Hematologic Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Anemia - hypoproliferative

  • 3 subtypes
  • Most common cause of each subtype
  • Oral manifestations
  • Treatment
A

Microcytic anemia

  • Iron deficiency
  • Glossitis
  • Iron supplement

Normocyctic anemia

  • Renal failure
  • No specific oral manifestations
  • Erythropoetin, Iron supplement

Macrocytic anemia

  • B12/folate deficiency
  • Glossitis
  • B12 supplement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anemia - Hyperproliferative

  • Subtypes
  • Most common examples of each
  • Blood smear findings
  • Site of RBC destruction
A

Intravascular

  • Liver/bloodstream
  • G6PD deficiency
  • Smear = shistocytes

Extravascular

  • Spleen
  • Hypersplenism
  • Smear = Spherocytes

Non-hemolytic

  • Blood loss trauma/surgery
  • No smear performed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sickle Cell Anemia

  • Incidence
  • Triggers
  • Types of Crises
  • Treatment and mechanisms
  • Anesthesia considerations
A
  • 1:5000 aa
  • cold, dehydration, hypoxemia, acidosis
  • Vasoocclusive: pain
  • Autosplenectomy: infacted spleen
  • Hemolytic crisis
  • Tx
    • Hydroxyurea: increases fetal Hg
    • Folate
    • Antibiotics
  • Anesthesia: keep warm, hydrated, avoid operating if infection present, maintain oxygen, consider transfussion, lowered functional reserve due to poor oxygen carrying capacity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sickle Cell Complications

  • Describe Acute Chest Syndrome
  • List two other acute complications
A
  • Acute chest is vasocclusion in pulmonary vasculature resulting in pain, hypoxemia, dyspnea, CVA, infiltrates on CXR
  • CVA
  • Splenic infact (Autosplenectomy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Von Willebrand

  • VwF has 3 important jobs
  • Types of VWf disease
  • Treatment
A
  1. Platelet agregation
  2. Adhesion
  3. Carry Factor VIII

Type 1: quantitative

Type 2: qualitative

Type 3: essentially no VWf

Types 1 and 2 = tx with DDAVP, Amicar

Type 3 = tx with factor VIII, Cryoprecipitate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mucosal bleeding, petechiae more common in VWf disease or Hemophilia

A

Mucosa bleeding, petechiae = VWf disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hemophilia A = factor?

Hemophilia B = factor?

Treatment

A

Hemophilia A = factor 8

Hemophilia B = factor 9

Treatment: DDAVP and/or factor for Hemophilia A

Treatment: factor only for hemophilia B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lab values for bleeding disorders

  • Prolonged PTT
  • Prolonged PT/INR
  • Prolonged bleeding time
  • Thrombocytopenia
A
  • Prolonged PTT = Hemophilia, VWf
  • Prolonged PT/INR = Normal in all types
  • Prolonged bleeding time = VWf
  • Thrombocytopenia = ITP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DIC

  • 2 main causes
  • Lab findings
  • Treatments
A

DIC

  • Excess bleeding or excess clotting
  • Lab findings: prolonged PT, PTT, d-dimers present, shistocytes
  • Treatments: platelets + cryoprecipitate for bleeding, low dose heparin for clotting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thrombophilia

  • Which disease only causes venous thrombi
  • Role of Protein C/S
  • Mechanism of HIT
A

Thrombophilia

  • Factor V Leiden only causes venous thrombi
  • Proteins C/S are anticoagulants
    • Proteins C/S bind and destroy clotting factor V (common pathway)
    • Protein S also inhibits complement activation to limit inflammation
  • Mechanism of HIT
    • Antibodies form against Heparin
    • Portion of antibody binds and activates platelets
    • Platelets are consumed creating bleeding diathesis AND thrombi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  • What is difference between Factor V and Factor V Leiden?
  • Inheritance of FVL?
  • Management of FVL?
A
  • Factor V Leiden is a clotting factor that doesn’t allow anti-clotting Factor C to bind
  • Autosomal Dominant with variable penetrance
  • Management
    • Perioperative anticoagulation
    • Standard treatment for thrombotic events
    • Lifelong anticoagulation is uncommon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HIT (HITT)

Heparin Induced Thrombocytopenia (and Thrombosis)

  • Mechanism
  • Incidence
  • Management
  • How long is patient at risk for redeveloping HIT
A

Mechanism of HIT

  • Antibodies form against Heparin
  • Portion of antibody binds and activates platelets
  • Platelets are consumed creating bleeding diathesis AND thrombi

Incidence = 1-5%

Management = Switch to non-heparin / non-warfarin anticoagulant

Antibodies remain active for 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Heparin

  • Mechanism of Heparin
  • What labs are required for monitoring Heparin
A

Heparin binds antithrombin III which then inactivates thrombin

Monitor anticoagulation with PTT

Monitor for HIT with platelet count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Warfarin blocks production of which clotting factors?

A

Warfarin blocks production of Vitamin-K dependent factors

II, VII, IX, X

Protein C, S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly