Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics Board ⭐️ > Hematology / Oncology > Flashcards

Hematology / Oncology Flashcards

1
Q

Low hemoglobin, low mean corpuscular volume (MCV), low iron, low transferrin saturation, low ferritin, high red cell distribution width (RDW), Mentzer index (MCV/RBCs) >13 and high total iron-binding capacity (TIBC)

A

Iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Low hemoglobin, low iron, low/normal TIBC, normal/high ferritin level

A

Anemia of chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mild anemia, low MCV, normal iron, normal TIBC, normal ferritin, normal RDW, Mentzer index

A

Thalassemia trait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mild anemia, low MCV, normal iron, normal TIBC, normal ferritin, normal RDW, Mentzer index

A

Alpha thalassemia trait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A 12-month-old boy adopted from China with delayed growth, hepatosplenomegaly, jaundice, and “chipmunk facies”

A

Beta thalassemia major. (Alpha thalassemia major leads to severe anemia and hydrops fetalis in utero, typically incompatible with life without treatment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Electrophoresis result showed: Hb A >98% with a small amount of Hb A2 visible

A

Normal electrophoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Electrophoresis of a 3-year-old child, result showed: Hb A is decreased to 94%, Hb A2 is increased at 5%, and Hb F is 1%

A

Beta thalassemia minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

After birth, hemoglobin electrophoresis result showed: No Hb A, Hb A2 of 4%, Hb F of 96%. No other abnormal hemoglobins seen

A

Beta thalassemia major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 2-month-old premature infant has a Hgb 9.0 with normal MCV

A

Anemia of prematurity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much will 10mL/kg of packed RBCs raise the hemoglobin?

A

~2g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Excessive cow milk consumption (>16oz/day) and microcytic anemia

A

Iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the best initial laboratory tests in cases with suspected iron deficiency anemia?

A

CBC and reticulocyte count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the best indicator of response to iron therapy?

A

An increase in hemoglobin, reticulocyte count, and MCV within 1–4weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long should iron therapy continue in cases of iron deficiency anemia?

A

At least 1–2months after anemia has been corrected to replete iron stores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the classic dose of iron in cases of iron deficiency anemia?

A

3–6mg/kg/day of “elemental iron”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A 2-year-old infant with a hemoglobin of 4g/dL, normal MCV, low reticulocyte count, normal ADA (adenosine deaminase activity), negative direct Coombs test and no signs of hemolysis

A

Transient erythroblastopenia of childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A 7-year-old child presents with pancytopenia, on exam also noted to have hypoplastic thumb and radius, hyperpigmentation, and abnormal facies

A

Fanconi anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A 4-month-old infant with severe anemia, high MCV (macrocytic), elevated ADA, and exam shows triphalangeal thumb

A

Diamond–Blackfan anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Macrocytic anemia, neutropenia, thrombocytopenia, exocrine pancreatic insufficiency, ring sideroblasts in the bone marrow

A

Pearson marrow-pancreas syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Short stature, imperforate anus, hypoplastic teeth, frequent infections, macrocytic anemia, neutropenia, thrombocytopenia, and exocrine pancreatic insufficiency

A

Shwachman–Diamond syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Child who consumes goat’s milk and has macrocytic anemia

A

Folic acid deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Child whose family is strictly vegan and has macrocytic anemia

A

Suspect B12 deficiency. Supplement with B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Child with macrocytic anemia, glossitis, abdominal pain, gait instability with positive anti-IF antibodies

A

Pernicious anemia (B12 deficiency due to IF antibodies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Child with pallor, increased jaundice, splenomegaly, reticulocytosis, and normocytic hemolytic anemia. Peripheral smear shows RBCs without central pallor

A

Hereditary spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

An African-American boy recently started on Bactrim for UTI with sudden onset of dark urine, jaundice, and pallor. Splenomegaly on the exam. Labs are notable for anemia, reticulocytosis, indirect hyperbilirubinemia, low haptoglobin, and normal G6PD enzyme activity (during the episode). Peripheral smear is positive for Heinz bodies , blister , bite , occasional spherocyte

A

G6PD deficiency. Enzyme activity test is usually normal (false negative) during active hemolysis due to the destruction of older erythrocytes (that are G6PD deficient) and presence of younger erythrocytes and reticulocytes (that have normal/near-normal enzyme activity). The test should be repeated during remission, not during active hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fava beans, primaquine, sulfa drugs, and nitrofurantoin are known to exacerbate which condition?

A

G6PD deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Sickle cell anemia, swollen hands and feet, severe pain in hands and feet

A

Dactylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The most common cause of sepsis in patients with sickle cell disease

A

Streptococcus pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Child with sickle cell disease presents with severe anemia, reticulocytosis, thrombocytopenia, and rapidly enlarging spleen

A

Splenic sequestration Next best step → transfusion of packed RBCs (monitor hemoglobin, expect additional rise in Hgb from auto-transfusion from spleen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Child with sickle cell disease, fever, malaise, rash, severe anemia, and reticulocytopenia

A

Aplastic crisis → treatment packed RBCs transfusion as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which virus is the most common cause of aplastic crisis?

A

Parvovirus B19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Common causes of morbidity and mortality in children with sickle cell disease

A

Infection, acute chest syndrome, stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Child with sickle cell anemia presents with fever, chest pain, tachypnea, shortness of breath, and new pulmonary infiltrate on imaging. Management?

A

Acute chest syndrome—start ceftriaxone + macrolide (to cover for atypical organisms). Avoid overhydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Sickle cell patients are at higher risk of which type of organisms?

A

Encapsulated organisms—due to functional asplenia. Make sure vaccines are up to date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common reason for hospitalization in the child with sickle cell anemia? Management?

A

Vaso-occlusive pain crisis Treatment: IV hydration, NSAIDs, and opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Adolescent male with a painful erection that has lasted for several hours. Management?

A

Prolonged priapism—needs emergent evaluation and treatment. Ask patient to come to the ER, aspiration +/− irrigation, phenylephrine, pain control, possible surgical management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the most common cause of osteomyelitis in a child with sickle cell disease?

A

Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the next best step in a child with sickle cell disease and suspected osteomyelitis?

A

Imaging studies (MRI), blood culture, antibiotics (cover Salmonella and other Gram- negative bacilli, as well as S. aureus), consider biopsy for culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Adolescent with sudden onset of fatigue, pallor, scleral icterus, and tachycardia, high reticulocyte count, positive direct antibody test. What is the most likely diagnosis?

A

Autoimmune hemolytic anemia (AIHA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the next best step in the previous lifethreatening case of autoimmune hemolytic anemia (AIHA)?

A

Start steroids. Supportive care may include transfusion of the least incompatible packed RBC unit(s) Fever and absolute neutrophil count (ANC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Fever and absolute neutrophil count (ANC)

A

Admit to the hospital, blood culture, IV antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Neutropenia for 1week every 3weeks, associated with gingivitis, pharyngitis, skin infections during nadir

A

Cyclic neutropenia

43
Q

How to establish the diagnosis of cyclic neutropenia?

A

CBC 2–3 times per week for 6–8weeks

44
Q

What is the best management of cyclic neutropenia?

A

Prophylactic granulocyte-colony stimulating factor (G-CSF). Immediate attention with fevers

45
Q

Severe neutropenia from birth, oral ulcers, gingivitis, recurrent infections, ANC is low all the time

A

Kostmann syndrome

46
Q

Persistent neck lymphadenopathy more than 1cm, fever, weight loss, night sweats, lack of response to oral antibiotics

A

Referral to a pediatric oncologist (lymph node biopsy)

47
Q

Child with a supraclavicular lymph node for 2weeks. No other symptoms

A

Referral to a pediatric oncologist (must be biopsied or investigated)

48
Q

Most common malignancy in infants

A

Neuroblastoma

49
Q

Most common malignancy in childhood

A

Acute lymphocytic leukemia

50
Q

Most common CNS tumor in children

A

Astrocytoma

51
Q

Most common benign tumor of the liver in children

A

Infantile hemangioendothelioma (most commonly occurs in the first 6months of life, rarely seen in children >3years of age)

52
Q

Toddler with an abdominal mass, ecchymosis, raccoon eye, myoclonic jerking, and random eye movements. The abdominal US is positive for a large suprarenal mass. Urine catecholamines are elevated (HVA and VMA )

A

Neuroblastoma

53
Q

Child presents with gingivitis, hepatosplenomegaly, orbital chloromas, WBC >100,000. Peripheral smear shows Auer rods in blasts

A

Acute myelogenous leukemia

54
Q

Chronic myelogenous leukemia is associated with which chromosome translocation?

A

Philadelphia chromosome t(9:22)

55
Q

A 1-year-old with very large spleen, moderate leukocytosis (increased monocytes), xanthoma, eczema, and café-au-lait spots

A

Juvenile myelomonocytic leukemia (JMML). JMML has an association with NF1 and Noonan syndrome

56
Q

Child with an abdominal mass presents with abdominal pain, weakness, lethargy, oliguria, edema, elevated lactate dehydrogenase (LDH) and uric acid, hyperkalemia, elevated phosphate, and low calcium

A

Burkitt lymphoma (tumor lysis syndrome)

57
Q

What is the next best step in the previous case of tumor lysis syndrome?

A

Transfer immediately to oncology unit or PICU for supportive care, including hydration, correction of electrolytes—hyperkalemia, hyperphosphatemia, hyperuricemia, renal dysfunction. May even require hemodialysis

58
Q

Microscopic picture of Hodgkin lymphoma

A

Reed-Sternberg cell

59
Q

The most common type of lymphoma in children

A

Non-Hodgkin lymphoma

60
Q

Most common malignant tumor of the kidney in children

A

Wilms tumor

61
Q

Child with macroglossia and Wilms tumor

A

Beckwith–Wiedemann syndrome

62
Q

Most common soft-tissue tumor in children

A

Rhabdomyosarcoma

63
Q

Long-term complications of radiotherapy

A

Growth retardation, hypothyroidism, early onset coronary artery disease, pulmonary fibrosis, secondary malignancy

64
Q

Complication of doxorubicin therapy

A

Cardiomyopathy

65
Q

Complication of vincristine therapy

A

Neuropathy

66
Q

This antineoplastic drug can cause renal impairment and ototoxicity

A

Cisplatin

67
Q

Complication of methotrexate therapy

A

Mucositis , Renal and liver toxicity

68
Q

Complication of cyclophosphamide therapy

A

Hemorrhagic cystitis

69
Q

Common electrolyte abnormalities in tumor lysis syndrome?

A

Hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia

70
Q

A 12-year-old boy with pain and swelling above the knee, pain is worse at night; radiograph shows a bone lesion with Codman’s triangle and sunburst pattern

A

Osteosarcoma

71
Q

A 16-year-old girl with back pain and limp, fever, weight loss, radiograph shows a mass on the iliac bone with a lytic lesion, onion-skin appearance

A

Ewing sarcoma

72
Q

The translocation is commonly seen in patients with Ewing sarcoma

A

t (11;22)

73
Q

Child with a painless, bony mass on the knee, radiograph shows broad base projection

A

Osteochondroma

74
Q

Child with persistent pain in the lower part of the right femur, radiograph shows metaphyseal lucency surrounded by sclerotic bone, NSAIDs relieve the pain

A

Osteoid osteoma

75
Q

Hemangioblastoma, pheochromocytoma, renal cell carcinoma, pancreatic cyst, and café-a- lait spots

A

Von–Hippel–Lindau disease

76
Q

Impaired upward gaze, mid-dilated pupil, nystagmus, and lid retraction

A

Parinaud syndrome

77
Q

New-onset head tilt or torticollis, early morning vomiting, headache, and gait disturbance

A

Posterior fossa brain tumor, e.g., medulloblastoma

78
Q

Most common malignant CNS tumor in children

A

Medulloblastoma

79
Q

Brain tumor with the best survival rate in children

A

Pilocytic astrocytoma

80
Q

Child with recurrent headaches, growth failure, polydipsia, double vision

A

Craniopharyngioma

81
Q

A 6-month-old child with strabismus, absent red reflex, and leukocoria

A

Retinoblastoma

82
Q

The liver tumor that is associated with prematurity

A

Hepatoblastoma

83
Q

The tumor that is associated with cryptorchidism

A

Hepatoblastoma

84
Q

An infant with intracranial hemorrhage, prothrombin time (PT), partial thromboplastin time (PTT), and platelet count, fibrinogen and vWD panel is within normal limits

A

Factor XIII deficiency

85
Q

Child with normal PT, very prolonged PTT, has no history of excessive bleeding even after injuries

A

Factor XII deficiency

86
Q

A 5-year-old with upper respiratory tract infection 2weeks ago, presents with a bloody nose, petechial rash all over the body and oral mucosa. CBC is normal except platelet count is 12,000, peripheral smear shows very few large platelets

A

Idiopathic thrombocytopenic purpura (ITP)

87
Q

What is the treatment in the previous case of ITP?

A

Observation if no signs of bleeding; if signs of bleeding, then treat with IVIG or steroids

88
Q

A 2-year-old boy with recurrent infections, eczema, severe thrombocytopenia, and small platelets

A

Wiskott–Aldrich syndrome

89
Q

Newborn with severe thrombocytopenia, maternal history of ITP or other autoimmune disorder

A

Neonatal ITP → give IVIG

90
Q

Newborn with severe thrombocytopenia, maternal history of prior children with neonatal thrombocytopenia and no maternal history of autoimmunity

A

Neonatal alloimmune thrombocytopenia → transfuse maternal platelets (gold standard); however, difficult to obtain. The alternative option is donor platelets +/− IVIG, steroids

91
Q

Unusual bleeding since birth, recurrent bruising, recurrent mucosal bleeding, low to normal platelet count, normal PT and PTT, normal fibrinogen, normal von Willebrand antigen and activity

A

Platelet function disorders, e.g., BernardSoulier syndrome, Glanzmann thrombasthenia

92
Q

A 10-year-old with recurrent epistaxis, easy bruising, gingival bleeding, normal count and morphology of platelets, platelets agglutinate to ristocetin, poor platelet aggregation with adenosine diphosphate (ADP), epinephrine, and collagen

A

Glanzmann thrombasthenia (normal platelet count and size)

93
Q

A 10-year-old with a suspected bleeding disorder, workup shows mild thrombocytopenia, with large abnormal platelets, platelets do not agglutinate to ristocetin but agglutinate to ADP, epinephrine, and collagen

A

Bernard–Soulier syndrome (large platelets, can have low platelet count)

94
Q

Most appropriate management for life-threatening bleeding in a child with a known or suspected platelet function disorder

A

Infusion of platelets with normal function

95
Q

A 48-h-old newborn presents with prolonged bleeding after circumcision, CBC shows severe thrombocytopenia. On exam no radii in both forearms but with normal thumbs

A

Thrombocytopenia with absent radii (TAR syndrome)

96
Q

Male newborn with prolonged bleeding after circumcision, and prolonged PTT

A

Factor VIII or IX deficiency, or hemophilia A or B

97
Q

A 15-year-old girl with excessive menstrual bleeding every month since menarche, normal PT and PTT, decrease in biological activity of ristocetin cofactor assay (rCoF)

A

Von Willebrand disease

98
Q

A 4-year-old child with a recent history of vomiting and bloody diarrhea found to have thrombocytopenia, elevated BUN and creatinine, schistocytes on peripheral smear

A

Hemolytic uremic syndrome—occurs in infants and children after prodromal diarrhea, associated with bacteria particularly E. coli O157: H7, and Shigella dysenteriae

99
Q

Child currently hospitalized in the PICU with prolonged PT, PTT, elevated D-dimer, thrombocytopenia, and decreased fibrinogen

A

Disseminated intravascular coagulation (DIC) Treatment: treat the underlying cause (e.g., antibiotics for sepsis). Supportive care with blood products—FFP +/− cryoprecipitate

100
Q

A 17-year-old Caucasian boy with recurrent episodes of DVT along with a strong family history of DVT

A

Factor V Leiden mutation—resistance to activated protein C

101
Q

A 2-year-old boy with oral ulcers, cradle cap-like rash, and gingivitis, with radiograph showing lytic lesions in the skull

A

Langerhans cell histiocytosis—Birbeck granules on electron microscopy

102
Q

A 1-year-old sick-appearing child with fever, hepatosplenomegaly, pancytopenia, hypertriglyceridemia, and very elevated ferritin; presence of hemophagocytosis in bone marrow

A

Hemophagocytic lymphohistiocytosis (HLH)

103
Q

Triad of iron deficiency anemia, esophageal webs, and dysphagia

A

Plummer-Vinson syndrome

Pediatrics Board ⭐️ (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions