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internal 5th year > hematology > Flashcards

hematology Flashcards

1
Q

Auto HSCT indication

A

lymphoma, MM

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2
Q

Allo HSCT

A

AML, ALL, MDS, (CML, CLL rare)

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3
Q

Sinusoidal obstruction syndrome (veno-occlusive disease) th

A

Mainly supportive; consider Defibrotide

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4
Q

Sinusoidal obstruction syndrome (veno-occlusive disease) Prophylaxis

A

Ursodiol

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5
Q

MM Transplant eligible th

A 
High-dose chemotherapy → autologous-HSCT → maintenance therapy
VTD regimen (bortezomib, thalidomide, dexamethasone)
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6
Q

MM Not transplant eligible th

A

Systemic chemotherapy

VRD (bortezomib, lenalidomide, dexamethasone) melphalan

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7
Q

AML young and fit old pt

A

induction: 7days cytarabine +3 days daunorubicin
consolidation: low risk- cytarabine high risk- allogenic HSCT

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8
Q

AML old unfit pt

A

palliative: azacytidine im injection

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9
Q

Acute Promyelocytic Leukemia (APL) th

A

All-trans-retinoic-acid

Arsenic

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10
Q

ALL th Induction:

A

4-6 weeks include combination of anthracycline, vincristine, steroids, asparaginase, cyclophosphamide
CNS prophylaxis → intrathecal MTX

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11
Q

ALL consolidation

A

6-9 months (cyclophosphamide, cytarabine, 6-MP)

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12
Q

ALL Maintenance

A

2-3 years (MTX, 6-MP).

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13
Q

PV low risk th

A

Phlebotomy

Low-dose ASA

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14
Q

PV high risk th

A

Cytoreductive therapy → hydroxyurea anagrelide
pregnant: INFa
ruxolitinib ( JAK2 inhibitor)

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15
Q

ET low risk th

  • Age < 60 y’
  • No history of thrombosis
  • PLT count < 1 million/mm3
  • No CV risk factors
A

ASA (< 100 mg/daily)

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16
Q

ET high risk th

A

ASA (< 100 mg/daily)

Cytoreduction: Hydroxyurea Anagrelide

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17
Q

PMF asymptomatic no anemia

A

no treatment

18
Q

PMF young pt with poor prgnosis

A 
allogenic HSCT
ruxolitinib
transfusions 
splenectomy 
hydroxyurea
19
Q

CML 1st line th

A

imatinib
Dasatinib
nilotinib

20
Q

MDS low risk asymptomatic th

A

watch and wait

21
Q

MDS low- intermediate risk

A

del (5q) : lenalidomide

DNA demethylating agents - azacytidine decitabine

22
Q

MDS intermediate high risk

A
  • DNA demethylating agents
  • Combination chemotherapy (similar to AML protocol)
  • Allogenic HSCT
23
Q

Aggressive NHL th

A

CHOP-R (cyclophosphamide, hydroxydaunorubicin = doxorubicin, oncovorin = vincristine, prednisone, rituximab).
Radiation therapy for localized or bulky disease.
CNS prophylaxis with intrathecal methotrexate

24
Q

CLL/SLL Rai stage >0 th

A

FCR: fludarabine, cyclophosphamide, rituximab
Chlorambucil – potential agent to use in elderly
Anti-CD52 (alemtuzumab) for del(17p)

25
Q

Follicular lymphoma (local symptoms, compromise of normal organ function, B symptoms, symptomatic extranodal disease)

A

CHOP

CVP : cyclophosphamide vincristine predniosne

26
Q

Hodgkin Lymphoma Stage I-II th

A 
ABVD regimen (adriamycin = doxorubicin, bleomycin, vinblastine, dacarbazine) 
*for non-classical HL → ABVD + Rituximab (anti-CD20)
IFRT after chemo used in pt have bulky dis only
27
Q

Stage III-IV Hodgkin lymphoma th

A

ABVD regimen for 6 cycles followed by BEACOPP regimen

28
Q

Hodgkin lymphoma Refractory or relapsed disease

A 
Brentuximab vedotin (anti-CD30)
High-dose chemotherapy + autologous HSCT  
Nivolumab (PD-1 inhibitor)
29
Q

Iron Deficiency Anemia (IDA) Management

A

Oral iron therapy: Ferrous-gluconate, Ferrous-fumarate

Intravenous iron: Iron-sucrose ferric preparations

30
Q

Vitamin B12 (Cobalamin) Deficiency Management

A

1 mg hydroxocobalamin IM

31
Q

Sickle Cell Disease Management

A

Hydroxyurea
Allogeneic HSCT
Pain crises treated with hydration, oxygen, and analgesia

32
Q

Paroxysmal Nocturnal Hemoglobinuria (PNH) targeted th

A

Eculizumab (Ab inactivates terminal complement C5s)

33
Q

Warm Autoimmune Hemolytic Anemia Management

A

corticosteroids +/- splenectomy; IVIG, rituximab

34
Q

Cold AIHA Management

A

cold avoidance; corticosteroids often ineffective, consider rituximab.

35
Q

Aplastic Anemia and Bone Marrow Failure Syndromes th

A

Allogeneic HSCT 1st line

anti-thymocyte globulin (ATG) + cyclosporine 2nd line

36
Q

Immune Thrombocytopenic Purpura (ITP) th

A

Corticosteroids, IVIG
Rituximab
TPO receptor agonists

37
Q

Thrombotic Thrombocytopenic Purpura (TTP) th

A
  • Urgent plasma exchange
  • Corticosteroids
  • FFP if delay to plasma exchange
  • Rituximab (for refractory cases) *Platelet transfusions contraindicated
38
Q

Hemolytic-Uremic Syndrome (HUS)

A

Mainly supportive

39
Q

Hemophilia th

A

Factor replacement therapy (purified or recombinant)
desmopressin
Anti-fibrinolytic therapy (aminocaproic acid or tranexamic acid)
Emicizumab

40
Q

Inhibitor formation in Hemophilia th

A

immune tolerance induction (ITI) based on daily infusion of missing protein until the inhibitor disappears

41
Q

Von-Willebrand disease th

A

desmopressin
VWF replacement therapy
Anti-fibrinolytic therapy (aminocaproic acid or tranexamic acid) prophylaxis before minor procedures.

42
Q

Antiphospholipid Syndrome (APS) th

A

heparin overlapped with warfarin(alone or in combination with 80 mg aspirin daily).

internal 5th year (2 decks)

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