Hematology Flashcards
Mucocutaneous bleeding and normal platelet count
Acquired platelet dysfunction (Platelet Function Analyzer-100)
Treatment for PE with PESI < 65
Apixaban or rivaroxaban
Treatment for inflammatory anemia
None
Supplemental treatments in patients with myelodysplastic syndrome requiring frequent transfusions to help decrease transfusion requirements, improve quality of life, and decrease transfusion associated iron overload and alloimmunization
Lenalidomide
Multisystem failure and end organ damage commonly involving skin, lungs, GI tract, heart
Hypereosinophilic syndrome
Initial lung imaging study to evaluate for pulmonary embolism and pregnant patients
Ventilation-perfusion lung scan
Viral infection that preferentially effects erythrocyte precursors in the bone marrow, causing transient pure red cell aplasia in patients with sickle cell anemia
Parvovirus B19
Isolated, mild neutropenia found on routine testing in asymptomatic black persons or certain other ethnic groups
Benign ethnic neutropenia
Transfusion transmissible pathogen that may be responsible for malaria like symptoms, hemolytic anemia, thrombocytopenia, and abnormal liver chemistry study results
Babesia microti
Management to prevent new skeletal related events and improve survival in patients with multiple myeloma requiring therapy
Zoledronic acid
Agent to reverse the effects of warfarin anticoagulation in patients experiencing severe bleeding and those requiring urgent surgery
Four-factor prothrombin complex concentrate (4f-PCC)
Agent to be given to provide passive immunity against causative organisms in patients with multiple myeloma, hypogammaglobulinemia, and recurrent infections
IVIG
Low-grade fever and features of hemolytic anemia after recent transfusion
Delayed hemolytic transfusion reaction (+ direct antiglobulin (Coombs) test)
Treatment of choice for patients with bleeding and hypofibrinogenemia secondary to DIC and:or liver disease
Cryoprecipitate
Treatment for patients with essential thrombocythemia who are older than 60 years or who have had previous thromboembolic complications
Aspirin + hydroxyurea
Gold standard for diagnosing amyloidosis
Biopsy of the affected organ and demonstration of characteristic Apple-green birefringence with Congo red staining
Diagnostic test of choice for Waldenström’s macroglobulinemia (Indolent B-cell lymphoma with clonal lymphoplasmacytic infiltration of the bone marrow that secretes IgM in the blood).
Bone marrow biopsy
Atypical presentations of rheumatoid arthritis and osteoarthritis, particularly with hook-like osteophytes of the second and third metacarpophalangeal joints
Hemachromatosis
Initial therapy for patients with iliofemoral DVT with acute limb ischemia
Thrombolysis
Recommended work up for all patients with smoldering multiple myeloma, per the International Myeloma Working group
Whole body MRI to assess for lytic lesions
Management for secondary iron overload from chronic transfusions
Oral chelation agents, such as defersirox
Initial treatment of chronic myeloid leukemia in the chronic phase
Tyrosine kinase inhibitors, such as imatinib
Diagnosis of proximal nocturnal hemoglobinuria
For cytometry, which can detect CD55 and CD59 deficiency on the surface of peripheral erythrocytes or leukocytes
Chronic microcytic anemia + normal hemoglobin electrophoresis pattern
Alpha thalassemia trait
Management for asymptomatic INR elevation between 4.5 and 10
Withhold warfarin
Mucosal or endometrial bleeding, normal PT and aPTT, and normal platelet count with evidence of a qualitative platelet defect
Von Willebrand disease
Respiratory distress within six hours of transfusion, positive fluid balance, elevated CVP, elevated BNP, and radiographic findings of pulmonary edema
Transfusion-associated circulatory overload (TACO)
Appropriate management for patients with sickle cell disease and acute chest syndrome with respiratory distress requiring mechanical ventilation
Exchange transfusion
A monoclonal antibody fragment that binds free and thrombin-bound dabigatran and neutralizes its activity given to patients taking dabigatran and requiring urgent surgery
Idarucizumab
Effective treatments for cold agglutinin disease
Cold avoidance and rituximab
Management for acquired hemophilia A with inhibitor
Activated factor VII, activated prothrombin complex concentrate, or recombinant porcine factor VIII
Most appropriate timing to perform thrombophilia testing
At least two weeks after discontinuation of anticoagulant therapy and not in the acute setting to minimize diagnostic error
Diagnosing a myeloproliferative neoplasm in a patient with hepatic vein thrombosis
JAK2 V617F gene mutation
Normocytic anemia with a low reticulocyte count and a normal erythrocyte morphology in a patient with underlying CKD
Erythropoietin deficiency
RA, splenomegaly, neutropenia
Felty syndrome
Treatment for -5q syndrome
Lenalidomide
Philadelphia chromosome on the BCR-ABL gene
Chronic myeloid leukemia
Management for essential thrombocythemia in high-risk (age > 60, previous thrombosis, platelet > 1.5mil) non-pregnant patients
Hydroxyurea
Management for severe acute chest syndrome
Erythrocyte Exchange transfusion
Preferred oral anticoagulant in patients with high risk (triple positivity for lupus anticoagulant, anticardiolipin Ab, anti-B2-glycoprotein) antiphospholipid antibody syndrome
LMWH followed by Warfarin
Treatment for acute promyelocytic leukemia
All-trans retinoic acid (ATRA)
serum monoclonal protein < 3g/dL
Bone marrow clonal plasma cells < 10%
No end-organ damage
MGUS
serum monoclonal protein > 3g/dL
Bone marrow clonal plasma cells > 10%
No end-organ damage
Smoldering multiple myeloma
Management for mild, asymptomatic hereditary spherocytosis
Folate
Management for Waldenström macroglobulinemia hyperviscosity syndrome
Plasmapheresis
