Anemia

Question 1

Anemia w/ increased haptoglobin & indirect bilirubin + history of trauma

Answer 1

hemolytic anemia

Question 2

AR mut causing Val –>glut resutling in a Bglobin mutation Dx? Tx?

Answer 2

Sickle Cell Anemia, tx w/ folate + Fe to support RBCs

Or HYDROXYUREA

Question 3

Tx of SS Crisis

Answer 3

IVF, O2, Anaglesia + EXCHANGE transfusion

Question 4

XLR, Bite Cells, Heinz Bodies

Answer 4

G6PD def

Question 5

AD mutation in spectrin , snkyrin cauing spherocytes

Dx? best test to Dx? Tx?

Answer 5

Hereditary spherocytosis, best test is osmotic fragility test

Tx w/ folate 4 support or splectomy if bad

Question 6

mut GPI anchor, morning hematuria. Dx? Tx?

Answer 6

Paraoxymal Nocturnal Hematuria

Tx w/ anti-ab drug = Eculizmab

Question 7

Microcytic Anemias

Answer 7

TAILS: thalassemia, Anemia of Chronic Dx, Iron def, Lead pois, Siderblastic

Question 8

Thalassemia
Mut?
dx?
tx?

Answer 8

microcytic anemia due to mutation in HEMOGLOBIN causing target cells, normal Fe studies
Dx: hemoglobin electrophoresis
tx: if minor = nothin, if major = transfuse*

**watch for Fe overload! tx w/deferoxamine

Question 9

Anemia of Chronic Dz

Labs? tx?

Answer 9

long standing inflammation causes body to store away Fe
decreased TIBC, increased Ferritin, decreased Fe

Tx: EPO + stop dz

Question 10

Iron Def Anemia

Labs? Tx?

Answer 10

slow bleeds(polyps, hemorroids, cancer, menorrhaga)
Labs: increased TIBC, Dec Ferritin, dec iron

*takes 6 wees to replace serum Fe & 6 m to replace stores

Question 11

Siderblastic Anemia
Mut?
dx?
tx?

Answer 11

1. acquired fucked up heme(lead, etoh, isoniazid, B6 def, AML) or 2. mutation in XL ALAS

Labs: normal Fe, Norm TIBC, incrase Fe
Tx: give B6(isoniazid) & BM Bx for cancer

Question 12

Folate def

how long before you see this?

Answer 12

3-6 wks, see in ppl who dont eat green leafy veggies or alcoholics
labs: increase in homocystine

Question 13

B12 def

how long before you see this? labs?

Answer 13

3-10 yrs

increased methamalonic acid & homocystine

Question 14

Old person w/lytic lesions, hypercalcemia, & non-tramatic fractures

Dx? how to dx? Tx?

Answer 14

Multiple Myeloma
Dx: Hgb w/Spep+ Mspike & +Upep
Tx: Melphalan + prenisone or Thalidomide or Bortezomib
if <70 + donor = transplant

Question 15

+Spep but no other symptoms

dx? tx?

Answer 15

Monoclonal Gammopathy of Uncertin shit, jsut watch! may progress to MM

Question 16

old person w/peripheral neuropathy, hyperviscosity +Spep

dx? tx?

Answer 16

Waldenstrom’s Macroglobulinemia = plasmacells make IgM(pentamer) = causing hypervisc

Tx: rituximab

Question 17

ITP vs TTP

Tx for both?

Answer 17

Both: decreased platelets,+schistocytes
**FAT RN: Fever, Anemia, thrombocytopenia, Renal Failure, Neuro sx
TTP: Hyaline clots due to ADAMS13 mutation(VWF protease)
ITP: idiopathic

Tx: IV Ig if ITP & Exchange Transfusion for TTP