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Surgery EOR > Hematology (Alice) > Flashcards

Hematology (Alice) Flashcards

1
Q

7 bleeding disorders to know

A

HIT
ITP
TTP
hemolytic uremic syndrome
hemohilia
DIC
VWD

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2
Q

meds that cause easy bruising (5)

A

nsaids - mc
steroids
antidepressants
abx
obviously anticoagulants/antiplatelets

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3
Q

3 nutrition related causes of easy bruising

A

protein malnutrition
vit c defic
vit k defic

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4
Q

X-linked bleeding disorders only affecting males (2)

A

factor VIII defic
factor IX defic

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5
Q

autosomal bleeding d.o affecting males and females equally

A

VWD

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6
Q

mc congenital d.o of hemostasis

A

VWD

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7
Q

what are the smallest bleeding lesions that suggest problems w. PLT number for fxn

A

petechiae

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8
Q

what do purpura make you think of (2)

A

thrombocytopenia
coagulation cascade d.o

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9
Q

palpable purpura make you think of

A

IgA vasculitis (henoch schoenline purpura)

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10
Q

purpura plus hypermobile joints

A

ehlers danlos

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11
Q

6 causes of post op bleeding

A

surgical bleeding
meds
inherited d.o
liver dz
renal dz
DIC

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12
Q

what do you think of when a pt has a hx of excessive bleeding after minor procedures or heavy menses

A

VWD

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13
Q

mc presentation of hemophilia

A

in childhood w. spontaneous hemarthrosis

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14
Q

why does renal failure cause easy bleeding

A

uremia inhibits PLT fxn

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15
Q

3 causes of DIC

A

severe sepsis
malignancy
childbirth complications

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16
Q

presentation of DIC (6)

A

bleeding and microthrombi
diffuse bleeding from wounds/surgical sites
hematemesis
digital cyanosis
renal insufficiency
stroke

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17
Q

young woman w. malar rash, arthritis, photosensitivity, renal/cardiac sx, fevers, malaise, and recurrent pregnancy loss, and elevated PTT

A

antiphospholipid syndrome (SLE)

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18
Q

young woman w. bleeding after mild surgical procedure or hx of excessive menses

A

VWD

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19
Q

mc anemia in the US

A

IDA

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20
Q

3 hallmarks of IDA

A

nail spooning
pica
glossitis

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21
Q

lab indicator that iron supplementation is working in a pt w. IDA

A

increasing reticulocytes means iron is working

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22
Q

basophilic stippling

A

lead poisoning

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23
Q

tx for lead poisoning

A

EDTA

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24
Q

dx for anemia of chronic dz requires

A

pesence of chronic infxn, inflammation, or ca

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25
Q

lab findings of anemia of chronic dz

A

low EPO
increased serum ferritin

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26
Q

tx for anemia of chronic dz

A

EPO
tx underlying cause

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27
Q

AI destruction of gastric parietal cells -> lack of intrinsic factor

A

vit B12 deficiency

28
Q

sx of B12 deficiency

A

loss of vibratory/fine touch

29
Q

how does B12 affect homocysteine levels

A

increased homocysteine

30
Q

hypersegmented neutrophils

A

B12 deficiency

31
Q

6 rf for B12 deficiency

A

etoh
vegetarian/vegan
celiac
ibd
surgery
parasites

32
Q

what is the role of folate in anemia

A

it is a cofactor for DNA synthesis -> deficiency = anemia

33
Q

6 causes of folate deficiency

A

malnutrition
etoh/drugs
pregnant
SSA
thalassemia
crohn’s/tropical sprue

34
Q

how does folate deficiency presentation differ from B12 defic

A

no neuro sx w. folate defic

35
Q

how does folate defic affect homocysteine

A

increased homocysteine

36
Q

“macro ovalocytes and hypersegmented PMNs” is pathognomonic for

A

folate deficiency

37
Q

4 hemolytic anemias to know

A

g6pd
hereditary spherocytosis
ssa
thalassemia

38
Q

hallmark lab finding of hemolytic anemia

A

increased reticulocytes

39
Q

3 sx of hemolytic anemia

A

dark urine
back pain
jaundice

40
Q

what type of bilirubin is increased w. hemolytic anemia

A

indirect

41
Q

what happens to haptoglobin w. hemolytic anemia

A

decreased

42
Q

peripheral smear findings of hemolytic anemia

A

microcytic, normochromic
spherocytes

43
Q

2 causes of g6pd deficiency

A

oxidative stress: infxn vs meds
malaria

44
Q

3 triggers for g6pd

A

fava beans
antimalarials
sulfonamides

45
Q

3 sx of g6pd deficiency

A

jaundice
LUQ pain
splenomegaly

46
Q

2 peripheral smear findings of g6pd defic

A

bite cells
heinz bodies

47
Q

inherited dysfxn or deficiency in one or both of the erythrocyte membrane proteins -> spherocytic erythrocytes are destroyed in the spleen -> hemolytic anemia

A

hereditary spherocytosis

48
Q

tx for hereditary spherocytosis

A

splenectomy

49
Q

complication of hereditary spherocytosis

A

hypoplastic crises following aute viral infxn

50
Q

5 sx of hypoplastic crisis

A

profound anemia
HA
nausea
pancytopenia
pigmented gallstones

51
Q

SSA is caused by a mutation in the _ gene

A

beta globlin -> changes 6th aa from glutamic acid to valine

52
Q

6 triggers for SSA

A

infxn/fever
excess exercise
anxiety
abrupt temp change
hypoxia
hypertonic dyes

53
Q

4 complications of SSA

A

pulmonary htn
ESRD
hand/foot/mouth
priaprism -> impotence

54
Q

increased reticuloycites PLUS severe pain in a male AA

A

SSA

55
Q

electrophoresis finding of SSA

A

Hgb S

56
Q

howell jolly bodies on peripheral smear is pathognomonic for

A

SSA

57
Q

tx for severe SSA sx

A

hydroxyurea

58
Q

indicatons for hydroxyurea w. SSA

A

3+ crises/year

59
Q

health maintenance for SSA (4)

A

-regular slit lamp exams
-abx if splenectomy/prophylactic prior to procedures
-vaccines early in life
-vigorous hydration prior to exercise/temp changes/stress/infxn

60
Q

abs bind to the patient’s erythrocytes -> hemolysis

A

AI hemolytic anemia

61
Q

2 types of AI hemolytic anemia

A

warm - mc
cold

62
Q

lab findings of AI hemolytic anemia

A

(+) direct coombs
increased: reticulocytes, LDH, indirect bili
decreased: haptoglobin

63
Q

tx for AI hemolytic anemia (5)

A

rituximab
steroids
cyclophospamide
cyclosporine
IVIG

64
Q

only two beta globin genes, but four alpha globin genes -> changes stability of Hgb -> hemolysis

A

thalassemia

65
Q

tx for thalassemia

A

transfuse PRN
iron/folate supplementation
bone marrow transplant
splenectomy

Surgery EOR (17 decks)

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