CIS, cumulative Part I Flashcards
most common type anemia encountered clinically
diminished/decreased red cell production
4 y.o M with fever and dry cough petechial hemorrhages on chest and around eyes suspect thrombocytopenia and order CBC most likely Dx? -Bernard Soulier -ALL-B -DLBCL -Hereditary spheorocytosis -Acute ITP
dDx
ALL-B
Acute ITP
4 y.o M with fever and dry cough petechial hemorrhages on chest and around eyes suspect thrombocytopenia and order CBC shows lymphocytosis low platelets and mild splenomegaly most likely Dx? -Bernard Soulier -ALL-B -DLBCL -Hereditary spheorocytosis -Acute ITP
ALL-B
What is indicated for ALL-B
- platelet adhesion study
- serum ferritin
- Hb electrophoresis
- osmotic fragility testing- red cells
- Haptoglobin
- karyotyping
- bone marrow aspirate and biopsy
- flow cytometry
- myeloperoxidase study
- white cell differential
white cell differential karyotyping bone marrow aspirate and biopsy flow cytometry myeloperoxidase
myeloperoxidase study in peripheral blood is looking for what
AML
what are examples of flow cytometry
tdt, CD markers etc
45 y.o M dysphagia, focally cystic mass in L neck 7.5 cm mass extending midline of upper thorax reasonable on ddx? -thyroid carcinoma -thymoma -DLBCL -hodgkin lymphoma -germ cell tumor
All of those
45 y.o M dysphagia, focally cystic mass in L neck
7.5 cm mass extending midline of upper thorax
biopsies show unremarkable thymic cortical and medullary regions
best dx?
-thymoma
-malignant thymoma
-squamous cell carcinoma
-graves
-germ cell tumor
thymoma
thymoma has been associated with
- cushing
- myasthenia gravis
- pure red cell aplasia
- graves
- pernicious anemia
myasthenia gravis
all of them really
22 y.o M in MVA, 15 min later heli massive gliding abrasions down to bone near total amputation of distal third of R leg, semi conscious, tachy, pale low BP intubated and urinary bladder inserted no output observed CBC included most likley: -slightly dec Hct -increased MCV -Increased RDW -Leukocytosis -Reticulocytosis
slightly dec Hct
14 y.o female with low grade fever, anemia and splenomegaly juandice most likely -chronic blood loss -sickle cell disease -beta thalassemia -hereditoary spherocytosis -parvovirusB19
hereditary spherocytosis
14 y.o female with low grade fever, anemia and splenomegaly juandice absolute lymphocytosis suffer aplastic crisis transfused, weks later has colicky abdominal pain splenectomy and cholecytectomy caliculi from GB are most likley -calcium oxalate -triple ammonium phosphate -bilirubin/heme metabolites -uric acid -aggregates of Salmonella sp
bilirubin/heme
struvite stones, triple ammonium phosphate assoc with
infections
splenectomy more increased risk for infection with what
encapsulated bacteria
11 y.o F sore throat and fever, purulent cough
improves with antibiotics but 3 days later tired and listless
peripheral smear shows bite cell with heinz bodies
most likely Dx?
assoc with?
G6PD
oxidant stress
52 y.o M with low Hb RDW 19% high platelet
constipation abdominal pain, weakness, malaise
general pallor with pale conjunctiva
best characterized as?
chronic blood loss anemia
52 y.o M with low Hb RDW 19% high platelet
constipation abdominal pain, weakness, malaise
general pallor with pale conjunctiva
small liver peptide has significant role in terms iron absorption in this disorder
what is the peptide
-haptoglobin
-hepcidin
-ferritin
-transferrin
-intrinsic factor
hepcidin
52 y.o M with low Hb RDW 19% high platelet constipation abdominal pain, weakness, malaise general pallor with pale conjunctiva most likely? -low serum ferritin -high transferrin saturation -low TIBC depleted hepcidin levels -hemochromatosis
low serum ferritin
52 y.o M with low Hb RDW 19% high platelet constipation abdominal pain, weakness, malaise general pallor with pale conjunctiva which etiology is most likely -manopause -aplastic anemia -plasma cell dyscrasia -adenocarcinoma of colon -squamous cell carcinoma of lung
adenocarcinoma of colon
42 y.o japanese F
mother had RA. she has low fever with painful swollen joints especially at articulations
RF+ and erosive arthritis
several lung lesions with granulomatous inflammation
normocytic normochromic anemia
most likely?
-early iron deficiency anemia
-anemia of chronic disease
-hemolytic anemia precipitated by seropositive spondyloarthropathy
-superimposition of myelodysplastic syndrome
-chronic blood loss anemia
anemia of chronic disease
myelodysplasias are characterized by what generally
cytopenias
RA anemia of chronic disease most likely? - dec haptoglobin lebels -dec hepcidin levels -increased TIBC -high serum ferritin level -high serum iron/low storage iron (marrow)
high serum ferritin
RA anemia of chronic disease most likely pathogenesis? decreased hepcidin inflammatory mediator IL6 increase CRP hight EPO level high TIBC
inflammatory mediator IL6
42 y.o japanese F mother had RA. she has low fever with painful swollen joints especially at articulations RF+ and erosive arthritis several lung lesions with granulomatous inflammation what explains lung? -concomitant TB -sarcoidosis -syphilis -RA -bronchopulmonary aspergillosis -MAI in an immunocompromised patient
RA