Hematology Flashcards
1
Q
What medication is used to prevent recurrences of sickle cell crisis in a patient with sickle cell disease?
A
hydroxyurea
2
Q
What is the best initial treatment for parvovirus B 19 (causing aplastic anemia)?
A
immunoglobulins
3
Q
What is a common manifestation of sickle cell trait?
A
isosthenuria (defect in the ability to concentrate urine)
4
Q
A patient presents with recurrent episodes of hemolysis and jaundice and has a family history of anemia/ hemolysis most likely suffers from ….
A
Hereditary Spherocytosis
5
Q
What is the most accurate test for Hereditary Spherocytosis?
A
Osmotic fragility
6
Q
How can you distinguish microcytic anemia due to iron deficiency form anemia due to thalassemia?
A
1) RDW (increased in iron; normal in thal)
2) iron studies (abnormal in iron; normal in thal)
7
Q
What is the initial best test in a patient with macrocytic anemia?
A
peripheral blood smear (hypersegmented neutrophils)
8
Q
What is the next best test in a patient with macrocytic anemia and hypersegemented neutrophils?
A
folate and B12 levels
9
Q
What medication can cause folate deficiency?
A
1) phenytoin
2) sulfa drugs
3) Methotrexate
10
Q
What are common causes of vitamin B12 deficiency? (5)
A
1) pernicious anemia
2) pancreatic insufficiency
3) inflammation of bowel (crohns, celiac, etc)
4) diphyllohothrium latum
5) blind loop syndrome (gastric bypass)
11
Q
What is the most common neurologic symptoms in patient with vitamin B 12 deficiency?
A
Peripheral neuropathy
12
Q
What is the best test to differentiate macrocytic anemia due to vitamin B12 deficiency versus folate deficiency?
A
methylmalonic acid level (elevated in B12; normal in folate)
used if B12 equivocal b/s transcobolamin is acute phase reactant
13
Q
What is the confirmatory test for pernicious anemia?
A
1) Anti-intrinsic factor
2) anti-parietal cell antibodies
14
Q
What electrolyte disturbance is a complication of vitamin B12 and folate replacement?
A
hypokalemia (K pushed into new cells)
15
Q
What are common non-hematology manifestations in sickle cell disease? (5)
A
1) bilirubin gallstones (due to increased indirect bilirubin)
2) increased infections (encapsulated due to autosplenectomy)
3) osteomyelitis (Salmonella)
4) retinopathy
5) stroke
16
Q
What is the most common cause of osteomyelitis in sickle cell disease?
A
Salmonella
17
Q
What is the best initial test for sickle cell disease?
A
peripheral smear (Howell- Jolly bodies)
18
Q
What is the most accurate test for sickle cell disease?
A
hemoglobin electrophoresis
19
Q
What cells are found on blood smear in sickle cell disease?
A
Howell- Jolly bodies (precipitated remnants of nuclear material in RBC)
20
Q
What cells are found in blood smear in G6PD deficiency?
A
Bite cells
21
Q
What is the treatment for hereditary spherocytosis?
A
- chronic folic acid replacement (support RBC production)
2) splenectomy (stops hemolysis)
22
Q
A patient presents with hemolytic anemia, spherocytosis on blood smear and a positive Coombs test most likely suffers from …
A
Autoimmune (Warm or IgG) hemolysis
23
Q
What is the most accurate diagnostic test for Autoimmune (Warm or IgG) hemolysis?
A
Coombs test (detects antibodies)
24
Q
What distinguishes hereditary spherocytosis from autoimmune (warm or IgG) hemolysis?
A
- Coombs test (negative in HS; postive in IgG)
2. Family hx of anemia (positive in HS; negative in IgG)
25
What is the best initial treatment for autoimmune (warm or IgG) hemolysis?
Steroids
26
What treatment can be used in a patient with recurrent hemolysis from autoimmune hemolysis who are already asplenic?
Rituximab
27
A patient presents with numbness or mottling of nose, ears, fingers, and toes that resolves when the body part is warmed most like suffers from ....
Cold agglutinin disease (IgM mediated)
28
What is the most accurate test for Cold agglutinin disease?
cold agglutinin titer
29
What is the best treatment for cold agglutinin?
1. stay warm
| 2. Rituximab
30
What is the inheritance pattern of G6PD deficiency?
X-linked recessive
31
What are common drugs that induce hemolysis in patients with G6PD deficiency? (6)
1. Dapsone
2. Quinindine
3. Sulfa (Bactrim)
4. primaquine
5. nitrofurantoin
6. fava beans
32
What is the best initial test for G6PD deficiency?
blood smear (bite cells and Heinz bodies w/ methylene blue stain)
33
What is the most accurate test for G6PD deficiency?
G6PD level 1-2 months after actue episode
34
A child presents with hemolytic anemia, schistocytes on blood smear, thrombocytopenia and renal insufficiency most likely has ...
Hemolytic Uremic Syndrome (HUS)
35
An adult presents with hemolytic anemia, schistocytes on blood smear, thrombocytopenia, renal insufficiency, fever and neuro disorder most likely suffers from ...
Thrombotic Thrombocytopenic Purpura
36
What is the deficient in patients with HUS and TTP?
metalloproteinase ADAMTS 13
37
A patient presents with episodic dark urine with first urination, pancytopenia, iron deficiency anemia most likely suffers form ...
paroxysmal nocturnal hemoglobinuria (PNH)
38
What is the defect in paroxysmal nocturnal hemoglobuinuria (PNH)?
defect in PIG-A gene leading to deficient decay accelerating factor (complement regulatory protein CD55 and 59)
39
What is the pathophysiology behind paroxysmal nocturnal hemoglobinuria?
hypoventilation during sleep --> acidosis --> RBCs are most sensitive to complement in acidosis leading to hemolysis and thrombosis
40
What is the most accurate test for paroxysmal nocturnal hemoglobinuria?
CD55 and CD59 levels/ flow cytometry (decreased)
41
What is the best initial treatment for hemolysis associated with paroxysmal nocturnal hemoglobinuria?
prednisone
42
What is the curative treatment for paroxysmal noctural hemoglobinuria?
bone marrow transplant
43
What is the mechanism of action of Eculizumab and what disease can it be used in?
inactivates C5; paroxysmal nocturnal hemoglobinuria
44
What is the most accurate test for aplastic anemia?
bone marrow biopsy
45
A patient presents with fatigue, anemia, increased infections and bleeding most likely suffers from ...
aplastic anemia (pancytopenia not due to other cause)
46
What is the curative treatment for aplastic anemia?
allogeneic bone marrow transplantation (BMT) (if young and matched donor)
47
What is the alternative treatment for aplastic anemia if patient is older or does not have a donor match?
Antithymocyte globulin (ATG) and cyclosporine
48
What is the mutation associated with polycythemia vera?
JAK2 protein
49
A patient presents with hypertension, splenomegaly, bleeding, thrombosis, elevated hct (>60%), oxygen sats normal, and low erythropoietin most likely suffers from ...
polycythemia vera
50
What is the most accurate test for polycythemia vera?
JAK2 mutation
51
A patient presents with elevated platelets (>1 million), erythromelalgia, thrombosis and bleeding most likely suffers from ...
Essential Thrombocytosis
52
What is the best initial therapy for Essential Thrombocytosis?
hydroxyurea
53
What is erythromelalgia?
painful red hands in essential thrombocytosis
54
A patient presents with pancytopenia, bone marrow fibrosis, hepatosplenomegaly, and teardrop-shaped cells on blood smear most likely suffers from ..
Myelofibrosis
55
What type of cells are present in blood smear in myelofibrosis?
tear-drop shaped cells
56
What are medications used in myelofibrosis?
thalidomide and lenalidomide (TNF inhibitors)
57
What is the best initial test for acute leukemia?
blood smear (blasts)
58
What is cause of death in a patient with anemia?
myocardial infarction
| if Hct > 20
59
How much should the hematocrit increase with each unit of packed RBC?
3 points per unit
60
What is considered microcytic anemia?
MCV < 80
| iron deficiency, thalassemia, sideroblastic, lead poisoning, anemia of chronic disease
61
What is considered macrocytic anemia?
MCV > 100 (B12, folate, liver, alcohol)
62
What is megaloblastic anemia?
macrocytic anemia with hypersegmented neutrophils (>4 lobes)
| b12, folate
63
What are causes of normocytic anemia (MCV 80-100)?
1. blood loss
| 2. hemolysis
64
What are common cause of folate deficiency?
1. decreased dietary intake (no green vegetables, no vitamin, alcoholic)
2. increased cell turn over (sickle cell, pregnancy, eczema)
3. phenytoin
65
What is the Schilling's test used for?
to detect cause of vitamin B 12 (pancreatic insufficiency, diphyllobothrium latum)
66
A pt with microcytic anemia along with pica, brittle nails, spoon shaped nail, and glossitis most likely suffers from ...
iron deficiency anemia
67
What are the iron studies for a patient with iron deficiency anemia?
high serum iron
high TIBC
low ferritin
high RDW
68
What is the cause of anemia of chronic disease?
inability to use iron sequestered in stores
69
What are the iron studies for a patient with anemia of chronic disease?
low serum iron
low TIBC
normal-high ferritin
70
What is the treatment for thalassemia major associated hemochromatosis?
defuroxamine (iron chelator)
| no phlebotomy b/c getting transfused regularly
71
When would you use iron supplementation and erythropoietin for anemia of chronic disease?
due to renal disease caused by chemotherapy/radiation for cancer
72
What is the most common cause of iron deficiency anemia?
1. GI blood loss
| 2. menstrual blood loss
73
What is the cause of sideroblastic anemia?
disorder of synthesis of hemoglobin characterized by iron trapped in mitochondria
74
What drugs can cause sideroblastic anemia?
1. alcohol
2. isoniazid
3. chloramphenicol
4. lead poisoning
75
What are the iron studies for sideroblastic anemia?
high serum iron
low TIBC
high ferritin
76
What is the most accurate diagnostic test for sideroblastic anemia?
Prussian blue stain (ringed sideroblasts- iron trapped in mitochondria)
77
What is a medical treatment that can be helpful with sideroblastic anemia?
pyridoxine (B6) (if have defect of ALA synthetase)
78
Which of the microcytic anemia diseases is more likely to be associated with target cells on peripheral smear?
Thalassemia
79
A 6 month old baby develops severe anemia, splenomegaly, jaundice and bone deformities most likely suffers from ....
Beta thalassemia major (Cooley anemia)
80
What are the iron studies for thalassemia?
normal iron
normal TIBC
normal ferritin
normal RDW
81
What are treatment options for thalassemia?
1. blood transfusion (tx iron-overload w/ deferasirox)
2. splenectomy (decrease frequency of transfusion)
3. bone marrow transplant
82
What is the best initial test for microcytic anemia?
iron studies
83
What is aplastic anemia?
failure of all 3 cell lines of bone marrow with unknown etiology (pancytopenia)
84
A pt presents with bleeding, infections and fatigue most likely suffers from ...
aplastic anemia
85
What is the treatment for aplastic anemia?
1. bone marrow transplant (young, healthy w/ donor)
| 2. immunosuppression (antithymocyte globulin, cyclosporine, prednisone)
86
Which microcytic anemia is the only one to have a high serum iron?
sideroblastic anemia
87
A pt with normocytic anemia, jaundice, dark urine, elevated LDH, elevated indirect bilirubin, elevated reticulocyte count, low haptoglobin suggests ...
hemolytic anemia (sickle cell disease, paroxysmal nocturnal hemoglobuinuria, hereditary spherocytosis, G6PD deficiency, drug-induced hemolysis, autoimmune hemolysis)
88
What is the most accurate test for thalassemia?
hemoglobin electrophoresis
89
What is the most accurate test for pancytopenia?
bone marrow
90
What does the bone marrow biopsy show if pancyotpenia due to aplastic anemia?
hypoplastic and fat filled with no abnormal cells
91
A patient presenting with pancytopenia symptoms with blasts present on smear most likely suffers from ...
acute leukemia (AML or ALL)
92
A pt with pancytopenia in adult with associated auer rods and myeloperoxidase most likely suffers from ...
AML (acute myelogenous leukemia)
93
What leukemia is associated with CALLA and terminal deoxynucleotidyl (TdT)?
ALL (CALLA is common ALL antigen)
94
Which type of acute leukemia is associated with disseminated intravascular coagulation (DIC)?
M3 promyelocytic leukemia
95
What is the treatment for acute leukemia?
daunorubicin and Ara-C (cytosine arabinoside)
96
What additional treatment is used for M3 promyelocytic leukemia?
all trans retinoic acid
97
What treatment is used as prophylaxis after acute episode of acute leukemia?
intrathecal methotrexate (leukemia usually recurs in spine)
98
If acute leukemia relapses after chemotherapy, what is the treatment?
bone marrow transplantation
99
A pt with leukemia develops headache, SOB, confusion and brain hemorrhage most likely suffers from ...
leucostasis (white cell sludging in vessels)
100
What is the treatment for leucostasis?
leukapheresis
101
What leukemia is associated with the philadelphia chromosome (translocation btw 9 and 22?
CML (chronic myelogenous leukemia)
102
What is the treatment for CML?
Imatinib (director inhibitor of tyrosine kinase)
103
How do you distiguish between CML and leukomoid reaction?
Leukocyte alkaline phosphatase (functional status of WBC) (low in CML)
104
How do you distinguish CML and CLL?
CBC with differential
| neutrophils- CML; lymphocytes- CLL
105
What is the staging for CLL?
0: lymphcytosis
1: lymphadenopathy
2: splenomegaly
3: anemia
4: thrombocytopenia
106
What type of cells are seen on blood smear in a pt with CLL?
smudge cells
107
What CD antigen is associated with CLL?
CD19
108
What is the treatment of choice for CLL?
fludarabine
109
What is the complications for myelodysplastic syndrome?
1. progression to AML
2. bleeding
3. infection
110
What are Pelger-Huet cells and what disease are they associated with?
bi-lobed neutrophils; myelodysplastic syndrome
111
what is the common genetic defect associated with myelodysplastic syndrome and what is the treatment used if present?
5q deletion; azacitidine or decitabine
112
What is the treatment for polycythemia vera?
phlebotomy
113
What is the most accurate test for polycythemia vera?
Janus Kinase 2 (JAK-2)
114
A pt presents with elevated hematocrit without hypoxia, elevated epo or carbon monoxide poisoning most likely suffers from ...
Polycythemia Vera
115
What is the treatment for essential thrombocytopenia?
hydroxyurea
116
What is the most accurate test for essential thrombocythemia?
JAK-2 (Janus Kinase-2)
117
A pt presents with anemia, elevated reticulocyte count, elevated LDH, elevated indirect bilirubin and decreased haptoglobin usually suffers from ...
hemolytic anemia
118
What is the function of haptoglobin?
transfer free hemoglobin (decreased in hemolysis)
119
What makes the urine dark in intravascular hemolytic anemia?
free hemoglobin (can result in renal failure and ATN)
120
What is the treatment for sickle crisis in sickle cell disease?
fluids, opioids, and oxygen
| give antibiotics if have fever
121
What complications are associated with Sickle Cell disease?
1. osteomyelitis (Salmonella but S. aureus most common)
2. aspetic necrosis of femoral head
3. bilirubin gallstones
4. skin ulcers
5. isosthenuria
122
What is the significant clinical manifestation of sickle cell trait?
isosthenuria (inability to concentrate urine)
123
What causes a large drop in H/H in a patient with sickle cell disease acutely?
Parvovirus B 19
124
What is the most accurate test for Parvovirus B19?
PCR for Parvovirus B 19 DNA
125
What is another diagnostic test that can be used to detect Parvovirus B19 other than PCR?
IgM antibodies against Parvovirus B 19
126
What is the treatment for parvovirus B 19 in sickle disease?
immunoglobulins
127
What is the treatment for acute chest syndrome, stroke,priapism, visual disturbances, and CNS manifestations in sickle cell patient?
exchange transfusion (decrease number of sickling RBC)
128
What is the diagnostic test for cold agglutinin disease?
Coombs test
129
A pt w/ hx of autoimmune diseases presents w/ hemolytic anemia and cyanotic fingers/toes/nose/ear usually in setting of cold, can have spherocytosis most likely suffers from ....
Cold agglutinin disease
130
What is the treatment for Cold agglutinin disease?
Steroids (splenectomy if continue to recur)
131
What is the diagnostic test for Hereditary Spherocytosis?
osmotic fragility test (lysis in hypotonic solutions)
132
What drugs can causes drug induced hemolytic anemia?
1. penicillin
2. methyldopa
3. quinidine
133
A pt presenting with recurrent episodes of hemolytic anemia, spherocytosis, splenomegaly, elevated MCHC and family hx of anemia most likely suffers from ...
Hereditary Spherocytosis
134
What is treatment for Hereditary Spherocytosis?
folate therapy (splenectomy to eliminate site of hemolysis)
135
What type of hemolytic anemia is associated with elevated MCHC (mean corpuscular hemoglobin concentration)?
Hereditary Spherocytosis
136
What is the treatment for paroxsymal nocturnal hemoglobinuria (PNH)?
steroids and anticoagulation
137
A pt presents w/ intermittent dark urine in the morning and thrombosis of major veins (hepatic vein) most likely suffers from ...
Paroxysmal noctural hemoglobinuria (PNH)
138
What is the cause of paroxysmal noctural hemoglobinuria (PNH)?
1. defect in PIG-A makes susceptible to acidotic environment (hypoventilation at night)
2. deficient in decay accelerating factor (CD55/59)
139
What are the diagnostic tests used to detect paroxysmal noctural hemoglobinuria (PNH)?
1. levels of CD55 and CD59
2. sugar-water test
3. acidified-hemolysis (Ham) test
140
What is the most common cause of death in pt with paroxysmal nocturnal hemoglobinuria (PNH)?
hepatic vein thrombosis
141
What type of cells are seen in blood smear of pt with G6PD deficiency?
Bite cell (removal of Heinz body)
142
What is a Heinz body and what disease is it associated with?
precipitated hemoglobin inclusions in RBC; G6PD deficiency
143
When is it best to perform a G6PD level in suspected G6PD deficiency?
1 week after hemolytic event
144
A pt presents with acute, severe hemolytic anemia after infection or use of sulfa drug/ dapsone/quinidine/ primiquine/ fava beans most likely suffers from..
G6PD deficiency
145
What is the function of the plasma cell?
produces immunoglobulins
146
What are the complications of over-active plasma cells?
1. excessive Immunoglobulin
2. osteoclastic activating factor (lytic lesions in bone; elevated calcium)
3. Bence jones protein (renal insufficiency)
4. hyperuricemia (cells turnover)
5. anemia (b/c bone marrow making mainly immunglobulins instead of RBCs)
6. amyloidodsis
147
A pt presents with bone pain, monocloncal immunoglobulin, renal failure, normocytic anemia, increased infections w/ Pneumococcus and H. flu most likely suffers from...
Multiple Myeloma
148
What is the most accurate test for multiple myeloma?
> 10% plasma cell
149
A pt has an isolated monoclonal immunoglobulin spike without symptoms most likely suffers from ...
Monoclonal Gammopathy of Uncertain Significance (MGUS)
150
What is the treatment for multiple myeloma?
1. < 70 y/o & healthy: autologous stem cell transplant (prepare marrow with vincristine, adriamycin, dexamethasone)
2. > 70 y/o & healthy: thalidomide
3. > 70 y/o %& unhealthy: melphalan
151
What treatment can be used for relapsing multiple myeloma?
Bortezomib (proteasome inhibitor)
152
A pt presents with enlarged, painless, firm, rubbery lymph node with night sweat, weight loss, and fevers most likely suffer from ....
Lymphoma
153
What type of cells are seen in histologic examination of lymph nodes in Hodgkin Lymphoma?
Reed-Sternberg cells
154
What is the initial diagnostic test for lymphoma?
excisional lymph node biopsy
155
What diagnostic test is used to determine extent of disease of lymphoma?
CT scan and bone marrow
156
What are the 4 stages of Lymphoma?
1: 1 lymph node
2: 2 lymph nodes on same side of diaphragm
3: lymph nodes on both sides of diaphragm
4: widespread disease w/ extralymphatic sites (liver, bone marrow)
157
What are the treatment options for the different stages?
1 & 2: radiation
| 3, 4 & B symptoms: chemotherapy
158
What type of chemotherapy is used for Hodgkin Lymphoma?
ABVD (adriamycin, bleomycin, vinblastine, decarbazine)
159
What type of chemotherapy is used for non-Hodgkin Lymphoma?
CHOP (cyclophosphamide, hydroxy-adriamycin, oncovin, prednisone)
160
What is the side effect of adriamycin?
cardiotoxicity
161
What is the side effect of bleomycin?
pulmonary fibrosis
162
What is the most common side effect of CHOP chemotherapy?
infertility
163
What is the side effect of cyclophosphamide?
hemorrhagic cystitis
164
What is the side effect of vincristine and vinblastine?
peripheral neuropathy
165
What is the side effect of cisplatin?
1. renal toxicity
| 2. oto-toxicity
166
What is a unique treatment for non-Hodgkin lymphoma?
Rituximab (anti CD20 antibody)
167
What is an important task before starting treatment with Rituximab?
Hep B and C testing (Rituximab can induce fulminant liver injury in pts with active hep B and C)
168
A pt presents with mucous bleeding, petchiae, elevated bleeding time, elevated PTT with normal PT and platelet count most likely suffers from ...
von Willebrand disease
169
What is platelet type of bleeding?
superficial/ mucosal (skin, epistaxis, gingival, petechiae, menorrhagia etc)
170
What is factor type of bleeding?
deep bleeding (joint, muscles, hematoma)
171
A young healthy female presents with mucosal bleeding with thrombocytopenia, elevated megakaryotes and normal PT and PTT most likely suffers from ...
ITP (immune thrombocytopenia purpura)
172
What is the only cause of isolated thrombocytopenia in healthy person with normal spleen?
ITP (immune thrombocytopenia purpura)
173
What is the initial treatment for ITP?
prednisone
174
What is the treatment for ITP that continues to recurrent and very low platelets < 20,000?
splenectomy
175
If a pt with ITP has life threatening bleeding with platelets <10,000, what is the best treatment?
IVIG or Rhogam
| b/c raise platelets the fastest but stopping macrophage from consuming platelets
176
What are the treatment options for von Willebrand disease?
1. DDAVP (desmospressin; mild disease)
2. factor 8 replacement (if DDAVP not effective)
3. avoid aspirin
177
What is the pathophysiology responsible for von Willebrand disease?
decreased vWf --> inability for platelets to adhere to endothelial lining
178
What disorder can result in elevatd PTT with history of clotting (multiple 1st trimester miscarriages, DVTs, PEs)?
Antiphospholipid antibody (lupus anticoagulants)
179
What coagulation study is elevated with heparin treatment?
PTT
180
What coagulation study is elevated with warfarin treatment?
PT
181
What is the triad of symptoms associated with hemolytic uremic syndrome?
1. microangiopathic hemolytic anemia
2. uremia
3. thrombocytopenia
182
What are the 5 symptoms associated with thrombotic thrombocytopenic purpura (TTP)?
1. microangiopathic hemolytic anemia
2. uremia
3. thrombocytopenia
4. CNS manifestation
5. fever
183
What is the pathophysiology associated with TTP (thrombotic thrombocyotpenic purpura)?
deficiency of ADAMTS 13 (protein that cleaves vWf) --> platelets stick too much clogging vessels
184
What is the treatment for TTP?
plasmapharesis
185
A male pt presents with delayed bleeding in form of hematoma and hemarthrosis with elevated PTT and normal PT and platelets most likely suffers from ...
Hemophilia (A: factor 8 deficiency; B: factor 9 deficiency)
186
What is the diagnostic study used in pt with hemophilia?
1. mixing study (PTT corrects -> factor deficient; PTT doesn't correct -> antibody)
2. factor 8 and 9 levels
187
What is the diagnostic test used to determine whether von Willebrand disease is due to dysfunctional von Willebrand factor?
ristocetin platelet aggregation (aggregate --> functional; no aggregation --> dysfunctional)
188
What is the treatment for uremia induced thrombocyopenia?
DDAVP (desmopressin)
189
What are the treatment options for hemophilia?
1. DDAVP (desmopressin causes release of subendothelial factor 8: mild disease)
2. replace factor (severe)
190
A pt with hx of sepsis/ trauma present with bleeding and hemolysis that may lead to renal failure and altered mental status most likely suffers from ...
DIC (disseminated intravascular coagulation)
| due to consumption of platelet and clotting factor
191
What are the most accurate diagnostic tests for DIC?
1. d-dimer
2. fibrin split products
(have elevated PT and PTT; decreased platelet)
192
What type of leukemia is associated with DIC?
promyelocytic leukemia (M3)
193
What is the treatment for DIC?
fresh frozen plasma and platelet transfusion if severe
194
What factors become deficient in setting of vitamin K deficiency?
factor 2,7,9 and 10
195
A pt presents with oozing from venapuncture sites in setting of elevated PT followed by elevated PTT most likely suffer from ...
vitamin K deficiency
196
What is treatment for vitamin K deficiency?
1. vitamin K (mild)
| 2. fresh frozen plasma (severe)
197
What are the 3 causes of elevated PT and PTT?
1. DIC
2. vitamin K deficiency
3. liver disease
198
A pt presents with GI bleeding in setting of elevated PT followed by elevated PTT, without correction after vitamin K replacement most likely suffer from ...
Liver disease causing coagulopathy
199
What is the most common cause of hypercoagulable state?
factor V leiden
200
A pt with low- normal PTT that does not increase with heparin use most likely suffers from ...
AT III deficiency
201
What should be used in a pt that requires anticoagulation in the setting of developing HIT (heparin induced thrombocytopenia)?
thrombin inhibtors (argatroban and lepirudin)
