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Family Medicine Shelf > Blood Disorders > Flashcards

Blood Disorders Flashcards

1
Q

Which type of anemia has low MCV, low ferritin, and increased TIBC (transferrin)?

A

Iron deficiency

“We’re running out of ferries because we have no iron”

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2
Q

Which type of anemia has low MCV, high/normal ferritin, and decreased TIBC (transferrin)?

A

Anemia of chronic disease

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3
Q

What’s a blood side effect from TMP-SMX?

A

Thrombocytopenia

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4
Q

What are some causes of low platelets?

A
  1. Heparin, TMP-SMX
  2. Infex
  3. B12/folate deficiency
  4. Pregnancy
  5. ITP
  6. Hypersplenism
  7. DIC
  8. TTP/HUS
  9. Malignancy
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5
Q

What’s the diff between TTP/HUS and ITP?

A

TTP has altered mental status

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6
Q

When is thrombocytopenia severe?

A

If less than 50,000

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7
Q

What are the 3 categories of hyponatremia?

A
  1. Hypovolemic
  2. Euvolemic
  3. Hypervolemic
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8
Q

What category of hyponatremia is from diuretics, dermal losses, GI losses, pancreatitis, and hyperaldosteronism?

A

Hypovolemic

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9
Q

What category of hyponatremia is from SIADH, pregnancy, hypothyroidism, or primary polydipsia?

A

Euvolemic

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10
Q

What category of hyponatremia is from acute HF or cirrhosis?

A

Hypervolemic

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11
Q

What is pseudohyponatremia?

A

Hyperglycemia, elevated lipids, high serum protein

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12
Q

What could be causing the symptoms of nausea, headache, confusion, malaise/weakness, seizures, and coma?

A

Hyponatremia

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13
Q

What could cause a urine osmolality greater than 100?

A

ADH release

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14
Q

In true hyponatremia, what’s the serum osmolality level?

A

Low

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15
Q

What can happen when you go from low to high?

A

The pons will die (osmotic demyelination syndrome)

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16
Q

What’s the goal increase in sodium correction in 24h?

A

8mEq in 24h

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17
Q

What’s the calculation for sodium correction in hyponatremia?

A

(Fluid Na-Serum Na)/(TBW+1)

18
Q

What’s TBW in males?

A

60% of weight

19
Q

What’s TBW in females?

A

50% of weight

20
Q

What’s the treatment for SIADH?

A

Fluid restriction, salt tablets, tolvaptan

21
Q

What might cause hypernatremia?

A

Sweat, GI losses, diabetes insipidus, osmotic diuresis

22
Q

What does a urine osmolality of 600+ indicate?

A

Hypernatremia

23
Q

What urine osmolality threshold applies to diabetes insipidus?

A

Less than 300

24
Q

What 2 populations are more likely to get hypernatremia because they cannot manage their fluid intake as well?

A
  1. Very young

2. Very old

25
Q

What’s the goal amount of decreasing Na in correcting hypernatremia (per day)?

A

No more than 10mEq per day

26
Q

How do you calculate the total water deficit?

A

Water deficit = TBW x [(Serum Na/140)-1]

27
Q

How do you calculate the rate of water correction for hypernatremia?

A

Rate of correction = Water deficit x [10mEq/(Serum Na-140)]

28
Q

What can cause hypokalemia?

A
  1. Alkalosis
  2. Hypothermia
  3. GI losses
  4. Renal losses
  5. Vol replacement with low K
  6. Insulin
  7. Low magnesium
29
Q

What EKG changes are present in hypokalemia (3)?

A

Flattened T waves, U waves, QT prolongation

30
Q

How do you differentiate between renal and non-renal causes of hypokalemia?

A

24-hour urine potassium:

<20: nonrenal
>20: renal

31
Q

Is oral or IV potassium replacement preferred unless K<2.5?

A

Oral

32
Q

What can cause hyperkalemia?

A
  1. Acidosis
  2. Exercise
  3. DKA
  4. Kidney failure
  5. K-sparing diuretics
  6. ACEi
  7. NSAIDs
  8. Hypoaldosteronism
  9. False elevation (hemolysis of blood in tube)
33
Q

Does hyperkalemia cause tachy or bradycardia?

A

Bradycardia

34
Q

What 4 EKG changes can occur due to hyperkalemia?

A
  1. Peaked T waves
  2. Lengthened PR
  3. QRS widening
  4. Sine wave pattern
35
Q

How can you remove potassium from the body?

A

Kayexalate, loop diuretics, or dialysis; stabilize the heart with calcium gluconate

36
Q

What is ADAMST13 associated with?

A

TTP

37
Q

What diagnosis does fibrinogen level help with?

A

DIC

38
Q

What infex can cause HUS?

A

Shiga toxin (STEC)

39
Q

Does ITP have schistocytes on peripheral smear?

A

No

40
Q

What’s the difference between TTP and HUS?

A

HUS has kidney damage

41
Q

What’s the first step of treating hyperkalemia?

A

Calcium gluconate

Family Medicine Shelf (16 decks)

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