Hematology/Oncology Flashcards
4 causes of microcytic anemia
TICS - Thalessemia, Iron deficiency anemia, anemia of Chronic dz, and Sideroblastic anemia
An elderly man w/ hypochromic, microcytic anemia is asx. Dx tests?
Fecal occult blood test and sigmoidoscopy; suspect colorectal CA
Precipitants of hemolytic crisis in pts with G6PD deficiency
Sulfonamides, antimalarial drugs, fava beans
Most common inherited cause of hypercoagulability
Factor V Leiden mutation
Most common inherited bleeding disorder
von Willebrand’s dz
Most common inherited hemolytic anemia
Hereditary spherocytosis
Dx test for hereditary spherocytosis
Osmotic fragility test
Pure RBC aplasia
Diamond-Blackfan anemia
Anemia a/w absent radii and thumbs, diffuse hyperpigmentation, café au lait spots, microcephaly, and pancytopenia
Fanconi’s anemia
Medications and viruses that lead to aplastic anemia
Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV
How to distinguish polycythemia vera from 2` polycythemia
Both have increased Hct and RBC mass, but polycythemia vera should have normal O2 sat and low epo levels
Thrombotic thrombocytopenic purpura (TTP) pentad
FAT RN: Fever, Anemia, Thrombocytopenia, Renal dysfxn, Neurologic abnormalities
HUS triad?
Anemia, thrombocytopenia, and acute renal failure
Tx for TTP
Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs. Platelet transfusion is contraindicated!
Tx for idiopathic thrombocytopenic purpura (ITP) in children
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Which of the following are increased in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hct.
Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hct are decreased
An 8 y/o boy presents w/ hemarthrosis and increased PTT w/ normal PT and bleeding time. Dx? Tx?
Hemophilia A or B; consider desmopression (for hemophilia A) or factor VIII or IX supplements
A 14 y/o girl presents w/ prolonged bleeding after dental surgery and w/ menses, normal PT, normal or increased PTT and increased bleeding time. Dx? Tx?
von Willebrand’s dz; tx w/ desmopression (DDAVP), FFP, or cryoprecipitate
A 60 y/o African American man presents w/ bone pain. What might a workup for multiple myeloma reveal?
Monoclonal gammopathy, Bence Jones proteinuria, and “punched-out” lesions on xray of the skull and long bones
Reed-Sternberg cells
Hodgkin’s lymphoma
A 10 y/o boy presents w/ fever, wt loss, and night sweats. Exam shows an anterior mediastinal mass. Suspected dx?
Non-Hodgkin’s lymphoma
Microcytic anemia with decreased serum iron, decreased TIBC, and normal or increased ferritin
Anemia of chronic dz
Microcytic anemia with decreased serum iron, decreased ferritin, and increased TIBC
Iron deficiency anemia
An 80 y/o man presents w/ fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. What is the suspected dx?
Chronic lymphocytic leukemia (CLL)
Lymphoma equivalent of CLL
Small lymphocytic lymphoma
Late, life-threatening complication of CML
Blast crisis (fever, bone pain, splenomegaly, pancytopenia)
Auer rods on blood smear
AML
AML subtype a/w DIC. Tx?
M3. Retinoic acid.
Electrolyte changes in tumor lysis syndrome
Decreased Ca2+, increased K+, increased phosphate, increased uric acid
50 y/o man presents w/ early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Dx?
CML
Heinz bodies
Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy
Virus a/w aplastic anemia in pts w/ sickle cell anemia
Parvovirus B19
25 y/o African American man w/ sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
O2, analgesia, hydration, and, if severe, transfusion
A significant cause of morbidity in thalassemia pts. Tx?
Iron overload; use deferoxamine.
