final lecture 2

Question 1

filgrastim name brand

Answer 1

neupogen

Question 2

filgrastim

Answer 2

G-CSF 5mcg.kg.day until ANC>10,000

Question 3

pegfilgrastim name brand

Answer 3

neulasta

Question 4

pegfilgrastim

Answer 4

G-CSF 6mg once

Question 5

Sargramostim name brand

Answer 5

leukine

Question 6

sargramostim

Answer 6

GM-CSF 250 mcg/m^2/day until ANC>1500

Question 7

high risk pts who may benefit from CSFs in neutropenia

Answer 7

neutropenia >10 days
ANC65
infectious complications
pts hospitalized at time of neutropenic fever

Question 8

ITP has ___ correlation with platelet count

Answer 8

lack of

Question 9

when to treat ITP

Answer 9

when pt is symptomatic
plts<30,000
consider when plts 30,000-50,000 & HTN, older age, or risk of trauma

Question 10

goal of ITP treatment

Answer 10

safe plt count, not normal plt count

Question 11

first line ITP management

Answer 11

corticosteroids
IVIG
anti-D
* only w/ intact spleen

Question 12

second line ITP management

Answer 12

splectomy, rituximab, romiplostim, eltrombopag

Question 13

corticosteroids in ITP

Answer 13

prednisone, dexamethasone, HD methylprednisolone

Question 14

IVIG doses in ITP

Answer 14

children: 0.8-1g/kg single infusion
adults: 1g/kg/day for 2 days

Question 15

IVIG MOA

Answer 15

block Fc receptor on macrophages; competitive inhibition of autoantibody

Question 16

IVIG black box warning

Answer 16

nephrotoxicity

Question 17

anti-Rh(D) in ITP

Answer 17

may delay/remove need for splenectomy
used in Rh+ pts only
50-75mcg/kg infused once over 5-10 min

Question 18

anti-Rh(D) MOA

Answer 18

binds to erythrocyte D antigen-> immune mediated clearance of erythrocytes; Fc

Question 19

anti-Rh(D) can cause

Answer 19

hemolysis

Question 20

immunizations needed before splenectomy

Answer 20

2 wees prior to surgery

H. influenzae B, meningococcal, pneumococcal

Question 21

rituximab brand name

Answer 21

rituxan

Question 22

rituximab

Answer 22

anti-CD20; inhibits autoantibody production

Question 23

TPO mimetics

Answer 23

romiplostim, eltrobopag

temp maintenance therapy

Question 24

romiplostim brand name

Answer 24

NPlate

Question 25

Eltrombopag brand name

Answer 25

Promacta

Question 26

romiplostim

Answer 26

1mcg/kg SQ once/wk
plts>50,000
monitor weekly CBC

Question 27

etrombopag

Answer 27

50mg PO qd

plts>50,000

Question 28

etrombopag black box warning

Answer 28

hepatotoxicity