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Hematology Flashcards

1
Q

In patients with reduced Fe, use up _____ first which will show a decreased serum_______ level?

A

Ferritin

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2
Q

Decreased Serum Iron, Decreased Ferritin, Inc. TIBC

A

Fe deficiency anemia

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3
Q

Decreased Serum iron, Increased ferritin and TIBC

A

Anemia of chronic disease

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4
Q

Microcytic Anemias include?

A 
Fe deficiency                    (FLATS)
Lead poison
Anemia of chronic Dz
Thalassemia
Sideroblastic anemia
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5
Q

Macrocytic Anemias include?

A
  • Folate *Alcohol (FATRBC)
  • Thyroid (Hypo) *Rx (meds)
  • B12 *Cirrhosis
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6
Q

Blood smear Rouleaux formation “Stack of coins”

A

Multiple Myeloma

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7
Q

Blood smear “Howell-Jolly bodies” (Dot on RBC)

A

Sickle Cell

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8
Q

Blood smear Heinz body “Bite Cells”

A

G6PD deficiency

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9
Q

Blood smear Basophilic stippling

A

Lead Poisoning or Sideroblastic anemia (Heavy metal)

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10
Q

Blood smear Codocytes “Target cells”

A

Thalassemia

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11
Q

Blood smear hypersegmented or >5 lobes in WBC neutrophil?

A

B12 and Folate deficiency

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12
Q

Blood smear Auer Rods

A

Acute Myelogenous Leukemia

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13
Q

Blood smear Reed-Sternberg Leukemia “Owl eyes”

A

Hodgkin Lymphoma

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14
Q

Approach to anemia step 1-2?

A 
#1. Reticulocyte (High or Low)
#2. LOW= MCV (<80 or >120)?
       High= Blood loss or RBC destruction G6, SC, Sphe?
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15
Q

Deficiency –> Abnormal synthesis of DNA
Almost exclusively MCV >115

Pernicious Anemia, strict Vegans, ETOH malabsorption

A

B12 (Cobalamin) Deficiency

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16
Q

What vitamin increases Fe iron absorption?

A

Vitamin C

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17
Q

Inhibits multiple enzymes for heme synthesis and shortens RBC life span.

Abdominal pain with constipation + Neurological Sx. Ataxia, fatigue, learning disability, shock or coma

A

Lead poisoning Anemia (Plumbism)

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18
Q

Decreased production of alpha globin chain with 3 abnormal alleles:

A

Alpha Thalassemia Intermedia (Hgb H Disease)

“Symptomatic”

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19
Q

Decreased production of alpha globin chain with 2 abnormal alleles:

A

Alpha Thalassemia Minor

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20
Q

Decreased production of alpha globin chain with 4 abnormal alleles:

A

Hydrops Fatalis “Bart’s” (Tetramer)

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21
Q

Decreased production of alpha globin chain with 1 abnormal allele:

A

Alpha Thalassemia Silent carrier

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22
Q

Decreased production of Beta globin chain w 1 normal and 1 deletion or mutation of alleles: B/ B+ (or B0)
X1 Mutated and X1 mutated or deleted)

A

Beta Thalassemia Trait (Minor)

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23
Q

Decreased production of Beta globin chain with both Alleles mutated

A

Beta Thalassemia Major (Cooley’s anemia) severe

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24
Q

Decreased production of Beta globin chain with 1 deletion and 1 mutation of alleles: B+/B 0
X1 Mutated and X1 mutated or deleted)

A

Beta Thalassemia Intermedia (Mild symptoms)

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25
Treatment for Alpha Thalassemia Moderate and Severe?
Moderate: Folate (Avoid Iron supplementation) Severe: IV deferoxamine (Fe Chelating Agents) Splenectomy: Bone marrow transplant definitive
26
Treatment for Betta Thalassemia Moderate and Severe?
Moderate-Severe: Folate, Vitamin C, IV Deferoxamine | Splenectomy : Bone marrow transplant Definitive
27
At what age is adult Hgb predominant and what type of Hgb is adults and which is fetal?
Predominant after 6 months (95% = 2 alphas/2 Betas) Adult Hgb= Hgb A Fetal Hgb= Hgb F
28
Anemia caused by infection, inflammation or malignancy: Normocytic Anemia
Anemia of chronic Disease
29
caused by oxidative stresses causing the RBC to rupture. infection is the MCC also fava beans, sulfa drugs or antimalarial drugs: Tx:?
Glucose-Phosphate Dehydrogenase deficiency Tx: Iron + Folate (Transfusion if severe)
30
Stress, infection or hypoxia --> Dactylitis (MC Sx), microthrombosis, hemolytic anemia, pain, hematuria infections (salmonella), H shaped vertebrae, skin ulcers. Tx:
Sickle Cell Anemia ``` Tx: #1. Pain control, IV Hydration, O2 #2. Hydroxyurea (reduces sickling "inc. Hgb F") #3. Transfusion ```
31
Sickle cell anemia trait Hgb
autosomal recessive disorder "HgbS Heterozygous"
32
Parvo B19 in Sickle cell disease can cause what?
Aplastic crisis
33
RBC membrane and cytoskeleton defect--> cell fragility and hemolysis: Lacks central pallor (donut) --> aplastic crisis with Parvo B19
Hereditary Spherocytosis
34
Hemolysis + thrombosis: Dar Coca-Cola urine during night or early a.m:
Paroxysmal Nocturnal Hemoglobinuria
35
Secondary hemostasis pathway with Normal PTT requires factors VIII, IX, XI, XII
Intrinsic Pathway
36
Extrinsic Pathway secondary hemostasis with normal ____ requires factors?
Normal PT Factors: VII and X
37
PTT and INR are affected mostly by what drug? what is the reversal/antidote?
Heparin, LMWH, UFH Protamine Sulfate
38
PT is affected mostly by what drug? what is the reversal/antidote?
Warfarin and Vitamin K deficiency Reversal-Vitamin K
39
Thrombocytopenia MC acquired by children post-infection: Autoimmune Ab against platelets: , epistaxis, menorrhagia, bruises teeth and gums bleeding: normal Coags/ (-) splenomegaly Tx:
Idiopathic Thrombocytopenic Purpura (ITP) Tx: Child IV Ig Adult: IV Ig + CS
40
Autoimmune Ab against ADAMTS 13: 2T SLE, HIV, Prego , malignancy: Thrombocytopenia (+) Splenomegaly Tx:
Thrombotic Thrombocytopenic Purpura (TTP) Tx: Plasmapheresis + CS
41
Thrombocytopenia, anemia, and kidney failure: preceded by E. Coli 0157:H7, shigella, salmonella: Antibiotic use may worsen condition Tx:
Hemolytic Uremic Syndrome Tx: Plasmapheresis
42
MC caused by Gram negative endotoxins: --> wide spread microthrombi consuming coagulation factors--> severe thrombocytopenia--> bleeding)
Disseminated Intravascular coagulation
43
Systemic Inflammatory Response Syndrome
Temperature (Hypo/Hyperthermia) Heart Rate > 90 Respiration >20 WBC < 4K or > 12K
44
MC hemophilia--> almost only in males: Hemarthrosis and excessive hemorrhage: Less common present with petechia/purpura: Tx:
Hemophilia A (Factor VIII deficiency) Tx: Desmopressin and Factor VIII
45
Hemophilia B AKA ______ disease will have deficiency of what factors? Tx?
"Christmas disease" Deficiency: Factor IX (prolonged PTT) Tx: Factor IX (Desmopressin not effective)
46
Study that differentiates Hemophilia A/ B from ?
``` Mixing study (Blood mixed w normal plasma->corrects=Factor Def.) ```
47
ineffective platelet adhesion autosomal dominant disorder: MC Hereditary bleeding disorder Mucocutaneus bleeding and Petechiae is common: Prolonged PTT Dx: Tx:
Von Willebrand Disease (Type II-Deficient III- Absent) Dx: Ristocetin decreased Tx: Mod (II) Desmopressin Severe (III) vWF and Factor VIII
48
Lymphocyte Neoplasm EBV associated: mediastinal LAD (clavicular cervical), weight loss, fever, peaks @ 20 Contiguous spread to local lymphnodes "Reed Sternberg" cell Owl-eye: highly curable
Hodgkin Disease (Lymphoma)
49
Non-Hodgkin lymphoma
- Peripheral painless lymphocyte - Non- contiguous spread to local lymphnodes - Extra nodal GI (Burkitt "Starry Sky"), Skin (pruritus), CNS - Aggressive/unpredictable (Especially Large B cell)
50
What are the 4 main types of Leukemia?
- Acute Lymphocytic Leukemia - Chronic Lymphocytic Leukemia - Acute Myelogenous Leukemia - Chronic Myelogenous Leukemia
51
MC in children peaks 3-7 yo (Trisomy 21 <5yo): B/T cell mediated: CNS sx: Fever MC Sx: anemia and >20% Blasts (Immature WBCs): CNS and testes MC site for METS
Acute Lymphocytic Leukemia
52
MC Leukemia in Adults: B cell clonal Malignancy: | Blood Smear= "Smudge Cells" ZAP-70= poor prognosis
Chronic Lymphocytic Leukemia
53
MC in older males: "WBC> 100K" Philadelphia chromosome: Asymptomatic until plastic crisis
Chronic Myelogenous Leukemia
54
MC acute Leukemia >50: Anemia, thrombocytopenia, Neutropenia: gingival hyperplasia: WBC >100K Bone Marrow "Auer Rods"
Acute Myelogenous Anemia
55
monoclonal Ab (IgA and IgG) accumulate in bone marrow disrupting normal cell production: AA >65 yo Punched out Lytic bone lesions (Skull) UA: Bence-Jones proteins: Blood smear "Rouleaux formation" Stack coins
Multiple Myeloma
56
Multiple Myeloma patient presentation?
K-CRAB - Kidney failure - Calcinosis - Recurrent infections - Anemia - Bone lesions (Lytic)/Pain
57
Pruritus after a hot bath, headaches, blurred vision, facial flushing, engorged retinal veins High hematocrit without hypoxia: hyper-viscosity and thrombosis: Tx
Polycythemia Vera Tx: Phlebotomy (Myelosuppression-Hydroxyurea)
58
Excess iron deposition due to increased Fe storage /absorption: Genotype HFE C282Y: Cirrhosis, Cardiomyopathy, Pancreatic Insufficiency: Bronze Diabetes: Bronze skin Dx: Tx:
Hereditary Hemochromatosis Dx: Liver Bx Tx: Phlebotomy (Chelating agents)
59
MC inherited cause of hypercoagulability: aProtein C "resistance": DVTs, PEs Dx: Tx:
Factor V Leiden Dx: Actiated Protein C resistance assay Tx: Indefinite Anticoagulation
60
Hypercoagulable disorder: deficiency of a vitamin-k dependent anticoagulant protein: recurrent DVTs/PEs Tx:
Protein C Deficiency Tx: PO Anti-coagulant for life
61
Child with a cobb angle of 10-19 degrees treatment?
Observation F/U every 6-9 months
62
Metronidazole should mixed with _______--> ______
Alcohol: Disulfiram reaction
63
Antidote for TCAs amitriptyline?
Sodium Bicarb
64
What can worsen the condition of aspirin overdose ?
Endotracheal intubation
65
Cipro treats almost all abdominal issues except____ which is treated with azithromycin.
Shigellosis
66
Air in orbit after trauma to the eye = what?
Ethmoid (Medial orbital wall) Fracture
67
Difference between a chronic and acute subdural hematoma?
Chronic is hypodense Acute is within 3 days f trauma and hyperdense (white)
68
When you see lymphopenia suspect what viral illness?
West Nile Virus
69
Latent Tuberculosis treatment for patient with liver disease?
Rifampin (Not Isoniazid)

PANCE (13 decks)

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