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PANRE > Heme > Flashcards

Heme Flashcards

1
Q

Diseases with macrocytosis

A

B12 def
folate def
liver dz
aplastic anemia

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2
Q

diseases with microcytosis

A

fe def
thalassemia
lead poisoning

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3
Q

“howell jolly bodies”

A

splenectomy or asplenism

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4
Q

“Heinz bodies” and “bite cells” (2)

A

thalassemia

G6PD def

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5
Q

“target cells” (2)

A

thalassemia

sickle cell

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6
Q

“basophilic stippling”

A

lead poisoning

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7
Q

“burr cells” (echinocytes)

A

uremia

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8
Q

“bands” seen

A

bacterial infx

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9
Q

Fe def anemia: high or low ferritin?

ACD: high or low ferritin?

A

Fe def: low ferritin

ACD: high ferritin

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10
Q

RBC life span

A

120 days

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11
Q

list (non-obvious) lab values for hemolytic anemia (5)

A 
inc reticulocytes
inc LDH
inc indirect bili
dec haptoglobin
\+ schistocytes
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12
Q

Hgb S on electophoresis

A

sickle cell

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13
Q

microcytic anemia
normal Fe
electrophoresis normal

A

alpha thalassemia

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14
Q

microcytic anemia
normal Fe
electrophoresis with low HgbA, high HgbF

A

beta thalassemia

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15
Q

MC presentation of alpha thalassemia major?

A

stillbirth

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16
Q

When do sx appear for beta thalassemia major

A

6 months

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17
Q

treatment for beta thalassemia major?

A

deferoxamine (chelating agent)
bone marrow transplant
weekly transfusions

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18
Q

what will iron labs show in ACD (3)

A

low iron
low TIBC
high ferritin

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19
Q

treatment of ACD in addition to treating underlying disease?

A

epo

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20
Q

management for someone with G6PD symptoms

A

self-limiting, remove offending agent if possible

supplement or transfuse if severe

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21
Q

if someone is a carrier of the sickle cell trait, what is the only symptom they might have

A

episodic hematuria

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22
Q

when do sx start for sickle cell anemia and what are the sx

A

6 months, dactylitis MC 1st presentation

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23
Q

other than dactylitis, what are 3 other presentation of sickle cell anemia

A
  1. dactylitis
  2. infections (salmonella osteo, asplenia)
  3. hemolytic anemia
  4. thrombotic sx (chest pain syndrome, splenic crisis, AVN)
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24
Q

what pain med can you NOT use in sickle cell dz

A

meperidol (demerol)

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25
Q

management of sickle cell crisis

A

1st step IV hydration and O2*

Hydroxyurea
Folic acid
Vaccinate for spneumo, hinf, nmeningitis

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26
Q

diagnostic tests for hereditary spherocytosis

A

microspherocytes that are hyperchromic
+ osmotic fragility test
- coombs test

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27
Q

diagnostic tests for autoimmune hemolytic anemia

A

microspherocytes
+ coombs test
smear w/ agglutination of rbcs

28
Q

tx for hereditary spherocytosis

A

folic acid

splenectomy TOC

29
Q

warm v cold autoimmune hemolytic anemia

A

warm - caused by SLE, malignant
IgG Ab

cold- caused by the cold, infx
IgM Ab

30
Q

tx for autoimmune hemolytic anemia

A

warm- steroids

cold - warm up

31
Q

“cola cola urine in early am”

A

paroxysmal nocturnal hemoglobinuria

32
Q

best test for paroxysmal nocturnal hemoglobinuria

A

flow cytometry

33
Q

best tx for paroxysmal nocturnal hemoglobinuria

A

ecluzimab (anti complement ab)

34
Q

list the extrinsic factors (PT)

A

1, 2, 5, 10

7

35
Q

list the intrinsic factors (PTT)

A

1, 2, 5, 10

8, 9, 11, 12

36
Q

which med prolongs PT

A

warfarin

37
Q

which med prolongs PTT

A

heparin

38
Q

happens to kids, following a viral illness, with mucocutaneous bleeds and petechiae.
labs show thrombocytopenia, PT/PTT normal

dx and treatment

A

ITP

tx kids by observing x 6 mos +/- ivig
adults needs ivig/steroids

39
Q

a patient with s/s of mucocutaneous bleeds, hemolytic anemia, kidney failure.
labs show thrombocytopenia, normal PT/PTT, increased ind bili, decreased haptoglobin

what 2 disease should you suspect

A

TTP and HUS

40
Q

what is the major symptom difference between TTP and HUS

A

TTP will have near symptoms and fever

HUS more likely to have kidney sx

41
Q

what is the major patient population difference between TTP and HUS

A

TTP: females 20-50yo
HUS: kids after a diarrheal prodrome

42
Q

what is the tx for TTP versus HUS

A

TTP: plasmapheresis and steroids
HUS: observe kids, +/- plasmapheresis

43
Q

hemophilia a
what factor
intrinsic or extrinsic

A

factor 8

intrinsic

44
Q

hemophilia b
what factor
intrinsic or extrinsic

A

factor 9

intrinsic

45
Q

what is the treatment of hemophilias

A

A: Factor 8 replacement and DDAVP
B: Factor 9 replacement only

46
Q

does VWD increase PT or PTT

A

increased PTT

due to decreased factor 8 associated with it

47
Q

gold standard test for VWD

A

risotecin activity test

no platelet aggregation with risocetin

48
Q

tx for mod to severe VWD

A

DDAVP

Cryoprecipitate (with factor 8, fibrinogen, vwf)

49
Q

which lymphoma

  • peaks in 20s and again in 50s
  • peaks 50+ with hx immunosuppression
A
  1. hodgkins

2. non hodg

50
Q

which lymphoma

  • is peripheral with noncontiguous LAD
  • is upper body with localized LAD
A

1 non hodg

2 hodgkins

51
Q

which lymphoma has reed sternberg cells with owl eye appearance

A

hodgkins

52
Q

which lymphoma shows diffusely large b cells or follicular

A

non hodgkins

53
Q

which lymphoma commonly has b sx

A

hodgkins

54
Q

which lymphoma is assoc with the “pel ebstein fever” 1-2 weeks of cyclical fevers

A

hodgkins

55
Q

which lymphoma is more assoc with EBV

A

hodgkins

also Burkitt’s which is a NHL

56
Q

leukemia assoc with kids with >30% blasts

A

ALL

57
Q

auer rods

A

AML

58
Q

+ philadelphia chromosome

A

CML

59
Q

indolent chemo that doesn’t need treatment until there is a crisis

A

CLL

60
Q

“smudge cells”

A

CLL

61
Q

how do you treat a blastic crisis

A

like AML - combo chemo and BMT

62
Q

“rouleaux formation” on CBC

A

multiple myeloma

63
Q

tx for multiple myeloma

A

stem cell transplant

chemo, bisphosphonates

64
Q

other than phlebotomy, what is med tx for polycythemia vera?

A

hydroxyurea

65
Q

extra-liver sx of hemochromatosis (4)

A

heart failure
hypogonadism
pancreatic insufficiency
bronze skin

PANRE (13 decks)

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