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Med 1 > Hem/Onc > Flashcards

Hem/Onc Flashcards

1
Q

cryoprecipitate for?

A

Hemophilia A
low fibrinogen (DIC
vWD

contains factor 8 and fibrinogen

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2
Q

Tx for dintravascular hemolysis- wrong blood transfusion

A

stop the transfusion
replace fluids
EPi for anyphylaxis
dopamne/NE for pressures

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3
Q

Extravascular homeless due to?

Tx

A

less sever, minor RBC antigens, Kell antibodies

see fever, jaundice and anemia

No mgmt

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4
Q

Retic index =

A

Retic count (Pts Hct/35)

2% excessive RBC destruction

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5
Q

macrocytic anemia that is not B12/foltate etiology

A

liver disease - altered plasma lipoproteins into membranes

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6
Q

High Fe requirement age groups -> Fe deficiency concerns

A

Infants/ toddlers

Adolescents

Pregnant

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7
Q

Dx of Beta thallesimia

A

HbF and Hb A2 are elevated

Peripheral smear - microcytic hypochromic anemia, Target cell

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8
Q

Pancytopenia

A

bone marrow failure in aplastic anemia

low Ptls, rbcs and PMNs

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9
Q

Pernicious anemia

A

special case of B12 def

autoimmune dosorder -> inadequate production of intrinsic factor -> impaired absorption of B12 in illium

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10
Q

Hi methylmalonyl and homocristeine, may be deficient in?

A

B12

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11
Q

Diagnose B12 vs folate b/c

A

replacement of flat can improve the symptoms but underlying B12 deficiency can lead to perm neuro deficits (demyelination of posterior columns, lateral corticospinal tract and spinocerebellar tracts)

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12
Q

Hypersegmentes neutrophil in what anemia

A

B12

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13
Q

Schilling test

A

Diagnose B12 def
- Give IM dose of unlabeled b12 to saturate site,
-Give oral dose radioactive B12
- measure B12 in urine and plasma
Redo w/ intirinsic factoe and then see if different

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14
Q

homocysteine elv in both of which anemias?

methymalonic is only elv in>

A

Folate and B12 deficiency

  • B12
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15
Q

Lab tests in hemolytic anemia (4)

A

elv retic count, LDH

decreased haptoglobin and Hgb

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16
Q

Schistocytes -intravascular

helmet cells- extravascular

seen on

A

TTP
DIC
prosthetic heart valves

17
Q

hemolytic anemia in sickle cell can commonly lead to

A

gallstone disease -pigmentes

18
Q

Aplastic crisis of sickle cell

A

human parvo virus precipitates -> lowers BM ability to compensate

19
Q

Acute chest syndrome

A

seen in sickle cell

2/2 repeated episodes of pulm infarction
clinical presentation ~ pneumonia
associated w/ chest pain, resp distress and pulm infiltrates, hypoxia

20
Q

First manifestation of sickle cell commonly is

A

hand foot syndrome - painful swelling of the dorsum of the hands and feet in infarct. and early childhood

21
Q

Pain crisis in sickle cell2/2

A

pain in bone infarcion

22
Q

Splenic sequestration crisis

A

sudden pooling of blood into the speed -: rapid splenomegaly and hypovoluemic shock

fatal complication of sickle cell and beta thalessima

23
Q

Infections in sickle cell

A

SHiN
Strep pneumonia
Haemophlius influenza
Nesseiria

Salmonella osteomyolitis concerns

24
Q

Spherocytosis causes (5)

A 
hereditary spherocytosis (Coombs neg)
G6PD deficiency
ABO incompatability - but nor Rh
hyperthemia
autoimmune hemolytic anemia
25
Q

Bite cells and heinz bodies seen in

A

G6PD deficency

heinz = abnormal Hgb precipitates w/in RBCs

26
Q

Warm AIHA

A

IgG binds to RBCs-> extravasculae hemolysis w/ sequestration in the spleen

  • primary or secondary to lymphomsa, leukemias, collagen vast disease, methyldopa

Coombs +

Tx w. glucocorticpoics, maybe splenectomy

27
Q

Cold AIHA

A

IgM leeds to complement activation -> intravascular hemolysis

idiopathic or due to mycoplasma pneumonia or mono

Tx - avoid the cold, RBC transfusions?, NO steroids

28
Q

HIT 1 vs HIT 2

A

1- heparin cause splatelets to aggregate, seen in <48 hrs, no Tx

2 - Heaprin induces Ab-mediated injury to platelet - seen 3-12 days after
-STOP heparin

29
Q

Petechiae and purpura seen in

A

thrombocytopeina many petechiae -> purpura

bruising also seen

30
Q

TTP = HUS +(2)

A

HUS + fever and AMA

HUS - microangiopathic hemolytic anemia + thrombocytopenia + renal failure

31
Q

Ristocetin assay

A

used to test for vWD

32
Q

Prolonged bleeding time, normal platelet count, maybe a longer PTT

meorrhagia, cutaneous/mucosal bleeding

A

vWD

33
Q

vWD Tx

A

DDVAP -desmopression - induces secretion of vFW from endothelial cells

Factor VIII concentrates

34
Q

r/o of DIC

A

fibrinogen level - normal/elv rules out

Med 1 (11 decks)

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