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Internal Medicine > HEME/ONC > Flashcards

HEME/ONC Flashcards

1
Q

Effects of transfusion of:
PRBCs?
Platelets?

A

 PRBCs: Hb +1, Hct +3

Platelets: platelets +10,000

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2
Q

Contained in…
FFP? (indications?)
Cryoppt? (indications?)

A

FFP: factors 1-12; ↓PT, ↓PTT

Cryoprecipitate: factors 1 + 8 only; ↓PTT

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3
Q

TIBC:
reflection of…
___ has negative feedback on TIBC

A

transferrin levels (protein that binds ferritin)

serum ferritin has a negative feedback on TIBC levels

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4
Q

↓RDW = a/w…

A

thalassemia

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5
Q

LDH:
enzyme of…
incr in…

A

enzyme of anaerobyic glycolysis

↑ w/ intravascular hemolysis or tissue hypoxia

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6
Q

Haptoglobin:
binds…
decr in…

A

free hgb

↓ w/ intravascular hemolysis

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7
Q

Sideroblastic anemia:
tx?
etiology?

A

Tx underlying cause, vit B6 supplements

lead poisoning, vit B6 deficiency, INH or EtOH use

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8
Q

Fanconi anemia:

presentation?

A

aplastic anemia + short stature, hypopigmented areas, eye/ear deformities

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9
Q

G6PD deficiency:
presentation?
dx?
etiology?

A

intravascular hemolysis, back pain, hemoglobinuria in men

Dx blood smear (Heinz bodies, bite cells)

Etiology: sulfa drugs, anti- malarials, infx, fava beans

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10
Q

Paroxysmal nocturnal hemoglobinuria (PNH):
presentation?
dx?
tx?

A

hemolytic anemia + hepatic vein thromboses

Dx ↑urine hemosiderin

Tx steroids, bone marrow txp


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11
Q

Heparin-induced thrombocytopenia (HIT):
type 1?
type 2?

A

HIT type 1: heparin directly causes platelet aggregation, within 0-2 days (*reassurance)

HIT type 2: heparin induces auto-antibodies against platelet factor 4, after 3-12 days (*d/c heparin)

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12
Q

Idiopathic thrombocytopenic purpura (ITP):
pathophys?
dx?
tx?

A

auto-antibodies against gpIIb/IIIa → platelet clearance

Dx plt <20, ↑megakaryocytes

Tx steroids, plt transfusion then splenectomy • (severe)

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13
Q

HUS:
presentation?
dx?
tx?

A

tons of clots form in small vx (e.g. renal vx) → micro- angiopathic hemolytic anemia + thrombocytopenia + renal failure

Dx CBC (↓plt, ↓RBC) + blood smear (schistocytes)

Tx emergent plasmapheresis

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14
Q

Thrombotic thrombocytopenic purpura (TTP):

presentation?

A

HUS + fever + ∆MS

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15
Q

Glanzmann thrombasthenia:

presentation?

A

AR ∆gpIIb/IIIa → platelets can’t aggregate

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16
Q

Bernard-Soulier syndrome:

presentation?

A

AR ∆gpIb → platelets can’t adhere to subendothelium

17
Q

HUS × diarrhea =

A

EHEC (O157:H7)

18
Q 
 PTT measures...
PT/INR measures...
Thrombin time measures...
Bleeding time measures...
Factor w shortest T1⁄2?
A

 PTT: measures intrinsic pathway (12→→1)

PT/INR: measures extrinsic pathway (7→→1)

Thrombin time: measures fibrinogen levels (2→1)

Bleeding time: measures platelet function

Shortest T1⁄2: factor 7

19
Q

 Heparin:
moa?
side-effects?
reversal?

A

MOA: potentiates AT-III to inhibit factors 2/10 → ↑PTT

side-effects: bleeding, HIT, osteoporosis

reversal: protamine sulfate

20
Q

tPA:
moa?
reversal?

A

moa: activates plasmin to break down existing clots
reversal: aminocaproid acid

21
Q

von Willebrand disease (vWD):
dx?
tx?

A

↓/∆/no vWF, ↑bleeding time

DDAVP (types 1 [AD, decr vWF] and 2 [AD, abn vWF])

factor 8 concentrate (refractory type 2, type 3 [AD, no vWF])

22
Q

Hemophilia A:
dx?
tx?

A

Dx ↑PTT, ↓factor 8

Tx factor 8 concentrate; analgesia + RICE (for acute hemarthroses)

23
Q

Hemophilia B (Christmas disease):
dx?
tx?

A

Dx ↑PTT, ↓factor 9

Tx factor 9 concentrate; analgesia + RICE (for acute hemarthroses)

24
Q

Hemophilia A vs. factor 8 inhibitor?

A

mix pt’s plasma w/ normal plasma; if PTT fails to normalize, then factor 8 inhibitor

25
Q

AT-III deficiency:
pathophys?
presentation?

A

can’t break down factors 2-12 → hypercoagulability that doesn’t respond to heparin

26
Q

Factor V leiden:

pathophys?

A

protein C can’t block factor 5 → hypercoagulability

27
Q 
Multiple myeloma:
pathophys?
presentation?
dx?
tx?
A

monoclonal plasma cell proliferation → makes lots of monoclonal IgG and eats up bone marrow space

CRAB – hyperCalcemia, Renal failure, Anemia, Bone lesions/fx

Dx SPEP (monoclonal spike), urinalysis (Bence Jones protein), X-ray (punched out lytic bone lesions), blood smear (rouleaux formation)

Tx chemo/radiation only if symptomatic

28
Q 
Monocolonal gammopathy of undetermined significance (MGUS):
presentation?
dx?
tx?
prognosis?
A

asx, precursor of myeloma

Dx SPEP (monoclonal spike), urinalysis (Bence Jones protein)

Tx close f/u

20% convert to MM in 10-15 yrs

29
Q 
Waldenstrom macroglobulinemia:
pathophys?
presentation?
dx?
tx?
A

monoclonal IgM plasma cell proliferation → ↑IgM

hyperviscosity (IgM is big), anemia, splenomegaly, LNopathy

Dx SPEP (monoclonal spike), urinalysis (Bence Jones protein), ↑IgM, no bone lesions

no tx exists

30
Q

MCC multiple myeloma?

A

recurrent lung or urinary tract infx (↓normal IgG)

Internal Medicine (15 decks)

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