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PANCE- Things I didnt know > HEME > Flashcards

HEME Flashcards

1
Q

Iron low
TIBC/ Transferrin high
Ferritin low

A

Iron Deficiency

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2
Q

Iron low
TIBC/ Transferrin low
Ferritin high

A

Chronic Disease

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3
Q

Physical exam findings of iron def

A

Kiolnychia
Angular Cheilosis
Tachycardia - heart is pumping harder with low o2
Glossitis

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4
Q

EKG of IRON deficiency

A

Global ST depression

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5
Q

Treatment for Thalassemia

A

Blood transfusions but ultimately splenectomy

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6
Q

key terms - kid with pica

A

Lead poisoning

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7
Q

Alcoholic with microcytic

A

Sideroblastosis

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8
Q

Name all the microcytic anemias

A

Iron def
Thalamssemia
Lead poisoning
Sideroblastosis

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9
Q

Name all the Normocytic Nomrochromic anemias

A

Chronic disease

  • kidney disease
  • infection
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10
Q

Name all the hemolytic anemia

A

Sickle cell

G6PD

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11
Q

what genetic disorder is sickle cell

A

X-linked recessive

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12
Q

which anemia
Bilirubin high
LDH high
Haptoglobin low

A

Hemolytic anemias

usually -> Sickle cell

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13
Q

Parvovirus B19 commonly causes what anemia

A

Aplastic Anemia
pancytopenia
shuts down the bone marrow

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14
Q

What is vasooculsive crisis

A

From massive sickle cells

  • > acute chest syndrome
  • > Pain in joints, ABD
  • > Pripsm
  • > stoke
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15
Q

What is the most lethal complication of sickle cell crisis

A

acute chest syndrome

they are tiny infarcts happening in the chest

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16
Q

Treatment for sickle cell

A

Hydroxurea

DONT GIVE NSAIDS LIKE TORADOL- will shut down kidneys

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17
Q

What does Hydroxurea do?

A

Increases the amount of Fetal Hemoglobin

really important for Sickle cell anemia

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18
Q

What causes G6PD

A 
Fava beans 
Dapsone
Primaquine
Sulfonamides- bactrium
Chloriquines 
Primaquine
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19
Q

Another name for Factor 8 deficiency

A

Hemophilia A

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20
Q

Another name for Factor 9 deficiency

A

Hemophilia B

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21
Q

What genetic disorder is Hemophilia

A

X-linked Recessive

Mendelian genetics

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22
Q

What is the hallmark of Hemophilia

A

Think kid with no history of trama
with red joint
not swollen but painful

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23
Q

What is the dose for Factor 8 deficency
mild
Moderate
severe

A

12.5
25
50

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24
Q

What is the dose for Factor 9 deficency
mild
Moderate
severe

A

25
50
100

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25
Q

Most common inherited bleeding disorder

A

Von Willebrand disease

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26
Q

Plts normal
Bleeding time - prolonged
PT normal
PTT normal

A

Von Willebrand disease

von williebrand activity level- decreased * most important test

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27
Q

Treatment for Von Willebrand disease

A 
Cryoparcipitate 
F8 itself 
DDAVP 
*Tranexamic Acid- Block fibrinolysis
*Amino-Caproic Acid - Blocks fibrinolysis
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28
Q

Treatment for an acute bleed due to Von Willebrand disease

A

Estrogen

29
Q

What are some inherited Hypercoaguable states

A
  1. Factor V leidin

2. protein C or S deficiency

30
Q

Treament for Idiopathic Thrombocytopenic purpura - ITP

A
  1. Steroids
  2. IVIG *
  3. Platelets
  4. Splenectomy
  5. new drugs- Rhogam, Rituximab
31
Q

Key terms for this diagnosis -

Kid with recent infection or vaccines then bruising, low plt levels, enlarged spleen

A

Idiopathic Thrombocytopenic purpura - ITP

32
Q

Key terms for this diagnosis -

Fever, confused/lethargic , Low RBC count, low plts, elevated BUN

A 
Thrombotic Thrombocytopenic Purpura - TTP 
"FATRN" 
Fever 
 Anemia  
Thrombocytopiena low plts 
 renal failure 
cNs symptoms
33
Q

Key terms for this diagnosis-

Microangiopathic hemolytic anemia with gross hematuria
CNS symtoms- headache, aphasia
low plts

A

Thrombotic Thrombocytopenic Purpura - TTP

34
Q

What drug is most commonly the cause of Thrombotic Thrombocytopenic Purpura - TTP

A

Clopidogrel

others- Quinine, Ticlopidine

35
Q

What can kill a patient with Thrombotic Thrombocytopenic Purpura - TTP

A

accidentally giving them plts

36
Q

What enzyme is absent in TTP causing plt & vWF not to get broken down leading to plt clots “thrombpocytopenia”

A

ADAMTS-13

it is the enzyme needed to break down the VWF /PLT strand

37
Q

Treatment for TTP

A
  1. Freash Frozen Plasma
    PLTS WILL KILL THEM
  2. Splenectomy
  3. IVIG
38
Q

Key terms for this diangosis-

kid with Microcytice hemolytic anemia, low plts, and acute renal failure

A

Hemolytic Uremia Syndrome

39
Q

Hemolytic Uremia Syndrome

what in the history should make you think this

A

KID
history of BLODDY DIARRHEA ! - Ecoli
ate rare meant, petting zooe, daycare, swimming

40
Q

Most common cause of Hemolytic Uremia Syndrome

A

E Coli - O157-H7

Shiga like toxin

41
Q

Treatment for Hemolytic Uremia Syndrome

A 
Support them 
admit for fluids 
RBC
sometimes need  hemodialysis 
NO ANTIBITOICS CAN MAKE WORSE
42
Q

What is Heparin Induced Thrombocytopenia HIT

A

<150 platelets
OR
Drop of 50% from their baseline

43
Q

What drug blocks the conversion of Factor X to Xa and

Prothrombn to thrombin

A

Heparin

44
Q

What drug blocks the conversion of Factor X to Xa

A

Low molecurlar weight heparin - LMWH

45
Q

Key terms for this diangosis- Had a hostpital stay and was given IV medication,
one week later now present with DVT, PE, Gangrene, storke, MI DIC

A

Heparin Induced Thrombocytopenia HIT

46
Q

Treatment for Heparin Induced Thrombocytopenia HIT

A 
STOP HEPARIN 
do not give platelets 
give direct thrombin inhibitors 
- Argatroban 
-Bivalirudin 
-Lepirudin
47
Q

Key terms for this diagnosis
Adult with extreme fatigue weight loss,
CBC- Myeloid stem cells with Auer Rods

A

Acute Myelogenous Leukemia

AML

48
Q

Key terms for this diagnosis
Child with recurrent infections, bloody nose, burising easily
CBC- Blasts, Lymphid stem cell line

A

Acute Lymphocytic Leukemia - ALL

49
Q

Treatment for ALL

A

Huge blast of Chemo then

consolidation chemo

50
Q

Treatment for AML

A

Chemotherapy

51
Q

What is a major complication when treating ALL or AML with chemotherapy ?

A 
Tumor lysis syndrome 
when you kill the cancer cells their insides are free around the body and get suck in the kidneys and can cause renal failure 
Also can cause metabolic changes like 
high K+ 
High uremia 
High Phosphates 
Low Calcium
52
Q

Key terms for this diagnosis
Adult male 55yrs with fatigue, weight loss, anemia
physical exam shows englarged spleen
CBC- WBW 100,000

A

Chronic Myeloid Leukemia - CML

it can go acute very quickly

53
Q

Philadephlia Chromosome 9:22

A

Chronic Myeloid Leukemia - CML

54
Q

Key terms for this diagnosis
Adult male 70yrs with fatigue, weight loss, recurrent infections
CBC- WBW 100,000 & Smudge cells

A

Chronic Lymphoid Leukemia - CLL

55
Q

BCR-ABL gene

what lukemia

A

Chronic Myeloid Leukemia - CML

56
Q

Reed Sternberg cell on lymph node biopsy

A

Hodgkin Lymphoma

57
Q

Key terms for this diagnosis
Teenage kid that noticed a painless swollen lymph node
when he drank alcohol at a party the node became painful

A

Hodgkin Lymphoma

58
Q

What type of Lymphoma is most common with HIV patients

A

Non- Hodgkin Lymphoma

59
Q

Which Lymphoma is the worst prognosis ?

A

Non- Hodgkin Lymphoma

60
Q

What is the ANN arbor Staging for Lymphoma

A
  1. single lymph node chain
  2. 2 or more lymph nodes above the belly button
  3. Lymph nodes above and below the belly button
  4. Anything that has spread beyond nodes, bone,lungs, brain
61
Q

EXAM * Treatment for Lymphoma

A 
AVBD * 
Adriamycin 
Bleomycin 
Vinblastine 
Dacarbazine 
with chem and localized radiation
62
Q

What lab value correlates with prognosis with Lymphomas

A

LDH
high bad - cells are proliferating
low good - cells are dying

63
Q

Malignant proliferation of plasma cells

A

Multiple Myleoma

64
Q

Xray- punched out skull lesions

A

Multiple Myleoma

65
Q

key terms for this diagnosis-

Adult with Anemia, Bone pain, seems to get a lot of colds, lower extremity weakness

A

Multiple Myleoma

lower extremity weakness due to spinal cord compression

66
Q

CBC shows Rouleaux

serum protein electrophoresis - monoclonal spike

A

Multiple Myleoma

67
Q

Key terms for this diagnosis- Low blood count, High BUN count, hypercalcemia

A

Multiple Myleoma

68
Q

Treatment for Multiple Myleoma

A
  1. Thalidomide - do not give if pregnant
  2. Steroids
  3. Doxorubicin

PANCE- Things I didnt know (21 decks)

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