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PANCE/PANRE info > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

most common inherited cause of hyper coagulability

A

Factor V Lediden

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2
Q

presence of kappa or lambda light chain proteins on urine electrophoresis

A

Multiple Myeloma

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3
Q

Rouleaux formation of RBCs
punched out lesions on Xray
hypercalcemia

A

Multiple Myeloma

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4
Q

medication that increases fetal Hgb levels, increases water content of RBCs and decreases sickling deformity of RBCs

A

Hydroxyurea

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5
Q

hemolytic anemia
venous thrombosis of large vessels
pancytopenia
CLASSIC FOR…

A

Paroxysmal nocturnal hemoglobinuria

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6
Q

Auer Rods seen, think..

A

AML

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7
Q

What is prolonged in Hemophilia B (Christmas dz)

A

PTT

Hemophilia B effects factor IX, which is part of intrinsic pathway..therefor PTT prolonged

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8
Q

10 yo African American male put on trimethoprim-sulfamethoxazole twice daily for a UTI. Comes back later with pallor, abdominal pain and back pain. Peripheral smear has SHISTOCYTES and HEINZ BODIES. Dx?

A

G6PD deficiency

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9
Q

Which drug is the initial management of choice for heparin induce thrombocytopenia?

A

Argatroban

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10
Q

Common presentation of sickle cell anemia in children under 2?

A

Dactylitis

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11
Q

C282Y HFE genotype associated with

A

Hemochromatosis

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12
Q

Thrombotic Thrombocytopenia Purpura is a disorder of ______

A

Platelets

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13
Q

Platelets are part of the ______ pathway

A

Primary coagulation

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14
Q

PTT and PT in Thrombotic Thrombocytopenia Purpura

A

Both normal!!

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15
Q

Decreased ADAMTS13 serum levels found in…

A

Thrombotic Thrombocytopenia Purpura (TTP)

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16
Q

Positive neurological symptoms

Schistocytes on periph smear

A

Thrombotic Thrombocytopenia Purpura (TTP)

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17
Q

69 yo male develops HA, fevers, purpuric rash. CSF pos for gm neg bacteria. Few hours later, pt develops spontaneous bleeding @ venipuncture site. Initial labs.. elevated PT, PTT, INR. Also showed decreased fibrinogen levels. What is diagnosis?

A

disseminated intravascular coagulation (DIC)

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18
Q

Pathological activation of coagulation system, leading to widespread microthombi and a subsequent phase of severe thrombocytopenia

A

DIC

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19
Q

Associated w thrombosis, widespread hemorrhages

A

DIC

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20
Q

Common after gm negative bacterial infections

A

DIC

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21
Q

Can be brought on by malignancy, OB complications, massive tissue injury, rocky mountain spotted fever, liver dz, aortic aneurysm, acute respiratory syndrome

A

DIC

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22
Q

PT, PTT, INR in ITP and TTP

A

should all be normal!

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23
Q

Non contiguous, extra nodal spread

A

Non Hodgkins Lymphoma

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24
Q

Bimodal distribution of increased incidence in 3rd and 6th decades
Reed Sternberg cells
Painful lymph nodes w ETOH ingestion

A

Hodgkins Lymphoma

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25
Q

Associated w EBV

A

Burkitts Lymphoma

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26
Q

What happens to serum ferritin levels in Anemia of Chronic Dz

A

INCREASES!

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27
Q

Philadelphia Chromosome (translocation between chromosome 9 and 22) seen in..

A

CML

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28
Q

First line therapy for TTP

A

Plasmapheresis (plasma exchange therapy)

..this removes all excess ADAMTS 13 anitbodies and replaces ADADMTS 13

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29
Q

If AML pt is receiving chemo and develops tumor lysis syndrome as a complication, what drug can be given?

A

Allopurinol

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30
Q

Most useful diagnostic tool in patients with a negative Coombs test and periph smear showing microcytic, hyper chromic, sphere-shaped cells

A

Osmotic Fragility Test

Hereditary Spherocytosis

31
Q

Due to defect in blood cell membrane, leading to sphere-shaped RBCs and increased cell fragility

A

Hereditary Spherocytosis

32
Q

Treatment for moderate Type I von Willebrand Disease

A

Desmopressin

would also use for Hemophilia A

33
Q

What is commonly seen as a consequence of thrombocytopenia?

A

Petechiae

34
Q

What is the most common clinical presentation of pts with sickle cell trait?

A

Episodic hematuria

may also have isosthenuria, the inability to concentrate urine

35
Q

Sickle cell trait is normally….

A

asymptomatic

36
Q

Hemophilia A lacks…

A

Factor VIII

37
Q

Condition of increased arterial and venous thrombi formation as well as frequent miscarriages

A

Antiphospholipid syndrome

38
Q

34 yo female has an increased PTT. a mixing study is performed and there is no correction of the increased PTT. what does she have

A

Antiphospholipid syndrome

39
Q

Chemotherapeutic agent that can also be used intrapleurally for pleurodesis

A

Bleomycin

40
Q

What organism is most commonly associated with the development of Hemolytic Uremic Syndrome (HUS)

A

Enterohemorrhagic E. Coli 0157:H7

Shigella and Salmonella can also cause

41
Q

Hemophilia B pt sprains ankle (grade 3), what is routine management of this patient?

A

Factor IX concentrates

42
Q

JAK2 mutation is associated with

A

Polycythemia Vera

43
Q

Headache, dizzniess, tinnitus, blurred vision and increasing pruritus of the last 2 weeks that worsens after hot showers…

A

Polycythemia Vera (JAK2 mutation)

44
Q

PE shows flushed face, engorged retinal veins w no evidence of papilledema. Increased hemoglobin and hematocrit

A

Polycythemia Vera (JAK2 mutation)

45
Q

What is the treatment of refractory immune/idiopathic thrombocytopenic purpura (ITP)

A

Splenectomy

…removal of the spleen is the definitive management of the splenic destruction of the platelets

46
Q

Management of severe thrombocytopenia (platelet count of

A

Platelet transfusion

47
Q 
Increase in:
Basophils
Platelets
RBCS
Hematocrit
A

Polycythemia Vera

NO INCREASE IN LYMPHOCYTES!!!

48
Q

First line management of sickle cell crisis?

A

IV hydration and oxygen. Pain medication is also administered

49
Q

Long term management to reduce frequency of crisis. Also can be used in SEVERE pain crisis

A

Hydroxyurea

50
Q

Positive Coombs test is associated with..

A

autoimmune hemolytic anemia

51
Q 
Folate deficiency
B12 deficiency
Alcoholism
Liver dz
Hypothyroidism

..all cause?

A

Macrocytic Anemia

52
Q

In addition to G6PD deficiency, where else can Heinz Bodies be seen in a peripheral smear?

A

Alpha Thalassemia Intermedia

53
Q

6 mo year old male is brought into pediatric ER when his mom noticed he was “pale and yellow”. CBC showed severe anemia and hypo chromic microcytosis. A peripheral smear shows: numerous target cells and teardrop cells (dacrocytes). Hgb electrophoresis shows:
Hgb A: decreased
Hgb A2: increased
Hgb F: increased (90%)

What does he have?

A

Beta Thalassemia Major (Cooley’s Anemia)

54
Q

In children, this is most commonly seen after a viral infections (such as the flu)

A

Idiopathic (Immune) Thrombocytopenic Purpura (ITP)

55
Q

The development of antibodies against platelets with associated splenic destruction of platelets

A

Idiopathic (Immune) Thrombocytopenic Purpura (ITP)

56
Q

Management of Idiopathic Thrombocytopenia Purpura (ITP) in children

A

Observation OR

IV immunoglobulin

57
Q

First line management of Idiopathic Thrombocytopenia Purpura (ITP) in adults

A

Corticosteroids

58
Q 
In children, classic presentation is:
abdominal pain w constipation
varying neurologic symptoms (ie difficulty concentrating)
anemia
metabolic acidosis
A

Lead poisoning

59
Q

CBC showing/Periph smear show:
Anemia
Microcytosis
Basophilic stippling

A

Lead poisoning

60
Q

Antibodies against ADAMTS 13 leading to large vonWillebrand multimers, causing platelet activation

A

Thrombolic Thrombocytopenic Purpura (TTP)

61
Q

Auto antibodies against glycoprotein IIb/IIIa receptor on platelets commonly following a viral infection

A

Idiopathic Thrombocytopenic Purpura (ITP)

62
Q

Mutated Factor V that is resistant to breakdown by activated protein C

A

Factor V Leiden

63
Q

Pathologic activation of the coagulation system causing micro thrombi and subsequent thrombocytopenia

A

Disseminated intravascular coagulation (DIC)

64
Q

Platelet activation by exotoxins (such as Shigella toxin or Shigella like toxin released from Enterohemorrhagic E. Coli)

A

Hemolytic Uremic Syndrome (HUS)

65
Q

Aplastic crisis in sickle cell anemia patients can be precipitated by ____ infections

A

Parovirus B-19

66
Q 
Ice/clay cravings
progressive dysphagia
pallor of conjunctiva
atrophic glossitis
angular chelitis
spooning of nails
esophageal webs upon endoscopy
A

Iron deficiency anemia

67
Q

large B cells with bilobed or multi lobar nuclei giving it an “owl eye” appearance due to eosinophilic inclusions in the nuclei

A

Reed-Sternberg cells, found in Hodgkins Lymphoma

68
Q

First line management of warm antibody type autoimmune hemolytic anemia in a patient with SLE?

A

Corticosteroids

69
Q

Treatment for cold antibody hemolytic anemia

A

Avoid the cold

70
Q

Argatroban is what kind of drug?

A

direct thrombin inhibitor

71
Q

First line management of polycythemia vera?

A

Phlebotomy

72
Q

First line management of Heparin overdose?

A

Protamine sulfate

73
Q

A patient with severe B12 deficiency is being treated with IM B12 supplementation. Which electrolyte abnormality is a common complication of B12 replacement therapy?

A

HYPOKALEMIA

With IM B12 replacement, hypokalemia may result as new blood cells are being formed, since most of the body’s potassium is found intracellularly.

PANCE/PANRE info (1 decks)

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