Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MS3 Year > Hematology Oncology > Flashcards

Hematology Oncology Flashcards

1
Q

What is the tx for HIT?

A

stop heparin! and give argatroban then warfarin

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

What’s the tx for sickle cell chronically, reduce attacks?

A

hydroxyurea (increases HbF)

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

How do you tx early stage lymphoma? How do you tx late stage (hodgkin vs non-hodg)

A

Radiation; Chemo - hodg: ABVD or BEACOPP; nonhodg: CHOP-R or rituximab alone (CNS ppx)

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

What one test do you get to separate microcytic anemias?

A

Ferritin

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

Iron deficiency anemia in an old man, what’s the dx and next step?

A

colon cancer, get a c-scope

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

Elevated ferritin, decreased TIBC, decreased iron, dx?

A

Anemia of chronic disease

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

Child, bone pain, frequent infxn, dx?

A

ALL

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

Two tests you should look at with every anemia?

A

MCV and reticulocyte count

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

How do you dx sickle cell disease?

A

hgb electrophoresis (first time); sickled cells on smear (for subsequent crises)

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

What does platelet bleeding look like (problem with primary hemostasis)? Factor bleeding (problem with secondary hemostasis)?

A

Primary: gingiva, skin, vagina
Secondary: hemarthrosis, hematoma

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

Sickle cell pt with chest pain and fluffy infiltrates on chest XR, dx and next step?

A

acute chest syndrome, exchange transfusion

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

How do you determine the stage of lymphoma? What defines each stage?

A

CT CAP or PET/CT; Stage 1: 1 LN; 2: gt/= to 2 LNs on same side of diaphragm; 3: LNs on opposite side of diaphragm; 4: mets

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

Pt has nontender lymphadenopathy, next step?

A

Excisional bx, not FNA

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

Normocytic anemia, elevated reticulocyte count, differential?

A

hemorrhage and hemolysis

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

Name 5 destruction causes of thrombocytopenia

A

Alphabet soup: 1) ITP; 2) TTP; 3) DIC; 4) HIT; 5) HUS

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

Bone marrow bx on Waldenstrom’s macroglobulinemia? MGUS? Multiple myeloma?

A

greater than 10% lymphocytosis; less than 10% plasma cells; greater than 10% plasma cells

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

Smear on TTP shows what?

A

schistocytes

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

Normocytic anemia, decreased reticulocyte count, differential?

A

cancer and CKD

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

What is the best test for hereditary spherocytosis?

A

osmotic fragility

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

How do you tx iron deficiency anemia?How do you tx anemia of chronic disease? Thalassemia?

A

Iron 2-6 wks (324 mg tid);
EPO in severe cases, tx inflammatory disease
Minor = do nothing
Major = transfusions

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

Starry sky pattern on bx shows what?

A

Burkitt’s non-hodgkin’s lymphoma

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

What are 4 causes of microcytic anemia?

A

1) iron deficiency; 2) anemia of chronic disease; 3) thalassemia; 4) sideroblastic

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

To diagnose pernicious anemia, what’s the best test? What’s the first step?

A

EGD with bx showing atrophy of gastric mucosa;

Anti-IF and Anti-parietal cell antibodies

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

Most common inherited thrombophilia?

A

Factor V Leiden

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What test can you get if the B12 and folate are equivocal?
methylmalonic acid (will be elevated in B12 deficiency and not elevated in folic deficiency)
26
What is splenectomy doesn't work for ITP
rituximab
27
Less than 10% plasmactyosis in the marrow, but multiple myeloma?
MGUS (monoclonal gammopathy of undetermined significance - SPEP is positive but UPEP, skeletal survey and BM bx are negative)
28
If you have low plts, you give what?
platelets
29
What is the tx for TTP?
Plasma exchange (do not give platelets!!)
30
Pallor, tachycardia, dyspnea on exertion, dx?
Anemia
31
How do you tx multiple myeloma? MGUS?
gt 70, no donor: chemo (melphalan + steroids) lt 70, donor: HSCT (stem cell transplant) MGUS - watch and wait (converts to MM 2%/yr)
32
Pt has intracranial hemorrhage, the INR is elevated, what is the next step?
Give FFP
33
T(9;22)?
philadelphia chromosome, BCR-ABL, CML
34
Thalassemia minor, next step?
has mild anemia - does not need tx
35
African American man, anemia, jaundice, joint pain, bone pain, how would you tx?
O2, IVF, pain control
36
80 yo man with fatigue, lymphadenopathy, splenomegaly, and a WBC of 80,000 (99% lymphocytes), dx?
CLL
37
Name 2 categories of causes of sideroblastic anemia and examples within each (6 total)
Irreversible: B6 deficiency, cancer Reversible: Lead, EtOH, Copper, Isoniazid
38
Compare the presentation of a patient with chronic leukemia to one with acute
Chronic: asymptomatic, WBC count gt 60 Acute: infxn, fever, anemic, bleeding, bone pain (SICK!) - they have low blood counts because the blasts are taking up all the bone marrow space
39
Long stay in the ICU, INR is up, plts and hgb is normal, dx?
Vit K deficiency (NPO often)
40
When do you see bite cells? Heinz bodies?
G6PD deficiency for both
41
How do you test for paroxysmal nocturnal hemoglobinuria?
flow cytometry (decreased CD55 and CD59)
42
Megaloblastic anemia, differential?
B12 deficiency and folate deficiency
43
Nontender lymphadenopathy made worse with alcohol, dx?
Hodgkin's lymphoma
44
What are B symptoms (3)?
fever, weight loss, night sweats
45
Which increases your risk for DVT the most: cancer, surgery/trauma, factor V Leiden/prothrombin 20210A?
cancer (20x) then surg/trauma (10x) then mutation (1.5x)
46
Normal iron studies in an Asian with microcytic anemia, dx?
thalassemia
47
Thalassemia major, next step and what to watch for? How do you tx the what to watch for problem?
monthly transfusions to support life; iron overload (hemosiderosis); deferoxamine (not phlebotomy!!)
48
Long term, last resort therapy for ITP?
splenectomy
49
What does the bone marrow look like in acute leukemia?
gt 20% blasts
50
How can you tx an acute flare of ITP?
IVIg
51
Plt bleeding, decreased plt count, dx and three categories?
thrombocytopenia - 1) destruction; 2) production; 3) sequestration (spleen, cirrhosis)
52
Decreased ferritin, increased TIBC, decreased iron, dx?
iron deficiency anemia
53
How does the presence of an inherited thrombophilia alter your management?
It doesn't
54
Name 3 chronic presentations in sickle cell pts
1) asplenia; 2) avascular necrosis; 3) osteomyelitis
55
Anti-phospholipid syndrome can cause __ clots. It can be diagnosed with __. Warfarin goal is __.
arterial and venous!; russel viper venom assay; 2-3 | causes anticoagulation in vitro and hypercoaguability in vivo
56
Young child that easily bruises with hemarthrosis - dx and next step?
``` Hemophilia A (8) or B (9) Give FFP or factors during bleed ```
57
What separates B12 from folate deficiency? (Not looking for MMA here)
Neurologic symptoms (irreversible)
58
Smear on DIC shows what? What about PT/PTT, fibrinogen, platelets, hemoglobin, D-Dimer
Schistocytes; INR up, fibrinogen down, plts down, hemoglobin down, D-dimer up
59
Fever, anemia, thrombocytopenia, renal failure, focal deficits, diagnosis?
TTP (thrombotic thrombocytopenic purpura (mnemonic: FAT RN)
60
Mediterranean man, salads, and HIV drugs, dx?
G6PD deficiency
61
What's the tx for hereditary spherocytosis?
Splenectomy (fixes anemia, not spherocytes) (before it can give folate and iron as support)
62
What are side effects of bleomycin? vincristine/vinblastine? cyclophosphamide? cisplatin? adriamycin/doxorubicin?
pulmonary fibrosis; peripheral neuropathy; hemorrhagic cystitis (mesna is antidote!); ototox and renal tox; cardiotox
63
How do you tx hemosiderosis vs hemochromatosis?
Both have iron overload, but hemosiderosis tx with deferoxamine, and hemochromatosis tx with phlebotomy (because hemosiderosis is caused by transfusions so you wouldn't use phlebotomy when they need the blood)
64
How do you test for warm autoimmune hemolytic anemia?
Coomb's test (positive for IgG)
65
Aplastic anemia in a sickle cell pt - causative organism?
Parvovirus B19
66
How do you dx thalassemia?
hemoglobin electrophoresis (B-thal will have increased HbA2 or HbF, while A-thal is a dx of exclusion)
67
African American man, anemia, jaundice, joint pain, bone pain, priapism, how would you tx?
Exchange transfusion (priapism is an acute emergency)
68
Blast crisis?
CML conversion into AML
69
What does the iron studies show for sideroblastic anemia? Thalassemia? Anemia of chronic disease? Iron deficiency?
Increased iron, normal ferritin and TIBC; Thal: normal for all 3; ACD: low Fe, high ferritin, low TIBC Def: low Fe, low ferritin, high TIBC
70
CD55 negative, dx?
paroxysmal nocturnal hemoglobinuria
71
If the fibrinogen is down, you give what?
cryoprecipitate
72
Who gets warfarin in a DVT and how long?
All patients if provoked - 3 mo if unprovoked - 6 mo if recurrence - lifetime
73
Tea and toast diet, diagnosis?
folate deficiency
74
TdT+ and __+ are markers for __.
cALLa; ALL
75
What is the first step in diagnosing multiple myeloma?
SPEP and UPEP (serum and urine electrophoresis - called immunofixation)
76
SPEP is positive, but nothing else in myeloma workup?
MGUS
77
What is the tx of ALL?
ARA-C intrathecally
78
What is the pathology in paroxysmal nocturnal hemoglobinuria? What is the tx?
PIG-A deficiency (ankrin protein) leads to inability prevent complement from binding; eculizumab (terminal complement inhibitor)
79
Auer rods, diagnosis and next step?
AML (M3 - promyelocytic leukemia); treat with all trans-retinoic acid
80
What is the underlying pathology in TTP?
ADAMTS-13 autoantibody leading to deficiency; ADAMTS-13 normally breaks down vWF
81
Name 3 causes of warm autoimmune hemolytic anemia and how to tx (4)
cancer, drugs, rheum | 1st line: steroids, recurrent: splenectomy; severe: IVIg; refractory to splenectomy: rituximab
82
70 yo man with hypercalcemia, renal failure, anemia, and bone pain, dx?
Multiple myeloma (CRAB = hyperCalcemia, Renal failure, Anemia, Bone pain)
83
Hydrops fetalis diagnosis (thalassemia)
4 alpha genes deleted - incompatible with life
84
A picture of a red blood cell with a circle of darkly pigmented iron, what's the diagnosis?
Sideroblastic anemia (ringed sideroblasts)
85
Fevers that come and go, cyclical fevers, diagnosis (not infxn)?
Pel-Ebstein fever = Hodgkin
86
How do you tx von Willebrand disease?
desmopressin
87
Name 3 production problem causes of thrombocytopenia
1) aplastic anemia; 2) MDS (myelodysplastic syndrome); 3) cancer
88
How do you tx cold autoimmune hemolytic anemia (3)?
Avoid the cold; tx mycoplasma or mono; refractory: rituximab
89
Plt bleeding normal count, dx (5)?
Platelet dysfunction: 1) Iatrogenic (nsaids, aspirin, clopidogrel); 2) von Willebrand disease; 3) uremia; 4) bernard soulier (GpIb); 5) Glanzmann's (GpIIb-IIIa)
90
Monoclonal expansion of IgG, dx? IgM?
Multiple myeloma; Waldenstrom
91
The four tests for diagnosing multiple myeloma?
SPEP+, UPEP+, skeletal survey + (lytic lesions), BM bx greater than 10% plasmacytes
92
What are the symptoms of Waldenstrom's macroglobulinemia?
Hyperviscosity syndrome (since IgM is a pentamer)
93
A mixing study fails to correct the bleeding problem, what's the problem?
Patient has factor inhibitors (examples include lupus anticoagulant or spontaneous factor inhibitor)
94
How do you tx CML?
imatinib
95
How do you tx recurrent venous thrombosis?
life long anticoagulation
96
What's the tx for a pain crisis in sickle cell?
IVF, O2, Pain control
97
What leads to a non-megaloblastic macrocytic anemia (4)?
1) Liver disease (cirrhosis); 2) EtOH; 3) medications (AZT, 5-FU, ARA-C); 4) metabolic syndrome (Lesch-Nyhan or hereditary orotic aciduria)
98
Macrocytic anemia, what is the next step?
blood smear (not B12 and folate) - checking to see if megaloblastic or non-megaloblastic (aka are there segmented neutrophils or not)
99
Name 3 acute emergencies in patients with sickle cell and how you tx them?
1) acute chest (MI, CHF); 2) Acute brain (CVA); 3) Priapism Tx with exchange transfusion

MS3 Year (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions