Hematology Oncology I Flashcards
Acute hemolytic transfusion reaction is distinguished from febrile non-hemolytic reaction by the presence of a […] direct antiglobulin (Coomb’s) test.
Acute hemolytic transfusion reaction is distinguished from febrile non-hemolytic reaction by the presence of a positive direct antiglobulin (Coomb’s) test.
Coombs test is negative in febrile non-hemolytic transfusion reaction
Acute hemolytic transfusion reaction is distinguished from febrile non-hemolytic reaction by the presence of plasma free hemoglobin > […] mg/dL.
Acute hemolytic transfusion reaction is distinguished from febrile non-hemolytic reaction by the presence of plasma free hemoglobin > 25 mg/dL.
may result in a “pink” appearing plasma; plasma free hemoglobin is
Autoimmune hemolytic anemia is differentiated from hereditary spherocytosis by a positive […] test.
Autoimmune hemolytic anemia is differentiated from hereditary spherocytosis by a positive Coombs test.
Chronic myeloid leukemia is associated with a […] leukocyte alkaline phosphatase (LAP) score.
Chronic myeloid leukemia is associated with a low leukocyte alkaline phosphatase (LAP) score.
helps distinguish CML from leukemoid reaction (high LAP)
CML is distinguished from a leukemoid reaction (benign neutrophilia) by presence of increased […] and/or myelocytes.
CML is distinguished from a leukemoid reaction (benign neutrophilia) by presence of increased basophils and/or myelocytes.
presence of basophilia and less mature neutrophil precursors (myelocytes > metamyelocytes) favors diagnosis of CML > leukemoid reaction
Diagnosis of paroxysmal nocturnal hemoglobinuria may be made with flow cytometry, which can detect the absence of the proteins […] and […].
Diagnosis of paroxysmal nocturnal hemoglobinuria may be made with flow cytometry, which can detect the absence of the proteins CD55 and CD59.
Does acute myeloid leukemia typically present with lymphadenopathy and hepatosplenomegaly?
No (rare)
typically manifests as symptoms related to > 1 cytopenias (e.g. weakness, bleeding, infection)
Heparin-induced thrombocytopenia causes decreased platelet counts with a […]-coaguable state.
Heparin-induced thrombocytopenia causes decreased platelet counts with a hyper-coaguable state.
due to IgG antibodies against heparin-platelet factor IV complexes
How do the following laboratory values change with tumor lysis syndrome?
Serum Ca2+: […]
Serum K+: […]
Serum phosphate: […]
Serum uric acid: […]
How do the following laboratory values change with tumor lysis syndrome?
Serum Ca2+: Decreased
Serum K+: Increased
Serum phosphate: Increased
Serum uric acid: Increased
K+, phosphate, and uric acid are released from lysed cells; phosphate binds and precipitates Ca2+
Intravascular hemolytic anemias are associated with […] levels of haptoglobin.
Intravascular hemolytic anemias are associated with decreased levels of haptoglobin.
haptoglobin is a serum protein that binds free hemoglobin for removal by the reticuloendothelial system
Leukemoid reaction is associated with a […] leukocyte alkaline phosphatase (LAP) score.
Leukemoid reaction is associated with a high leukocyte alkaline phosphatase (LAP) score.
helps distinguish leukemoid reaction from CML (low LAP)
Lupus anticoagulant (anti-phospholipid antibody) is associated with […] PTT and a […]-coagulable state.
Lupus anticoagulant (anti-phospholipid antibody) is associated with prolonged PTT and a hyper-coagulable state.
PTT will not correct when mixed with normal plasma (mixing study); prolonged PTT is an in vitro artifact
Multiple myeloma is associated with an elevated protein gap (> […] g/dL).
Multiple myeloma is associated with an elevated protein gap (> 4 g/dL).
i.e. the difference between serum protein and serum albumin
Patients with infectious mononucleosis are advised to avoid contact sports for at least […].
Patients with infectious mononucleosis are advised to avoid contact sports for at least 4 weeks.
due to risk of splenic rupture
Patients with pernicious anemia should be monitored for development of […] cancer.
Patients with pernicious anemia should be monitored for development of gastric cancer.
e.g. periodic fecal occult blood testing; pernicious anemia is associated with 2-3x increased risk of gastric cancer compared to the general population due to chronic atrophic gastritis
Pica, especially for ice (pagophagia), may be indicative of […].
Pica, especially for ice (pagophagia), may be indicative of iron deficiency anemia.
Polycythemia vera is characterized by […] levels of erythopoietin.
Polycythemia vera is characterized by low levels of erythopoietin.
helps differentiate polycythemia vera from secondary forms of polycythemia (e.g. chronic hypoxia, EPO-secreting tumors)
The abnormal promyelocytes seen in APML contain numerous primary granules that increase risk for […].
The abnormal promyelocytes seen in APML contain numerous primary granules that increase risk for DIC.
Auer rods can activate coagulation cascade; DIC is common presentation
The pentad of symptoms seen in thrombotic thrombocytopenic purpura (TTP) may be remembered using the mnemonic FAT RN:
F: […]
A: […]
T: […]
R: Renal symptoms
N: Neurologic symptoms
The pentad of symptoms seen in thrombotic thrombocytopenic purpura (TTP) may be remembered using the mnemonic FAT RN:
F: Fever
A: Anemia (MAHA)
T: Thrombocytopenia
R: Renal symptoms
N: Neurologic symptoms
however, only MAHA and thrombocytopenia are required for diagnosis; peripheral blood smear helps aid in diagnosis (e.g. schistocytes suggestive of intravascular hemolysis)
The pentad of symptoms seen in thrombotic thrombocytopenic purpura (TTP) may be remembered using the mnemonic FAT RN:
F: Fever
A: Anemia (MAHA)
T: Thrombocytopenia
R: […]
N: […
The pentad of symptoms seen in thrombotic thrombocytopenic purpura (TTP) may be remembered using the mnemonic FAT RN:
F: Fever
A: Anemia (MAHA)
T: Thrombocytopenia
R: Renal symptoms
N: Neurologic symptoms
however, only MAHA and thrombocytopenia are required for diagnosis; peripheral blood smear helps aid in diagnosis (e.g. schistocytes suggestive of intravascular hemolysis)
The pentad of symptoms seen in […] may be remembered using the mnemonic FAT RN:
F: Fever
A: Anemia (MAHA)
T: Thrombocytopenia
R: Renal symptoms
N: Neurologic symptoms
The pentad of symptoms seen in thrombotic thrombocytopenic purpura (TTP) may be remembered using the mnemonic FAT RN:
F: Fever
A: Anemia (MAHA)
T: Thrombocytopenia
R: Renal symptoms
N: Neurologic symptoms
however, only MAHA and thrombocytopenia are required for diagnosis; peripheral blood smear helps aid in diagnosis (e.g. schistocytes suggestive of intravascular hemolysis)
What amino acid is likely elevated in a patient with the following peripheral blood smear?
Homocysteine
smear is consistent with folate or vitamin B12 deficiency (hypersegmented neutrophils); both vitamins are involved in the conversion of homocysteine to methionine
What anticoagulant is associated with decreased levels of proteins C and S?
Warfarin
also decreases levels of factors II, VII, IX, and X
What blood smear finding is consistent with autoimmune hemolytic anemia?
Spherocytes
differentiated from hereditary spherocytosis by a positive Coombs test
