Heme/Onc Flashcards
Elderly M with hypochromic microcytic anemia is asxic. Dxic tests?
FOBT and sigmoidoscopy; suspect CRC
Precipitants of hemolytic crisis in pts with G6PD deficiency
Sulfonamides, antimalarial drugs, fava beans (“HEMOLYSIS IS D PAIN And No Fun”)
MC inherited cause of hypercoagulability
Factor V Leiden mutn
MC inherited bleeding d/o
von Willebrand’s dz
MC inherited hemolytic anemia
Hereditary spherocytosis
Dxic test for hereditary spherocytosis
Osmotic fragility test
Pure RBC aplasia
Diamond-Blackfan anemia
Anemia a/w absent radii and thumbs, diffuse hyperpigmentation, café au lait spots, microcephaly, and pancytopenia
Fanconi’s anemia
Meds and viruses that lead to aplastic anemia
Chloramphenicol, sulfonamides, radiation, HIV, chemo, hepatitis, parvovirus B19, EBV
How to distinguish polycythemia vera from 2˚ polycythemia
- Both: increased Hct and RBC mass
- Polycythemia vera: normal O2 sat, low EPO levels
Thrombotic thrombocytopenic purpura (TTP) pentad
“FAT RN”: Fever, Anemia, TCP, Renal dysfcn, Neurologic abnlities
HUS triad
Anemia, TCP, acute renal failure
Tx for TTP
- Emergent large-volume plasmapheresis
- Corticosteroids
- Antiplatelet drugs
Tx for idiopathic thrombocytopenic purpura (ITP) in kids
- Usually resolves spontaneously
- May require IVIG and/or corticosteroids
Which of the following are increased in DIC: fibrin split products, D-dimer, fibrinogen, plts, Hct
- Elevated: fibrin split products, D-dimer
- Decreased: plts, fibrinogen, Hct
8 yo M presents with hemarthrosis and increased PTT with normal PT and bleeding time. Dx? Tx?
- Dx: hemophilia A or B
- Tx: consider desmopressin (for hemophilia A) or factor VIII or IX supplements
14 yo F presents with prolonged bleeding after dental surgery and with menses. Nl PT, nl or increased PTT, and increased bleeding time. Dx? Tx?
- Dx: von Willebrand’s dz
- Tx: desmopressin, FFP, or cryoprecipitate
4 causes of microcytic anemia
“TICS”: Thalassemia, Iron deficiency, anemia of Chronic dz, and Sideroblastic anemia
60 yo AAM presents with b. pain. W/u for multiple myeloma might reveal ___.
Monoclonal gammopathy, Bence Jones proteinuria, “punched-out” lesions on XR of skull and long bb.
Reed-Sternberg cells
Hodgkin’s lymphoma
10 yo M presents with fever, wt loss, and night sweats
Exam: anterior mediastinal mass
Suspected dx?
Non-Hodgkin’s lymphoma
Microcytic anemia with
- Decreased: serum iron, TIBC
- Normal or increased: ferritin
Anemia of chronic dz
Microcytic anemia with
- Decreased: serum iron, ferritin
- Increased: TIBC
Iron deficiency anemia (IDA)
80 yo M presents with fatigue, LAD, splenomegaly, and isolated lymphocytosis. Suspected dx?
Chronic lymphocytic leukemia (CLL)
Lymphoma equivalent of CLL
Small lymphocytic lymphoma
Late, life-threatening complication of chronic myelogenous leukemia (CML)
Blast crisis (fever, b. pain, splenomegaly, pancytopenia)
Auer rods on blood smear
Acute myelogenous leukemia (AML)
AML subtype a/w DIC
M3
Lyte ∆s in tumor lysis syndrome
- Decreased: Ca2+
- Increased: K+, phosphate, uric acid
Tx for AML M3
Retinoic acid
50 yo M presents with early satiety, splenomegaly, and bleeding. Cytogenics show t(9;22). Dx?
CML
Heinz bodies
Intracellular inclusions seen in thalassemia, G6PD deficiency, and post-splenectomy
AR d/o with a defect in the GPIIbIIIa platelet R and decreased plt aggregation
Glanzmann’s thrombasthenia
Virus a/w aplastic anemia in pts with sickle cell anemia
Parvovirus B19
25 yo AAM with sickle cell anemia has sudden onset of b. pain. Management of pain crisis?
- O2
- Analgesia
- Hydration
- Transfusion (if severe)
Significant cause of morbidity in thalassemia pts. Tx?
Iron overload. Tx with deferoxamine.
