Hematology

Question 1

what are causes of anemia of chronic disease

Answer 1

inflammation, CKD, Cancer, RA, TB

Question 2

what is the treatmetn of anemia of chronic disease

Answer 2

Erythropoietin 50-150 U/kg IV 3xweekly
treat the underlying disease

Question 3

what is the only anemia where all three cell lines are decreased

Answer 3

aplastic anemia

Question 4

what population is affected by folate deficiency

Answer 4

alcoholics

Question 5

what causes hemolytic anemia

Answer 5

premature breakdown of RBCs

Question 6

what is G6PD deficiency

Answer 6

after infxn or medication in African American male

Question 7

what is seen with G6PD deficiency on lab tests

Answer 7

Heinz bodies and bite cells on smear

Question 8

what is the most common anemia in the US

Answer 8

iron deficiency

Question 9

what is the presentation of Iron deficiency anemia

Answer 9

decreased MCV, MCH, Ferritin
Increased TIBC
target cells, pica and nail spooning, SOB, weakness, headaches and tinnitus

Question 10

what is the treatment of sickle cell anemia

Answer 10

Hydroxyurea
-vaccine: meningococcal, penumococcal, H.infleunzae, influenze

Question 11

What is thalassemia

Answer 11

a family history of blood cell disorder, microcytic hypochromic, elevated iron

Question 12

what are the types of thalassemias

Answer 12

beta thalassemia major
beta thalassemia trait
alpha thalassemia

Question 13

what is the presentation of Vitamin B12 deficiency

Answer 13

smooth beefy, sore tongue. Neurologic symtpoms (poor balance, low proprioception)

Question 14

a 8yo boy with hemophilia A with sponataneous bruising and nose bleeds. What type of factor deficiency is this?

Answer 14

Factor 8

Question 15

a 7yo boy with hemophilia B with large right knee hemartosis is missing what factor

Answer 15

Factor 9

Question 16

a 23 yo woman with vWB who develops bleeding complications - what is the treatment

Answer 16

first try DDAVP, then cryoprecipitate prn

Question 17

a 67yo pt with liver failure and s/p fall in the OR for ex-lap; the pt develops progressive oozing; the PT and PTT are normalized; platelets 300,000; fibrinogen 49.7. what is the treatment

Answer 17

cryoprecipitate - provides fibrinogen

Question 18

pt with liver failure and poor nutrition with elevated PT that is refractory to multiple transfusions of FPP what is the next treatment option

Answer 18

VItamin K

Question 19

A 60-year-old man presents with a history of easy bruising and prolonged bleeding after minor cuts. He is scheduled for an elective hernia repair. His past medical history is significant for hypertension and type 2 diabetes mellitus. He denies any family history of bleeding disorders. Laboratory tests reveal a normal platelet count, prolonged PT, and normal aPTT. Which of the following is the most likely cause of his bleeding tendency?
A Hemophilia A
B Vitamin K deficiency
C Von Willebrand disease
D Disseminated intravascular coagulation (DIC)
E Chronic liver disease

Answer 19

b. Vitamin K deficiency

Vitamin K deficiency leads to a decrease in the synthesis of vitamin K-dependent clotting factors (II, VII, IX, and X), resulting in a prolonged prothrombin time (PT) and normal activated partial thromboplastin time (aPTT). This deficiency can be caused by inadequate dietary intake, malabsorption, or the use of certain medications such as antibiotics or warfarin. Given the patient’s prolonged PT and normal aPTT, vitamin K deficiency is the most likely cause of his bleeding tendency.