Heme / Onc Flashcards
macrocytic anemia in sickle cell patient is from
folate deficiency
could also be from hydroxyurea
indications for hyper coagulability testing
Less than 45 yrs old
family history
recurrent or unusual site of VTE
incr AFP and bHCG
nonseminomatous germ cell tumor
- yolk sac tumor
- choriocarcinoma
- embryonal carcinoma
differential for anterior mediastinal mass
thymoma
teratoma
thyroid neoplasm
terrible lymphoma
palpable venous cords
- syndrome name
- what cancers
- next step
migratory superficial thrombophlebitis / Trousseau syndrome
pancreas, stomach, lung, colon, acute leukemias
CT abd
heavy smoking, abdominal pain, superficial thrombophlebitis
- dx
- next step
pancreatic ca
CT abd
characteristics of Leydig cell tumors
high estrogen
low LH and FSH
gynecomastia
diarrhea, steatorrhea, ulcers distal to duodenum
zollinger ellison syndrome (gastrin producing tumor)
most common cause of anemia in alcoholics
folate deficiency
Pappenheimer bodies associated with
sideroblastic anemia
hypothyroidism associated with what type of anemia
macrocytic anemia
GI malabsorption causes what type of anemia
iron deficiency anemia
tx for Diamond blackfan anemia
corticosteroids
if doesn’t work: transfusion
diamond blacken: type of anemia
macrocytic (but don’t see hyperseg neutrophils)
other congenital abnormalities of diamond blackfan anemia
shield chest webbed neck triphalangeal thumbs short stature cleft lip
tumor in females that produce a lot of estrogen and can cause precocious puberty or postmenopausal bleeding
granulosa cell tumor
tumor producing androgens, causing masculinization of females
sertoli-leydig cell tumor
characteristics of mets to bone
age greater than 50
worse at night
wt loss
cauda equina syndrome (weakness, urine incontinence/retention, saddle anesthesia)
end stage renal failure and a lot of bleeding (nosebleeds, ecchymoses, GI bleeds, etc)
- dx
- pathology
- labs
- tx
uremic coagulopathy
dysfunctional platelets
bleeding time high (all else like PT and PTT normal)
DDAVP
iron deficiency anemia in male or postmenopausal female. next step?
test occult blood to r/o GI causes of blood loss
burr cells / echinocytes (serrated edges).. differential
liver dz
ESRD
spur cells / acanthocytes seen in
liver dz
target cells.. differential
thalassemia
obstructive liver dz
hereditary spherocytosis
- lab findings
- tx
- complications
Lab: neg coombs incr MCHC osmotic fragility on acidified glycerol lysis test abnormal EMB test
Tx:
folic acid, blood transfusions, splenectomy
complications:
pigmented gallstones, Parvo B19 infxns
indications for erythropoeitin
chronic renal failure and Hb less than 10%, with iron deficiency ruled out (if have IDA, give iron first)
hemodialysis patient with sxs attributed to anemia
side effects of erythropoeitin
HTN
HA
flu- like sxs
red cell aplasia
hypochromic and normochromic RBCs
acquired sideroblastic anemia (ex: from INH in TB tx without B6)
peripheral smear of CLL
many small lymphocytes
smudge cells
characteristics of CML
incr WBC, more than 100,000 incr basophils and neutrophils (myelocytes) splenomegaly incr plts anemia
sxs of hemochromatosis
cirrhosis heart failure DM hypogonadism arthritis
