Hem/Onc Flashcards
What is the diagnostic criteria for HSP?
Palpable purpura plus diffusive abdominal pain, acute arthritis, arthralgia, hematuria, proteinuria
What is the treatment for methemoglobinemia
Methylene blue IV
What is the management of tumor lysis syndrome?
Aggressive hydration, diuretics, correct electrolytes, dialysis in extreme cases
What is the most common cause of death in sickle cell?
Sepsis or meningitis
What is the treatment for hyperleukocytosis?
Prompt chemotherapy, dexamethasone for pulmonary leukostasis, avoid RBCs until WBC reduced
What cells are seen on a peripheral smear of a patient with ALL?
Blasts
What is the most common solid tumor?
CNS tumors
What sickle cell complication is an indication for stem cell transplant?
Stroke
What condition presents with isolated thrombocytopenia?
Immune thrombocytopenia purpura
What conditions are associated with an increased risk of developing ALL?
Trust me 21, Franconia anemia, client filter syndrome, shwachman diamond syndrome
What is the goal of treatment for splenic sequestration?
Restore circulating volume and oxygen carrying capacity
What is the triad for hemolytic uremic syndrome?
Thrombocytopenia, hemolytic anemia, organ damage
What is the treatment for hyperleukocytosis?
Prompt chemotherapy, dexamethasone for pulmonary leukostasis, avoid RBCs until WBC reduced
What is the treatment for it wilms tumor?
Nephrectomy or resection maybe with chemotherapy or radiation
What type of tumor is typically found due to leukocoria on exam?
Retinal blastoma
What is the management of a mediastinal mass?
Prom position, costume with anesthesia, positive pressure ventilation if necessary
What transfusion reaction is caused by an immune response resulting in acute hypoxemia, non-cardiogenic pulmonary edema and occurs within 6 hours?
TRALI
What is a life-threatening failure of hematopoiesis leading to a peripheral pencytopenia in bone marrow aplasia?
Aplastic anemia
What are complications with the treatment of thalassemia?
Iron overload, CHF
What disorder is a hypochromic, microcytic, low and MCV anemia?
Thalassemia
What does an increased retic and low MCV tell us about the cause of anemia?
Hemoglobinopathy
When’s the first episode of splenic sequestration occur?
Between age 3 months and 5 years
How does TACO present?
Respiratory distress, hypoxia, rails, hypertension
What disorder results in the production of abnormal forms of hemoglobin resulting in the destruction of RBCs?
Thalassemia
What is the management for a plastic anemia?
Bone marrow transplant
In the prevention of stroke what is the goal percentage of hemoglobin S through exchange transfusions?
Less than 30%
What disorder is defined as an immune mediated small vessel vasculitis?
HSP
Define acute chest?
Ischemia or infarction of lung segments due to sickling
What is a neoplasm of the adrenal glands?
Neuroblastoma
How does splenic sequestration present?
Cute weakness, power, abdominal distinction, pain, slowly
What does acute chest look like on x-ray?
Infiltrates
What medications are given to reduce hyperglycemia or protect the kidneys from the extra uremic acid?
Rasburicase or allopurinol
What oncologic emergency causes you to question the safety of anesthesia?
Mediastinal mass
What blood transfusion reaction causes hemolysis secondary to ABO incompatibility?
Acute hemolytic reaction
What does a peripheral smear look like in a child with a plastic anemia?
Very few cells, no evidence of malignancy
How does leukemia present?
Phone pain, anemia, fatigue, fever, bruising
What is the most concerning complication of HSP?
Renal failure
How does HUS present?
Abdominal pain, bloody diarrhea, fever, lethargy, pallor, petechiae, ecchymosis, hematuria
What is the treatment for acute chest?
Exchange transfusion, antibiotics if infiltrates present
What does a low MCV tell us about the cause of anemia?
Iron deficiency anemia, lead toxicity, thalassemia
How does von willebrand disease present?
Later in life with easy bruising, frequent epistaxis, heavy menstrual bleeding
Mediastinal mask can lead to what syndrome?
Superior vena cava syndrome
What infection commonly proceeds HSP?
Group a strip
What cause of anemia is the result of a genetic inborn error of metabolism that results in the breakdown of red blood cells?
G6PD deficiency
Is Hodgkin lymphoma or non-Hodgkin lymphoma found in ages 5 to 15? 15 to 35?
Non-hodgkin lymphoma 5 to 15. Hodgkin lymphoma 15 to 35
What is diagnostic for DIC?
Positive d dimer
What is the most common age for HUS?
Less than 4 years
How does ITP present?
Bruising, particular, epistaxis, hematuria
What abnormal cell type causes sickle cell anemia?
Deoxygenated hemoglobin S
How does someone get hemophilia?
X-linked chromosome disease
Differentiate between Hodgkin lymphoma and non-Hodgkin lymphoma?
Hodgkin lymphoma is slower with a more orderly spread while non-hodgkin lymphoma multiplies rapidly and is aggressive
What is the most common cause of HUS?
E coli and its shiga toxin
What infection requires penicillin prophylaxis in patients with sickle cell disease?
Pneumococcus
What transfusion reaction occurs when circulatory capacity is exceeded causing circulatory overload and pulmonary edema?
TACO
Hemophilia is caused by a deficiency in what? For a and B
Deficiency in fector 8 for hemophilia a
Deficiency in factor 9 for hemophilia B
Describe a malignant lymph node
Non-smooth, non-mobile, hard, painful
What kind of tumor is a solid tumor of the kidney?
Wilms tumor
How is sickle cell diagnosed?
Hemoglobin electrophoresis which can identify hemoglobin S and hemoglobin A
What does a high MCV tell us about the cause of anemia?
A plastic anemia, immune disorders, a plastic crisis
What are some common causes of DIC?
Infection, trauma, ARDS, ECMO, hematologic malignancies
What is the typical age range for a wilms tumor?
Two to three years
What does an increased retic and normal MCV Tell us about the cause of anemia?
Chronic blood loss, infection induced hemolysis, enzyme or immune disorder
What changes are seen in the coagulation panel of a person with DIC?
Thrombocytopenia, prolonged PT, PTT
How does HSP present?
Purple on lower extremities, hematuria, protein area, hypertension
What is the most sensitive diagnostic study for a PE or DVT?
CT angiography
What is disseminated intravascular coagulation?
Disturbance normal coagulation cascade, consumption of coagulation factors and platelets, which trigger thrombosis and hemorrhage
Combination of impaired coagulation and hemorrhage
What is the treatment for thalassemia?
Blood transfusions
What are the four electrolyte changes in tumor lysis syndrome?
Hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia
How does an acute hemolytic reaction present?
Fever, chills, hypotension, lumbar pain, shock, diaphoresis
How does non-hodgkin lymphoma typically present?
Masses, chest pain, SCV syndrome, cervical lymphadenopathy
What anemia is microcytic, low retic, elevated RDW?
iron deficiency
what anemia is normochromic, macrocytic anemia?
diamon blackfan
what anemia is severely low hgb, high retic, high RDW?
G6PD
what is a normal RDW?
12-16
what is a normal MCV?
80-100
What is a normal retic?
0.5-2.5%
What are normal plt?
150-450,000
classic triad in HSP
abdominal pain, purpura, arthritis
