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Step 2/Level 2 > Hematology > Flashcards

Hematology Flashcards

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1
Q

What conditions will you see basophilic stippling with?

A
  • Lead poisoning
  • Thallasemia
  • EtOH abuse
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2
Q

Treatment of lead poisoning?

A
  • Adults: EDTA or succimer

- Kids: Dimercaprol (iron chelation)

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3
Q

If a peripheral blood smear shows microcytic, hypo chromic anemia with basophilic stippling, what should you suspect?

A

Lead poisoning

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4
Q

What medication can be given to sickle cell patients to decrease vasoocclusive crises?

A

hydroxyurea (increases the hemoglobin F production)

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5
Q

What medication are children with sickle cell given until the age of 5?

A

Penicillin (as prophylaxis for pneumococcal infection)

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6
Q

What vaccines are important for kids with Sickle Cell?

A

“Please Hit My Infection”

  • pneumococcal
  • HiB
  • Meningococcal
  • Influenza
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7
Q

What drugs can cause hemolysis in G6PD patients?

A

“Spleen Purges Nasty Inclusions From Damaged Cells”

  • Sulfonamides
  • Primaquine
  • Nitrofurantoin
  • Isoniazid
  • Fava Beans
  • Dapsone
  • Chloroquine
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8
Q

Howell-jolly bodies are seen in what condition?

A

Hereditary spherocytosis

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9
Q

Bite cells and Heinz bodies?

A

G6PD deficiency

Heinz bodies (oxidative stress --> clumps of hemoglobin) 
-bite cells (from splenic removal heinz bodies)
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10
Q

Transfusion reaction where IgE antibodies attack soluble antigens in donor plasma? Tx?

A

-Urticarial reaction
-Tx: diphenhydramine
(can continue reaction if urticaria resolves)

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11
Q

If a patient with IgA deficiency receives blood with IgA antigens, what reaction is likely to occur?

A

-Anaphylaxis (2/2 anti-IgA IgG antibodies in recipient)

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12
Q

What is the cause of non hemolytic febrile reaction? When is this seen?

A

-cytokines produced by stored donor cells cause fever, chills, malaise 1-6 hours after transfusion

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13
Q

What is the most common cause of acute hemolytic reaction? What are the symptoms?

A
  • ABO incompatibility (2/2 clerical error)

- hemolysis, fever, chills, tachycardia, tachypnea, hypotension

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14
Q

What is the cause of fever, hemolysis or elevated indirect bilirubin 2-10 days after a blood transfusion?

A
  • Anti-kidd or and-D(Rh) antibodies
  • “delayed hemolytic reaction”
  • No treatment needed
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15
Q

Findings in hemolytic anemia?

A

inc LDH, inc indirect bili, Dec haptoglobin, inc reticulocyte count

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16
Q

What can a parvovirus B19 infection lead to? What patients are more likely to experience this?

A 
Aplastic anemia (pancytopenia) 
-sickle cell and hereditary spherocytosis
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17
Q

What is the diagnostic test for aplastic anemia? What will it show?

A

bone marrow biopsy–> hypocellularity and fatty infiltration

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18
Q

What labs are elevated in a B12 deficiency? How does this differ from folate deficiency?

A

Methylmalonic acid and homocysteine

-folate deficiency will have an elevated homocysteine and normal methymalonic acid

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19
Q

Microcytic anemia + neuro symptoms?

A

Lead poisoning

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20
Q

What is the cause of ITP?

A

anti-platelet IgG antibodies

treatment is normally glucocorticoids and IVIG or platelet transfusion if bleeding

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21
Q

What are the clinical features of HUS?

A

-hemolysis, uremia (renal failure) and thrombocytopenia

22
Q

What are the clinical features of TTP?

A

Hemolysis, uremia (renal failure), thrombocytopenia, neurological sequelae (AMS, seizures, coma) and fever

23
Q

What is the treatment for HUS and TTP?

A

Plasma exchange and glucocorticoids

24
Q

What other 2 less critical disorders should be considered as differentials in a patient with thrombocytopenia?

A

Alcoholism and B12 deficiency

25
Q

What are the causes of DIC?

A 
"STOP Making Thrombi"
Sepsis
Trauma
OB complications 
Pancreatitis 
Malignancy 
Transfusions
26
Q

Treatment for von Willebrand Disease?

A

DDAVP (desmopressin)

27
Q

How does hemophilia A affect PT and PTT?

A

Increase PTT

28
Q

How does von willebrand affect PT, PTT, platelet count and bleeding time?

A

Normal platelet count, increases bleeding time, normal PT, increases PTT

29
Q

How does DIC affect platelet count, PT, PTT and bleeding time? Fibrinogen?

A

Decreases platelet count. Increases bleeding time, PT and PT. Decreases fibrinogen

30
Q

How does end stage liver disease affect PT and PTT?

A

Increases PT and PTT

31
Q

What’s the most common mutation that predisposes people to venous thrombus?

A

Factor V Leiden

32
Q

What autosomal dominant bleeding disorder often presents with easy bruising, mucosal bleeding, skin bleeding and menorrhagia?

A

von Willebrand disease

33
Q

What lab is used to monitor Heparin anticoagulation?

A

PTT

34
Q

What is the main use for the direct thrombin inhibitors (dabigatran, argatroban, bivalirudin, desirudin)?

A

anticoagulation in patients that develop HIT

35
Q

What lab is used to monitor warfarin anti-coagulation?

A

PT

36
Q

Treatment for a heparin overdose?

A

Protamine sulfate

37
Q

Smear shows peripheral blasts that are PAS + and TdT +. What is it?

A

ALL

38
Q

Smear shows peripheral blasts that are PAS-, myeloperoxidase + and have Auer rods. What is it?

A

AML

39
Q

Which cancer is associated with a t(9;22)?

A

CML (Philadelphia chromosome, bcr-abl, tyrosine kinase)

40
Q

What is the treatment for CML?

A

Tyrosine kinase inhibitors (Imatinib, Dasatinib, Nilotinib–> all end in “-ib” like inhIBitor)

41
Q

What do smudge cells on a smear indicate?

A

CLL

42
Q

What does a smear with pseudo Pelget-Huet anomaly (neutrophils with 2 nuclear lobes connected by a thin strand) indicate?

A

Myelodysplastic syndromes

43
Q

Symptoms of Multiple Myeloma?

A

CRAB

  • hyperCalcemia
  • Renal failure
  • Anemia
  • Back pain (bone lytic lesions)
44
Q

What are the diagnostic tests for Multiple Myeloma?

A
  • SPEP and UPEP (serum and urine protein electrophoresis)

- skeletal survey (look for bone lytic lesions)

45
Q

What is the characteristic cell type seen on lymph biopsy in Hodgkin lymphoma?

A
  • Reed-sternberg cell

- looks like owl eyes –> large binucleate cells with prominent nucleoli and clearing around the cell

46
Q

What is the most common type of Hodgkin Lymphoma? What are the features of this?

A
  • Nodular sclerosis.

- Nodules of lymphocytes separated by sclerotic bands of collagen, few reed-sternberg cells

47
Q

What translocation is associated with Burkitt lymphoma?

A

t(8;14)

48
Q

What does the histology of Burkitt lymphoma look like?

A
  • Starry sky

- background of dense dark lymphocytes with scattered macrophages.

49
Q

What are the common findings in polycythemia vera?

A
  • thrombosis
  • pruritis
  • erythromelalgia (burning pain in the hands and feet with erythema, pallor or cyanosis)
50
Q

What is associated with a translocation t(14;18)?

A

Follicular lymphoma (non-hodgkin)

51
Q

Most common lymphoma in the US?

A

Diffuse large B cell lymphoma

Step 2/Level 2 (18 decks)

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