OME - HemOnc Flashcards by Alex Hamidi

What meds induce G6PD?

Dapsone
TMP-SMX
Nitrofurantoin

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Antiphospholipid Ab Syndrome does what?
Presents how?

Dx:

Tx?

Arterial and venous thrombosis
Recurrent early miscarriages

Russell Viper Venom Assay

Warfarin 2-3

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In ACD, what are the lab values:

Fe
Ferritin
TIBC

Dec
Inc
Dec

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When do you transfuse platelets in a pt w/low platelets?

< 20,000
OR
< 50,000 AND bleeding

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Pt w/thrombocytopenia d/t inc destruction is bc of what?

ITP
TTP
DIC

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NHL presents how?

Spreads how?

What kind of disease normally?

Treated how?

IIb or worse

Hematogenously

Extranodal

RCHOP

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Bleeding w/normal platelet count is d/t what?

vWD
Glanzmann’s - IIb/IIIa
Bernard-Soulier - In
Uremia
Drugs

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Treatment of chemo for HL is done with what?

Normally presents in what stage?

ABVD or BEACOPP

IIa or better

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Why do sickle cell pts need an annual DEXA scan?

Aseptic necrosis of hip/femur

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Thrombocytopenia is d/t what 3 main categories?

Dec Production

Inc Destruction

Sequesteration

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Pt w/thrombocytopenia d/t dec production is bc of what?

Aplastic anemia

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How does Chronic Leukemia present?

Next step is to get what?

Then what?

ASx, wbc > 60

Differential
PMN = CML
Lymph = CLL

Bone marrow bx

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What is the antidote to heparin?

Protamine

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What are the sx of HIT?

Treat with what?

Plt drops and NEW thrombus formation

Direct Thrombin Inhibitor - Lepirudin

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Pt w/CLL, what will you see?

Treat if > 65 and have sx?

< 65 + donor?

Smudge cells

chemo: Fludarabine or Rituximab

HSCT

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ITP is treated how?

Steroids, IVIG

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What presents w/thrombocytopenia, fever, AMS, RF, and microangiopathic hemolytic anemia?

Treat how?

TTP

Exchange transfusion

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Multiple myeloma what kind of scan should you get?

Shows what?

Skeletal survey

Lytic lesions

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Pt that has HL or NHL, what are some uncommon findings that are non-specific?

Pel-Epstein fevers that come and go over weeks or painful LAD w/EtOH and HSM

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Sickle cell pt in vasoocclusive crisis with MCV of 105, what is the cause?

Folate deficiency, v common in these pts

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Quick summary:
Primary hemostasis deals with what?

Secondary?

Platelets

Factors

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Sideroblastic anemia has what values?

Fe
Ferritin
TIBC

Treatment?

Inc
Normal
Normal

Give B6, look for cancer

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What presents w/thrombocytopenia in a female w/no other sx?

Treatment?

ITP

Plt < 20 or bleeding give IVIG
Plt > 20 give steroids
Refractory - splenectomy

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When does HIT occur?
Presents how?

Dx how?

Tx?

7-14 days
Low Plts

HIT Ab+

Stop heparin
Give argatroban
Bridge to warfarin

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What are the 3 stages in order of primary hemostasis?

Adhesion Activation Aggregation

HS diagnosed how? Confirm how/Best test? Treatment?

Smear Osmotic fragility Folate > Fe and if severe splenectomy

Pt w/thrombocytopenia d/t sequestration is bc of what?

Cirrhosis

Autoimmune ABs for Warm will show what? Caused by what? Treat how?

IgG - WG Autoimmune disease (R.A.), PCN, sulfa, Rifampin, Cancer Steroids, IVIG, Rituximab, splenectomy

HbSS pts should be on what? Treat how?

Daily folate and Fe Hydroxyurea

After finding cancer on biopsy how do you stage?

1) CXR 2) CT 3) BM Bx

What is the path behind TTP? Pt presents how?

Hyaline clot d/t def of ADAMTS-13 FAT RN Fever, anemia, thrombocytopenia, Renal failure, neuro sxs

After you see PT/PTT is increased, what is the next step?

Get mixing study

If mixing study does not correct the PT/PTT do what? If it does correct, what does it mean? D/t what?

Inhibitor, do nothing Factor Def Hemophilia A/B, Vit K Def, Warfarin, DIC, vWD/Factor 8

Pt w/peripheral neuropathy and on BM bx there is > 10% lymphocytes, what does the pt have? Treat how? What special feature does it have?

Waldenstrom’s Plasmapheresis and Rituximab Serum viscosity > 5-6

What starts primary hemostasis? What happens 1st? What is this process called?

Endothelial injury vWF is released, grab Glycoproteins-Ib Adhesion

What random things can cause nonmegaloblastic macrocytic anemia?

Liver disease EtOH Meds Metabolic conditions - Lesch-Nyah’s, Orotic Aciduria

Pt w/ HIT, treat how?

Stop heparin | Give Tirofiban

Pt that has MCV of 124, Hg of 10 and drinks a pint of liquor a day and eats a good diet, what will be seen on peripheral blood smear?

Microcytic rbcs alone | Does NOT have B12/folate def

Treatment for AML M3? See how? Everything else?

All-trans retinoic acid Auer rods Chemo

Avg age for pt w/ALL? Treat how? For what?

7 Intrathecal ppx chemo w/Ara-C or MTX Bc the cancer hides in the CNS

Autoimmune ABs for Cold will show what? Caused by what?

IgM - CM Mycoplasma, Mono

Chemo treatment for Multiple myeloma?

Melphalan + Prednisone + Thalidomide/Bortezomib

What are the Emergent conditions to look for in sickle cell crisis? Treatment?

Acute chest - MI, CHF Acute brain - CVA Priapism Exchange Transfusion

Pt w/thalassemia has what iron studies? What sx?

Normal Fe studies Anemia

TTP CBC shows what? Smear shows what? Means what?

Low Plts Schistocytes Microangiopathic hemolytic anemia

Non-cardiogenic pulmonary edema and a fever following transfusion = ?

TRALI

Pt that has multiple myeloma and is under 70 y/o, what is the goal?

Stem cell transplant, even if they are doing well on chemo

Microcytic anemia has what kind of RI? | Describe it

RI > 2%, high | Production anemia

Secondary hemostasis ends w/ what?

Fibrinogen mesh turning into fibrin

85 y/o pt w/Spep +, Upper -, skeletal survey - w/BM Bx < 10% is what? Treatment?

MGUS Observe

How to confirm multiple myeloma? Shows what?

BM biopsy > 10% plasma cells

Pt that has a BM biopsy that shows < 10% plasmacytosis, + Mspike but with NO symptoms what is the management?

Repeat labs in 6 months | If abnormal, re-biopsy

CML avg pt age? CLL?

47 87

Avg pt age in AML? Exposure? + for what?

67 y/o Benzene, radiation, blast crisis in CML MPO

Pt presents w/Non-tender LAD, next step?

Excisional biopsy

Dx G6PD how? Confirm how?

Blood smear shows Heinz bodies and Bite cells G6PD 6-8 weeks after attack

Multiple myeloma pt presents with what? 1st step in Dx?

``` CRAB Calcium (hyper) Renal Failure Anemia Bone pain ``` Spep for Mspike and a Upper for Bence Jones

Stage 3 Cancer means LNs located where?

Above and below diaphragm

Old Pt that is slowly developing anemia but is mostly asymptomatic that is suspicious for cancer may have what causing the anemia? How to work up?

Sideroblastic Bone marrow Bx

What meds causes B12 deficiency?

AZT 5-FU ARA-C

How do acute leukemias present? 1st step in w/u? Next step? Diagnose how?

Fever, bone pain, infxn, anemia, bleeding Blood smear BM bx > 20% blasts on peripheral blood

Pt that has PNH presents how? Dx PNH how? Treat how?

ABD pain and morning hematuria Flow cytometery CD55 Negative Supportive or Eculizumab if really severe

Normocytic anemia has what level of RI? Describe it What indicates hemolysis?

RI > 2% Destruction anemia Inc Retic count, Inc LDH, Inc bili Dec Haptoglobin

SS anemia occurs d/t what mutation? Occurs when?

AR in B-Globin Hypoxia, infection, dehydration, DKA

What diseases can cause B12 deficiency? If untreated can cause what?

Pernicious anemia Crohn’s Gastric bypass Irreversible subacute combined degeneration of the cord

Treatment of severe thalassemia? What else do you need to give?

Transfusion Give Deferoxamine

What kind of pt has ACD? Treatment?

SLE, R.A. usually nothing, but if severe give EPO

What are the microcytic anemia? What is the 1st test you should order? RI will be low or high? Describe it

ASLIT - ACD, Sideroblastic, Lead, Iron Def, Thalassemia Ferritin Low - production anemia (bone cannot make rbcs)

OME - HemOnc Flashcards

(68 cards)