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Internal Medicine > Deja - Internal - Hematology > Flashcards

Deja - Internal - Hematology Flashcards

1
Q

5 Macrocytic anemias:

A 
B12
Folate
Alcoholism
Hypothyroidism
Liver disease
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2
Q

6 Normocytic anemias:

A 
Chronic disease
Renal failure
Aplastic anemia
Spherocytosis
Autoimmune destruction
Mechanical obstruction
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3
Q

Symptoms of iron def. anemia:

A
  1. Pallor
  2. Tachycardia
  3. Easy fatigability
  4. Pica
  5. Esophageal webs
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4
Q

Triad of Plummer-Vinson:

A
  1. Microcytosis
  2. Atrophic glossitis
  3. Esophageal webs
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5
Q

Drugs that commonly cause sideroblastic anemia:

A
  1. INH.
  2. Chloramphenicol
  3. Cu chelators
  4. Lead
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6
Q

Some other causes of sideroblastic anemia?

A
  1. Alcoholism.

2. Heredity.

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7
Q

How is sideroblastic anemia diagnosed?

A

Iron stain of bone marrow shows ringed sideroblasts with Prussian blue stain.

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8
Q

What can intravascular hemolysis lead to in children?

A

“Pigment” gallstones.

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9
Q

How is pernicious anemia diagnosed?

A
  1. UP MMA.
  2. UP homocysteine levels.
  3. Atrophic gastritis on gastroscopy.
  4. Abnormal Schilling test (not used as much any more).
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10
Q

What is the MCC of folate deficiency?

A

Hypoalimentation.

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11
Q

What are other causes of folate deficiency?

A
  1. Pregnancy.
  2. Tropical sprue.
  3. Hemolytic anemia.
  4. Long-term treatment with TMP-SMX.
  5. Methotrexate use.
  6. 5-flourouricil use.
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12
Q

Folate deficiency in pregnancy?

A

Neural tube defects in the developing fetus.

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13
Q

How can the diagnosis of folate deficiency be differentiated from that of B12?

A

Normal MMA and NO neurologic symptoms in folate.

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14
Q

6 etiologies of aplastic anemia:

A
  1. Parvo B19 in SCA.
  2. Hepatitis.
  3. Chloramphenicol.
  4. Benzene.
  5. Radiation therapy.
  6. Idiopathic.
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15
Q

How is aplastic anemia diagnosed?

A
  1. Normocytic, normochromic pancytopenia.

2. Hypocellular bone marrow in a bone marrow biopsy.

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16
Q

What can trigger an attack in a patient with G6PD deficiency?

A
  1. Infection.
  2. Fava beans.
  3. Dapsone.
  4. Sulfa drugs.
  5. Primaquine.
  6. NSAIDs.
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17
Q

Heinz bodies of G6PD def.?

A

Inclusions within RBCs made of denatured Hb.

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18
Q

What 2 infections are associated with cold autoimmune hemolytic anemia?

A
  1. Mycoplasma pneumonia.

2. Mononucleosis.

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19
Q

Platelet <50.000:

A

Increased RISK for bleeding.

20
Q

Platelet <20.000:

A

Significant bleeding begins.

21
Q

Platelet <10.000:

A

Patient at risk for an intracranial bleeding.

22
Q

ALL - Which subtype is more common in children?

A

80% are L1.

23
Q

Of the adult cases of ALL, what subtype is most common?

24
Q

What is the L3 subtype morphologically identical?

A

Burkitt lymphoma.

25
Q

How is ALL diagnosed?

A

Peripheral blood smear with increased blast cells and TdT+, PAS+, CALLA+.

26
Q

Prognosis of ALL in children:

A

80% remission.

27
Q

Prognosis of ALL in adults:

A

30% remission.

28
Q

Subtypes of AML:

A 
M1-M7.
M1-M3: Granulocytic differentiation.
M4-M5: Monocytic precursors.
M6: Erythroblasts.
M7: Megakaryocytes.
29
Q

What hematologic disorder is the M3 subtype associated with?

30
Q

Prognosis of AML in adults:

A

Those younger than age 60 have about a 70-80% remission rate.

31
Q

What are the unique signs and symptoms of CML?

A
  1. Abdominal pain/fullness.
  2. Anorexia.
  3. Diaphoresis.
  4. Bone pain.
32
Q

Different phases of CML:

A
  1. Chronic phase: HSM and increase in WBCs.
  2. Accelerated phase: Platelet and RBC decrease while patient develops symptoms of night sweats, fever, bone pain, and weight loss.
  3. Blastic phase: Acute phase of the disease. Blood and marrow are rapidly filled with proliferating blasts.
33
Q

Blast crisis:

A

Acute phase of the disease in which the blood and marrow are rapidly filled with proliferating blast cells.
–> Takes about 3-4yrs to develop and death is usually within 3-6months.

34
Q

Prognosis after a bone transplant in CML?

A

About 60% of patients go into remission.

35
Q

What can CML progress to?

36
Q

Treatment for hairy cell leukemia?

A
  1. IFN-alpha.

2. Splenectomy.

37
Q

Lymphoma - Can involve the GI tract as well as the head and neck?

38
Q

Lymphoma - Can involve the CNS and bone marrow:

A

Lymphoblastic lymphoma.

39
Q

Lymphoma - Derived from thymic T cells?

A

Lymphoblastic lymphoma.

40
Q

What can the myeloproliferative diseases transform into?

A

Acute leukemias.

41
Q

Possible long-term complication that occurs in about 20% of patients with polycythemia vera?

A

Fibrosis of the bone marrow.

42
Q

Classical signs-symptoms of essential thrombocytosis?

A
  1. Burning and throbbing hands and feet as well as splenomegaly.
  2. Bleeding from nose and gums due to platelet dysfunction.
43
Q

Idiopathic myelofibrosis?

A

Disorder in which there is extensive extramedullary hematopoiesis causing replacement of marrow with fibrous connective tissue.

44
Q

What is the pathogmononic sign of myelofibrosis?

A

Peripheral smear shows tear drops.

45
Q

What is the ratio of white to African Americans who have multiple myeloma?

46
Q

What is the triad that is often seen in MM?

A
  1. Anemia.
  2. Back pain.
  3. Renal failure.
47
Q

5 Microcytic anemias:

A

LISTS

Lead poisoning
Iron def.
Sideroblastic
Thalassemias
SCA

Internal Medicine (107 decks)

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