Heme Flashcards
Tx thalassemia (2)
Folic acid, hydroxyurea
Iron studies in anemia of chronic disease
Low iron, low transferrin, high ferritin
Dx hereditary spherocytosis
osmotic fragility test
Which diagnosis? Anemia, thrombocytopenia, and neurologic symptoms
TTP
Which diagnosis? Anemia, mild thrombocytopenia, AKI
HUS
Which diagnosis? Intra-erythrocytic parasites
Babesiosis, Malaria
Reason for newborn screening for sickle cell disease
Prophylactic PCN x5 years (prevent pneumococcal disease)
Most common cause of death in SCD
Acute chest syndrome
Tx of sickle cell anemia (2)
folate, hydroxyurea
Tx of SCD CKD (2)
EPO, ACEI
Severe cause of ITP
IIB/IIIA Inhibitors (Abciximab, eptifibatide, tirofiban)
Screening for what disease is indicated in ITP?
HIV
First-line tx of ITP
glucocorticoids or IVIG
Indications for ITP treatment (3)
Plt <10,000; active bleeding; Plt <50,000 and new dx
Which disease? Antibodies to ADAMTS13 protein
TTP-HUS
Tx TTP-HUS
Plasma exchange/glucocorticoids in severe cases
Which diagnosis? hypocellularity with increased fatty deposits on bone marrow biopsy
Aplastic anemia
Tx aplastic anemia (3)
HSCT, Cyclosporine, anti-thymocyte globulin
Dx AML
> 20% blasts on bone marrow biopsy
APML mutation
t(15;17)/RAR
Tx AML (2)
idarubicin, cytarabine
Mutation in polycythemia vera
JAK2
Tx of polycythemia vera
Phlebotomy
Mutation in CML
t(9;22)/BCR-ABL
Tx CML
Imatinib
Dx essential thrombocythemia
Plt>600,000; JAK2 negative
Which diagnosis? M protein <30, plasma cells <10%
MGUS
Which diagnosis? Monoclonal IgM gammopathy, anemia, lymphadenopathy
Waldenstrom Macoglobulinemia
Dx multiple myeloma
Plasma cells >10% on bone marrow biopsy or M protein >3.5g IgG
Tx Multiple Myeloma
Induction therapy then autologous HSCT (age <75)
Inheritance vWD
AD
Dx vWD
Ristopetin cofactor assay
Tx vWD
desmopressin
Inheritance Hemophilia
XR
Reversal of NOACs
Prothrombin Complex Concentrate
Inheritance Protein C Deficiency
AR
Inheritance Protein S Deficiency
AD
Inheritance Antithrombin deficiency
AD
Dx FVL
FVL Gene mutation
Dx Hyperhomocyteinemia
Fasting plasma homocysteine levels
Cause of delayed hemolytic transfusion reaction
Minor non-ABO antibodies
Which transfusion reaction? dyspnea, cough, cyanosis, edema, elevated BNP; 1-2 hours
TACO
Which transfusion reaction? drop in hemoglobin, jaundice, fever; 3-10 days
Delayed hemolytic transfusion reaction
Which transfusion reaction? Fever, flank pain, red/brown urine
Acute Hemolytic transfusion reaction
Which transfusion reaction? dyspnea, hypoxia, bilateral infiltrates on CXR; within 6 hours
TRALI
Which transfusion reaction? fever/chills within 1-6 hours
Febrile reaction
Prevention of transfusion-related anaphylaxis/allergy
Washing of cellular blood products
Which transfusion reaction? Severe pancytopenia, diarrhea, skin rash, liver test abnormalities
Graft vs. Host disease
Prevention of GvHD
Irradiation of blood products
Tx TACO
Diuretics, oxygen
