heme buzz words/ key points Flashcards
1
Q
iron deficiency
A
- low fe, ferritin
- high TIBC
- pica, chelitis, tach
- give Fe with stool softener
2
Q
anemia of chronic disease
A
- low FE, TIBC
- high ferritin
- high ESR/CRP
- inflamm or endocrine dz
- tx underlying condition
3
Q
thalassemia general
A
- normal Fe
- dx: electrophoresis
- tx: transfusion if major
4
Q
alpha thalassemia smear
A
- heinz bodies
- target cells
5
Q
beta thalassemia smear
A
- basophilic stippling
- dacrocytes
- target cells
6
Q
sideroblastic anmeia
A
- cant incorp Fe -> high Fe, ferritin
- high RDW
- low TIBC
- tx: transfusion, Cu if needed
7
Q
sideroblastic anemia smear
A
- basophilic stippling
- target cells
- pappenheimer bodies
- sideroblasts
8
Q
hereditary spherocytosis
A
- spherocytes
- neg coombs
- abnormal ankyrin and spectrin
- tx: supportive, transfusion prn
9
Q
AIHA lab findings
A
- warm= IgG
- cold= IgM
- spherocytes
- pos coombs
10
Q
AIHA si/sx and tx
A
- angina pectoris
- splenomegaly
- warm: prednisone
- cold: avoid cold, retuximab
11
Q
PNH lab findings
A
- lack CD55/59
- high hemosiderin
- high LDH
- Fe def
12
Q
PNH si/sx and tx
A
- episodic hemoglobinuria
- thrombosis
- pulm htn
- tx: transfusion, eculizumab, steroids
13
Q
G6PD def smear
A
- bite cells
- heinz bodies
14
Q
G6PD def
A
- episodic hemolysis
- dx 6-8 wks after episode
- avoid triggers, transfusions if severe
- triggers= fava beans, dapsone
15
Q
benefits of G6PD def
A
- protect vs malaria
- less CAD
- less CA
- longer life
16
Q
sickle cell dx
A
- HgS on electrophoresis
- sickled cells
- howell- jolly
- WBCs/ platelets elevated
17
Q
si/sx of sickle cell
A
- retinopathy
- priapism
- pain
- poor healing ulcers
- vaso-occlusive, hemolytic or infx crisis
- trigger= deoxygenation
18
Q
tx of sickel cell
A
- analgesia
- hydroxyurea
- transfusions
- hydration
- VTE ppx
19
Q
b12 def
A
- lack of absorption
- stores= 3 years
- high MMA
- low b12
- neuro sx, vague GI sx
20
Q
folate def
A
- dietary def or alcoholism
- 2-3 mo stores
- normal MMA
- low folate
- vague GI sx, no neuro sx
21
Q
aplastic anemia si/sx
A
- cardiopulm compromise
- recurrent infx
- easy bleeding, petechiae
- BM cellularity < 30% in 2 of 3 lines
22
Q
myelodysplatic syndrome
A
- blasts < 20%
- preleukemia
23
Q
AML
A
- auer rods
- B sx, LAD, papilledema
- chemo + radiation
24
Q
CML
A
- BCR- ABL, Ph chromosome
- hepatosplenomegaly
- LAD
- imatinib
25
ALL
- most common ca of kids
- assoc with down syndrome
- bleeding, bruising, secondary infx
- b sx
- neuro involvement- ppx
26
CLL
- most common in adults
- B cells
- 13p/ 17q
- smudge cells
- CD 19/20/23
- only follow up if early, then chemo
- recurrent infx, LAD, b sx
27
hairy B cell
- CLL without LAD
28
MM
- lytic lesions, plasmacytosis > 30%, M spike
- hyperCa, renal failure, anemia, bone lesions
- usu fatal
- rouleaux cells on smear
29
essential thrombocytosis
- plt > 450k
- thrombotic or bleeding events
- tx: plasmapheresis
30
polycythemia vera
- increased RBC dt JAK2 -> thick blood
- primary: EPO indep
- secondary: EPO dep "heart"- hypoxia, EPO tumor, adrenal, renal, testosterone
31
si/sx and tx of polycythemia vera
- TIA, high SBP
- erythromelalgia with burning
- aquagenic pruritis
- high plt
- tx: ASA, phlebotomy, hydroxyurea
32
follicular NHL
- waxing/ waning LAD
33
DLBCL NHL
- most common
| - bulky LAD
34
burkitts NHL
- EBV in african kids
- starry sky
- MYC
35
T cell NHL
- precursor: thymus
| - peripheral: dermis, GIT
36
hodgkins lymphoma
- reed sternberg cells
- CD 30/15
- LAD painful with alcohol
- cyclic fever
- b sx
- erythema nodosum
37
hemophilia
- A= 8
- B= 9
- C= 11
- spont bleeding, ecchymosis
- hemarthrosis
- elevated PTT
- tx with recombinant factors
38
DIC
- bleeding and clotting
- sepsis
- purpura fulminants, thrombosis
- bleeding
- renal failure
- prolonged PT/ PTT
39
thrombocytopenia
- platelets < 150k
- spont bleeding, cutaneous bleeding
- tx may need platelets
40
type 1 HIT
- related to heparins effects on platelets
| - will normalize
41
type 2 HIT
- IgG binds PF4 -> thrombocytopenia
42
dx of HIT
- confirmed with ELISA
| - 4t's: thrombocytopenia, timing of fall, thrombosis, other
43
vWD
- type 1: quantity
- type 2: quality
- type 3: none
- tx: desmopressin for 1 and 2, transfusion for 3
44
ITP
- isolated thrombocytopenia
- normal BM
- Ab only present in 60% of pts
- dx of exclusion
- purpuric rash, bleeding
- tx only if plt < 20-30k
- tx= steroids, IVIG
45
TTP
- ADAMTS13 -> cant cleave vWF -> coag/ microthrombi/ RBC shearing
- end result= ischemia
- tx; plasmapheresis with FFP
46
pentad of TTP
- fever
- anemia (hemolytic)
- thrombocytopenia
- renal failure
- neuro sx
- "fat rn"
