Hem/Onc Flashcards
Iron def anemia - PE?
fatigue
glossitis
koilonychia
plummer-vinson sx
Alpha Thalassemia - labs?
MILD anemia
MCV is LOW
RBC is NORMAL
Alpha Thalassemia - ethnicity?
ASIANS
Beta Thalasssemia - ethnicity?
GREEK
MEDITERRANEAN
How does adult hemaglobin change from child?
INCREASE in A1 and F compared to A
Iron def anemia - labs?
HIGH RDW
HIGH TIBC
LOW Fe
Beta Thalassemia minor - labs?
NORMAL RDW
NORMAL TIBC
HIGH Fe
Thalassemia - PE?
splenomegaly
How to can you differentiate between thalessemia and sickle cell?
electrophoresis
Thalessmemia - tx?
folate
How to defferentiate between alpha and beta thalessemia?
elctrophoresis
beta: increased A2 and F and LOW A
alpha: NORMAL
How to tx microcytic anemia -peds?
iron supplement for 3-6mo
How to tx microcytic anemia - adults?
check colonoscopy
What is sickle cell?
autosomal recessive
AA
Sickle cell carrier?
asymptomatic until put in low O2
Sickle cell PE?
splenomegaly - removed
ulcers on legs-non healing
systolic murmurs
retoniopathy
Sickle cell - cx of deat?
organ failure
Sickle cell - prognosis?
40-50yrs
Sickle cell sx?
pain crisis - vasoocclusion –> ischemia
kidney cannot concentrate urine
Sickle complications?
asplastic crisis
DI
Sickle cell -dx?
peripheral smear
electrophoresis
Sickle cell tx?
folic acid
abx prophylaxis
opthalmologic exam
hydroxyurea
ITP?
idiopathic thrombocytopenic purpura
ITP -PE?
pt feels fine but has rash (petechia)
ITP-labs?
CBC - normal except thrombocytopenia
peripheral smear: megakaryocytes
ITP -hx?
post viral infxn
What 2 viral infxn can show as rash after viral infxn?
ITP
HSP
*do CBC; HSP DOES NOT have thrombocytopenia
ITP -tx?
mild: >50,000 - self limiting
mod: 10-20K - IV Ig and corticosteroid
severe: <10K - BAD; transfusion needed asap
Acute lymphocytic leukemia - labs?
decrease WBC pancytopenia anemia peripheral smear: blast cells HIGH uric acid, K, LDH
Acute lymphocytic leukemia has the highest risk in?
down sx
Acute lymphocytic leukemia - sx?
4P pallor pyrexia (fevers and infxn) petechiae/purpura pain (bone pain)
Acute lymphocytic leukemia-PE?
splenomegaly
Kid has low WBC, not eating, bruising?
ALL
Acute lymphocytic leukemia - tx and prognosis?
chemo
good
AML?
Auer rods
CML?
philadelphia
CLL?
older adults (60yo+) chronic course
CNS tumors - sx?
changes in behavior, mentation vomiting increasing in head circumference seizures waking up from bad HA visual disturbances
CNS tumors - PE?
papilledema
CNS tumors - dx?
MRI
Neuroblastoma?
common OUTSIDE BRAIN tumors
When is neuroblastoma found?
usually metastic stage - not good prognosis
Neuroblastoma - sx?
wt loss
anorexia
bone pain
Neuroblastoma vs ALL?
both have bone pain but neuroblastoma has wt loss (warning sign for bad cancer)
Neuroblastoma -labs?
UA for catacholamines and uric acid
Neuroblastoma - imaging?
CT
Neuroblastoma- tx?
surgery and chemo
Wilms tumor?
ABDOMINAL neuroblastoma
Wilms tumor-sx/PE?
abdominal mass but NO complaints
WAGR syndrome?
WAGR
- Wilms tumor (the tumor itself)
- Aniridia (absence of iris in both eyes)
- Genitourinary anomalies
- mental Retardation
Beckwith-Wiedmann sydrome?
genetic defect
wilms tumor
Wilm tumor imaging?
CT/US
Wilm tumor- tx?
resection and chemo
When someone suddenly has an allergic rxn to something they were not allergic to before?
IgE has reached the threshold and now they are allergic
memory cells will react to the foreign (now allergic) stuff
What is the allergy triad?
allergic rhinitis
asthma
eczema
Allergic rhinitis - sx?
runny nose red eyes Dennie Morgan lines (lines under eyes) nasal salute (lines on nose) nasal mucosa is grey and boggy
Allergic rhinitis family hx?
atopy
Gold standard for allergic rhinitis?
skin test
but NOT ALL POSITIVE are ALLERGY
Allergic rhinitis tx?
environmental control antihistmine leukotriene inhibitors decongestants mucinolytic nasal steroids
Allergic rhinitis tx fails?
vasomotor rhinitis
sinusitis
CF
Food allergy vs food intolerance?
allergy: eosinophils and IgE
intolerance: NOT IgE but lacking some sort of protein
Food intolerance: enzymatic, pharmocologic, toxin?
enzymatic: lacking a protein
pharmocologic: MSG, caffiene
toxin: antihistamine that is naturally found in some foods (tomatoes and strawberries)
Food allergy: anaphylaxis vs localized?
anaphylaxis: SOB, wheezing, hypotensive
localized: utricaria (hives), eczema
What cause MOST food hypersensitive rxn?
body is reacting to proteins in food
ie) nuts, eggs, soy
What is the most common food allergy in peds?
milk protein allergy (cow)
Milk protein allergy - sx?
bloody diarrhea
Mom precaution in milk progein allergic babies?
if mom is breast feeding, mom has to avoid milk products too
Is milk protein allergy lifelong?
no-out grow age of 3
reintroduce in 15mo
Is nut allergy lifelong?
yes - do not reintroduce
When to use epi pen?
difficulty breathing
swelling of tongue
collapse
hypotensive
Who should know how to use epi pen?
asthma pts
no ER facility
What IgE mediated allergic manifestation can occur in allergic rhinitis pts?
oral allergy sx
What is oral allergy sx?
may have reaction to certain foods that have a cross rxn with air pollens
able to eat the food after cooked (protein that they are allergic to is denatured)
What are 3 humoral immunodeficiencies?
bruton
Digeorge*
SCIDS*
What is DIgeorge sx?
missing the 4th pharayngeal outpoutching - needed for the superior parathyroid gland - ABSENT PARATHYROID
CARDIAC DEFECTS
developmental delays
DiGeorge sx-sx?
sx AT BIRTH cyanosis HYPOcalcemic seizures - d/t ABSENT PARATHYROID ABNORMAL FACIES CARDIAC DEFECTS Tcell dysfxn
DiGeorge sx- tx?
cardiac surgery
Vit D and Ca
bone marrow transplant
Severe Combined Immunodeficiency -tx?
protective isolation
bone marrow transplant
Leukocyte adhesion deficiency?
leukocytes are not able to migrate from vasculature to the tissue
Leukocyte adhesion deficiency - prognosis?
NOT GOOD (no more than 2yo)
Umbilical chord doesn’t fall off ?
Leukocyte adhesion deficiency
DiGeorge sx -dx?
chromosomal FISH analysis
