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Hematology > Awesome Review > Flashcards

Awesome Review Flashcards

1
Q

Difference btwn MCV and RDW?

A

MCV- measure of RBC size
RDW- measure of variation of red cell size

Note: if RDW is high, it’s a mixed anemia

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2
Q

Bite Cell

A

G6PD deficiency

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3
Q

Too much Erythropoietin can cause what 4 major problems?

A

Lymphoma, VTE, CVA, HTN

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4
Q

Most sensitive assay for IDA

A

Serum Transferrin receptor level/log ferritin which is
Transferrin receptor index

> 2.0 is IDA

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5
Q 
IDA: 
Transferrin saturation 
Serum ferritin 
TIBC
Transferrin receptor index
A

Transferrin saturation 2.0

Note: transferrin saturation is also low in AOCD

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6
Q

What would you see on hemoglobin electrophoresis for beta thalassemia?

A

Increased A2 levels
Increased fetal Hgb levels
Must have Both!

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7
Q

How to diagnose alpha thalassemia?

A

DNA PCR analysis

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8
Q

What will you see on XRAY of hip for Avascular necrosis of femur head

A

Diffuse articular sclerosis and patches of decalcification

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9
Q

Treatment algorithm for acute chest syndrome in sickle cell anemia patient?

A

Abx
Oxygen
PRBCs
Exchange transfusion if still hypoxic!!

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10
Q

Diagnose and Treat a schoolteacher with anemia and arthalgias- Parvovirus B19

A

IgM Antibodies or PCR assay

Treat with IVIg

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11
Q

MC cause of osteomyelitis in Sickle Cell Disease

A

Salmonella

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12
Q

If MCV is > 110, what are you thinking?

A

Vitamin B12 deficiency

Folate deficiency

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13
Q

Difference btwn B12 and folate deficiency?

A

B12 deficiency will have both increased MMA and Increased Homocysteine

Folate deficiency will only have increased homocysteine

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14
Q

Metformin and PPI can cause what macrocytic anemia?

A

B12 deficiency due to decreased absorption of Vitamin B12

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15
Q

5 causes of folic acid deficiency

A 
Alcohol
Folic acid antagonist (MTX) 
OCP
Low dietary intake of folate 
Infection 
Celiac Sprue 
Dilantin/Phenytoin
Relative Folate deficiency (chronic hemolysis or hereditary spherocytosis)
Old 
Pregnancy
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16
Q

Treat Myelodysplastic Syndrome

A

If 55 yo, Azacitidine

If erythropoietin level > 500, antithymocyte globulin and cyclosporine
If 5q gene deletion or can’t tolerate antithymocyte globulin- Lenalidomide

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17
Q

Transferrin saturation is >45%

A

Hemochromatosis with HFE gene

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18
Q

Treat Aplastic Anemia

A

50 give antithymocyte globulin and cyclosporine
If can’t tolerate or doesn’t work, give
Alemtuzumab

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19
Q

Name 5 causes of Pancytopenia

A 
MDS
B12 deficiency
Fanconi Syndrome 
Viral hepatitis 
HIV
Hypersplenism 
Hairy cell Leukemia
Bactrim
Copper Deficiency
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20
Q

Name etiology of warm AIHA

A 
SLE
CLL
Lymphoma 
Methyldopa
PCN
Procainamide
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21
Q

Etiology of Cold AIHA

A 
Quinidine 
Lymphoma 
Infectious Mononucleosis
Influenza
Mycoplasma
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22
Q

Treatment of Warm AIHA

A 
Steroids 
Danazol
Rituximab 
Splenectomy
Immunosuppressive drugs
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23
Q

Treatment of Cold AIHA

A

Cyclophosamide
Chlorambucil
Rituximab
NOT STEROIDS

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24
Q

Diagnose and Treat Hereditary Spherocytosis

A

Osmotic Fragility Test

Tx: folate supplement or splenectomy in severe cases

25
Q

Screening and Specific Test for Hereditary Spherocytosis

A

Screening- fluorscent spot for G6PD activity in men

Specific- quantitative level of G6PD enzyme (but not during acute hemolysis)

26
Q

Name 4 conditions you see schistocytes

A

DIC
HUS
HELLP
TTP

27
Q

After massive blood transfusion, patient has seizure due to?

A

Citrate toxicity

28
Q

What causes acute hemolytic transfusion reaction?

A

ABO incompatibility

29
Q

What causes delayed Hemolytic transfusion reaction?

A

Rh incompatibility

2-10 days after transfusion

30
Q

Prevent febrile nonhemolytic transfusion reaction, give what kind of PRBC

A

Leukoreduced (remove contaminating WBCs)

31
Q

Give what kind of PRBC if IgA deficiency

A

Washed (removes protein)

Especially if urticaria and recurrent allergic reaction

32
Q

Etiology for Transfusions Related Acute Lung Injury

A

Anti leukocyte antibody from donor

Stop donating!

33
Q

Etiology and treatment of

Post transfusion Purpura

A

PLA-1 Antibodies

Tx: IVIg

34
Q

What primary hemostasis disorder gas giant platelets?

A

Bernard Soulier disease

Normal PTT

35
Q

Diagnose VonWilibrand Disease

A

Decreased Ristocetin factor assay
Increased bleeding time
Increased PTT

36
Q

Treat VonWilibrand Disease

A

Mild- DDAVP

Severe- factor 7 concentrate contains vWD

37
Q

Treatment for Idiopathic/Immune Thrombocytopenic Purpura

A

If bleeding or platelet

38
Q

You need to anticoagulate someone with HIT

A

Argatoban or Bilavirudin

Direct thrombin inhibitor

39
Q

How to determine factor 13 deficiency?

A

Clot Retraction Test

40
Q

What are the Factor Xa inhibitors?

A

Rivaroxaban
Apixaban
Fondaparinux
Edoxaban

41
Q

What are Low Molecular Weight Heparin?

A

Dalteparin
Enoxaparin
Tinzaparin

(Inhibit thrombin and Xa)

42
Q

What are direct thrombin Inhibitors?

A

Hirudin, bivalirudin, lepirudin, desirudin
Argatroban
Dabigratan

43
Q

Russel Viper Venom Time Test for..?

A

Lupus anticoagulant syndrome

44
Q

How long do you treat provoked cause of DVT or post surgically?
How long do you treat Leiden factor V defect or protein C deficiency DVT?

A

3 months

6 months

45
Q

Cause of Warfarin Skin Necrosis

How to treat?

A

Protein C deficiency

FFP

46
Q

Treat Polycythemia Vera

A

Low dose Aspirin with phlebotomy to get Hct 60, give hydroxyurea
Or consider Ruxolitinib (JAK2 inhibitor)

47
Q

In Essential Thrombocytosis,

What are the 2 associated mutations?

A

JAK2

CALR

48
Q

Diagnose CML

A

FISH for t(9:22)
Or
PCR analysis for abl/bcr fusion gene

49
Q

3 diseases you see decreased leukocyte alkaline phosphatase

A

CML
PNH
Wilson’s disease

50
Q

Long standing history of PV

Blood smear is tear drop cells, uncleared RBC, giant platelets

A

Myelofibrosis

51
Q

Translocation and treatment of

Acute Promyelocytic leukemia

A

T(15:17)
Auer rods!
Tx: All trans retinoic acid and arsenic trioxide

52
Q

Signs/Symptoms and Treatment of ATRA differentiation syndrome

A

ATRA- all trans retinoic acid
Dyspnea, pulmonary infiltrate, fever, weight gain, hypotension

Give Dexamethasone

53
Q

Mutation for Hairy Cell Leukemia

A

BRAF V600E

54
Q

What ethnicity is common in alpha thalassemia?

A

SE Asia like Vietnam, Cambodia, Laos

55
Q

What ethnicity is common in beta thalassemia?

A

Mediterranean/Asian like Italian, Greek, Indian

56
Q

Spurr cell OR acanthocyte

A

Liver Disease

57
Q

Burr Cell OR Echinocyte

A

Anemia of Uremia

58
Q

Smear shows Tear Drop, nucleated RBC and giant platelets

A

Myelofibrosis

59
Q

Side Effect of Lenalidomide

A

VTE/PE

Hematology (1 decks)

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