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CEN Medical Emergencies > Hematologic Disorders > Flashcards

Hematologic Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

Elevated RBC

A

Polycythemia

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2
Q

Decreased RBC

A

Anemia

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3
Q

Elevated WBC

A

Infection/Leukemia

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4
Q

Decreased WBC

A

All 5 WBC low

Leukopenia

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5
Q

How many WBC do we have

A

5

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6
Q

PLT Elevated

A

Thrombocytosis

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7
Q

PLT Low

A

Thrombocytopenia

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8
Q

Sickle Cell Anemia

A

Usually round and spongey!

Hemoglobin S - Hard and Long

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9
Q

Bad things for sickle cell anemia

A 
Cold temperatures
High altitudes
Infection
Acidosis
Stress
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10
Q

what do sickle cells do?!

A

Block capillary beds - PAIIIINNNNN!

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11
Q

What can sickle cell do to men?

A

Priapism - blood stuck in penis

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12
Q

Tx for Sickle Cell

Pain

A

NSAIDs/Opioids/Toradol

Heat for painful areas

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13
Q

What drug for Sickle Cell Anemia

A

Hydroxyurea - prevents formation of sickle cell shape

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14
Q

Other Tx for Sickle Cell

A

IV rehydration
O2
Transfusion
Abx for infection

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15
Q

Dc Tx for Sickle Cell

A 
Apply warm
Moist heat to affected areas to reduce pain and swelling
Well hydrated
Exercise
Avoid high altitudes (helicopters)
Limit exposure to cold
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16
Q

Thrombocytosis can be due to

A

Chronic Hypoxia (overactive bone marrow)
Splenic Disorders
Bone Marrow Disorders

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17
Q

What is erythromelalgia

A

Severe redness and burning in hands and feet (thrombocytosis)

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18
Q

Tx for thrombocytosis

A

Low-dose ASA

Treat underlying condition

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19
Q

Thrombyoctopenia usually related to

A

Immune conditions

After viral infection in a child

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20
Q

Why do you bruise with low PLT?

A

Need PLT for clotting!

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21
Q

PLT 30-50

A

Brusing

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22
Q

PLT 10-30

A

Petechia/Gum bleeding

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23
Q

PLT <10

A

Internal Bleeding

24
Q

Tx for thrombyoctopenia

A

Prednisone for immune causes

Possible PLT transfusion for <30

25
Q

DIC is

A

Disseminated intravascular coagulation

26
Q

DIC is a what type of syndrome?

A

paradoxical!! Two different things at the same time

BLEEDING and CLOTTING

27
Q

First stage of DIC

A

Clotting stage!

28
Q

Factors that can cause PLT abnormal clotting? (4 eg)

A
  1. Metabolic acidosis
  2. Pregnancy - much higher clotting factors
  3. Cold Body
  4. Trauma
29
Q

DIC Abnormal Clotting problems

A

Metabolic acidosis
Mottling
Gangrene
Organ Failure

30
Q

Second stage of DIC

A

Bleeding stage!

31
Q

How can you bleed with clotting? DIC?

A

Every clot produces fibrin degradation products - help to break down the clot - cause you don’t want to keep the clot!

Number of clots being formed + fibrin degradation (anticoagulant) = so many FDPs (only so many PLT - consuming all clotting factors and you run out - can’t clot)

BEGIN TO BLEED.
OCCUR AT SAME TIME.

32
Q

Lab values of DIC

A

PLT = LOW

PT/PTT = High (no clotting factors)

Fibrinogen levels = Low (clotting factor being consumed)

D-Dimer = High (FDP)

H/H = Low (actively bleeding)

33
Q

Tx for DIC

A

Call the priest
Chance of survival Low

Control pokes!
Handle gently
Apply direct pressure to bleeding sites

34
Q

DIC in pregnancy can be caused by the

A

placenta

35
Q

DIC Pharmacological Interventions (Controversial)

A

Heparin
TXA
Amicar

Due to paradox.

36
Q

DIC Blood Products

A

PRBC for bleeding

PLT for thromcocytopenia

Cryoprecipitate for low fibrinogen levels

FFP for dec PT/PTT

37
Q

Hemophilia

A

Affects males

Cannot form a clot

One clotting factor that doesn’t work decreases ability to form clot

38
Q

3 Forms of Hemophilia

A

Factor VIII (Hemophilia A)

Factor IX (Hemophilia B - Christmas Disease)

Factor XI (Hemophilia C - Rosenthal’s syndrome) usually africa

39
Q

How do hemophilia tx at home?

A

Clotting factors at home

40
Q

Tx for Hemophilia

A

Give the factor

DDAVP - stimulates release of Factor VIII

41
Q

Treat Hemophilia Hematoma

A

Ice
Compression Dressing
Immobilization
Elevation

42
Q

Treat Hemophilia lac

A

Administer replacement factor before suturing or cast to avoid compartment syndrome

43
Q

Treat Hemophilia nosebleed

A

Topical Thrombin

44
Q

Treat Hemophilia venipuncture

A

Hold pressure minimum 5 minutes

NEVER GIVE IM INJECTION

45
Q

Why do immunocompromised not have symptoms?

A

Already lack the WBC that show the redness/swelling/puss

46
Q

Immunocompromised BAD BAD SIGN

A

FEVER

47
Q

Fever in child under 28 days?

A

Poor immune system

Sign of life threatening bacterial infection

48
Q

28 - 6 month child w/ fever

A

Risk of bacterial infection decreases

49
Q

after 6 months w/ fever

A

Most common cause is viral

50
Q

Three most common life-threatening causes of fever in young adult

A
  1. Sepsis
  2. Pneumonia
  3. Peritonitis
51
Q

Fever in the elderly (or chronically ill)

A

Immune system weans

Older we get the less immune system response we have

May lack a fever - hypothermia

52
Q

Febrile seizures are most common between

A

6 months and 5 years of age

53
Q

After one febrile seizure

A

risk of recurrent febrile seizures are high

54
Q

HR increases how with fever?

A

0.5 C elevation HR increases 10 BPM

55
Q

RR increase how with fever?

A

1 C elevation RR

5 BPM

CEN Medical Emergencies (6 decks)

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