Hematology / Oncology Flashcards
Four causes of microcytic anemia
TICS: Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia
An elderly man with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Precipitants of hemolytic crisis in patients with G6PD deficiency
Sulfonamides, antimalarial drugs, fava beans
The most common inherited cause of hypercoagulability
Factor V Leiden mutation
The most common inherited bleeding disorder
von Willebrand disease
The most common inherited hemolytic anemia
Hereditary spherocytosis
Diagnostic test for hereditary spherocytosis
Osmotic fragility test
Pure RBC aplasia
Diamond-Blackfan amnesia
Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au lait spots, microcephaly, and pancytopenia
Fanconi anemia
Medications that lead to aplastic anemia?
Viruses that do so?
Medications: Chloramphenicol, sulfonamides, chemotherapeutic agents, radiation
Viruses: HIV, Hepatitis, Parvovirus B19, EBV
How to distinguish polycythemia vera from secondary polycythemia
Polycythemia vera should have normal O2 saturation and low EPO levels. (Both have increased hematocrit and RBC mass).
Pentad of thrombotic thrombocytopenic purpura (TTP)? Treatment?
Pentad: FAT RN: Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities
Treatment: Emergent large-volume plasmapheresis, corticosteroids, and antiplatelet drugs. Platelet transfusion is CONTRAindicated!
Triad of hemolytic-uremic syndrome?
Anemia, thrombocytopenia, and acute renal failure
Treatment 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 hematocrit?
Elevated: Fibrin split products and D-dimer
Decreased: Platelets, fibrinogen, and hematocrit
An 8 year old boy presents with hemarthrosis and elevated PTT with normal PT and bleeding time. Diagnosis? Treatment?
Diagnosis: Hemophelia A or B
Treatment: Consider desmopressin (for hemophelia A) or factor VIII or IX supplements
A 14 year old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or increased PTT, and increased bleeding time. Diagnosis? Treatment?
Diagnosis: von Willebrand disease
Treatment: Desmopressin, FFP, or cryoprecipitate
A 60 year old African American man presents with bone pain. What might a workup for multiple myeloma reveal?
Monoclonal gammopathy, Bence Jones proteinuria, and “punched out” lesions on radiographs of the skull and long bones
Condition associated with Reed-Sternberg cells
Hodgkin lymphoma
A 10 year old boy presents with fever, weight loss, and night sweats. Examination shows an anterior mediastinal mass. Suspected diagnosis?
Non-Hodgkin lymphoma
Microcytic anemia with decreased serum iron, decreased total iron binding capacity (TIBC), and normal or elevated ferritin?
Anemia of chronic disease
Microcytic anemia with decreased serum iron, decreased ferritin, and increased TIBC?
Iron deficiency anemia
An 80 year old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. What is the suspected diagnosis?
Chronic lymphocytic leukemia (CLL)
Patient with fatigue is found to have a decreased hemoglobin and increased mean corpuscular volume. What are the potential causes of this anemia?
Decreased B12 (pernicious anemia, vegetarian diet, Crohn ds/GI disorders), or decreased folate (e.g. in alcoholics)
A late, life-threatening complication of chronic myelogenous leukemia (CML)
Blast crisis (fever, bone pain, splenomegaly, pancytopenia)
Auer rods on blood smear
Acute myelogenous leukemia (AML)
Subtypes M2 (acute myeloid leukemia with granulocytic maturation) and M3 (acute promyelocytic leukemia
AML subtype associated with DIC? Treatment?
Subtype: M3 (acute promyelocytic leukemia)
Treatment: Retinoic acid
Electrolyte changes in tumor lysis syndrome
Elevated potassium, phosphate, and uric acid
Decreased calcium.
A 50 year old man presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9;22). Diagnosis?
CML
A patient on chemotherapy service with an absolute neutrophil count (ANC) of 1,000 is noted to have a fever of 38.8 C (102.1 F). Next best step?
Neutropenic fever is a medical emergency. Start broad-spectrum antibiotics.
Virus associated with aplastic anemia in patients with sickle cell anemia
Parvovirus B19
A 25 year old African American man with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Oxygen, analgesia, hydration, and if severe transfusion
A significant cause of morbidity in thalassemia patients?
Treatment?
Cause: Iron overload
Treatment: Deferoxamine
