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FM MED II GENERAL > HEME AND ONC > Flashcards

HEME AND ONC Flashcards

1
Q

hat are the macrocytic anemias? What would we see on a blood smear with these anemias?

A

B12 and Folate deficiency

Megaloblastic (hypersegmented neutrophils)

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2
Q

What would a pt have with B12 deficiency?

A

Peripheral neuropathy

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3
Q

What type of anemia may be secondary to alcoholism?

A

Folate deficiency

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4
Q

What type of anemia is associated with glossitis?

A

Folate (can also occur in B12)

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5
Q

What are the microcytic anemias? What consititues as microcytic?

A 
*TICS*
              Anemia or chronic disease
              Iron def anemia
              Thalassemia
              Sideroblastic
              MCV is less than 80
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6
Q

What are the differences between Anemia of chronic dz and iron def anemia?

A

Both have LOW Serum Iron
Ferritin is NORMAL in ACD
Ferritin is LOW in IDA
IDA will also have a high iron binding capacity

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7
Q

What is the max amount of ferrous sulfate a person absorb/day?

A

Max = 4mg

Males require 1mg

Females require 2mg (more if preggo)

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8
Q

If the iron levels are normal but the MCV is still less than 80, what should you think of?

A

Thalassemia or sideroblastic

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9
Q

What is thalassemia?

A

Reduced or absent beta or alpha chain

*Normal hemoglobin is made up of two alpha globin & two beta globin chains

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10
Q

How do you diagnose a thalassemia?

A

Electrophoresis (Hgb A2 and F)

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11
Q

When would we see Beta thalassemia diagnosed?

A

Intermediate and Major occur between 4-6months when the switch from fetal hemoglobin to adult occurs

Minor is asymptomatic

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12
Q

How do we treat alpha vs beta thalassemia?

A

Alpha H – folic acid supplements, avoid iron supplements

Beta = transfusions, iron chelation

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13
Q

What is the MC cause of sideroblastic anemia? Dx?

A

Lead toxicity

Lead level followed by bone marrow biopsy

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14
Q

What would normocytic anemia be caused from? What are the MCV levels?

A

Acute blood loss, organ failure, or impaired marrow function.

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15
Q

What is hemolytic anemia?

A

HIT (hereditary, immune attack, and trauma to the RBCs); characterized by decreased RBC survival and increased cell lysis

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16
Q

What are some of the causes of hemolytic anemias?

A

spherocytosis, elliptocytosis, G6PD, thalassemias, and sickle cell

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17
Q

How might a patient present with hemolytic anemia?

A

Jaundice, delayed puberty (from sickle cell), hepatosplenomegaly, and petechiae and purapura

18
Q

Target cells are associated with what?

A

Thalassemias

19
Q

Heinz body or bite cells are associated with what?

A

G6PD

20
Q

Howell-Jolly cells are associated with what?

A

Folate def (can also be seen in a Sickle cell smear)

21
Q

A pt presents with epistaxis, HA, dizzy. The pt notes extreme pururitis last night after bathing – dx?

A

Polycythemia vera

22
Q

What would be seen on labs with polycythemia vera?

A

Increased number of RBC’s and increased total blood volume

Thrombocytosis, leukocytosis, increased basophils and eosinophils, and increased number of large platelets

23
Q

How do we treat polycythemia vera?

A

Phlebotomy and low-dose aspirin

24
Q

What is the classification system for leukemias?

A

Acute or Chronic

Myelocytic or Lymphocytic

25
Q

What type of leukemia MC occurs in young children?

A

ALL

26
Q

What type of leukemia typically occurs in adults over the age of 60?

A

AML

27
Q

What type of leukemia presents in young to middle aged adults?

A

CML

28
Q

What type of leukemia has the worst prognosis?

A

CLL

29
Q

Auer rods are associated with what type of leukemia?

A

AML

30
Q

The Philadelphia chromosome is associated with what?

A

CML

31
Q

Smudge cells are associated with what?

A

CLL

32
Q

What is the standard of treatment for acute leukemias?

A

Chemotherapy

*better prognosis in AML if under the age of 60

33
Q

How do we treat CML? CLL?

A

Imatinib and allogeneic bone marrow transplantation

CLL is palliative care

34
Q

Reed-Sternberg cells are associated with what?

A

Hodgkin disease (along with enlarged spleen and liver)

35
Q

What type of hodgkin’s is found in patients aged 15-45?

A

Hodgkin’s disease

36
Q

How do we treat Hodgkin’s?

A

chemo and radiation

37
Q

Which type of hodgkin’s has a better prognosis?

A

Hodgkin’s

38
Q

A pt presents with bone pain and anemia – what dx? Workup?

A

Multiple myeloma

Monoclonic spike on serum protein electrophoresis

*Bence-Jones protein in urine

Lytic lesions on xray

39
Q

What is considered mild thrombocytopenia?

A

100,00 – 150,000 platelets

40
Q

What is considered severe thrombocytopenia?

A

less than 50,000 platelets

41
Q

When/how to we start treatment for thrombocytopenia?

A

start when platelets are less than 30,000

Start with glucocorticoids (+/- IVIG)

Splenectomy

FM MED II GENERAL (6 decks)

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