Hematology

Question 1

what is the antidote to eliquis?

Answer 1

andexanet alfa

Question 2

first line therapy for epistaxis if bleeding continues and source is not visualized after holding pressure for at least 15 min; in office treatments if bleeding source is visualized?

Answer 2

anterior nasal packing placement (if still not controlled or hemodynamically unstable then send to the ED); if source seen can use topical silver nitrate or topical TXA

Question 3

in transfusion dependent thalassemia, which medications can help each of the following:
-decrease frequency of blood transfusions needed
-improve bone density if osteoporosis is present
-if ferritin levels are >1000 to minimize iron overload

Answer 3

-plaquenil
-zinc (in addition to calcium, vit D, bisphosphonates)
-deferoxamine

Question 4

would the following lab results be elevated or low in a patient with tumor lysis syndrome?
-potassium
-calcium
-uric acid
-phosphorus
-creatinine

Answer 4

-elevated K+
-low Ca2+
-elevated Phos
-elevated uric acid
-elevated Cr (acute renal failure)

of note, an elevated LDH from high cell turnover before cancer treatment can predict an increased risk of developing tumor lysis

Question 5

for patients under 60 what is first line treatment for immune (idiopathic) thrombocytopenia purpura?

Answer 5

steroids (also sometimes first line is IVIG or rituximab); usually treat when <50k

Question 6

what is the preferred method for diagnosing lymphoma?

Answer 6

open lymph node biopsy

Question 7

what is the alternative test for diabetes diagnosis to A1C in patients with sickle cell and other hemoglobinopathies?

Answer 7

fructosamine test shows average over 2-3 weeks and can be alternative to A1C for diagnosis