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True Learn Studying 2021 > Hematology Review > Flashcards

Hematology Review Flashcards

1
Q

highest risk of transmission from a blood transfusion is what blood born illness?

A

Hepatitis B

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2
Q

most common congenital bleeding disorder

A

Von Willebrand’s disease

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3
Q

What is the issue in type I vWD

What is the mode of inheritance

A
  • autosomal dominant inheritance

- quantitative decrease in endogenous vWF

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4
Q

initial treatment for type 1 vWD

A
  • Desmopressin (DDAVP)
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5
Q

what is the issue in type 2 vWD

What is the inheritance pattern

A
  • autosomal dominant inheritance

- qualitative decrease in vWF

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6
Q

initial treatment for type 2 vWD

A

desmopressin (DDAVP)

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7
Q

what is the issue in type 3 vWD

Give inheritance pattern

A
  • autosomal recessive inheritance

- near-complete absence of endogenous vWF

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8
Q

initial treatment for type 3 vWD

A

Factor VIII/vWF Concentrate

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9
Q

needle stick from Hep C+ patient, do you get post-exposure prophylaxis?

A

no, the risk of infection is 0.1-1.8%

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10
Q

mechanism of action for Dabigatran?

A
  • direct thrombin inhibitor

- non-vitamin K dependent

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11
Q

what can you use to reverse dabigatran?

A

idraucizumab
or hemodialysis
or PCC

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12
Q

patient is started on Warfarin and presents 3 days later with necrotic skin lesions…what happened?

A
  • patient is deficient in protein C
  • transiently becomes prothrombotic as protein C dissolves clots and is inactivated by Warfarin before its anticoagulant effects can take hold
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13
Q

what is a provoked DVT?

A
  • DVT caused by a known event (i.e. surgery, recent travel, OCPs, pregnancy)
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14
Q

how long do you anti-coagulate for a provoked DVT?

A
  • 12 weeks
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15
Q

Anticoagulation time line for provoked DVT in patient with mobility impairments

A

6-12 months

also for patients with phlegmasia cerulean dolens

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16
Q

what is an unprovoked DVT

A

DVT caused by malignancy or inherited disorder

life long anticoagulation

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17
Q

Absolute indications for IVC filter?

A
  • contraindication to anti-coagulation
  • recurrent thromboembolic disease despite AC
  • significant bleeding complications from AC
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18
Q

Patient with DES for unstable angina place 3 months ago on dual anti-platelet therapy, but has obstructing colon mass at hepatic flexure…next step

A

hold clopidogrel for 5 days and do surgery on aspirin alone

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19
Q

what is the name given to effort thrombosis/thrombosis from repetitive motions

A

Paget-Schroetter disease

20
Q

Patient with acute paget-schroetter disease, first step?

A

catheter directed thrombolysis

after recovery can consider decompression surgery

21
Q

multiple 45 um cells with multiple nuclei containing large inclusion nucleoli

A

this describes Reed-Sternberg cells

associated with Hodgkin-type lymphoma

22
Q

treatment of choice for thrombotic thrombocytopenia purpura

A

Plasmapheresis

23
Q

first line treatment for methemoglobinemia from drug exposure?

A

methylene blue injection

24
Q

R time of TEG

A

time to start forming a clot

25
Q

normal R time in TEG

treatment if abnormal

A

4-8 minutes

FFP

26
Q

K time of TEG

A

time it takes for clot to get to fixed state

27
Q

normal time for k-time

treatment if abnormal

A

1-3 minutes

Cryoprecipitate

28
Q

alpha angle on TEG

A

speed of fibrin accumulation

29
Q

normal alpha angle on TEG

treatment if abnormal

A

53-72 degrees

Cryoprecipitate

30
Q

maximum amplitude on TEG

A

highest vertical amplitude on TEG, deals with platelet function

31
Q

normal maximal amplitude on TEG

treatment if abnormal

A

50-70 mm

platelets and/or desmopressin

32
Q

Lysis at 30 minutes on TEG

A

percentage decrease of max amplitude at 30 minutes, a measure of fibrinolysis

33
Q

normal value of L-30 on TEG

treatment if abnormal

A

0-8% decrease of MA

TXA or aminocaporic acid

34
Q

when do you give anti-histamines for transfusion reaction?

A
  • in a non-hemolytic transfusion reaction, within 30-60 minutes patient should show signs of an allergic reaction (urticaria)
35
Q

blood transfusion started, 15 minutes later patient has fever, chills, and uticaria

A
  • febrile non-hemolytic reaction
36
Q

what is the underlying cause of a non-hemolytic reaction during a blood transfusion?

A

reaction to DONOR cytokines released from DONOR WBCs

37
Q

female with history of menorrhagia presents with petechiae and platelets are noted to be 25,000. CT scan shows normal spleen and blood smear shows megakaryocytes. What does she have?

A

idiopathic thrombocytopenia purpura

38
Q

Antidote for Rivaroxaban

A

Andexanet alfa (Andexxa)

39
Q

how do you treat bleeding when patient is on clopidogrel

A

platelet transfusion

40
Q

how do you treat bleeding while on Argatroban

A
  • no antidote, but half-life is 45 minutes so just stop transfusion and support patient
41
Q

mechanism of action of aspirin

A

inhibits prostaglandin synthesis from platelets, which causes permanent dysfunction of platelets

42
Q

best treatment for bleeding skin squamous cell carcinoma for non-surgical patients

A

radiation treatment will stop the bleeding

43
Q

what is heparin-induced thrombocytopenia a result of?

A

autoantibodies against endogenous platelet factor 4 (PF4)

44
Q

how long do you hold warfarin before a surgery

A

5-7 days

45
Q

when do you start your bridge with heparin for a patient on warfarin

A

once INR < 2

46
Q

treatment for a fat embolus

A

supportive, may need endotracheal intubation

47
Q

highest rate of transfusion transmitted infections, come from what?

A

bacterial infections

True Learn Studying 2021 (27 decks)

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