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Bi > hematologie > Flashcards

hematologie Flashcards

1
Q

coagulation cascade

A
  1. 3
  2. 7
    9
    8
    X
    5
    2
    1
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2
Q

Normale INR

A

0,8-1,1

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3
Q

Wat werk ADP tgene

A

Clopidogril/ticagrelor/dipyridomol

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4
Q

Wat werk thromboxane A2 tegen

A

Aspirin

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5
Q

wat bind platelets aan elkaar

A

Gp11b/111a

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6
Q

wat werk tegen Gp111a

A

aboximab

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7
Q

Wat doen direct oral anticoag

A

inhibit factor X

apixaban, endoxaban, rivaroxaban

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8
Q

Welke factoren zijn Vit k afhankelijk

A

10972 prot c en s
wafarin en acenocumarol
measure INR

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9
Q

Oorzaken massive splenomegaly

A

CML/CLL
myelofibrosis
polycythemia vera

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10
Q

Wat is belangrijk post splenectomie

A

vaccinatie tegen
H.influenza
N.meningitides
S.pneumonia

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11
Q

Verschill tussen bloeding bij VWf ziekten en hemofilia

A

VWF ziekte: slijmvliesbloed

Hemofilie: gewrichtsbloed

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12
Q

Afbraak van clot stel wat vrij

A

d-dimer

fibrinogeen

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13
Q

Wat doen desmopressin

A

stimuleer Vwf production

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14
Q

Welke stollingsfactoren geaffecteerd bij lever ziekten

A

almal behalwe 3, 4 , 12

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15
Q

wat is antiphospholipid syndroom

A

verhoogd risico thrombosis door deactivering anticoag prot en activeren van plaatjes
en preganacy complications
causes: idiopathic
lupus,RA,HIV,syphilis,Heb b

serology: lupus anticoagulant
verhoogd aptt
anticardiolipin antibody positive( false pos syphilis)
mixing study neg

management: stop coagulation–>heparin
severe: high dose steroids

prophylaxis:
low dose aspirin
high risk no children—. wafarin
high risk children—> heparin

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16
Q

Von willebrands disease

A

increase predisposition for platelet type bleeding from decreased amounts of VWF

autosomal dominant
most common congenital disorder of hemostasis
decreased ability of platelets to adhere to surface of endothelium

mucosal bleeding, incr menstruation,petechiae,bruising
incr bleeding after aspirin use

dx: normal plt, increased bleeding time
ristocetin plt binding test abnormal

rx: desmopressin/ factor 8

17
Q

oorzaken van verlengde PT

A

inherited: Factor7 def
acquired: Vit K def
liver disease
wafarin use
factor 7 inhibitor

18
Q

Oorzaken verlngde PTT

A 
inherited:
VWF
Factor 7,9,11,12 def
acquired;
Heparin
antiphospholipid syndrome
19
Q

Oorzaken van verlengde PTT en PT

A 
inherited:
Prothrombin
fibrinogen
factor5
factor10
acquired:
Vit k def
liver disease
DIC
Subtherapeutic heparin/wafarin
Direct thrombin inhibitors
inhibitors of factor 10, 5, fibrinogen, prothrombin
20
Q

Multiple myeloma

A

Malignan disease of plasma cells in bone marrow

signs:
Backpain
bonepain
hypercalceamia
spont fractures
increased infections
petechial bleeding
foamy urine
workup:
vehoogd ESR
pancytopenia
renal dysfunctie
verhoogd ldh
uitstrijk: Rouleoux formation
urine 24 hour electrophoresis M protein
bone marrow: monoclonal plasmacells in clusters

Behandeling:
watchfull waiting
stemcell transplant

21
Q

indolent non hodgekins lymphoma

A 
CLL
Hairy cell
Folicular
Marginal zone(H pylori)
Ziekte walderstorm
22
Q

Aggresief non hodgekins lymfoon

A

Diffuse grootcellig b-cell
Burkit
Mantelcell
primer mediastinal

23
Q

langdurig immunosupresive medicatie welke 2 lymfoma verhoogd risico

A

Hodgekins

Diffuse grootzellig

24
Q

Hodgekins lymfoom

A

EBV (b-symptoms and LN)
Reed sternberg op histo

behandeling chemo/radiation
levenslang opvolg

25
Q

Mastocytose

A

hoog tryptase

anaphalactic shock

26
Q

CML

A

Philadelphichromosome (9,22)

27
Q

Differentielen telling vit b 12 anemie

A

Hypersegmentatie van neutrofielen
1% 6 lobben
5% 5 of meer lobben

28
Q

Berekening van MCV

A

10 x heamatocrit / erythrocyten

29
Q

Behandeling vit B12 anemie

A

Cyanocobalamine 1000mg po 1 dd
Hydroxocobaline 1mg IMI x 10 3 dagen uit elkaar dan 2 maandelijks
degelijks folic acid

30
Q

oorzake macrocytic anemie

A

megaloblasties: Vit b12 en Folic acid

Niet megaloblasties: etoh, hypothyroid, meyeloproliferAative disorders

31
Q

G6PD deficiency

A 
hemolytic anemie
g6pd beskerm de rooibloedsel tegen oxidatieve stress
x-linked ( vrouw dragen)
flava beans
alleen supportive mng 
vermij oxidative situaties
32
Q

Vitamine A deficiency

A

retinol
Nachtblind
xeroftalmie
keratopathie

Intoxicatie:
diplop[lia
botschade
braken
hoofdpijn
33
Q

Vitamine B1 def

A

Thiamine
verlies sensibiliteit en motorische uitval
hartfalen
verlies korttermijnheugen, desorientatie, konfubulatie

34
Q

Vitamine B6 deficiency

A

Pyridoxine
perifere neuropatie
sensoriesche ataxia
amnesie

intoxicatie: polyneuropathie

35
Q

sjogrens

A 
autoimmune disease
exocrine gland
xerostomia
sicca
extraglandulaire:
gewrichten
mononeuritis
polyneuritis
raynauds
ILD
Onderzoek:
ANA pos. RF pos. 
schirmertest(traan)
sialografie
behandeling:
kunsttrane
NSAIDS
Glucocorticoids
hydroxychloroquin
dMARDS

Bi (13 decks)

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