1.9 Hematology

Question 1

what are causes of microcytic anemia

Answer 1

iron defficiency

thalassemia

sideroblastic anemia

anemia of chronic disease

Question 2

in what disease is platelet transfusion contraindicated?

Answer 2

TTP

Question 3

reverse warfarin toxicity

Answer 3

Prothrombin Complex Concentrate

(all vitamin K factors)

Question 4

what kind of anemia does chronic renal failure give?

Answer 4

normocytic anemia

Question 5

which thalassemia has high recitulocytes

Answer 5

3-gene depletion alfa thalassemia

Question 6

what are the only things that can cause hypersegmented neutrophils?

Answer 6

B12 deficiency

folate deficiency

antimetabolite medications

Question 7

what do we use to confirm B12 deficiency when the history suggests it but the B12 level is borderline or normal?

Answer 7

methylmalonic acid level

Question 8

🚩 high LDL + high bilirubin + low reticulocytes

Answer 8

ineffective erythropoyesis

(B12 dificiency)

Question 9

💡 decreased position and vibratory sensations

Answer 9

B12 deificiency

Question 10

what do we use to confirm pernicious anemia?

Answer 10

anti-intrinsic factor

anti-parietal cell antibodies

Question 11

💡 increased levels of LDL + increased bilirrubin + high reticulocytes

Answer 11

hemolytic anemia

Question 12

what lowers mortality in sickle cell disease?

Answer 12

hydroxyurea (prevention)

antibiotics with fever

Question 13

💡 howell-jolly bodies

Answer 13

precipitated remnants of nuclear material inside RBC of a patient with no spleen

sickle cell disease

Question 14

🚩basophilic stippling

Answer 14

sideroblastic anemia

Question 15

🚩 bite cells

Answer 15

G6PD deficiency

Question 16

schistocytes

Answer 16

fragmented red blood cells seen with intravascular hemolysis

Question 17

🚩 morulae

Answer 17

inside neutrophils in Ehrlichia infections

Question 18

when should you give exhcange transfusion to a patient with sickle cell disease

Answer 18

patient with sickle cell presenting vasooclusive crisis with

• acute chest syndrome
• priapism
• stroke
• visual disturbance (retinal infarction)

Question 19

💡 spherocytes

Answer 19

• hereditary spherocytosis
• autoimune hemolysis (warm/IgG)
• cold agglutinin

Question 20

what is associated with Cold Agglutinin Disease

Answer 20

• EBV
• waldenström macroglobulinemia
• mycoplasma pneumoniae

Question 21

what is TTP associated with?

Answer 21

ticlopidine

clopidogrel

cyclosporing

AIDS and SLE

Question 22

⚠️ what to give prior to administerin eculizumab

Answer 22

meningococcal vaccine

Question 23

eculizumab

Answer 23

complement inhibitor

• interrupts hemolysis of HUS
• removes complement 5 in PNH

Question 24

mutation responsible for polycythemia vera

Answer 24

JAK 2

inhibitor of JAK: ruxolitinib

Question 25

Ruxolitinib

Answer 25

inhibits JAK2 used for: polycythemia vera, essential htrombosis with JAK mutation, myelofirbosis

Question 26

💡 teard drop shaped cells

Answer 26

myelofibrosis

Question 27

what TNF inhibitors increase bone marrow production?

Answer 27

thalidomide lenalidomide (myelofibrosis tx)

Question 28

5 q deletion tx?

Answer 28

myelodysplastic syndrome lenalidomide

Question 29

philadelphia chromosome

Answer 29

9:22 transloaction BCR-ABL **chronic myelogenous leukemia** CML

Question 30

🚩 pegler huet cells

Answer 30

MDS myelodysplasic syndrome

Question 31

💡rouleaux smear

Answer 31

multiple myeloma

Question 32

💡 bence-jones protein

Answer 32

multiple myeloma

Question 33

what vaccines to apply before splenectomy?

Answer 33

neisseria meningitidis haemophilus influenzae pneumococcus

Question 34

🚩 giant platelets

Answer 34

Bernard Soulier

Question 35

💡 sickle cell patient with sudden drop in hematocrit level

Answer 35

parvovirus B-19 infection measure **reticulocyte** count to confirm sudden drop in reticulocyte count causes aplastic crisis (only RBC)

Question 36

💡 schistocytes

Answer 36

fragmented red blood cells from intravascular hemolysis