Hem/Onc

Question 1

HUS

Answer 1

5-10 days after bloody diarrhea
Hemolysis = low RBCs, low plt, Schistocytes, ^ bili,
purpura
AKI
Tx fluid/lytes, transfusion, dialysis

Question 2

Anemia of prematurity

Answer 2

limit blood draws, iron, tfusions

Question 3

Pinealoma

Answer 3

Parinaud syndrome (UP = upward gaze/upper eyelids, pupils NR)
\+ obstructive hydrocephalus (acqueduct)

Question 4

Wiskott-Aldrich

Answer 4

X linked recessive
WBCs + plt
ECZEMA
Tx stem cell transplant

Question 5

Diamond-Blackfan

Answer 5

RBCs only (macrocytic)
Triphalangeal thumb (biggest fan, 3 thumbs up)
Tx steroids, tfusion

Question 6

ALL

Answer 6

MC kids ca boys 2-6yo
Pancytopenia (bleeding, petechiae), bone pain, HSM
Kid refusing to walk

Question 7

Acquired aplastic anemia

Answer 7

Most idiopathic (infx, rx, benzene)
BM biopsy w fat and dec cells

Question 8

B thal major

Answer 8

Ok until 6-12 mo (fetal hgb)

Tx chronic tfusions + chelation

Question 9

Sickle cell aplastic crisis

Answer 9

Low retics!

Parvo B19

Question 10

Hydroxyurea

Answer 10

> 15% HgF, a little less than normal HgS (nl 85-95%), ~80%

Question 11

Sickle cell trait

Answer 11

Most common sx hematuria, renal probs RTA (type 1), renal papillary necrosis, hypothestenuria w/ normal Na

Question 12

Spherocytosis

Answer 12

AD, ankyrin, cholelithiasis

Question 13

Polycythemia

Answer 13

Crit>65%

Question 14

Microcytic anemia iron def vs thalassemia

Answer 14

Iron def = high RDW, low RBCs (MCV/RBC>13), low retics

Thal = nl RDW, nl RBCs (MCV/RBC<13), high retics

Question 15

Too much cows milk

Answer 15

> 24 oz

Question 16

Serum sickness-like reaction

Answer 16

FUJ-1 = Fever, Urticaria, Joint pain 1 week after penicillin, type III

Question 17

Osteosarcoma

Answer 17

Femoral humeral head, sunburst Codman on XR boys 13-16

Question 18

Langerhans cell histiocytosis

Answer 18

BiRD (lafawnda langerhans) = Bone, rash, diabetes insipidus, XR punched out lesions

Question 19

Idiopathic thrombocytopenia

Answer 19

Chronic = <100,000 for >1 y
1st line IVIG prednisone
2nd line splenectomy (IgG)

Question 20

Factor VIII def

Answer 20

Hemophilia A

25% get inhibitor development

Question 21

Gaucher dz

Answer 21

Anemia, thrombocytopenia
HSM
Bone pain
Delayed puberty

Question 22

Wilms tumor v neuroblastoma

Answer 22

Both abd mass, systemic sx

Neuroblastoma +raccoon eyes +opsoclonus-myoclonus

Question 23

Kasabach-Merritt

Answer 23

Hemangioma + thrombocytopenia

Question 24

Superior vena cava syndrome

Answer 24

Face swelling, JVD