Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1. AA my internal medicine > 7. Hematology > Flashcards

7. Hematology Flashcards

1
Q

Causes of iron deficiency anemia ?

A
  • Chronic blood loss. “most common cause in adults”

- Dietary deficiency/increased iron requirements.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical features of iron deficiency anemia ?

A
  1. Pallor
  2. Fatigue, generalized weakness 3. Dyspnea on exertion
  3. Orthostatic lightheadedness.
  4. Hypotension, if acute.
  5. Tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lab tests for iron deficiency anemia ?

  • Serum Ferritin:
  • Serum Iron:
  • TIBC:
  • RDW:
A
  • Serum Ferritin: low
  • Serum Iron: low
  • TIBC: HIGH
  • RDW: HIGH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thalassemias ?

A
  • Inherited disorders characterized by inadequate production of either the α- or β-globin chain of hemoglobin.
  • Classified into a-Thalassemia and B-Thalassemia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pernicious anemia ?

A

is a special case of vit. b12 deficiency. It is an autoimmune disorder resulting in insdequate production of intrinsic factor, which leads to impaired absorption of vit. B12 in the terminal ileum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hemolytic Anemias ?

A
  • Premature destruction of RBCs that may be due to a variety of causes.
  • Bone marrow is normal and responds appropriately by increasing erythropoiesis, leading to an elevated reticulocyte count. However, if erythropoiesis cannot keep up with the destruction of RBCs, anemia results.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hemolytic anemia can be classified based on ?

A
  • Mechanism:
    1. Hemolysis due to factors external to RBC defects—most cases are acquired.
    2. Hemolysis due to intrinsic RBC defects—most cases are inherited.
  • Predominant site of hemolysis:
    1. Intravascular hemolysis—within the circulation.
    2. Extravascular hemolysis—within the reticuloendothelial system, primarily the spleen.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Labs in hemolytic anemia ?

A
  • ELEVATED: reticulocytes count, LDH.

- DECREASED: haptoglobin and hempglobin/hematocrit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sickle Cell Anemia ?

A
  • Autosomal recessive disorder that results when the normal Hb A is replaced by
    the mutant Hb S.
  • Sickle cell disease is caused by inheritance of two Hb S genes
    (homozygous).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of Sickle Cell Anemia painful crisis ?

A
  • Hydration (oral if mild episode, otherwise IV saline).
  • Morphine.
  • Keep the patient warm.
  • supplemental O2 if hypoxia is present.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

von Willebrand Disease ?

A
  • Autosomal dominant disorder characterized by deficiency or defect of factor VIII- related antigen (vWF).
  • The most common inherited bleeding disorder (affects 1% to 3% of population).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Disseminated Intravascular Coagulation (DIC) ?

A
  • abnormal activation of the coagulation sequence, leading to formation of microthrombi throughout the microcirculation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lab tests of Disseminated Intravascular Coagulation (DIC) ?

A
  • INCREASED:
  • PT, PTT, bleeding time, TT.
  • Fibrin split products.
  • D-dimer.
  • DECREASED:
  • Fibrinogen level (a normal/elevated fibrinogen level essentially rules out the diagnosis)
  • Platelet count.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hemophilia A ?

A
  • X-linked recessive disorder.

- Caused by deficiency or defect of factor VIII coagulant protein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heparin ?

A
  • inhibit clotting factors IIa and Xa.

- Prolongs PTT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Low-molecular-weight Heparin ?

A
  • inhibit factor Xa.

- Examples include enoxaparin, dalteparin, and tinzaparin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Plasma Cell Disorders types ?

A
  1. Multiple myeloma.
  2. Monoclonal Gammopathy of Undetermined Significance (MGUS).
  3. Waldenström Macroglobulinemia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Multiple myeloma ?

A
  • CRAB symptoms (hypercalcemia, renal disease, Anemia, bone pain)
  • Lytic bone lesions.
  • > 10% plasma cells on bone biopsy.
  • usually of the ((IgG)) or IgA type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Monoclonal Gammopathy of Undetermined Significance (MGUS) ?

A
  • Asymptomatic.
  • No bone lesions.
  • <10% plasma cells.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common cause of death in MM ?

A

up to 70% of patients die of infection (lung or

urinary tract most common)

21
Q

Hodgkin Lymphoma age incident ?

A
  • Bimodal age distribution: (15-30 yrs) or (>50 yrs).
22
Q

Hodgkin Lymphoma lymph node histology divides the disease into ?

A
  • 4 subtypes:
    1. Lymphocyte predominance (5%) - (few reed-sternberg cells and many B cells)
    2. Nodular sclerosis (70%) - (occurs more frequently in women; bands of collagen envelope pools of Reed-sternberg cells).
    3. Mixed cellularity.
    4. Lymphocyte depletion.
23
Q

Lymphoma staging system ?

A

Ann arbor staging system.

- 4 stages. name them

24
Q

B symptoms of lymphoma ?

A

Fever, night sweats, weight loss.

25
Q

Diagnosis of Hodgkin Lymphoma ?

A
  1. Lymph node biopsy—the presence of Reed–Sternberg cells is required to make the diagnosis.
  2. Presence of inflammatory cell infiltrates - this distinguishes Hodgkin’s from nonHodgkin.
  3. CXR and CT - to detect lymph node involvement.
  4. Bone marrow biopsy.
  5. Labs findings
26
Q

TTT of Hodgkin Lymphoma ?

A
  • Consists mainly of chemotherapy and radiation therapy to the involved field.
27
Q

Non-Hodgkin Lymphoma ?

A

is a diverse group of solid tumors which occurs with the malignant transformation and growth of B or T lymphocytes or their precursors in the lymphatic system.

  • Twice as common as Hodgkins.
  • B-cell lymphocyte 85%
  • T-cell lymphocyte 15%
28
Q

Risk factors for NHL ?

A

A. HIV/AIDS.
B. Immunosuppression (e.g., organ transplant recipients).
C. History of certain viral infections (e.g., EBV, HTLV-1).
D. History of Helicobacter pylori gastritis (risk of primary associated gastric lymphoma).
E. Autoimmune disease—for example, Hashimoto thyroiditis or Sjögren syndrome
(risk of mucosa-associated lymphoid tissue [MALT]).

29
Q

Classifications of NHL ?

A
  • There are more than 20 different subtypes.
30
Q

Diagnosis of NHL ?

A
  1. Lymph node biopsy (excisional)—for definitive diagnosis. Any lymph node >1 cm present for more than 4 weeks that cannot be attributed to infection should be biopsied.
31
Q

CHOP therapy consist of ?

NHL

A
  • Cyclophosphamide.
  • Hydroxydaunomycin (doxorubicin).
  • Oncovin (vincristine).
  • Prednisone.
32
Q

Most common subtype of NHL ?

A

diffuse large B-cell lymphoma

33
Q

Acute leukemia ?

A
  • Two types:
    1. Acute myelogenous leukemia (AML).
    2. ALL
34
Q

What is the most common malignancy in children under age 15 ?

A

ALL

35
Q

Poor prognostic indicators of ALL are ?

A
  • Age <2 or >9.
  • WBC > 10(5).
  • CNS involvement.
36
Q

Clinical features of acute leukemia ?

A
  • Anemia and associated symptoms.
  • Increased risk of bacterial infections (due to neutropenia).
  • Abnormal mucosal or cutaneous bleeding (due to thrombocytopenia).
  • Splenomegaly, hepatomegaly, lymphadenopathy.
  • Bone and joint pain (invasion of periosteum).
  • CNS involvement.
37
Q

Lab findings of of acute leukemia ?

A
  • The WBC count is variable (from 1,000/mm3 to 100,000/mm3). There are significant numbers of blast cells (immature cells) in peripheral blood.
  • Anemia.
  • Thrombocytopenia.
  • Granulocytopenia.
  • Electrolyte disturbances (hyperuricemia, hyperkalemia, hyperphosphatemia).
38
Q

Bone marrow biopsy in acute leukemia ?

A
  • Is required for diagnosis.
  • ALL: proliferation of lymphoblasts in the bone marrow (20% or
    greater) .
  • AML: Auer rods, especially if it is the APL phenotype
39
Q

what is the least aggressive type of leukemia ?

A

CLL

  • The most common leukemia that occurs after age 50.
40
Q

Clinical features of CLL ?

A
  • Usually asymptomatic at time of diagnosis; CLL may be discovered on a routine CBC (lymphocytosis).
  • Generalized painless lymphadenopathy (lymph nodes are nontender), splenomegaly.
  • Frequent respiratory or skin infections due to immune deficiency.
41
Q

diagnosis of CLL ?

A
  • labs:
    A. CBC - WBC: 50,000 to 200,000.
    B. Anemia, thrombocytopenia, and neutropenia are common
    C. Peripheral blood smear is often diagnostic:
    1. Absolute lymphocytosis.
    2. Presence of smudge cells.
    D. Flow cytometry of the peripheral blood will show clonal population of B cells
  • Bone marrow biopsy—presence of infiltrating leukemic cells in bone marrow
42
Q

Chronic Myeloid Leukemia gene association ?

A
  • It is associated with translocation t(9,22).
  • The fusion of the BCR gene on chro-
    mosome 22 with the ABL1 gene on chromosome 9 results in the Philadelphia chromosome—present in more than 90% of patients.
43
Q

Standard drug in CML ?

A

Imatinib

44
Q

Polycythemia Vera ?

A
  • Malignant clonal proliferation of hematopoietic stem cells leading to excessive erythrocyte production.
  • Mutations in the JAK2 tyrosine kinase are found in >90% of polycythemia vera cases.
  • The increase in RBC mass occurs independent of erythropoietin.
45
Q

Symptoms of Polycythemia Vera ?

A
  1. Symptoms due to hyperviscosity: headache, dizziness, weakness, pruritus, visual impairment, dyspnea.
  2. Thrombotic phenomena—DVT, CVA, myocardial infarction, portal vein thrombosis.
  3. Bleeding—GI or genitourinary bleeding, ecchymoses, epistaxis.
  4. Splenomegaly, hepatomegaly.
  5. HTN.
46
Q

Diagnostic Criteria for Polycythemia Vera ?

A
  • Must have all three major criteria or any two major criteria plus any two minor criteria:
  • MAJOR criteria:
    1. Elevated RBC mass.
    2. Arterial oxygen saturation >92%.
    3. Splenomegaly.
  • MINOR criteria:
    1. Thrombocytosis.
    2. Leukocytosis.
    3. Leukocyte alkaline phosphate > 100.
    4. Serum vit B12 >900
47
Q

Multiple myeloma diagnosis criteria ?

A
  1. At least one of the CRAB symptoms.
  2. M-protein in either urine or serum.
  3. > 10% plasma cells in bone marrow.
48
Q

Hodgkin lymphoma might release cytokines that leads to ?

A

Minimal change disease.

1. AA my internal medicine (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions