Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical: Emergency Medicine > Hematology > Flashcards

Hematology Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

what is the presentation of the patient with ALL

A

CHILD + Lymphadenopathy + bone pain + bleeding + fever in a CHILD, bone marrow > 20% blasts in bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

a 5 y/o child with lymphadenopathy, bone pain, bleeding, and fever. Bone marrow demonstrates > 20% lymphoblasts
what is the most likely diagnosis

A

ALL (acute lymphocytic leukemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a 60-year-old male complaining of fatigue. Blood tests demonstrate severe anemia, decreased neutrophil count, and small, abnormal B lymphocytes in the bone marrow (>30%) with levels at 90,000 per cubic millimeter. He has painless cervical lymphadenopathy and hepatosplenomegaly.
what is the diagnosis

A

CLL (chornic lymphcytic leukemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are diagnostic tests for CLL

A

SMUDGE cells on peripheral smear
mature lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

a 52-year-old male who reports that he has been feeling very tired lately, and his wife thinks that he looks pale. You order a complete blood count, which shows: Hgb 8.5 g/dL (normal 13.5-17.5); WBC 1,200/microliter (normal 4,500 – 11,000); platelets 70,000/microliter (normal 150,000 – 400,000). The patient is referred for bone marrow biopsy, which shows myeloblasts with Auer rods.
what is the diagnosis

A

AML (acute myeloid leukemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the classic presentation of AML on diagnostic testing

A

blasts + AUer rods in adult patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

a 49-year-old healthy male without complaints, but on a routine complete blood count (CBC) has markedly increased white blood cell count of 40,000 per uL (normal 4500 – 11,000). A peripheral blood smear demonstrates leukocytosis with myeloid cells present at various stages of differentiation, with more mature cells present at a greater percentage than less mature cells. The cytogenetic analysis is positive for the Philadelphia chromosome.
what is the diagnosis

A

CML (Chronic myeloid leukemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the lab presentation of anemia of chronic disease

A

Normal or ↓ MCV, ↓ TIBC, ↑ Ferritin (high iron stores) ↓ serum erythropoietin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the treatment of anemia of chronic disease

A

erythropoietin and tx underling disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the lab presentation of aplastic anemia

A

The only anemia where all three cell lines are decreased ↓ WBC ↓ RBC ↓ Platelets - will have normal MCV and ↓ Retic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what diagnostic test proves aplastic anemia

A

Pancytopenia ⇒ decreased WBC, RBC, platelets; most accurate = bone marrow biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what population is commonly affected with folate deficeincy

A

alcoholics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the presentation of G6PD deficiency

A

After infection or medication (oxidative stress) in an African American male (x-linked) + Heinz Bodies and Bite Cells on a smear (damaged hemoglobin - G6PD protects RBC membrane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are triggers for G6PD deficiency

A

fava beans
antimalarials
sulfonamindes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what diagnostic test for G6PD deficiency

A

Heinz bodies and bite cells on smear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what physical exam findings are commonly seen with iron deficiency anemia

A

Pica and nail spooning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

African American, pain, family history of blood disorder, Hemoglobin electrophoresis: Hemoglobin S, Blood smear: Sickled RBCs, Howell-Jolly bodies, target cells
what is the diagnosis

A

sickle cell anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the treatment of sickle cell anemia

A

Hydoxyurea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is seen on blood smear with sickle cell

A

sickled RBCs, Howell-jolly bodies and target cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what factor is diminished with Hemphilia A

A

facotr VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what factor is diminished with Hemophilia B

A

Factor IX

22
Q

a 30-year-old woman with a recurrent history of nosebleeds and heavy menses. She recently read that taking a baby aspirin was good for the heart. However, ever since she started taking aspirin, she has been experiencing more and more nosebleeds. Her father and paternal uncle similarly have histories of prolonged nosebleeds. Labs show increased PTT, normal PT, and increased bleeding time.
what is the diagnosis

A

VWD

23
Q

what is the treatment of VWD

A

DDAVP (desmopressin)
or tranfusion if massive bleeding

24
Q

what is virchows triad

A

blood stasis
hypercoagulable state
vascular injury

25
Q

what is factor V leiden

A

procoagulant clotting favor - amplifies production of thrombin a clot formation

26
Q

how is factor V leiden diagnosed

A

activated protein C resistance assay
normal PT/PTT

27
Q

what is the treatment of factor V leiden

A

LMWH bridge to warfain; long term antithrombotic therapy is not recommended

28
Q

what is protein C deficiency

A

vitamin K dependent anticoagulant liver protein that stimulates fibrinolysis and clot lysis (inactivates factor V and VIII) – potentiated by protein S

29
Q

what is the treatment of protein C deficiency

A

heparin and oral anticoagulation for life

30
Q

what is protein S deficiency

A

vitamin K dependent that is a cofactor for activated protein C, which inactivates procoagulant factors Va and VIIIa ⇒ reducing thrombin generation

31
Q

what is antithrombn III deficiency present with

A

recurrent venous thrombosis and PE, repetitive intrauterine fetal death (IUFD)

32
Q

what is antithrombin III

A

natural anticoagulant; inhibits thrombin (IIa), Xa and other proteases; potentiated by Heparin

33
Q

what is antiphospholid antibody syndrome

A

autoimmune; often associated with SLE; characterized by thromboses and recurrent spontaneous abortions

34
Q

how is antiphospholipid antibody syndrome diagnosed

A

lupus anticoagulant
anticardiolipin
DRVVT test
prolonged PTT

35
Q

what is the treatment of Antiphospholipid antibody syndrome

A

High dose IV heparin with thrombotic events then oral anticoagulation indefinities

36
Q

what is the presentation of Hodgkins lymphoma

A

painless lymphadenopathy + bimodal age distribution (15-35) and (>60)
Fever, chills, and night sweats for > 1 month
Painless enlarged posterior cervical and supraclavicular lymph nodes Virchow’s node

37
Q

what is the diagnostic test for Hodgkin lymphoma

A

CXR - mediastinal adenopathy
excisional bx of lymph nodes with Reed-Sternberg cells

38
Q

what is the presentation of Non-Hodgkin lymphoma

A

immunocompromised (HIV) patient with GI symptoms and painless peripheral lymphadenopathy

39
Q

what is polycythemia vera

A

malignancy of the bone marrow that results in overproduction of RBC and can also affect platelets and WBCs

40
Q

what are classic symptoms of polycythemia vera

A

pruritis s/p hot baths
swelling, burning pain and rubor of hands and feet

41
Q

what is erythromelalgia

A

swelling, burning pain, and rubor of the hands and feet

42
Q

what are the 4 H’s of polycythemia

A

Hypervolemia, Histaminemia, Hyperviscostity and Hyperuricemia

43
Q

what is the treatment of polycythemia

A

repeated phlebotomy to lower hematocrit to ≤ 42%

44
Q

what is idiopathyic thrombocytopenic purpura (ITP)

A

Autoimmune reaction to platelets usually after a viral illness

45
Q

what is the treatment of ITP

A

children - supportive care (IVIG for refractory cases)
adults - prednisone

46
Q

what are causes of Thrombotic Thrombocytopenia (TTP)

A

After drugs: Quinidine, cyclosporine & pregnancy
Inhibition of ADAMTS13

47
Q

what is the presentation of TTP

A

Adults
Purpura and “FAT RN”- Fever, Anemia, Thrombocytopenia, Renal failure, Neurological symptoms

48
Q

what is treament of TTP

A

steroids, plasmapheresis

49
Q

what is the presentation of HUS

A

Post-infection: E.coli or Shigella
Children
Severe kidney problems

50
Q

what is treatment of DIC

A

cyopercipitate, FFP, platelet transfusion (if <30,000), heparin and treat the cause

Clinical: Emergency Medicine (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions