Heme/Onc Flashcards
Why do SLE pts develop pancytopenia?
Peripheral destruction by Ab’s
Megaloblastic anemia Atrophic glossitis (shiny red tongue) Vitiligo Thyroid disease Neurologi abn
Pernicious anemia
Causes vit B12 deficiency
Pt has a DVT and elevated homocysteine. What supplement should be given?
Pyridoxine
Pt has tender erythematous, and palpable cord like veins on the L arm and chest
What does she need next?
CT scan of the abdomen
Suspicous for Trousseau’s syndrome - hypercoagulability disorder with recurrent/migratory superficial thrombosis
Associated with visceral malignancy (usually pancreatic
leukemia with predominance of myelocytes
CML
Low leukocyte alk phos score
Auer rods
AML
Abd pain, dark urine
Hemolytic anemia
cytopenias
Hypercoagulable state
Paroxysmal nocturnal hemoglobinuria
Flow confirms absence of CD 55/59
Pt receiving transfusion develops fever, flank pain, hemolysis, oliguria, ARF, DIC within an hour of starting
Acute hemolytic transfusion rxn
life threatening, caused by mismatched blood (ABO mismatch)
Fever and chills 1-6h s/p transfusion
Febrile nonhemolytic transfusion rxn
Phenytoin use increases risk for macrocytic anemia d/t?
Folate deficiency
Healthy young guy presents with PE. Why?
Factor V Leiden
AD point mutation in factor V that makes it resistant to activated protein C
Most commonly inherited hypercoagulable disorder
Test all of those with a unprovoked thrombus <45 y/o
Smoker presents with occasional ear pain and lump in his neck
PE - hard non tender submandifular LN
Dx?
squamous cell carcinoma
Firm solitary LN is high suspicious of a LN met
Nontender LN in Head/neck - SCC
After starting warfarin pt presents with skin necrosis. Why?
Underlying protein C deficiency
Tx - stop warfarin, give Protein C concentrate
