hemato Flashcards
blisters+photosensitivity+hyperpigmentation+tea colored urine? dx and tx? pato?
Porphyria cutanea tarda
hidroxicloriquina/cloroquina o plasmaferesis
deficiency of the enzyme uroporphyrinogen decarboxylase (UROD)
uremia (missed dialysis, CKD) que pasa con labs de sangre?
uremia (flapping tremor, pruritus leading to excoriations)
-bleeding time increased due to platelet aggregation dysfunction > increased risk of bleeding
-platelet count normal
-prothrombin time normal
-partial thromboplastin time normal
Malaria prophylactic medication of choice for pregnancy? (africa o sureste asiatico/P. falciparum)
Mefloroquina
africa, sureste asiatico tienen P falciparum resistente a cloroquina
Malaria profilaxis america (Plasmodium vivax and Plasmodium ovale)
Primaquine
Malaria prophylaxis in travelers to chloroquine-resistant regions?
(africa, sureste asiatico, p. falciparum)
“MAD Travellers”:
Mefloquine (embarazo)
Atovaquone- proguanil
Doxycycline
Tafenoquine
como esta la RDW (amplitud de distribución eritrocitaria) en talasemia vs anemia x deficiencia de hierro?
tanto en talasemia como en anemia x deficiencia de hierro vas a tener Hb baja + MCV bajo (<80) la diferenciaesta en RDW.
Talasemia lo tiene normal
Anemia x deficiencia de hierro lo tiene aumentado
schystocyte en que patologías se ven?
A sheared erythrocyte fragment seen on peripheral blood smear. senala microangiopatic hemolytic anemia
DIC,
TTP/HUS,
HELLP syndrome
mechanical heart valves.
The classic triad of hemolytic uremic syndrome (HUS)?
Microangiopathic hemolytic anemia
Thrombocytopenia
Acute kidney injury
Mieloma multiple. Sx, electroforesis de orina que muestra y frotis de sangre?
CRAB criteria: malignant cells activate osteoclasts
Calcio aumentado
Renal disfunction
Anemia
Bone lesion
electroforesis de orina: Bence jones (foamy urine)
frotis de sangre: Roaleux formation
left upper quadrant pain radiating to left shoulder + trauma/anemia dx?
splenic rupture
kehr sign: left upper quadrant pain radiating to left shoulder
acute traumatic coagulopathy. definicion y manejo?
Multiple traumatic injuries,
persistent oozing from wounds,
PT/PTT > 1.5× normal
Increased bleeding time
tx: Transfuse packed RBC, fresh frozen plasma, and platelet concentrate in a 1:1:1 ratio
encapsulated bacteria in sickle cell?
SHiNE SKiS
Strep pneumonia
Hemofilus influenza
Neisseria meningitidis
Escherichia coli
Salmonella
Klebsiella
group b Strep
Due to recurrent splenic infarction, children with SCD develop functional asplenia at an early age (typically by the age of 4), increasing their risk of infection with encapsulated organisms.
Hemoglobin electrophoresis HbA2 >3.5% dx?
beta thalassemia menor
leucemia linfocitica cronica
poblacion, sx, celulas?
adulto mayor
linfadenopatia generalizada, esplenomegalia, leucocitosis
smudge cells
CD 5,19,20,23
CD20 (+) symptomatic CLL = rituximab
leucemia mieloide cronica
LAP score BAJO
neutrofilos altos
basofilos altos
esplenomegalia
perdida de peso
cromosoma filadelfia (9,22) +
imatimib
Chronic myelogenous leukemia (CML) is distinguished from a leukemoid reaction (benign neutrophilia) by a(n) negative leukocyte alkaline phosphatase (LAP) stain
Chronic myeloid leukemia (CML) is distinguished from a leukemoid reaction (benign neutrophilia) by presence of increased basophils
how does Hodking lymphoma cause hypercalcemia?
^ 1α-hydroxylase activity by lymohoid tissue > ^ ectopic vitamin D> ^ Ca reabsorption from intestines and renal > hipercalcemia cuases decreased PTH
translocation 15,17 dx y tx?
Acute promyelocitic leukemia
tx: Transretinoic acid
cual es el unico parametro elevado es anemia of chronic disease?
ferritina es el unico parametro elevado en anemia of chronic disease
Serum iron: decreased
TIBC: decreased%
Saturation (of transferrin): decreased
Ferritin: increased
esferocitosis hereditaria
sx, labs, dx?
anemia+ictericia+esplenomegalia
reticulocitosis
esferocitosis
^ concentración de hemoglobina corpuscular media (31-36%)
dx:
Eosin-5-maleimide binding test, acidified glycerol lysis fragility
acute myelocitic leukemia frotis de sangre que se ve?
Auer rods
mieloperoxidasa +
hiperplasia gingival
tx policeitemia vera?
To reduce the red blood cell mass and thus the risk for thrombotic complications:
Flebotomia+aspirina:
- Phlebotomy (250–500 mL) every 2–3 days until a hematocrit of ≤ 45% is established.
- Thrombocytosis is less affected by phlebotomy because platelets have a significantly shorter lifespan and regeneration period. Therefore, all patients with PV should receive antiplatelet prophylaxis with aspirin unless contraindications are present.
If first-line treatment (i.e., phlebotomy and aspirin) is ineffective or poorly tolerated, or if the patient has a high risk of thrombosis (e.g., > 60 years of age, history of thrombosis), cytoreductive therapy with hydroxyurea or interferon alpha is recommended. Ruxolitinib is used for patients resistant or intolerant to hydroxyurea.
G6PD deficiency drugs and frotis?
SELL FAVA beans in INDIA
Sulfa
Fava beans
Infecciones
Nitrofurantoina
Dapsona
Isoniazida
Antimalarials (quininas)
Bite cells
enfermedad en la que hay insensibilidad a la proteina C?
Factor V leiden
en esta enfermedad no se permite que la proteina C (anticoagulante) inhiba la cascada de coagulacion, entonces hay un estado protrombotico
Mutation of coagulation factor V (Factor V Leiden) does not allow activated protein C, a potent anticoagulant, to inhibit the coagulation cascade, leading to a procoagulant state by activation of prothrombin into thrombin (i.e., thrombophilia). Consider a hereditary thrombophilia in a young, otherwise healthy patient with venous thromboembolism with no obvious risk factors. Factor V Leiden is the most common inherited thrombophilia.
macrocitic anemia+cafe au lat+microcefalia
dx? fisiopatologia?
fanconi anemia: Defect in DNA crosslink repair
tamb presenta:
defecto en radio y pulgar
estrabismo
pancitopenia
acute lymphoblastic leukemia
translocation that indicated good prognosis?
t(12;21)
Bone marrow aspirate: immature cells positive for CD10, CD19, CD20, and transferasa deoxinucleotidil terminal
Fever, urticaria, and polyarthralgia 1-2 weeks after taking β-lactams or TMP-SMX ?
enfermedad del suero
