test post

Answer 15

autoimmune hemolytic anemia

Question 16

peripheral blood smear for what

Answer 16

ALL, CLL, CML, MM

Question 17

chemo pt with fever

Answer 17

think neutropenia

Question 18

test for hereditary spherocytosis

-symptoms

Answer 18

osmotic fragility test

-jaundice, splenomegaly

Question 19

thrombophilia, lupus pts, may have blood clots, recurrent miscarriages
-tx

Answer 19

antiphospholipid syndrome

tx with anticoagulation therapy

Question 20

SE of chloramphenicol

Answer 20

aplastic anemia

check CBC 2 x a week

Question 21

intrinsic pathway factors

Answer 21

8 and 9; affect PTT

Question 22

recombinant factor tx for what factors

Answer 22

8 and 9

Question 23

intrinsic pathways clotting cascade

Answer 23

9, 11, 12

Question 24

heparin
MOA
blood test

Answer 24

activates antithrombin

Increased PTT

Question 25

warfarin affects what factors; blood test | -antidote

Answer 25

2, 7, 9, 10; increased PT | -FFP, vit K

Question 26

tPA MOA, blood test antidote

Answer 26

aid in conversion of plasminogen to plasmin(breaks down fibrin) increased PT and PTT aminocarproic acid

Question 27

lytic lesions on radiographs

Answer 27

multiple myeloma

Question 28

stage one hodgkin

Answer 28

single site

Question 29

stage 2 hodgkin

Answer 29

2 or more lymphnodes on same side of diaphram

Question 30

stage 3 hodgkin

Answer 30

affected lymphnode on both sides of diaphram; with involvement of spleen or another lymphnode site

Question 31

stage 4 hodgkin

Answer 31

presence of b symptoms or diffuse extra lymphnode involvement

Question 32

no bleeding in joints; but have frequent nosebleeds, heavy menstrual bleeding, "jew" - def in what - tx

Answer 32

hemophilia C; def in factor X1 | -FFP

Question 33

often present of childhood - usual FH - worsen with aspirin use - autosomal dominant

Answer 33

vWD

Question 34

easy brusinng, frequent epistaxis, gum bleeding

Answer 34

vWD

Question 35

accurate test for vWD | -avoid what for tx

Answer 35

ristocetin cofactor assay | -avoid aspirin

Question 36

avoid aspirin for what

Answer 36

vWD, ITP

Question 37

low platelets; nml PT/aPTT, ADAMTS13, schisocytes

Answer 37

TTP

Question 38

PT and PTT prolonged. thrombocytopenia, low fibrinogen concentration

Answer 38

DIC

Question 39

DIC tx and mortality

Answer 39

platelet transfusion, FFP; 10-15% survival