Hem/Onc Flashcards
precipitants of hemolytic crisis in pts w/ G6PD def
sulfonamides, antimalarial drugs, fava beans
most common inherited cause of hyper-coagulability
factor V leiden mutation
most common inherited bleeding disorder
von willebrand’s dz
most common inherited hemolytic anemia
hereditary spherocytosis
diagnostic test for hereditary spherocytosis
osmotic fragility test
pure RBC aplasia
diamond-blackfan anemia
meds and viruses that lead to aplastic anemia
chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutics, hepatitis, parvovirus B19, and EBV
distinguish polycythemia vera from secondary polycythemia
both have increased hematocrit and RBC mass, but polycythemia vera should have normal O2 sat and low EPO levels
TTP pentad
FAT RN - fever, anemia, thrombocytopenia, renal dysfunction, neurologic abnormalities
HUS triad
anemia, thrombocytopenia, and acute renal failure
tx for TTP
emergent large-volume plasmapheresis, corticosteroids, anti-platelet drugs. platelet transfusion is contraindicated!
auer rods on blood smear
AMl
AML subtype associated w/ DIC. tx?
M3. tx w/ retinoic acid
electrolyte changes in tumor lysis syndrome
decreased Ca, increased K, increased phosphate, increased creatinine, increased LDH, and increased uric acid* everything is high except Ca
intracellular inclusions seen in thalassemia, G6PD def, and post-splenectomy
heniz bodies
virus associated w/ aplastic anemia in pts w/ sickle cells anemia
parvovirus B19
four causes of microcytic anemia
TAILS - thalassemia, anemia of chronic dz, iron def, lead poisoning, and sideroblastic anemia
autoimmune hemolytic anemia (AIHA) and hereditary spherocytosis (HS) can cause extravascular hemolytic anemia. peripheral blood smear may show spherocytes w/o central pallor in both. how do you differentiate them?
AIHA = - family hx and + coombs testHS = + family hx and - coombs tests
recent chemo + fever
febrile neutropenia (hem/onc emergency)
IgM spike on electrophoresis + hyperviscosity + s/s of increased size of spleen, liver, and some lymph nodes, tiredness due to anemia, tendency to bleed/bruise easily, night sweats, HA/dizziness, visual problems, pain/numbness in extremities = dx?
waldenstrom’s macroglobulinemia
transplant rejection
hyperacute - time, path, tx?
acute - time, path, tx?
chronic - time, path, tx?
hyperacute - w/in mins; due to preformed antibodies (prevent w/ ABO compatibility); tx w/ cytotoxic agents
acute - w/in days to months; due to T-cell mediated destruction; tx w/ corticosteroids, antilymphocyte antibodies (OKT3), tacrolimus, or MMF
chronic - w/in months to years; due to chronic immune reaction causing fibrosis causing gradual loss of organ function; no tx available
transfusion reactions…
non-hemolytic febrile rxn - mech, s/s, tx?
minor allergic rxn - mech, s/s, tx?
hemolytic transfusion rxn - mech, s/s, tx?
transfusion reactions…
non-hemolytic febrile rxn:
mech = due to cytokine formation during storage of blood
s/s = fever, chills, rigors, and malaise 1-6 hrs after transfusion
tx = stop transfusion and give tylenol
minor allergic rxn:
mech = due to antibody formation against donor proteins
s/s = prominent urticaria
tx = give anti-histamines and if severe, possibly stop transfusion and give epi
hemolytic transfusion rxn:
mech = due to antibody formation against donor erythrocytes, resulting either from ABO incompatbility or from minor antigen mismatch
s/s = fevers, chills, nausea, flushing, tachycardia, hypotension during or shortly after transfusion
tx = stop transfusion and give increased IVF
iron studies in iron def anemia MCV = ? iron = ? TIBC = ? Ferritin = ? Transferritin Sat = ?
iron studies in iron def anemia MCV = decreased iron = decreased TIBC = increased Ferritin = decreased Transferritin Sat = decreased
iron studies in anemia of chronic disease MCV = ? iron = ? TIBC = ? Ferritin = ? Transferritin Sat = ?
iron studies in anemia of chronic disease MCV = normal/decreased iron = decreased TIBC = increased Ferritin = increased Transferritin Sat = normal/decreased
iron studies in thalessemia MCV = ? iron = ? TIBC = ? Ferritin = ? Transferritin Sat = ?
iron studies in thalessemia MCV = decreased iron = normal/increased TIBC = decreased Ferritin = increased Transferritin Sat = increased
3 causes of microangiopathic hemolytic anemia
HUS, TTP, and DIC
pt presents w/ the 5 P’s - painful abdomen, port wine-colored urine, polyneuropathy, psychological disturbances, precipitated by drugs, alcohol, and starvation
acute intermittent porphyria (due to defect in prophobilinogen deaminse leading to accumulation of prophobilinogen, ALA, corphorphobilinogen)
pt presents w/ blistering cutaneous photosensitivty
porphyria cutanea tarda (due to defect in uroporphyrinogen decarboxylase leading to accumulation of uroporphyrin (tea-colored urine))
multiple myeloma - CRABBI
hyperCalcemia, Renal insufficiency, Anemia, Bone lytic lesions/Back pain, Bence Jones proteinuria, IgM (monoclonal M protein spike)
major cause of anemia in pts w/ ESRD? type of anemia? tx? s/e of tx?
major cause is due to def of erythropoeitin. anemia is normocytic and normochromic. tx of choice is recombinant erythropoietin (started at Hb
