Hematology/ Oncology Flashcards
Pulmonary embolism is heralded
“abrupt onset of dyspnea, chest pain, apprehension, hemoptysis, or syncope”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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good initial screening tool for DVT in moderate- to high-risk patients;
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Venous Duplex ultrasound with compression
If negative and suspicion is high repeat in 5–7 days
“the gold standard for the diagnosis of DVT”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Venography
What Arterial blood gases along with respiratory alkalosis are seen in PE.”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Low PO2, low PCO2
“this is the preferred test for diagnosis of PE. It allows direct visualization of emboli and detection of parenchymal abnormalities”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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CT angiogram
“CT angiography has mostly replaced invasive pulmonary angiography as the gold standard for the diagnosis of PE in the presence of an equivocal ventilation/perfusion scan” in many facilities
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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In treatment of DVT how long should anticoagulation be maintained
3-6 month for unprovoked proximal DVT or PE
TREAT provoked DVT or PE no more than 3 months
Treat unprovoked calf DVT 3 months
First study to perform in evaluating VTE during pregnancy
Cxr
If CXR normal order v/q scan
If abnormal order CT SCAN
During anticoagulation in pregnancy convert from LMWH in the month to?
Easier to stop quickly Un fractionated heparin
Compression stockings until anticoagulation resumed after delivery
Vaginal- restart 4-6 hours
C-section restart after 6-12 hours
MCV >100
Macrocytic anemia
Causes be-12 deficiency
Myelodysplasia
Reticulocytosis
Hypersegmented PMNs, elevated LDH, HIGH methylmalonic acid levels low b12
Megaloblastic anemia
I “Reed-Sternberg cells present (these are large binucleate cells with single distinct nucleoli) is pathognomonic of”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Hodgkins lymphoma
“One or two unexplained, enlarged lymph nodes in a young person indicates Hodgkin disease until it is proved otherwise”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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“Weight loss
b. Bleeding from skin and mucous membranes
c. Bone marrow biopsy: dry tap, normal bone marrow replaced by fibrotic material”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Myelofibrosis
“Plethora, sometimes cyanosis
b. Proliferation of all hematopoietic cell lines
c. Elevated hemoglobin, red blood cell mass, and thrombocytosis”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Polycythemia vera
65 yo male presents complaint constant back pain unrelieved by positioning. Plain film reveals compression fracture T-12
Pathology: plasma cell malignancy or plasma cell proliferation
3. Signs and symptoms: (a) bone pain (sternum, skull, ribs, and back); (b) anemia (normochromic, normocytic); (c) immune suppression (history of bacterial infections); (d) renal failure; (e) hypercalcemia; and (f) weakness, confusion, depression, fatigue
4. Diagnosis: (a) serum protein electrophoresis, (b) bone marrow biopsy of 10% plasma cells (c) Bence Jones protein in the urine, qualitative immunoglobulins, and skeletal survey
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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MULTIPLE myeloma
“Reed-Sternberg cells are pathognomonic”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Hodgkins disease
“Lymph node enlargement in the supraclavicular area is common for”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Hodgkin’s disease
“The most common sign/symptom is solitary or nonsolitary lymph node enlargement.
b. The presence or absence of systemic symptoms is not only a staging phenomenon (A or B) but also prognostic.
c. The most common systemic symptoms include weight loss, night sweats, fevers, and pain.”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Lymphoma
“Disease is associated with excessive proliferation of erythroid, granulocytic, and megakaryocytic precursors.
• Splenomegaly is almost universal in this disease.
• Disease has significantly elevated red blood cell mass.
• Patient presents with plethora.
• Disease characteristically has thrombocytosis”
Excerpt From: Alfred F. Tallia, Joseph E. Scherger & Nancy Dickey. “Swanson’s Family Medicine Review.” Saunders, 2013. iBooks.
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Polycythemia rubra vera