Hematology Error List

Question 1

What defines an Acute Leukemia

Answer 1

Acute: Precursors so >20% blasts

Question 2

What defines a Chronic Leukemia

Answer 2

Chronic: Differentiated, so

Question 3

What defines Myeloid Leukemia

Answer 3

Myeloid: Granules (neutrophils, basophils, mast cells, macrophages)

Question 4

What defines a Lymphocytic Leukemia

Answer 4

Lymphocytic: B-Cells and T-Cells (lymphocytes)

Question 5

What are features of Acute Myeloid Leukemia

Answer 5

Adults, 50 yrs old
Granulocyte Precursor (>20% blasts)
Sx: Anemia, Thrombocytopenia, Neutropenia, Gingival Hyperplasia, Bone Pain
Dx: AUER RODS
Tx: Combined Chemo

Question 6

What are features of Chronic Myeloid Leukemia

Answer 6

Adults, 50 yrs

Differentiated cells

Question 7

What are features of Acute Lymphocytic Leukemia

Answer 7

KIDS
B-Cell or T-Cell Precursors (Lymphocytes)
Fatigue, lethargy, bone pain, Headache, stiff neck, visual changes
Dx: Hypercellular bone marrow
Tx: Oral Chemo (Hydroxurea, Imatinib)
Very response, good prognosis

Question 8

What are features of Chronic Lymphocytic Leukemia

Answer 8

Most common form in adults
Usually >70yrs
B-Cell Clonal Malignancy
Sx: Asymptomatic, fatigue, increased infections
Dx: SMUDGE CELLS, Well differentiated Lymphocytes
Tx: Observation, if chronic use oral chemo, if acute treat like AML

Question 9

What is G6PD

Answer 9

X-linked recessive train that affects mianly males, AA

Oxidative Stress leads to hemolytic anemia after spleen destroys RBC

Question 10

What causes oxidative stress in G6PD

Answer 10

Infections (DKA, pneumonia)
Fava Beans
Sulfa Drugs (TMP-SMX), Anti-Malarials

Question 11

Sx of G6PD

Answer 11

Episodic, non-immune hemolytic anemia

Back or abdominal pain, fatigue, jaundice, splenomegaly

Question 12

Dx of G6PD

Answer 12

Peripheral Smear: Hemolytic Anemia, Schistocytes (Bite Cells), Heinz Bodies
Labs: Increased reticulocytes, increased direct bilirubin, decreased Haptoglobin

Question 13

Tx of G6PD

Answer 13

Avoid offending food/drug, self-limited

Severe Anemia needs iron and folic acid supplement, blood transfusion

Question 14

What is Sickle Cell Anemia

Answer 14

Autosomal Recessive disorder of HgbSS

RBC sickling causes thrombosis that can lead to organ damage and hemolytic anemia (spleen destroys defective RBC)

Question 15

Sx of Sickle Cell Anemia

Answer 15

Dactylitis at 6 months of age
Infections: Osteomyelitis, increased risk of infections
Hemolytic Anemia: Jaundice, Gallstones, Penumococcal Meningitis
Infarction Signs: Avascular necrosis of bones, splenic sequestration crisis (splenomegaly), skin ulcers
Painful Occlusive Crisis: triggered by cold, hypoxia, infection, dehydration

Question 16

Dx of Sickle Cell Anemia

Answer 16

Hemoglobin Electrophoresis: Sickle Cell Disease see no HgbA, High HgBF, and HgbS
Peripheral Smear: Target Cells, Sickled Erythroctyes, Howell-Jolly Bodies

Question 17

Tx of Sickle Cell Anemia

Answer 17

Pain contorl (IV hydration, Oxygen)
Hydroxurea
Folic Acid
Transfusion