Hematology 2

Question 1

Widespread microthrombi causing severe thrombocytopenia and diffuse bleeding.

exam shows bleeding from venipuncture sites, catheters, drains.

Extensive arterial and or venous gangrene

Labs show decreased fibrinogen, Increased PT, PTT, and INR

Increased D-dimer

Answer 1

DIC

Tx underlying cause (Gram neg sepsis mc cause)

Question 2

Tx for and isolated thrombocytopenia in a patient with mucocutaneous bleeding.

Normal coagulation studies,

MC after a viral infection.

Answer 2

ITP

Glucocorticoids

IVIG

Question 3

Patient with an autosomal dominant disorder associated with ineffective platelet adhesion.

mucocutaneous bleeding

Prolonged PTT

Tx is Desmopressin

Answer 3

Von willebrand

Question 4

Tx for a patient with excess iron deposits in either the heart, liver, pancreas or endocrine

a decreased hepcidin leads to increased intestinal iron absorption.

Liver bx is most accurate test, shows increased hemosiderin.

Answer 4

Hemochromatosis

Tx is phlebotomy

Question 5

This cancer presents as bone pain and vertebral involvement.

Elevated calcium

Serum protein electrophoresis shows monoclonal protein spikes IgG mos common

Bence-Jones proteins on urine electrophoresis

Rouleaux formation on CBC

Punched out lytic lesions on skull radiographs

Management is stem cell transplant

Answer 5

Multiple myeloma

Question 6

Tx for ALL

Answer 6

Combo chemotherapy

Question 7

Elderly patient with pancytopenia and fatigue.

Exam shows lymph adenopathy and splenomegaly

CBC shows absolute lymphocytosos with small well differentiated normal-appearing lymphocytes with scattered “smudge cells”

Answer 7

CLL

Question 8

Auer rods

Answer 8

AML

Question 9

Tx for CML

Answer 9

Tyrosine kinase inhibitors like Imatinib

Question 10

Bimodal peaks at age 20 and then again > 50

Presents as painless lymphadenopathy

Systemic B symptoms such as fever, night sweats, wt. loss,

associated with EBV

Excisional lymph node biopsy shows Reed sternberg

Answer 10

Hodgkin lymphoma