Hematology Flashcards
What are the most common causes of neutropenia in adults
- ethnic neutropenia
- drug-induced neutropenia
What medications cause neutropenia
- Psychotropics
- Antivirals
- Antibiotics
- NSAIDs
- Anti-thyroid
- ACEi
- Beta Blockers
Neutropenia is defined as an ANC of
<1500
Vitamin B12 Deficiency
- peripheral neuropathy starting in the feet or arms
- numbness
- ataxia
- loss of vibration and position sense
- impaired memory
- dementia
Hodgkin’s Lymphoma presents with
- night sweats
- fever
- pain with drinking ETOH
- generalized pruritus
- painless enlarged lymph nodes
- anorexia
- weight loss
How is Hodgkin’s Lymphoma Identified
Presence of Reed-Sternber Cells
Non-Hodgkins lymphoma presents with
- night sweats
- fever
- weight loss
- generalized lymphadenopathy
Multiple Myeloma presents with
- fatigue
- weakness
- bone pain in back or chest
- proteinuria with Bence-Jones proteins, hypercalcemia and normocytic anemia
What are sx of Hemophilia A (Factor VIII)
- easy bruising
- excessive brusing
- bleeding into joints
- bleeding for prolonged periods
- severe bleeding with trauma
- heavy menses
- hematuria
- aPTT is prolonged
- PT; FIbrinogen and platelets are normal
What is the presentation of iron-deficiency anemia
- pallor
- fatigue
- exertional dyspnea
- glossitis
- angular chelitis
- pica
- koilonychia
- systolic murmurs
- tachycardia
- heart failure
Diagnostic findings for IDA
- Low ferritin/serum iron
- High TIBC
- High RDW
- Poikilocytosis (variable shapes)
- Anisocytosis (variable sizes)
What is the gold standard diagnostic test for pernicious anemia
elevated antiparietal antibodies
What is the gold standard diagnostic test for folate deficiency
Decreased folate level; Elevated Homocystine
What is the gold standard test to dx B12 deficiency
B12 level (decreased)
What is the gold standard test for sickle cell
hgb electorphoresis
What are risk factors for IDA
- PUD
- NSAID use
- Cancer
- Heavy periods
- Poor diet
- Postgastroectomy
- Increased physiologic requirement
Cows milk before ___ age in children causes
12 months of age GI bleeds
What are iron rich foods
- meat
- beans
- green leafy vegetables
Avoid taking iron at the same time as
Antacids, dairy, quinolones or tetracyclines
Screening tests for all anemias is
CBC
What is pernicious anemia
An autoimmune disorder caused by the destruction of parietal cells by antiparietal antibodies, resulting in cessation of intrinsic factor production which is necessary for the absorption of vitamin B12
What are risk factors for B12 deficiency
- malabsorption
- dietary insufficiency
- alcoholism
- small bowel disease
- antacids
- H2 receptor antagonists
- PPIs
- Metformin
What are sx of B12 deficiency
- Tingling/numbness in hands and feet
- Neuropathy
- Difficulty walking
- Difficulty performing fine motor tasks
- paresthesias
- decrease reflexes
- inflammed tongue and glossitis
Treatment for B12 anemia
B12 injection (1,000mcg/week) x 4 weeks then monthly for life
What are sx of hemochromatosis
- Chronic fatigue
- skin hyperpigmentation
- swelling of the 2nd and 3rd MCP joints
- joint stiffness
What is the most common cause of folic acid deficiency anemia
- inadequate dietary intake
- Alcoholism
- Over cooking veggies
What is the treatment of folic deficiency anemia
- folic acid 1-5mg/day
- stop overcooking veggies
- women should be taking at least 400mcg of folic acid at least 1 month before conception
What is glucose-6-phosphate dehydrogenase deficiency anemia
-An x-linked recessive genetic disease that is more common in males that is usually asymptomatic unless hemolysis occurs
Hemolysis in glucose-6-phosphate dehydrogenase deficiency can be triggered by
Drugs (primaquie, sulfa, hydroxychlorquine, macrobid)
-after injection you will see hemolytic changes (acute jaundice, yellow sclera, pallor, fatigue, SOB, tachycardia, dark urine)
What are sources of B12
All foods of animal origin (meat, poultry, eggs, milk, cheese)
What are sources of folate
leafy green veggies, grains, beans, liver
Thalassemia is more common in
Southeast asia, mediterranean, North africa, middle east and asia
The most common hemophilia in the US is
Factor VIII deficiency
