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Misc Boards Review > Hematology/Oncology > Flashcards

Hematology/Oncology Flashcards

1
Q

Normal MCV size? What does it tell us?

A
  • 80-100
  • The size of the RBC
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2
Q

What does Mean Corpuscular Hgb (MCH) mean?

A
  • Average amount of hgb in RBC
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3
Q

What does Mean Corpuscular Hgb Concentration mean? (MCHC)

A
  • Color
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4
Q

What is the reticulocyte count?
What does it tell you?
What if it stays low?

A
  • # of young RBCs in the blood
  • Tells us bone marrow’s ability to create new RBCs
  • Low: may want to eval for malignancy
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5
Q

Condition where there is too many RBCs?

A
  • Polycythemia Vera
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6
Q

Normochromic Anemias (4)

A
  • Sickle Cell
  • Anemia of Chronic Disease/Cancer
  • B12 and Folic Acid deficiency
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7
Q

Hypochromic Anemias (2)

A
  • IDA
  • Thalassemia
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8
Q

What are 2 bone marrow disorders?

A
  • Aplastic anemia
  • Myelodysplastic Anemia
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9
Q

3 conditions people might have with anemia?

A
  • Cheilitis
  • Glossitis (beefy red tongue)
  • Koilonychia (spoon shaped nails)
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10
Q

Conditions that can increase H&H?

A
  • Living at high altitudes
  • Testosterone use
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11
Q

How to evaluate if you have 2 kinds of anemia at once?

A
  • Peripheral smear
  • Ex: IDA and B12 deficiency
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12
Q

How long for H&H to start increasing after supplementing the deficient substance? (iron, B12, folate)

How long to be back to normal?

A
  • 1-2 weeks
  • up to 2 months
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13
Q

What 2 tests to check for B12 deficiency with normal B12 levels?

A
  • Anti-parietal antibodies
  • Methylmalonic Acid (MMA)
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14
Q

How many AA in the US have sickle cell?

A
  • 1 out of 500
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15
Q

What are 3 normocytic anemias?

A
  • Sickle Cell
  • Anemia of chronic Disease
  • G6PD Deficiency
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16
Q

What conditions are associated with normocytic anemias? (2)

A
  • Chronic autoimmune or inflammatory disorders
    (polymyalgia rheumatica and RA)
  • Chronic infection
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17
Q

Anemia of Chronic Disease
Mild vs. long-standing

A
  • Mild: normocytic normochromic
  • Longstanding: Microcytic, hypochromic
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18
Q

Normal RBC lifespan?
Lifespan in ACD?

A
  • 100-120 days
  • 60-90 days
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19
Q

Initial tests for ACD? (6)

A
  • CBC
  • Serum ferritin, Serum transferrin (TIBC)
  • B12, folate
  • reticulocyte count
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20
Q

What newborn screening is required for sickle cell?

A
  • Sickledex
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21
Q

What are 3 microcytic anemias?
MCV?

A
  • LIT: Lead intox, IDA, Thalassemia
  • MCV <80
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22
Q

What MCV/MCHC in IDA?

A
  • Low MCV (microcytic)
  • Low MCHC (hypochromic)
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23
Q

What is the RDW in IDA?
New onset vs. long standing

A
  • > 15% if new onset (new deficiency = new donut holes)
  • < 15% if long standing (all we get are donut holes)
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24
Q

Serum ferritin vs. Serum iron

A
  • Ferritin: Measure of iron in storage (iron stores)
  • Iron: Measure of iron in circulation
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25
Q

What does Total Iron Binding Capacity (TIBC) tell us?
Other name?
Why would it be high?

A
  • Capacity to take in iron
  • Transferrin
  • High when there is not enough iron to fill the storage containers in IDA
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26
Q

Most common cause of IDA?
Common times to experience during lifetime?

A
  • Blood loss
  • 12-24mo, starting menses, during pregnancy
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27
Q

How long are the effects of aspirin?

A
  • 7-10 days
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28
Q

Unique symptoms of IDA? (3)

A
  • Nail spooning
  • PICA
  • Angular cheilitis
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29
Q

Why do we want patients to avoid iron supplements before rechecking labs?

A
  • Can affect TIBC and serum iron
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30
Q

What should we limit in kids
< 1 to prevent IDA?

A
  • Cow’s milk and cow’s milk products because they are low in iron and inhibit absorption from other sources
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31
Q

Diet high in iron?

A
  • Red meats, liver
  • Leafy greens
  • Beans/peas
    -Whole grains
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32
Q

How much elemental iron do we need per day?
Which form is good for pregnant patients to prevent?

A
  • 150-200mg per day
  • Ferrous gluconate d/t low dose
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33
Q

How long does it take to replace iron stores?

A
  • 4-6 months
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34
Q

Normal increase in H&H
1 month after starting iron replacement?

A
  • 3 points HCT
  • 1 point Hgb
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35
Q

What do we need to check before stopping iron supplements?
When?

A
  • Serum ferritin (stores) in 4-6 months
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36
Q

How to take iron?
What if it upsets our stomach?

A
  • On empty stomach
  • Take with vitamin C drink
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37
Q

How to prevent botulism in kids?
When should we start giving PB and eggs?

A
  • No honey before 12mo
  • 6mo to prevent allergy and atopic disease
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38
Q

What is happening in Thalassemia?
Is it inherited?

A
  • The body isn’t making enough hgb so they have too much IRON
  • Body makes defective alpha or beta chains
  • YES need to screen the whole family
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39
Q

Where do we see thalassemia?

A
  • beta: Mediterranean
  • alpha: SE Asian countries
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40
Q

MCV/RDW/MCHC in thalassemia?

A
  • Microcytic, normal RDW, hypochromic
  • Not enough hgb, so cells will be pale
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41
Q

What happens when the body absorbs too much iron?
How do we treat it?

A
  • Hemochromatosis
  • Regular phlebotomy
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42
Q

What organ is affected by too much iron?

A
  • Excess iron stored in liver, and it doesn’t work when it gets too full
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43
Q

Which anemia has glossitis?

A
  • B12 deficiency
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44
Q

Meds that can cause Folic Acid deficiency?

A
  • Methotrexate
  • Bactrim
  • Dilantin
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45
Q

Tests for B12/folic acid anemias?

A
  • MMA 24hr urine (high in b12)
  • Homocysteine level (high in both)
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46
Q

Antibody tests for B12 deficiency?

A
  • Anti-parietal and anti-intrinsic factor
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47
Q

Medications that cause B12 deficiency (4)

A
  • Antacids
  • PPIs, H2 blockers
  • Metformin
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48
Q

When should neuro symptoms improve after starting B12 replacement?

A
  • 5-10 days
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49
Q

How does B12 deficiency present in older adults? (6)

A
  • Cognitive changes
  • unexplained weakness and unsteady gait
  • paresthesia
  • Decreased reflexes, abnormal Romberg
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50
Q

B12 injections regimen?

A
  • SQ daily x1 week, weekly x1 mo, monthly for life
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51
Q

When to check retic count and CBC after starting B12 supplements?

A
  • 2 weeks
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52
Q

Most common cause of B12 deficiency?
Other causes? (3)

A
  • Pernicious anemia
  • Vegan diet, gastric surgery, IBD
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53
Q

What does intrinsic factor do?

A
  • Allows the body to absorb B12
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54
Q

What is pernicious anemia?
How to Dx?

A
  • Autoimmune destruction of parietal cells resulting in intrinsic factor destruction
  • Dx: anti-parietal antibodies
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55
Q

Diet causes of Folic Acid deficiency?

A
  • Overcooking veggies, low citrus
56
Q

What conditions cause folic acid deficiency?

A
  • Gastrectomy
  • Celiac disease (sprue)
57
Q

What is happening in aplastic anemia?
Causes? (3)

A
  • Destruction of stem cells in the bone marrow
  • Radiation, drugs, viral infection
58
Q

Labs of aplastic anemia?
Dx?

A
  • Pancytopenia
  • Bone marrow biopsy
59
Q

How to diagnose thalassemia and Sickle cell?

A
  • Hgb electrophoresis
60
Q

How is Thalassemia managed?

A
  • Regular transfusions, which also increase amount of iron
61
Q

2 main causes of SC crisis? Tx?

A
  • Illness and dehydration
  • Refer to ED most of the time
62
Q

What is happening is Polycythemia Vera?
High risk for what?

A
  • Bone marrow makes too many RBCs, making the blood thick and sticky
  • High risk for blood clots
63
Q

Polycythemia Vera
Common with what 2 things?
Treatment?

A
  • COPD and high altitudes
  • Tx: regular phlebotomy
64
Q

How is Hep B transmitted?

A
  • Blood, semen, body fluids
65
Q

When do we get the Hep B vaccine?

A
  • 3 dose series
  • Birth, 2mo later, 6mo
66
Q

Symptoms of Hep B (5)

A
  • Vague abdominal pain
  • Dark urine, fever, fatigue, jaundice
67
Q

HBsAg indicates what?

A
  • Acute or chronic infection
68
Q

IgM means?

A
  • Positive the minute someone is infected
  • Acute Hep B
69
Q

What does IgG mean? (2)
+ findings mean?

A

It’s gone or never there
- Positive: resolved or chronic

70
Q

What does Anti-HBc tell is?

A
  • C= Core
  • Whether patient has Hep B now or had it at some point
  • Tells us whether IgG or IgM is positive
71
Q

What will Anti-HBc be if the patient is vaccinated?

A

Negative

72
Q

What is Anti-HBs? (HBsAB)
Positive vs. negative

A

-surface antibody tells us about immunity
- +Anti-HBs = immunity from past infection or vaccine
- -Anti-HBs = not immune and susceptible to infection

73
Q

+HBc +HBs with -HBsAg?

A
  • Immunity due to natural infection
74
Q

+ HBsAg with +IgG means what?
- HbsAg with +IgG means what?

A
    • HBsAg, +IgG = Chronic Hep B
    • HBsAg with +IgG = Resolved Hep B
75
Q

Does Hep B go away?

A
  • Usually resolves on its own
76
Q

What to do when patient exposed to Hep B and are unvaccinated

A
  • Give them Hep B vaccine AND IgG within 24 hours
77
Q

What to do if patient exposed to Hep B and are vaccinated

A
  • Give them IgG within 24 hours
78
Q

Can pregnant patients get Hep B?

A
  • Yes – one of the first vaccines that babies get
79
Q

How to stage CA?

A
  • TNM: Tumor, Nodes, Mets
80
Q

Which lymph nodes are biopsied first in CA?

A
  • Virchow’s (sentinels) nodes
  • Found at left supraclavicular area of chest
81
Q

2 most common lymphomas? Age groups?

A
  • Hodgkins- adolescents and young adults
  • Non-Hodgkins – Older adults
82
Q

Which lymphoma has Reed Sternberg cells?

A
  • Hodgkins
83
Q

Symptoms of lymphoma? (5)
What to order?

A
  • Enlarged LN, night sweats, fever, weight loss, fatigue
  • CBC
84
Q

Symptoms with CLL/CML (6)
Fast or slow?

A
  • Slow progression
  • Night sweats, fever, fatigue, weight loss
  • Easy bruising, lymphadenopathy
85
Q

CBC findings in CLL and CML?

A
  • Very high WBC > 60,000
86
Q

CLL vs. CML distinguishing factors?

A
  • CLL: less symptoms, may not need tx
  • CML: abdominal complaints d/t enlarged spleen and liver, anemia
87
Q

Treatments for CML/CLL if bad enough?

A
  • Bone marrow transplant,
    C/R
88
Q

Most common type of leukemia in adults?
Survival rate?

A
  • Acute Myeloid Leukemia
  • 5-year survival 30%
89
Q

What is multiple myeloma? Age group?

A
  • Cancer of plasma cells (B cells)
  • Adults > 60
90
Q

Symptoms of multiple myeloma?

A
  • Bone pain, fractures, hypercalcemia
91
Q

Average size of spleen? Palpable?

A
  • 6-12cm
  • Usually not in healthy people
92
Q

Causes of enlarged spleen?

A
  • Mono, sickle cell, CML
93
Q

What is the treatment for Hep C?

A
  • Direct-acting anti-viral tablets
94
Q

What does HIV 1/2 antibody test look at?

A
  • suggestive of acute infection but not confirmatory
95
Q

What do to if HIV 1/2 antibody test is positive?
Then what?

A
  • Positive: order HIV1/2 differentiation immunoassay
  • If that is negative, may need RNA or nucleic acid test
96
Q

Older tests to diagnose HIV?

A
  • Elisa and western Blot
97
Q

HIV at risk for what? (3)
Do we vaccinate these people?

A
  • Kaposi Sarcoma, PJP, TB
  • Don’t give vaccines to these people
98
Q

What to do if patient’s partner is HIV positive?

A
  • PrEp (pre-exposure prophylaxis)
  • Partner takes anti-retrovirals to prevent getting HIV
  • Can reduce chance of getting HIV by 99%
99
Q

What meds are in PrEp?

A
  • Tenofovir disoproxil plus Truvada (men and women)
  • Tenofovir alafenamide plus descovy (men)
100
Q

What to do after HIV exposure?

A
  • HIV test in 3 days
  • PEP (post-exposure prophylaxis): Give anti-retroviral therapy within 3 days
101
Q

Catch up vaccines pneumonic

A
  • Its Time for Many Happy Happy Vaccines
  • IPV, Tdap, MMR, Hep B, HPV, Varicella
102
Q

Who gets DTaP vs. Tdap?

A
  • DTaP if < 7
  • Tdap if > 7
103
Q

What age for HIB?

A

< 5

104
Q

What age for HPV?

A
  • 9-14: 2 dose series
  • > 15: 3 dose series
105
Q

Most common cause of epiglottitis?

A

Hib

106
Q

What to do if child is exposed to pertussis?

A
  • Give prophylactic azithromycin
107
Q

Labs found with malaria (4)

A
  • Anemia, thrombocytopenia
  • low Na from vomiting
  • Elevated bili
    (unconjugated, can’t get rid of until conjugated)
108
Q

Incubation period for malaria?
Diagnosis?

A
  • 6-18 days
  • Blood test for the parasite
109
Q

How to take malarone?
Safe for pregnant women? Kids?
What else might work?

A
  • Start 1-2 day before travel and continue until 7 days after return
  • NO
  • Can’t give to children < 5kg
  • Doxy
110
Q

How to take Chloroquine? -quine drugs

A
  • Start 1-2 weeks before travel
111
Q

Treatment for malaria?

A
  • Malarone or Chloroquine or Doxy
112
Q

TB test >/= 5mm
Positive with who?

A
  • Immunocompromised patient
  • Immigrants with exposure
113
Q

TB test >/= 10
Positive with who?

A
  • Immigrants
114
Q

TB test >/= 15
Positive with who?

A
  • General public and healthy adults
115
Q

Causes of thrombocytopenia? (3)

A
  • Recent infection
  • Drugs
  • Leukemia
116
Q

Treatment for thrombocytopenia

A
  • Refer hematology
  • Prednisone 4-6 weeks
117
Q

Most common bleeding disorder in the US?

A
  • Von Willebrand disease
118
Q

First responder WBCs in infection?

A
  • Neutrophils and lymphocytes
119
Q

Leukocytes/WBCs also called what?

A
  • Segs, polys
120
Q

What do monocytes tell us?

A
  • About how long the patient has been sick
  • Don’t increase for 24 hours
121
Q

What do eosinophils tells us?

A
  • Allergic or parasitic in nature
122
Q

WBCs in a viral vs. bacterial infection
Neutrophils and Lymphocytes

A
  • Viral: neutrophils and lymphocytes CLOSE in number
  • Bacterial: neutrophils and lymphocytes BIG difference
123
Q

What are bands?
What do bands tell us?

A
  • Immature WBCs – bone marrow things it’s bad
  • Released when infection seems to be bad according to the bone marrow
124
Q

Mechanical valve replacement target INR

A
  • 2.3-3.5
125
Q

What does a Coombs Test look for?
What is this condition has increased risk for this condition?

A
  • Hemolytic anemia
  • SLE
126
Q

Symptoms of polycythemia vera?

A
  • Facial plethora, distended retinal veins
  • HA, blurry vision
  • Frequent nosebleeds
  • Fatigue, pruritis
127
Q

What medication is used for polycythemia vera?
What does it help with?

A
  • Hydroxyurea
  • Reduced risk of clots
128
Q

When are phlebotomies indicated in polycythemia vera?
How are they done?

A
  • When the hct > 45%
  • 500ml blood removed weekly until levels are down
129
Q

What is hemochromatosis?

A
  • Overload of iron
130
Q

Complications of hemochromatosis? (4)

A
  • Severe organ damage
  • Diabetes
  • Skin hyperpigmentation
  • Arthritis
131
Q

Beta thalassemia vs. alpha thalassemia regions?

A
  • Beta: Mediterranean
  • Alpha: Asian SE
132
Q

Foods high in vitamin K?

A
  • Potatoes, greens, lentils
133
Q

Foods high in vitamin d?

A
  • OJ nonorganic, milk, salmon
134
Q

Foods high in iron?

A
  • Red meat, tuna, eggs
135
Q

What is G6PD deficiency?
Which genre most affected?

A
  • Condition where RBCs are broken down in response to meds, illness
  • boys
136
Q

What medications cause G6PD Deficiency to worsen?

A

Salicylates - aspirin and pepto bismol
Fava beans

Misc Boards Review (19 decks)

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