Hematology Flashcards

1
Q

What are the lab changes in hemolytic anemia?

A
reticulocytosis
increased LDH
decreased haptoglobin (binding free iron)
spherocytes
increased bilirubin (uncong)
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2
Q

What is the difference between a b12 and folate deficiency?

A

time: b12 takes longer

neuro symptoms: b12 has neuro symptoms

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3
Q

What do you watch for with injections of b12?

A

hypokalemia (k goes into new cells being made)

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4
Q

How do you tx alpha thalassemia?

A

heme (fe + protoporphyrin) + globin
bad globin chains (alpha chains in all types)

mild: no tx
moderate: folate, avoid oxidative stress, no extra fe
severe: blood transfusions and fe chelation (IV deferoxamine)

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5
Q

Pt presents with back pain, anemia symptoms, jaundice, and splenomegaly. Just took antibiotic for a sinus infection. Schistocytes are seen on a peripheral smear. What do you suspect?

A
G6PD deficiency
(bactrim = trimethoprim-sulfamethoxazole which is a sulfa drug)  Sulfa drugs can trigger oxidative stress
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6
Q

How do you treat a sickle cell crisis?

A

(beta chain mutated from substitution of valine for glutamate)

IV hydration
oxygen

RBC transfusion if needed

(maybe morphine?)

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7
Q

How do you dx hereditary spherocytosis?

A

osmotic fragility test

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8
Q

What is tx for hereditary spherocytosis?

A

splenectomy

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9
Q

What is the best screening test for paroxysmal nocturnal hemoglobinuria?

A

flow cytometry

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10
Q

IgG ab are associated with which hemolytic anemia? What autoimmune disorder is it associated with?

A

autoimmune hemolytic anemia
warm agglutinins
extravascular destruction after being tagged

SLE

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11
Q

What is the triad of hemolytic anemia? What is the pentad of ttp?

A

thrombocytopenia
microangiopathic hemolytic anemia
kidney failure

add: fever, neurologic symptoms

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12
Q

Do you give antibiotic in HUS?

A

no, might worsen by releasing more toxin

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13
Q

what is a common cause of HUS?

A

enterohemorrhagic e coli 0157:H7

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14
Q

Heparin is what side of the coag cascade?

A

12, 11, 9,8

intrinsic

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15
Q

Warfarin affects what side?

A

7, extrinsic

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16
Q

Hemophilia A affects which coag test?

A

factor 8
intrinsic
PTT

17
Q

What is given for hemo A that increases release of Factor 8 and vWF?

A

desmopressin (DDAVP)

not useful in 9

18
Q

What is the MC hereditary bleeding disorder?

A

vWF

19
Q

What disease are associated with a hypercoagulable state?

A
oral contraceptives (estrogen increases coag factors)
factor V leiden (lacks cleavage site)
Protein C/S deficiency (they normal deactivate V/VIII)
Prothrombin 20210A (thrombin over expressed)
ATIII deficiency (heparin like molecules reduced)
20
Q

What are the “B” symptoms?

A
fever
night sweats
WL
anemia
pruritis
21
Q

What is hodgkin’s lymphoma associated with?

A

reed-sternberg cells
owl eyes
epstein-barr virus (also burkitt lymphoma, a nhl)

22
Q

Which is more curable: hodgkin’s or nonhodgkins?

A

hodgkins is highly curable

23
Q

What is the MC childhood malignancy?

A

ALL

24
Q

What is the MC form of leukemia in adults?

A

AML

25
Q

What do you find in the bone marrow of AML?

A

auer rods

26
Q

How do you tx polycythemia vera?

A

phlebotomy

hydroxyurea causes myelosuppression

27
Q

What differentiates polycythemia vera from secondary erythrocytosis?

A

in secondary only RBCs are increased

in vera all myeloid lines are increased (RBCs, WBCs, platelets)

28
Q

what disorders would make you bleed?

A

advanced liver disease (decreased coag factors)
hemophilia A/B
vWF

29
Q

What is aplastic anemia?

A

hematopoeitic stem cell damage resulting in pancytopenia

30
Q

What causes aplastic anemia?

A

chemicals
viral infections
autoimmune