Clinical Flashcards
What is the normal range for the Hb levels in the serum?
12.5-15.5 g/dL
What is the inital test used to evaluate anemia?
CBC
What is the most common type of anemia?
Microcytic anemia
What are the 3 main causes of hypochromic microcytic anmeia?
Iron deficiency
Thalassemias
Anemia of chronic disease
Blood loss, increased requirement, and decreased absorption can lead to a deficiency in what ion?
Fe
What is the inital test for the screening of Fe deficiency?
Serum ferritin test
Under what serum ferritin levels shows a deficiency?
< 15 ng/mL
How long do u have to treat Fe deficiency with ferrous sulfate?
6 months
takes 6 weeks to correct the Sx
Iron dextran with HMW dextran, Iron dextran with LMW dextran, iron sucrose, and ferric gluconate are all IV forms of iron and are used in which pts?
Dialysis or inability to take oral iron
Which Hb levels are increased in B-thalassemia?
HbA2
What is the deficiency if there is microcytic anemia and purpura, with classic GINGIVAL disease and peipheral edema?
Vit C
Scurvy
What is the test performed to exclude hemolysis in the evaluation of normochromic normocytic anemia?
Reticulocyte count
Which lab test differentiates iron deficiency anemia from anemia of chronic disease?
Transferrin levels (usually ↑ in Fe deficiency)
Which 3 pts can u use EPO in the treatment regimen?
Anemia from neoplastic agents
Anemia from renal insufficiency
Anemia due to HIV in pts who are taking zidovudine
In which pts is EPO ineffective?
Anemia due to iron deficiency, B12 deficiency, or another correctable cause.
What are the main complications with EPO use?
HTN in dialysis pts
Thrombosis (MI or stroke)
Cancer progression (if the cancer pt isnt receiving chemo)
Since transfusion therapy can ↑ the risk of aplastic anemia, what must u select for teh transfusions to pts?
NONrelated donors with CMV-, leukocyte poor, and single donor
After what age can u start to use immunosuppression in the treatment of aplastic anemia?
40
What must u have to get a bone marrow transplant in the Tx of aplastic anemia?
Syngenetic (identical) twin
What are the 3 diseases assocaited with basophilic stippling?
Thalassemias
Anemia of chronic diesease
Lead poisoning
“BASte the ox TAiL”
What are the 3 diseases assocaited with hypochromia?
Thalassemia, sideroblastic anemia, lead poisoning
What are the 4 diseases assocaited with target cells?
HcC disease
Asplenia
Liver disease
Thallassemia
(“HALT” said the hunter to his TARGET)
Chronic liver disease, abetaproteinemia, malabsorption, and anorexia nervosa can lead to what RBC morphology?
Spur cells (Acanthocytes)
What is the disease aassciated with Burr cells?
Uremia
What ist eh disease assocaited with heinz bodies?
G6PD deficicency
What are the 2 associated diseases for Howell-Jolly bodies?
Hyposplenism
Megaloblastic anemia
Which is ht eonly form of hemolytic anemia that may be treated with corticosteroids?
idiopathic autoimmune hemolytic anemia
What are the 2 drugs used for the treatment of PNH?
Prednisone
Eculizumab (did u know this is the world most expensive medication? it costs $400,000/year to be on it)
What is the survival rate of TTP with and without treatment?
Without- 90% mortality
With- 70-80% survival rate
What drugs has been shown to decrease the frequency of painful vaso-occlusive crises in sickle cell?
Hydroxyurea
If the sickle cell pt has had a stroke and recurrent acute chest syndrome, what are the 2 curative treatmetns for sickle cell disease?
Hematopoietic stem cell transplant w/marrow
Umbilical cord blood from HLA-identical siblings
What is teh most commonc ause of death in sickle cell disease?
Acute chest syndrome
What is the problem with transfusions in AIDS?
decrease the risk of durvival and increased risk of CMV infections
What is the 2nd most common assocaited malignancy in AIDS?
Non-hodgkins lymphoma
kaposi sarcoma is #1
How do u exclude the Dx of pseudothrombocytopenia?
Collect the specimen in citrate and do a peripheral blood smear
What is the DOC for the intial treatment of ITP?
Prednisone
What is teh treatment of ITP with severe bleeding?
IVIG and platelets
What is the treatment of steroid-refractory ITP?
Splenectomy
What is the main problem with Protein S deficiency?
Recurrent venous thrombosis
Which deficiency (C or S) is tehre a potential risk for warfarin necrosis in the longterm treatment?
Protein C deficiency
What is the msot common gene affected in herediatry hemochromatosis?
HFE gene
