Heme Onc Flashcards
Monitor heparin vs warfarin
heparin: PTT (intrinsic via antithromb III)
warfarin: PT (extrinsic via vit K)
Hemophelia A, B, C factor deficiencies and tx
A: VIII B: IX C: XI Tx: transfusion of cryoprecipitate (VIII, fibrinogen) DDAVP for mild (+ fluid restriction)
Ristocetin assay
test for vWF, measures ability to agglutinate platelets
Deficiencies: Bernard soulier, glanzmann thormbasthenia
Bernard Soulier: GpIb
Glanzmann: GpIIb/IIIa
Long term tx of DVT
1st: 3-6mo warfarin
2nd: 6-12 mo
3rd+: lifelong warfarin
DIC vs severe liver disease
Factor VIII depressed in DIC
3 causes microangiopathic hemolytic anemia
HUS (incr creat)
TTP
DIC (abn clotting, incr PT/PTT/ d-dimer)
Tx: TTP vs ITP
TTP: plasmapheresis, plasma replacement, steroids
ITP: corticosteroids, IVIG, splenectomy
B12 vs folate deficiency: labs
B12: incr MMA and homocysteine
folate: normal MMA, incr homocysteine
cafe au lat spots, short stature, thumb hypoplasia, anemia
fanconi anemia
health maintenance for sickle cell
folate suppl, pneumo vax,
Tx: acute chest syndrome
hydration, incentive spirometry, sickle variant
Tx of polycythemia vera
cytoreductive drugs (eg hydroxyurea, IFN), ASA for prothrombotic
How distinguis leukemoid rxn vs leukemia
LAP: high in leukemoid rxn, low in leukemia
photodermatitis, neuropsych, colicky abd pain: dx and tx
porphyria
glucose to decr heme synth
Auer rod on smear: dx and tx
AML type M3, ATRA
WBC >100,000 with TIA/ other blood vessel occlusion: dx and tx
leukostasis
hydroxyurea +/- leukopheresis
smudge cells: dx, workup, tx
CLL
CD5+CD20/21+
Tx when symptomatic: chemo, radiation
TRAP + staining: dx and tx
hairy cell leukemia
Tx: cladribine (nucleoside analog), IFNa, spelectomy
Dx and classification of NHL
excisional bx of LN # of nodes and sides of diaphragm involved
B symptoms, pruritis, hepatosplenomegaly, weekly fevers, alcohol-induced pain: dx and tx, prognostic factors
Hodgkin’s disease
excisional LN biopsy: Reed-sternberg cells
Chemo and/or radiation; lymphocyte predominant= best prognosis
Anemia, renal failure, bone pain: what must be ruled out, tx
multiple myeloma (>10% plasma cells in BM, M protein, lytic bone lesions) Tx: melphalan, prednisone
Marrow shows dutcher bodies (PAS+ deposits around nucleus)
Waldenstrom’s
tx: remove excess Ig with plasmapheresis
Common causes sepsis for neutropenia, tx
S. aureus, Psuedomonas, E coli, proteus, klebsiella
tx: cefepime
