Hematology Flashcards
What solid cancer are patients with allogeneic hematopoietic cell transplants at risk of developing?
Oral cancers
Phenytoin use causes anemia due to deficiency of what substance?
Folic Acid
Chronic isoniazid use causes deficiency of what vitamin?
Vitamin B 6
What are the levels of MCV, homocysteine and methylmalonic acid in Vitamin B6 deficiency?
MCV is normal, homocysteine levels are elevated and methylmalonic acid levels are normal
Which myeloproliferative disorder has the highest risk of transformation into acute leukemia?
Chronic myeloid leukemia. May accelerate and transform to AML or ALL (blast crisis)
What is the single most accurate test for diagnosing alpha thalassemia?
Genetic studies (DNA PCR)
Which is the best initial test to diagnose sickle cell disease?
Peripheral blood smear
What is the treatment of choice for M3 subtype of AML (aPML)?
ATRA + Daunorubicin
What is the standard post-remission monitoring of acute promyelocytic leukemia?
Sequential monitoring of RT-PCR for t(15;17)
DIC is a common presentation of which subtype of AML?
AML M3 (APL)
What does the iron panel (Iron, Ferritin, Transferrin saturation, TIBC) look like in anemia of chronic disease ?
Low iron, high ferritin, high transferrin
saturation, low TIBC
What kind of anemia is common in chronic inflammatory conditions ?
Anemia of chronic disease
What does the iron panel (Iron, Ferritin, Transferrin saturation, TIBC) look like with iron deficiency anemia ?
Low iron, Low ferritin, Low transferrin saturation, High TIBC
What condition is associated with ATP7B gene?
Wilson’s Disease
True or False: Wilson’s disease is an exacerbating condition for porphyria cutanea tarda (PCT).
False; Wilson’s disease is not an exacerbating condition for PCT.
True or False: Estrogen use, Chronic alcohol use, Hemochromatosis, and Hepatitis C infection are all exacerbating conditions for PCT.
True
Patients whose lab results show either elevated PT or PTT levels and who are not on anticoagulation should have a ____________ study completed
1:1 mixing study
If the mixing study corrects the PT or PTT, what would this indicate?
This would indicate that the patient has a factor deficiency.
What condition is described here? “Condition that is associated with BCR/ABL fusion gene on cytogenetic testing”
Chronic myelogenous leukemia (CML)
Chronic myelogenous leukemia (CML) will usually cause an (elevated or depressed?) LAP level
Chronic myelogenous leukemia (CML) will usually cause a depressed LAP level
How long should heparin be continue to be used for at least __ hours until two consecutive INR readings are greater than or equal to __?
48 hours; 2.0
What are the most common and second most common forms of porphyria?
Porphyria cutanea tarda (PCT) and Acute intermittent porphyria (AIP)
This most common porphyria is characterized by onycholysis and blistering of the skin generally in areas that are exposed to higher levels of sunlight.
Porphyria cutanea tarda (PCT)
This second most common porphyria is a rare autosomal dominant metabolic disorder in which the porphobilinogen deaminase enzyme is deficient.
Acute intermittent porphyria (AIP)
What electrolyte is low with syndrome of inappropriate antidiuretic hormone (SIADH)?
Sodium; Low sodium levels is known as hyponatremia
What electrolyte is low with primary hypoparathyroidism?
Calcium; Low calcium levels is known as hypocalcemia.
What electrolyte is low with renal tubular acidosis type 1 and 2?
Potassium; Low potassium levels is known as hypokalemia.
What electrolyte is low with primary hyperparathyroidism?
Phosphorous; Low phosphorous levels is known as hypophosphatemia.
Late hemolytic reactions tend to have a (negative or positive?) Coomb’s test result
Negative
Early hemolytic reactions due to ABO incompatibility generally result in a (negative or positive?) Coomb’s test.
Positive
Which is the only type of microcytic anemia associated with increased iron levels?
Sideroblastic anemia
Microcytic anemia associated with an abnormal or slightly increased erythrocyte count is seen with which disease?
Beta thalassemia
What is the treatment for myelodysplasia with 5q syndrome?
Lenalidomide
What kind of anemia (microcytic or macrocytic or normocytic) does myelodysplasia present with?
Macroctyic anemia
What is the treatment for myelodysplasia without 5q syndrome?
Azacitidine
Which kind of macrocytic anemia does alcohol abuse more commonly result in?
Macrocytic anemia due to folate deficiency
Environmental exposure to nitrous oxide/laughing gas can cause which kind of macrocytic anemia?
Macrocytic anemia due to B12 deficiency. Nitrous oxide inactivates Vitamin B12
What is the target hemoglobin level while treating patients of anemia of chronic kidney disease with EPO?
11-12 g/dL
Which is the most common infection preceeding aplastic anemia?
Hepatitis
What cause is suggested by aplastic anemia associated with Café au lait spots and short stature?
Fanconi’s anemia
What is the best therapy for aplastic anemia in a young patient?
Hematopoietic stem cell transplantation
What is the most accurate test for diagnosing beta thalassemia?
Hemoglobin electrophoresis
What is the cause of microcytic anemia with normal iron studies?
Thalassemia
How is Cooley’s anemia managed?
Chronic transfusion lifelong
Which of the following therapies for sickle cell disease is contraindicated in pregnancy? Hydroxyurea, folic acid,
oxycodone, acetaminophen, exchange transfusion
Hydroxyurea
What is the most common manifestation of HbSC disease?
Visual problems like retinopathy
Which of the following is not associated with increased reticulocyte count? Acute blood loss, PNH, Iron deficiency anemia, Hereditary spherocytosis
Iron deficiency anemia
How much time is required by reticulocytes in circulation to transform into mature RBCs?
1 day
How does metformin affect vitamin B12?
Metformin may hinder absorption of vitamin B12 in the terminal ileum
Alcohol use can lead to which deficiency associated with elevated MCV?
Folate deficiency
