Hematology Flashcards
Normal or ↓ MCV
↓ TIBC
↑ Ferritin (high iron stores)
↓ serum erythropoietin
anemia of chronic disease
↓ MCV (microcytic)
↓ MCH (hypochromic)
↑ TIBC
↓ Ferritin (best test, low iron stores)
Target cells, pica, and nail spooning
IDA
Tx of IDA…
Ferrous sulfate 325mg TID + CBC.q 3 mo
PRBCs if Hg < 8
+ Heinz Bodies and Bite Cells on smear
G6PD Deficiency
(+ Direct Coombs Test)
Autoimmune hemolytic anemia
(+) osmotic fragility test, spherocytes
hereditary spherocytosis
The below lab profile indicates what type of anemia?
↑ Retic
↑ LDH
↓ Haptoglobin
↑ Bilirubin (indirect)
hemolytic
Very ↑ Retic count
howell-jolly bodies
target cells
sickle cell
profoundly decreased MCV
normal TIBC/Ferritin
Elevated iron
thalassemia
Tx of beta thalassemia
transfusion
desferoxamine (chelation)
Hg electrophoresis shows HbA2 and HbF…
beta thalassemia
Hg electrophoresis shows HbA2
Beta thalassemia trait
Chinese/SE Asians
Hg electrophoresis shows HgH, HgBart’s
Alpha thalassemia
Smooth beefy, sore tongue. Neurologic symptoms
B12 deficiency
Diagnostic for pernicious anemia…
schilling test
recurrent history of nosebleeds and heavy menses, recent nosebleeds
FHx of similar sxs
Incrased PTT, bleeding time
NORMAL PT
von willebrand disease
This disease has missing factor that prevents platelets to adhere to the vessel wall. Therefore, bleeding doesn’t stop as quickly as it should
vWD
How can you differentiate vWD and hemophilia?
lack of hemarthrosis
Tx of vWD
DDAVP (desmopressin)
Missing clotting factor VIII
hemophilia A (aight)
Missing clotting factor IX… christmas disease…
Hemophilia B
Genetic inheretance of hemophilia
X linked (will affect males)
Hemarthrosis
Increased PTT
Normal PT and Platelets
hemophilia
Which leukemia?
Pediatric patient
LAD
Bone Pain
Bleeding
Fever
ALL
20% blasts in bone marrow can indicate which leukemia?
ALL
Which leukemia?
Middle age patient (peak age 50)
Sometime asymptomatic
+/- fatigue, LAD, splenomegaly
CLL
Dx of CLL
Smudge cells and mature lymphocytes on peripheral smere
Tx of CLL
observation… if lymphocytes > 100,000 start chemo
Which leukemia?
Adult patient
Anemia, thrombocytopenia, neutropenia.
Splenomegaly, gingival hyperplasia and Leukostasis (WBC > 100k)
AML
Which leukemia?
Aur rods and 20% blasts in bone marrow
AML
Which leukemia?
Strikingly increased WBCs (> 100k)
Hyperuricemia
Adult patient
CML
Dx of CML can be done via…
philadelphia chromosome
AML can be treated with…
bone marrow transplant
Which lymphoma has bimodal peaks in 20s and 50s?
hodgkin’s
non-hodgkins is common in what age group?
> 50 yo
Reed sternberg cells indicate…
hodgkin’s
Which lymphoma?
Painless LAD with contiguous spread to local lymph nodes
hodgkin’s
Which lymphoma?
extranodal spread to GI and skin lymph nodes
non-hodgkin’s
Which lymphoma?
B sxs present
a/w EBV
hodgkin’s
Mediastinal adenopathy on CXR indicates which lymphoma?
hodgkin’s
Which lymphoma?
SOB
intussusception
bowel obstruction
abdominal mass
non-hodgkin
biologic available for non-hodkin lymphoma
rituximab
Patient presents with:
pruritis after hot baths
burning pain
rubor of hands/feet (redness)
polycythemia vera
4 Hs of polycythemia vera…
hypervolemia (increased RBCs)
Hisaminemia
Hyperviscosity (Increased Hct)
Hyperuricemia
Tx of polycythemia vera…
repeated phlebotomy
Tx for DIC…
cryoprecipitate, FFP, heparin
Bleeding and thrombosis occuring at the dsame time…
Decreased platelets
increased bleeding time, PT, PTT, D-Dimer
DIC
Autoimmune reaction to platelets usually after a viral illness
Insidious onset, chronic
idiopathic throbocytopenic purpura (ITP)
Associated with HIV, HCV, SLE, CLL
CBC normal except low platelets. (+ Direct Coombs Test)
idiopathic throbocytopenic purpura (ITP)
↓ Platelets + anemia + schistocytes (RBC fragments) on smear and NEG Coombs
After administration of quinidine, cyclosporine or pregnancy
TTP
Purpura and “FAT RN”-
Fever Anemia Thrombocytopenia Renal failure Neurological symptoms
TTP
Post-infection: E.coli or Shigella
Children
Severe kidney problems
HUS
