Heme/Onc Flashcards
Plt activation, prothrombosis, thrombocytopenia 5-10 d after anticoag
HIT (abs to hep-plt factor 4)
Paraprotein gap (ptn-alb >3-4), increased risk for infection because decreased functional abs, maybe leukopenia.
multiple myeloma
Nuclear remnants within RBCs, blue inclusions, s/p splenectomy
Howell-Jolly bodies
DDx for anterior mediastinal mass
Terrible Ts Thymoma, Teratoma (and other germ cell tumors) Terrible lymphomas Thyroid
MMA and homocystine with b12 and folate
b12: MMA and homocystine both increased
folate: ml MMA, elevated homochysteine
MCV in hemolytic anemia
NL
Thalassemia MCV
typically very very low. Nl iron studies
Risks for polycythemic infants infants
respiratory distress, poor feeding and nn probs (not hyperglycemia)
hyposthenuria
inability to concentrate urine. sickle cell trait
Salvage therapy
Therapy when standard therapy fails
Infections in sickle cell asplenia
s pneumo most common
Anabolic steroid use effect on hct
increase hct
Sx dvts
from iliofemoral vv (calf vv often asx)
Thrombocytopenia in Wiskott Aldrich
from impaired production
HIV is a RF for TTP
schistocytes, hemolytic anemia. nl mcv. increased retic
Hairy cell leukemia
TRAP +, tx with cladrabine
Smudge cells
Seen with CLL. From fragile cells and smear preparation. Low PLT is a poor prognostic sign.
Sunburst pattern on XRAY/codmans triangle. PE - large, tender mass
Osteosarcoma
Onion skin on XRAY (osteolytic lesion with a periosteal reaction that produces layers of reactive bone). Concurrent flu-like symptoms
Ewings Sarcoma - 22:11
How to treat decreased appetite in cancer patients
Progesterone analogues. Cannabanoids dont have eough research behind them. Or steroids, but prog analogues have fewer side effects
Middle Mediastinal Mass?
Bronchogenic cyst
Posterior Mediastinal Mass?
Neurogenic tumors - meningocele, enteric cyst, lymphoma, diaphragmatic hernia, esophageal tumors, aortic aneurysm
Elderly patient, painless LAD, smudge cells. Thrombocytopenia and hemolytic anemia also maybe present
CLL - tx with CD20 MAB
Most common causes of malignant pleural effusion?
Breast and Lung CA. MM isnt common
MSK pain in sickle cell - caused by?
Vaso-occlusion. Can manifest as spinal and nn pain
Renal damage in MM cause by ?
Renal tubular damage more common than glom pathology
A Thalassemia - located on what chromosome ? What is minor look like?
11 - minor can be cis or trans. Only one deletion (a,a,a,-) shows no clinical dz.
Elevated PTT, petechiea, bruising in hospital/post op setting?
think HIT - remove offending agent
Anemia s/p gastrectomy. What type of anemia?
Think B12def - megaloblastic. IF isn’t produced as much
Breast cancer, most important prognostic factor?
TNM. More important than ER+/PR+
EBV infection can cause what hematologic abnormality?
Autoimmune hemolytic anemia. usually 2-3 weeks after onset of sxs
Spherocytes on peripheral smear. Low haptoglobin, high ldh, anemia. Coombs positive. dx?
AIHA. Can be warm (igG) or cold (IgM) mediated. Hereditary spherocytosis has a negative coombs.
ALWAYS check cbc/diff for eosinophils. It really narrows potential dx.
SErz. Makes it a lot easier. DNAAACP
HIT is thrombogenic and you need to monitor closely for aa or vv clots
truth
Hematuria in a patient who recently took medication?
Think G6PD def
Stroke in sickle cell patients. Treatment?
Do exchange transfusion to decrease percentage of sickled cells. Fibrinolytic therapy won’t work because it’s not a true embolus.
VERY high WBC with lots of granulocyte forms. Also has low leukocyte alk phos.
CML. PHL chromosome
fever, chills, malaise 1-6 h after blood products
TRALI. Tx is to irradiate cells (wash cells with IgA def)
Young patient with cervical LAD <2.0 cm, mobile. Otherwise no sx. What do you do?
Observe. no need to bx in this patient. Only bx if >2.0 cm or sx
Tx for sarcoid
steroids
Treatment for TTP/HUS?
emergent plasmapheresis
eczematous rash over nipple. does not respond to topical treatment. bx shows large cells surrounded by clear halos
PAget’s disease of breast/adenoCa
