Hematology DDx

Question 1

High fever, shaking chills due to systemic lysis of RBC, hepatosplenomegaly, abdominal pain, myalgia, headache and cough?

Answer 1

Malaria

Question 2

Chills ever 48 hours?
Chills every 72 hours?
Chills in daily spikes with no pattern?

Answer 2

48 hours - P. vivax and P. ovale
72 hours - P. malariae
Daily spikes w/ no pattern - P. falciparum

Question 3

Malaria with seizures and coma, severe anemia, acute renal failure, acute respiratory failure and acute respiratory distress syndrome is caused by which pathogen?

Answer 3

P. falciparum

Question 4

Microscopy of blood samples in Malaria should be examined at ___ to ___ hour intervals ___x times and a _______ stain with a thick smear indicates infection

Answer 4

12-24 hour intervals

Giemsa stain with thick smear indicates infection

Question 5

Malaria rapid antigen detection tests have ___% sensitivity and ___% specificity.

Answer 5

98% sensitivity

99% specificity

Question 6

_________ is the drug used to treat malaria

Answer 6

Hydroxychloroquine

Question 7

_________ anti-malarial medication should not be combined with the CHF drug _____ or with the drinking _______.

Answer 7

Hydroxychloroquine should not be combined with the CHF drug Digoxin or with drinking alcohol

Question 8

_________ anti-malarial medication is contraindicated in _______ or _________ field changes and should not be used _____-______ in children

Answer 8

Hyroxychloroquine medication is contraindicated in retinal or visual field changes and should not be used long-term in children

Question 9

Hydoroxychloroquine is / is not contraindicated in pregnancy?

Answer 9

Hydoroxychloroquine is not CI in pregnancy

Question 10

Adverse effects of Hydroxychloroquine include _______opathy, _____ loss, ________ (causes rash), ear symptoms of ________. Long term use leads to myopathy.

Answer 10

Retinopathy
Hair loss
Photosensitivity causes rash
Tinnitus

Question 11

Warm skin d/t ________ of blood vessels, bounding pulse d/t ________ cardiac output, Acute Respiratory Distress Syndrome due to ________ infiltration into the _________ of the lungs, and DIC along with fever, chills, shortness of breath, fatigue, malaise, anxiety and confusion are signs of what condition?

Answer 11

Warm skin d/t vasodilation
Bounding pulse d/t increased cardiac output
ARD d/t neutrophil infiltration into the alveolae of the lungs and DIC along with fever, chills, shortness of breath, fatigue, malaise, anxiety and confusion are signs of Septicemia

Question 12

In septicemia, temperature shows ______, respiration is _________, pulse is _______, BP is _________ and there are signs of _______.

Answer 12

Temperature Fever
Respiration Tachypnic
Pulse Tachycardic
BP Hypotensive
Signs of infection

Question 13

Lab workups for septicemia are aimed at dealing with shock, bleeding, infection, impact on metabolism, and major organ systems. What labs make sense?

Answer 13

All of them
CBC w/ differential
Electrolytes
BUN / Creatinine
Liver enzymes
INR / PTT
Blood cultures
Urine culture and sensitivity
Culture any wounds

Question 14

Emergency treatment for septicemia should include supplemental __________, supportive IV ______ and IV _________.

Answer 14

Oxygen
Fluids
Antibiotics

Question 15

Lymphadenitis is caused by any of three processes. _______ of immune cells within the node; _______ of cells from outside the node; or _______ of an infection into local lymph nodes.

Answer 15

Lymphadenitis is caused by any of three processes. multiplication of immune cells within the node; infiltration of cells from outside the node; or drainage of an infection into local lymph nodes.

Question 16

Microcytic anemias are due to decreased production of _________.

Answer 16

Microcytic anemias are due to decreased production of Hemoglobin.

Question 17

________ + _______ = Heme

and

_______ + ________ = Hemoglobin

Answer 17

Iron + Protoporphyrin = Heme

Heme + Globin = Hemoglobin

Question 18

In Iron deficiency anemia, there is less iron to combine with ______ to make _______, so there is microcytic anemia.

Answer 18

Less iron to combine with Protoporphyin to make Hemoglobin

Question 19

In anemia of chronic disease iron is not deficient but it is ________ in _______ because of the patient’s inflammatory condition.
So, iron is present, but less _______. Hence, there is less iron to combine with _______ to make _______, so there is microcytic anemia.

Answer 19

Iron is sequestered in macrophages because of inflammatory condition, so iron is present but less available. Hence less iron to combine with protoporphyrin to make hemoglobin so there is microcytic anemia.

Question 20

In Thalassemia, there is decreased production of ________, there less to combine with _______ to make ________, resulting in microcytic anemia.

Answer 20

In Thalassemia, there is decreased production of globin chain so there less to combine with heme to make hemoglobin, resulting in microcytic anemia.

Question 21

In Sideroblastic anemia, there is plenty of iron, plenty of globin, but decreased production of _________. This means ________ cannot combine with ________ to make ________, resulting in microcytic anemia.

Answer 21

In Sideroblastic anemia, there is plenty of iron, plenty of globin, but decreased production of protoporphyrin. This means iron cannot combine with protoporphyrin to make heme, resulting in microcytic anemia.