Heme/Onc Flashcards
Triad of paroxysmal nocturnal hemoglobinuria
Hemolysis, cytopenias, and a hypercoagulable state (e.g. PVT)
CYP450 inducers that lead to decreased warfarin levels
- OCPs
- AEDs: carbamezepine, phenytoin, phenobarbital
- Rifamping
- Ginseng and St. John’s Wort
CYP450 inhibitors that lead to increased warfarin levels
- Acetaminophen and NSAIDs
- Some antibiotics and antifungals (e.g. metronidazole)
- SSRIs
- Amiodarone
- Cimetidine and omeprazole
- Thyroid hormone
- Gingko, cranberry juice, vitamin E
Reversal of warfarin
IV vitamin K plus prothrombin complex concentrate (or FFP if that is unavailable)
What is LMWH CI that unfractionated heparin is not?
ESRD
When do you treat ITP, and what with?
Bleeding or platelets <30k. Give steroids or IVIG
Triad of GVHD
- Dermatitis (maculopapular rash)
- Gastroenteritis (bloody diarrhea)
- Hepatitis (jaundice and elevated LFTs)
Marker for ALL
TdT
Transient visual disturbances, burning cyanosis in hands and feet, and itching in the shower
PV (can also see HTN and thrombosis)
Hyperviscosity syndrome in Waldenstrom macroglobulinemia
Diplopia, tinnitus, HA, and dilated/segmented fundoscopic findings
(Elevated IgM can also lead to neuropathy and cryogloblinemia).
(Infiltration can lead to hepatosplenomegaly, anemia, and thrombocytopenia)
Smudge cells
Pathognomonic for CLL
High mitotic index and “starry sky” appearance
Burkitt lymphoma
VHL syndrome
- Hemangioblastomas
- Clear cell RCC
- Phochromocytoma
Anterior mediastinal masses
- Thymoma
- Thyroid tumor
- Teratoma and germ cell tumors
- Terrible lymphoma
Middle mediastinal masses other than lymphomas and lymph nodes
Bronchogenic cysts and tracheal tumors
Posterior mediastinal masses other than lymphomas and lymph nodes
Neurogenic tumors
Test required before starting rituximab
PPD
Work-up for first provoked unprovoked thromboembolism
CXR and age-appropriate cancer screening
Macrocytic anemia with elevated bilirubin
Intramedullary hemolysis in megaloblastic anemia
Who is at risk for primary hypotensive transfusion reaction?
Patients on ACEIs (bradykinin accumulation in blood products leads to hypotension, ACE breaks down bradykinin)
What do you do for the next transfusion for a patient who had anaphylaxis after an RBC transfusion?
Washed RBCs (to wash away IgA)
What do you do for the next transfusion for a patient who had febrile non-hemolytic transfusion reaction after an RBC transfusion?
Leukoreduced RBCs (FNHTR due to antibodies against donor WBC or breakdown of donor WBC releasing cytokines)
Finding on exam in X-linked agammaglobulinemia
Absent lymphoid tissue (tonsils and lymph nodes)
Will present with recurrent sinopulmonary infections after 6 months of age
Recurrent infections, eczema, and thrombocytopenia.
What is the underlying defect?
Wiskott-Aldrich syndroe. Due to defect in regulation of actin cytoskeleton
Test for chronic granulomatous disease
Dihydrorodamine or nitroblue tetrazolium for lack of oxidative burst
Most common organism causing sepsis in sicklers
Pneumococcus (even if vaccinated)
Key side effect(s) of cyclophosphamide
Hemorrhagic cystitis and bladder cancer
Present with hydration and mesna
Key side effect(s) of platinum-based chemotherapies
Cochlear dysfunction
Electrolyte changes in tumor lysis syndrome
Elevations in phosphate, potassium, and uric acid, but hypocalcemia (precipitates with phosphate).
