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PANRE > Hematology > Flashcards

Hematology Flashcards

1
Q

What is best lab used to correct for degree of anemia?

A

Reticulocyte count

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2
Q

SS of Fe def anemia?

A

PICA, Angular stomatitis with atrophy of tongue. Spooning of nails–> Koilonychia

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3
Q

When should you see an increased Reticulocyte count in response to Oral Fe therapy?

A

7-10 days and increase in H/H in 2-3 weeks

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4
Q

What is responsible for Hydrops Fetalis?

A

Alpha-Thalassemia

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5
Q

Microcytic anemia, Severe anemia with bone changes, Cooper colored skin, Jaundice and hepatosplenomegaly?

A

Beta-Thalassemia

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6
Q

How do you dx Thalassemia?

A

Electrophoresis

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7
Q

Heridatry trait of Sideroblastic anemia?

A

X-Linked Recessive

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8
Q

Mitochondrial defect that prevents the incorporation of iron into Hgb? Iron accumulates in mithochondria around RBC nucleus forming a Ringed….

A

Sideroblast

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9
Q

What differentiates Vit B12 deficiency from Folate (Vit B9) deficiency?

A 
B12 has Neuro sxms
Loss of memory
Paresthesia/numbness in extremities
Dimished position of vibratory sense
Weakness and ataxia
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10
Q

What type of anemia is Folate and Vit B12 def?

A

Macrocytic with low Reticulocyte count

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11
Q

What is a required cofactor for Folate synthesis?

A

Vit B12

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12
Q

What is the most common cause of anemia in the chronically ill pt?

A

AOCD

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13
Q

Labs with AOCD?

A
  • Decreased Reticulocyte count
  • Increased ESR
  • Decreased serum Iron but with increased serum ferritin
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14
Q

Decreased Haptoglobin with intravascular hemolysis?

A

Think Hemolytic Anemia

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15
Q

Coomb’s test is used for

A

Dx of Hemolytic Anemia

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16
Q

Direct Coombs?

A

Detects antibody on red blood cell surface
Detects IgG, IgM, or C3
Used in eval of Acquired hemolytic anemia

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17
Q

Indirect Coombs?

A

Detects antibodies in plasma

Used in cross matching of Blood Pro

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18
Q

Schistocytes?

A

Mechanical distruption of the RBC

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19
Q

Which test is used to diagnose Alpha Thalassemia?

A

Hemoglobin Electrophoresis

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20
Q

Cold Autontibody?

A

Usu IgM antibody

Caused by Intravascular hemolysis

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21
Q

Warm autoantibody?

A

Usu IgG antibody

Due to tumor infection or SLE

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22
Q

Heridatary spherocytosis?

A

Congenital Hemolytic Anemia
Autosomal Dominant Disorder
—>Splenomegaly and Spherocytes on periphearl smear

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23
Q

G6PD Deficiency?

A
  • Sex Linked disorder
  • Usu African/Mediterranean
  • Intravascular/Extravascular hemolysis
  • Due to stress-induced hemolysis 2 to Sulfa drugs, antimalarials, Vit K, Infxn, or Fava Beans
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24
Q

Pathoneumoic for G6PD deficiency?

A

Heinz Bodies (Oxidation of Hgb)

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25
Q

Heinz Bodies?

A

G6PD Defiency

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26
Q

Inheretid disorder resulting in prod of defective Hgb
Defect in position 6 on the beta chain
Very common in Africk Americans?

A

Sickle Cell Anemia

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27
Q

African American with fatigue, pallor, jaundice, Leg ulcers?

A

Think Sickle Cell Anemia

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28
Q

What is diagnostic with Sickle Cell?

A

Hgb Electrophoresis HbS

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29
Q

Hydroxyurea?

A

Anti-sickling agent

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30
Q

Sickle Cell Trait?

A

Heterozygotes are carriers

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31
Q

Target Cells on peripheral smear?

A

Sickle Cell Anemia

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32
Q

Pancytopenia wiht bone marrow hypocellularity?

A

Aplastic Anemia

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33
Q

Asymptomatic Pancytopenia?

A

Aplastic Anemia

34
Q

Most common Leukemia in childhood and uncommon in Adults?

A

Acute Lymphocytic Leukemia (ALL)

35
Q

Child with Abrupt onset of fatigue, malaise, bone pain, sweats, bleeding and easy bruising (pallor, petechiae, ecchymoses)?

36
Q

Tx for ALL?

A

Chemo

CNS proph with intrathecal methotrexate or brain XRT, Bone marrow transp.

37
Q

Lyphocytosis, Lymphadenopathy, and splenomegaly in elderly men?

A

Think CLL

-Enlarged cervical LN later splenomegaly

38
Q

Smudge Cells?

39
Q

First line for CLL?

A

Chlorambucil

40
Q

Auer Rods?

A

Pathognomic for AML

41
Q

Tx for AML?

A

Daunomycinand Cytarabine No CNS proph needed

42
Q

Philadepadelphia Chromosone?

A

Patho for CML

43
Q

Marked splenomegaly with fatigue, wt loss, night sweats and fatigue in older person?

44
Q

Lymphocytes with hairlike, cytoplasmic projections?

A

Hairy Cell Leukemia

45
Q

Malignant disorder of the Lymphatic system that affects the Lymph Nodes?

-Bimodal dsitribution (second, third decades and and after 50)

A

Hodgkin’s Lymphoma

May have after a Epstein-Barr virus? With Localized firm, Freely mobile and non-tender.

46
Q

Chronic pruritis and disulfiram-like reaction after drinking alcohol?

A

Think Hodgkins Lymphoma

47
Q

Reed Sternberg Cells

A

Think Hodgkins

48
Q

Reed Sternberg Cells?

A

Larger, Binucleated cells with prominent nucleoli

49
Q

Tx for Hodgkins Lymphoma

A

Get CT of chest too

XRT / Chemo 85% CURABLE with tx

50
Q

Solid Tumor of immune, 90% B cell in origin?

A

Hon-Hodgkin Lymphoma

51
Q

Chest pain, cough, SVC, Abd and back pain, Spinal cord compression?

A

Non-Hodgkins Lymphoma

52
Q

Most common presentatoin in Non-Hodgkins Lymphoma?

A

Cervical, axillary, or inguinal region.
Nodes firm, non-tender with size > 1.0 CM

Need Bx

53
Q

Multiple Myeloma?

A

Neoplastic proliferation of a single clone of Plasma (B Cells

54
Q

Bone pain, weakness, fatigue, hypercalcemia, M proteins in urine? Punched out bone lesions?

A

MM

Compresion and path fxrs common

55
Q

Dx of MM?

A

Serum protien electrophoresis

56
Q

IgM protien and Bence Jones Protein

57
Q

Tx for MM?

A

Chemo with Melphalan and Prednisone

Autologous stem cell transplantiation

58
Q

Hemophilia A?

A 
Factor VIII
Sex Linked Recessive
Hemarthroses after trauma
Spont CNS bleeds
Prolonged PTT
PT/Platelets/bleeding time normal
Decreased activity of Factor VIII
59
Q

Factor VIII deficiency?

A

Hemophilia A

60
Q

TX fo Hemophilia A?

A

Avoid asa and other anticoag
Factor VIII concentrate
FFP/Cryoprecipitate

61
Q

Factor IX disorder?

A

Hemophilia B

62
Q

Hemophilia B?

A

Factor IX (Christmas Factor) deficiency

63
Q

Retroperitoneal hematomas?

A

May be seen in Hem A and B

64
Q

Tx for Hem B?

A

Factor IX concentrate

FFP/Cryoprecipitate

65
Q

ITP?

A

Idiopathic Thrombocytopenic Purpura ITP

66
Q

Autoimmune bleeding disorder in which patients develop antibodies against their own platelets

67
Q

Superficial bleedin of skin, mucous membranes or GU tract?

68
Q

TX ITP

A

Usu self limited

Avoid all drugs tha cause Thrombocytopenia

69
Q

Drugs that worsen Thrombocytopenia?

A

Sulfa, quinine, PCN, furosemide, phenytoin, cimetidine, etc….

70
Q

TTP?

A

Severe thrombocytpenia, hemolytic anemia and neuro abnormalities
Typically with GI S/S such as abd pain and diarrhea
ARF common
Severe HTN is seen

**Neuro abn. Headache, aphasia or stupor

71
Q

Therapy TTP?

A

Large volume plasmapheresis

72
Q

Vw disease?

A

Platelet fxn disorder

Vw protein normally binds to Factor VIII delivering it to sites of coag and preventing its clearance from ciruclation

73
Q

What so bad about VW disease?

A

Cant form platelet plug

74
Q

Vw deficiency Sxms?

A

Easy bruising and mucosal surface bleeding
Worse after NSAID or Asp use
Menorrhagia

75
Q

Tx for Vw?

A

Factor VIII concentrate

DDAVP (synthetic analog of ADH)–>induces release of VWF

76
Q

DIC?

A

Coagulation factors activated and degraded at the same TIME. Triggered by endothelial cell inury or release of tissue factore that activate the coag cascade

77
Q

SS DIC?

A

Bleeding
Bleeding from skin/mucous membranes
Small purpuric to large ecchymoses
Thrombic events can cause gangrenous ditits and nose, and hemm necrosis of skin

78
Q

TX for DIC?

A

FFP/Platelets/IV heparin for thromboses

79
Q

Fatigue, Nausea, Abdominal fullness

A

Classic CML

80
Q

BCR/ABL on Peripheral Smear

PANRE (14 decks)

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