Heme Onc Flashcards
1
Q
Trousseau’s Syndrome (Migratory sueprficial thrombophlebitis)
A
- Unexplained superficial VTs in unusual sites (chest, arm).
- Usually associated with cancer (pancreas especially, also lung, prostate, stomach, colon, leukemias).
- Likely due to tumor releasing mucins
2
Q
Peripheral septic thrombophlebitis
A
- Associated with catheters, venipuncture, IVs
- Fever, pain, swelling at infection site
3
Q
Pericarditis (Clinical, Causes, Tx)
A
- Clinical: Chest pain, pericardial frxn rub (specific), EKG: Diffuse ST elevation and PR depression (specific) +/- effusion +/- tamponade, +/- fever/leukocytosis
- Infection (Viral-Coxsackie, bacterial), Iatrogenic (surgery, trauma, radiation, drug), RA/SLE, Dressler’s (Post-MI–usually 1-6 weeks), Uremic (BUN >60, may not have EKG changes), Malignancy, Chemo.
- Tx: treat underlying cause (dialysis if uremic), pericardialcentesis if tamponade
4
Q
Vitamin K deficiency
A
- NOT Warfarin (Antagonism, not deficiency)
- Infants and pts on Abx (gut bacteria produce)
5
Q
HITT
A
- Heparin-induced thrombocytopenia and thrombosis
- Autoimmune mediated excessive PLT aggregation state in small % of pts started on heparin
- -> Skin necrosis and hemorrhage
6
Q
Warfarin MoA and adverse effect
A
Inhibits Vitamin K reduction (epoxide reductase)
- limits maturation of II, VII, IX, X, as well as protein C/S
- Factors have half-lives of ~60hrs, but Protein C has half-life of 9 hrs. So warfarin can lead to relative protein C deficiency in the first few days –> hypercoagulable state!
- Can –> skin necrosis, thrombus formation
