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Internal Med PAEA > Hematology > Flashcards

Hematology Flashcards

1
Q

MC cause of iron deficiency in the US?

A

Chronic blood loss

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2
Q

MC cause of iron deficiency in the world?

A

diet

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3
Q

Sx of iron defiency?

A

pic, pagophagia, koilonychia, glossitis, angular cheilitis, pallor

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4
Q

CBC seen in iron deficiency?

A

microcytic hypochromic anemia

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5
Q

Iron study seen in iron deficiency anemia?

A

decreased ferritin
decreased serum iron
increased TIBC

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6
Q

Txt for iron deficiency anemia?

A

ferrous sulfate

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7
Q

Adv effects of iron?

A

constipation, GI, dark stools

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8
Q

Txt for severe iron deficiency anemia

A

RBC transfusion

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9
Q

MC cause of B12 deficiency?

A

pernicious anemia

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10
Q

Who are at risk for B12 deficiency?

A

vegans, chronic alcoholics

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11
Q

Sx of B12 defiency?

A

neurologic abnormalities

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12
Q

MC initial sx of B12 deficiency?

A

symmetric paresthesias

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13
Q

Blood smear for B12 defiency?

A

macrocytic anemia, hypersegmented neurtophils

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14
Q

What can be used to distinguish B12 deficiency from folate?

A

increased methylmalonic acid, neurologic sx

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15
Q

Txt for B12 deficiency?

A

oral, IM cynaobalamin

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16
Q

Txt for B12 deficiency due to pernicious anemia?

A

lifelong monthly IM B12 injections

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17
Q

Where is B12 absorbed?

A

distal ileum

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18
Q

What is needed for B12 absorption?

A

intrinsic factor

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19
Q

What cells make intrinsic factor?

A

parietal cells

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20
Q

MC cause of folate deficiency?

A

inadequate intake

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21
Q

Sx of folate deficiency?

A

no neurologic abnormalities, normal methylmalonic acid

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22
Q

Txt for folate deficiency?

A

oral folic acid

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23
Q

CBC seen in anemia of chronic dx?

A

normocytic normochromic anemia

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24
Q

Iron studies seen in chronic anemia?

A

normal or increased ferritin
decreased TIBC
decreased serum iron

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25
Q

Txt for anemia of chronic dx?

A

treat underlying cause

erthyropoietin alpha if renal dx

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26
Q

Sickle cell trait is what type of genetic disorder?

A

autosomal recessive

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27
Q

Sx of pts w/ sickle cell trait?

A

asymptomatic. May develop sx if exposed to factors

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28
Q

Dx of sickle cell?

A

hemoglobin electrophoresis

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29
Q

Txt for sickle cell trait?

A

none

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30
Q

MC presenting sx of sickle cell dx?

A

dactylitis

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31
Q

Pts with sickle cell dx are at risk for?

A

infection w/ encapsulated organisms
Osteomyeltis
Stroke

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32
Q

MC organism in patients w/ sickle cell dx?

A

Salmonella spp.

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33
Q

Dx of sickle cell dx?

A

peripheral smear

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34
Q

What is seen on peripheral smear for sickle cell dx?

A

Howell-jolly bodies, target cell, sickled erythrocytes

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35
Q

What is seen on hemoglobin electrophoresis for sickle cell dx?

A

HbS, little to no HbA, increased HbF

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36
Q

What is the definitive dx for sickle cell dx?

A

DNA analysis

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37
Q

Txt for sickle cell dx?

A

IV hydration and oxygen

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38
Q

Med for sickle cell dx?

A

Hydroxyurea

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39
Q

Definitive cure for sickle cell?

A

bone marrow transplant

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40
Q

What supplement is need in sickle cell dx?

A

folic acid

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41
Q

What drug reduces the frequency and severity of pain episodes and prolongs survival in sickle cell dx?

A

Hydroxyurea

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42
Q

Adverse effects of Hydroxyurea?

A

Myelosupression, GI upset

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43
Q

What is the prophylactic for sickle cell dx?

A

Penicillin given at 2-3 mo till 5yrs

Pneumococcal and influenza vaccine

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44
Q

What’s the problem in Thrombotic thrombocytopenic purpura?

A

ADAMTS13 deficiency

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45
Q

Pentad seen in Thrombotic thrombocytopenic purpura?

A 
Fever
Anemia
Thrombocytopenia
Renal failure
Neuro sx
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46
Q

Txt for Thrombotic thrombocytopenic purpura?

A

plasmapheresis

glucocorticoids and/or Rituximab

47
Q

What txt should not be done in Thrombotic thrombocytopenic purpura?

A

platelet transfusions

48
Q

MC primary bone malignancy in adults?

A

Multiple myeloma

49
Q

Sx of multiple myeloma?

A 
bone pain
recurrent infections
elevated calcium
anemia
kidney injury
50
Q

What proteins are seen in multiple myeloma?

A

Bence jones proteins

51
Q

What is seen on CBC for multiple myeloma?

A

Rouleaux formation

52
Q

Txt for multiple myeloma?

A

stem cell transplant

53
Q

MC leukemia in children?

A

ALL (acute lymphocytic leukemia)

54
Q

Children who have ?? are at risk for ALL?

A

Down syndrome

55
Q

What symptoms are associated with ALL?

A

Pancytopenia, fever & infections, bleeding, anemia

56
Q

Findings on PE for ALL?

A

hepatomegaly or splenomegaly

57
Q

Txt for ALL?

A

chemo

58
Q

MC form of leukemia in adults?

A

CLL (chronic lymphocytic leukemia)

59
Q

MC sx of CLL?

A

fatigue

60
Q

MC sx on PE for CLL?

A

lymphadenopathy, splenomegaly

61
Q

Characteristic of CLL?

A

Smudge cell

62
Q

MC acute leukemia in adults?

A

AML (acute myeloid leukemia)

63
Q

Characteristic of AML?

A

Auer rods

64
Q

Characteristic of CML?

A

Philadelphia chromosome

65
Q

Leukemia associated w/ pruritus after hot baths?

A

CML

66
Q

Txt for CML?

A

Tyrosine kinase inhibitors Imatinib

67
Q

Risk factor for Hodgkin lymphoma?

A

Epstein Barr virus

68
Q

Sx of Hodgkin lymphoma?

A

asymptomatic painless lymphadenopathy (painful w/ Etoh ingestion)

69
Q

MC site for Hodgkin lymphoma?

A

neck (cervical and supraclavicular)

70
Q

Systemic B symptoms?

A

fever, night sweats, weight loss, Pel Ebstein fever

71
Q

Dx of Hodgkin lymphoma?

A

excisional whole lymph node biopsy

72
Q

How to differentiate Hodgkin from Non-Hodgkin?

A

Reed Sternberg cell (Hodgkin)

73
Q

What does Reed Sternberg cells look like?

A

owl eyes

74
Q

Txt for Hodgkin lymphoma?

A

chemo + radiation

advance- combo chemo

75
Q

MC type of Non-Hodgkin?

A

diffuse large b cell

76
Q

MC site of extranodal Non-Hodgkin?

A

GI tract

77
Q

What type of genetic disorder is G6PD?

A

X-linked recesive

78
Q

Seen on peripheral smear for G6PD?

A

schistocytes “bite cells”, heinz bodies- hallmark

79
Q

Txt for G6PD defeciency?

A

avoid offending food and drugs

80
Q

What can exacerbate G6PD deficiency?

A

infection, fava beans

meds: dapsone, primaquine, methylene bluse, nitrofurantoin

81
Q

What type of genetic disorder is Hemophilia A and B?

A

X-linked recessive

82
Q

Sx seen in Hemophilla A and B?

A

hemathrosis, delayed bleeding, swelling in joints- ankles, excessive hemorrhage

83
Q

What coagulation is is messed up in hemophilia?

A

prolonged aPTT

84
Q

1st line Txt for hemophilia A acute or prophylaxis?

A

factor VIII

85
Q

Mild txt of Hemophilia A?

A

Desmopressin (DDAVP)

86
Q

1ST Txt and prophylaxis for hemophilia B?

A

Factor IX

87
Q

What type of genetic disorder is Von Willebrand?

A

autosomal dominant

88
Q

MC hereditary bleeding disorder?

A

von willebrand

89
Q

Sx of Von Willebrand disorder?

A

mucocutaneous bleeding

90
Q

What coagulation is messed up in Von Willebrand?

A

prolonged PTT and BT

91
Q

Txt for Von Willebrand?

A

DDAVP

92
Q

MC inherited cause of hypercoagulability?

A

Factor V Leiden

93
Q

What sx are seen in Factor V Leiden?

A

increased DVT, PE, hepatic vein , cerebral thrombosis

94
Q

Txt for Factor V?

A

indefinite anticoag

95
Q

Patho of immune throbocytopenic purpura?

A

autoantibodies against platelets, leading to splenic destruction of platelets

96
Q

ITP is most common after what?

A

viral infection

97
Q

Sx seen in ITP?

A

mucocutaneous bleeding, NO SPLENOMEGALY

98
Q

1st Txt for ITP?

A

Glucocorticoids

99
Q

2nd Txt for ITP?

A

IVIG

100
Q

Txt for children with no bleeding or mild bleeding in ITP?

A

observation

101
Q

What should make you think of Thalassemia?

A

microcytic anemia w/ normal or increase serum Fe with no response to Iron treatment

102
Q

Who is Alpha Thalassemia most common in?

A

SE Asians

103
Q

Sx of alpha thalessemia?

A

sx present at birth

frontal bossing

104
Q

Definitive txt for thalassemia?

A

bone marrow transplant

105
Q

Txt for alpha thalassemia?

A

episodic blood transfusion

iron chelating agents

106
Q

Risk factor Beta thalassemia?

A

Mediterranean

107
Q

MC type of beta thalassemia?

A

minor

108
Q

Sx of beta thalassemia?

A

sx present after >6mo
hemolytic anemia
chronic anemia
hepatosplenomegaly

109
Q

Txt for Beta thalassemia?

A

frequent transfusions
iron chelating
Vit C & folate

110
Q

Antiphospholipid syndrome is associated with what dx?

A

systemic lupus erythematosus

111
Q

Sx of antiphospholipids?

A

increased risk of arterial & venous thromboses
recurrent DVT or PE
recurrent miscarriages

112
Q

What type of anticoag is seen in antiphospholipid syndrome?

A

lupus anticoagulant

113
Q

Txt for antiphospholid syndrome?

A

asymptomatic no txt
lifelong Warfarin
LMHW- preggo

Internal Med PAEA (9 decks)

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