Hematology/Immunology Flashcards
Name the condition: Blood enzyme disorder with skin lesions caused by the sun.
Porphyria
When is TIBC increased and decreased?
INCREASED: Fe deficiency anemia, PG and hormonal birth control.
DECREASED: Anemia chronic disease, sideroblastic anemia and hemochromatosis.
What defines a “left shift”? a “right shift”?
Over 6% immature band neutrophils (indicates bacterial infection.
Hypersegmented neutrophils - macrocytic anemia. B12-Folate deficiency
Common causes of microcytic anemia?
Iron def, thalassemia, sideroblastic anemia, lead poisoning
Common causes of normocytic anemia?
Acute blood loss, hemolysis, anemia of chronic dz, anemia of renal failure, myelodysplastic syndromes
Common causes of macrocytic anemia?
Folate or B12 def, drug toxicity, alcoholism/chronic liver dz
What is contraindicated in patients with G6P deficiency?
Oxidant drugs (e.g. Vit C > 5 gram), sulfa-drugs
What is a primary presenting symptom of sickle cell crisis?
Bone pain after exertion
What vascular bleeding disorder occurs in children after acute URI and report joint pain, abd pain, and possible renal involvement?
Henoch-Schonlein Purpura
Disorder that follows URI or viral infection and present with petechiae and other bleeding (gums).
Idiopathic thrombocytopenia purpura
Disorders of 30-40yo due to inhibitor of vWF-cleaving protease and unchecked platelet aggregation.
Thrombotic thrombocytopenic purpura
What are common organisms that might cause Hemolytic Uremic Syndrome?
E. Coli O157:H7, Shigella, Staphylococcus, or other E. Coli
Drugs to - esp chemo, and OCPs
In what condition are Bence Jones proteinuria found?
Multiple myeloma
MC hereditary coagulation disorder presenting with possible hx of heavy menses, epistaxis, easy bruising, GI bleeds.
Von Willebrand’s Dz
Causes of DIC.
Complications of obstetrics, infection (Gm - with endotoxin), malignancy (adenocarcinoma of the pancreas, prostate, or leukemia)
Hemophilia A is associated with a genetic deficiency of what factor?
Factor VIII `
Hemophilia B is associated with a genetic deficiency of what factor?
Factor IX `
Name the disorder: absolute inc in red cell mass, ssx: fatigue, weakness, dizziness, HA, visual problems, itching after warm bath, easy bruising or bleeding with little or no injury
Polycythemia vera (malignant)
What are SSX of multiple myeloma?
Bone/back pain, unexplained fractures, bleeding problems, aggravation of arrhythmias
What finding is pathognomonic for AML found MC in adults 15-39 yo?
Auer rods
Which leukemias is MC in children and has 90% survival rate?
ALL
What leukemia is found in older people (65 yo average) and has a very poor prognosis? What cytogenetic abnormality is found in 95% of pts with this leukemia?
CML
The Philadelphia chromosome
What leukemia is found in the much older population and usually presents with no symptoms? What type of cell is found in this leukemia?
CLL
Slowest and sneakiest
Virgin B cell (smudge cells)
Name the CA: 20yo or 60 yo age predominance. “single/asymptomatic node spreads,” unexplained recurrent fevers, night sweats.
Hodgkin’s Lymphoma
What cell is seen in Hodgkin’s disease?
Reed-Sternberg cells
MC Lymphoma, most deadly, associated with Burkitt’s and immunoblastic lymphomas
Non-hodgkins lymphoma
B-lymphocyte tumor, LA in the maxilla or mandible, assoc w/ EBV in US, Malaria in Africa, predisposes to Non-hodgkin’s lymphoma.
Burkitt’s lymphoma
Tests for H. pylori.
Nitrogen breath test (sens)
Serum IgG
Serum IgM
Serum, Salivary, or Stool IgA (sens)
Tests for syphilis
VDRL/RPR
Gm + antimicrobials
Bacitracin
Vancomycin
Penicillin G
Gm - antimicrobials
Aminoglycosides
Polymyxins
Broad spectrum antimicrobials
Quinolones Ampicillin Cephalosporins Tetracyclines Chloramphenicol Sulfonamides
Target INR on warfarin therapy?
2-3
What problem might a pt with a potential penicillin allergy in taking a cephalosporin?
15% cross reactivity
What virus is associated with Hodgkin’s lymphoma?
EBV
Symptom picture for multiple myeloma?
Calcemia (Hyper)
Renal failure
Anemia
Bony Lesions
What workup would you find in dermatomyositis and polymyositis?
ANA pos in 30%
Elevated muscle enzymes
Inc creatinine kinase, ALT, AST
Muscle biopsy shows lymphocytic infiltrate
What two conditions often have positive HLAB27?
Ankylosing spondylitis
Reiter’s Syndrome (Reactive arthritis)
What is the constellation of symptoms of Scleroderma?
Calcification Raynaud's Esophageal dysmotility Sclerodactyly Telangiectasias
What lab work is indicated in a patient with SLE?
ANA - screen
Anti-dsDNA and Anti-Smith
Titers of Anti-dsDNA and C3, C4 to monitor treatment
What dose of epi IM in anaphylaxis? Benadryl?
.3-.5 1:1000 IM, q5-15 min
50mg IV or IM q4-6hrs
