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Hem/Onc > Exam 1: Must know > Flashcards

Exam 1: Must know Flashcards

1
Q

What is considered severe aplastic anemia? (want lab values)

A

Neutrophils: (ANC) less than 500

Platelets less than 20K

Retic (ARC) less than 60K

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2
Q

What is considered VERY severe aplastic anemia? (want lab values)

A

Neutrophils: (ANC) less than 200

Platelets less than 20K

Retic (ARC) less than 60K

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3
Q

What are the SE of Epoetin / Darbepoetin? What is the CI?

A

HTN and thrombosis

uncontrolled HTN

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4
Q

What is the most form of inherited sideroblastic anemia?

A

x-linked

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5
Q

What are some common ways for acquired sideroblastic anemia? What syndrome is it associated with?

A

Often part of a general myelodysplastic syndrome

Chronic alcoholism
Lead poisoning
Copper deficiency
Chronic infection/inflammation
Medications - mostly antimicrobials
isoniazid, linezolid, chloramphenicol

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6
Q

What does erythroid hyperplasia indicate?

A

ineffective erythropoiesis

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7
Q

You must order ____ to diagnosis sideroblastic anemia

A

bone marrow aspirate

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8
Q

What are the ringed sideroblasts made up of?

A

erythroid cells with IRON deposits in mitochondria encircling the nucleus

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9
Q

What is the MC cause of anemia worldwide?

A

Iron deficiency anemia

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10
Q

What is Plummer-Vinson Syndrome? What is it associated with?

A

esophageal webs leading to dysphagia

iron deficiency anemia

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11
Q

What is the recommended oral iron replacement dose? What is the alternative?

A

Ferrous sulfate 325 mg orally three times per day on an empty stomach

Ferrous gluconate

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12
Q

When would you want to give parenteral iron?

A

If pt cannot tolerate or absorb oral iron, or anemia is refractory to it

Hx of bariatric surgery, GI malabsorption

May also be used for late-stage renal disease, later in pregnancy

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13
Q

Name a way you can differentiate Iron def. anemia from anemia of chronic disease

A

iron def anemia: ferritin is DECREASED

anemia of chronic disease: ferritin is normal or INCREASED

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14
Q

What is the anemia of endocrine disorders caused by?

A

Decreased EPO secretion → normocytic, normochromic anemia

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15
Q

What is anemia of chronic liver disease caused by?

A

Cholesterol deposits in RBC membrane → shortened RBC survival and inadequate EPO secretion to compensate

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16
Q

What is anemia of starvation caused by?

A

Decreased protein intake → decreased metabolism → decreased EPO

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17
Q

What is anemia of the elderly caused by?

A

resistance to EPO, decreased EPO secretion, and chronic low-level inflammation

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18
Q

____ is the cyanide anitdote

A

Hydroxocobalamin

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19
Q

When can you use oral B12 therapy?

A

May use oral or sublingual B12 if mild (Hgb >8) and no neuro s/s, or for maintenance
and if absorption is adequate orally

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20
Q

What is the MC of folic acid deficiency?

A

Anorexia, alcoholism, no fruits/vegetables, overcooked fruits/vegetables

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21
Q

What is the classic difference between B12 and folate def?

A

B12 will have NUERO s/s and folate will not

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22
Q

When will B12 and folate deficiency begin to respond to treatment?

A

retic: 1 week
CBC: approx. 2 months

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23
Q

______ excessive production of all hematopoietic cells, especially RBCs

A

Polycythemia vera

24
Q

_____ excessive platelet production

A

essential thrombocytosis

25
Q

_____ excessive production of collagen or fibrous tissue in the marrow

A

myelofibrosis

26
Q

_____ excessive production of granulocytes

A

Chronic myelogenous leukemia (CML)

27
Q

In what condition does the patient have ruddy facial features?

A

polycythemia vera

28
Q

What is the classic traid of hemochromatosis?

A

hyperpigmentation, DM, cirrhosis

29
Q

What is the most common x-Linked genetic disease?

A

Hemophilia A

30
Q

Should give hemophilia patients ____ for mild pain relief

A

Celebrex

31
Q

____ is the most common inherited bleeding disorder

A

vWD

32
Q

What are the platelets counts associated with bleeding risks?

A

<10,000 = spontaneous hemorrhage
<50,000 = increased bleeding during invasive procedures and in trauma (non-CNS)
<100,000 = increased bleeding/complications during invasive procedures in closed spaces (CNS, eye)

33
Q

You have a pt with ITP, when is it necessary to start pharmcotherapy?

A

Severe thrombocytopenia (platelets <10,000/microL) with signs of substantial cutaneous bleeding

Moderate thrombocytopenia (platelets <20,000/microL) with mucosal bleeding

Past or anticipated factors that increase bleeding risk (such as recent head trauma)

34
Q

You have a pt with ITP, when do they need to go the hospital?

A

Patients with major bleeding or very severe thrombocytopenia (<10,000) should be admitted to the hospital for management/monitoring

35
Q

When is a splenectomy indicated for a pt with ITP?

A

thrombocytopenia persists for 6 months or more with medical therapy

35
Q

qualitative PLT disorders manifest as _____

A

mucous membrane bleeding

36
Q

How do you stop the bleeding caused by qualitative plt disorders?

A

transfusion of normal donor platelets

37
Q

severe deficiency of enzyme ADAMTS13 molecule what disease are you thinking?

A

Thrombotic Thrombocytopenic Purpura

38
Q

What is the role of ADAMTS13?

A

breaks down vWF when it is no longer needed

aka small blood clots form more frequently

39
Q

____ is the most common cause of acute renal failure in children

A

HUS

40
Q

_____ is the most common cause of inherited thrombophilia, accounting for 40 to 50 percent of cases

A

Factor V Leiden

41
Q

____ pts are at risk for warfarin-induced skin necrosis. What is the treatment?

A

Protein C deficiency

stop warfarin, start vit K, heparin and protein C concentrate/FFP

42
Q

The probability of a DVT Wells score, what is high?

A

3 or greater
moderate: 1-2
low: 0 or less

43
Q

The probability of a PE Wells score, what is high?

A

hight is greater than 4
low: 0-4

44
Q

_____ you cannot use if the CrCl >95`

A

Savaysa

45
Q

What DOACs should if you avoid if your patient LOVES grapefruits juice?

A

Eliquis and Xarelto

46
Q

What are the dosing instructions for a pt who is on ASA and NSAIDs at the same time?

A

take ASA 60 minutes before or 8 hours after taking NSAIDs

47
Q

Name all the IRREVERSIBLE P2Y12

A

Plavix
Effient
Ticlid

48
Q

Is ASA reversible or irreversible?

A

irreversible

49
Q

Do not give ___ and omeprazole together

A

Plavix

50
Q

What are the CI of Effient?

A

Hx of TIA or CVA

51
Q

What is the major SE of Ticlid?

A

life threating hematologic reaction

must monitor CBC every 2 weeks for the first 3 months

52
Q

What are the REVERSIBLE P2Y12 medications?

A

Brilinta: Ticagrelor
Kengreal: cangrelor

53
Q

What is a major SE shown in clinical trials with Brilinta?

A

dypsnea

54
Q

What is the BBW with Brilinta?

A

CI when taking ASA 100mg or higher daily

55
Q

____ is the IV only form of P2Y12 class of medication.

A

Kengreal : Cangrelor

normally found in the cath lab

56
Q
A

Hem/Onc (14 decks)

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