Heme/Onc - bleeding/hypercoag - quiz

Question 1

5 yr old boy - thrombocytopenia - abnormal GFR - recent diarrhea - schistocytes

Answer 1

HUS

Question 2

HUS treatment

Answer 2

supportive; no antibiotics

Question 3

48 yr old woman - thrombocytopenia - fever - delirium - schistocytes

Answer 3

TTP

Question 4

TTP treatment

Answer 4

plasmaphoresis

Question 5

33 yr old woman - stroke - hx 4 miscarriages

Answer 5

lupus anticoagulant

Question 6

45 yr old woman - first DVT/no history - what do you want to check for?

Answer 6

malignancy

Question 7

most common systemic vasculitis in children

Answer 7

Henoch-Schonlein purpura

Question 8

4 yr old boy - palpable purpura over lower extremities - arthritis in knees and ankles

Answer 8

Henoch-Schonlein purpura

Question 9

treatment for Henoch Schonlein purpura

Answer 9

prednisone

Question 10

most common inherited bleeding disorder

Answer 10

von willebrand disease

Question 11

initial treatment for ITP

Answer 11

corticosteroids

Question 12

treatment for recurrent/relapsing ITP

Answer 12

splenectomy

Question 13

your immediate handling of HIT

Answer 13

1. discontinue heparin
2. U/S LE for thrombosis
3. give direct thrombin inhibitor

Question 14

one key difference in labs for vit K deficiency and coagulopathy of liver disease

Answer 14

factor V: not impacted by vitamin K; decreased in CoLD

Question 15

sudden thrombosis (3)

Answer 15

1. polycythemia vera
2. essential thrombocytosis
3. HIT

Question 16

essential thrombocytosis treatment

Answer 16

aspirin

hydroxyurea

Question 17

polycythemia vera lab value

Answer 17

extremely elevated Hct

Question 18

essential thromocytosis lab value

Answer 18

extremely elevated platelets

Question 19

polycythemia vera treatment

Answer 19

phlebotomy; NO iron supplementation

Question 20

polycythemia vera: erythropoietin high or low?

Answer 20

low (high RBCs not caused by high erythropoietin - in fact, high RBCs cause low erythropoietin)

Question 21

JAK2 associated with (3)

Answer 21

1. polycythemia vera
2. essential thrombocytosis
3. myelofibrosis

Question 22

striking splenomegaly

Answer 22

myelofibrosis

Question 23

compare bone marrow of aplastic anemia, pure red cell aplasia, myelodysplasia

Answer 23

aplastic anemia: hypocellular
pure red cell aplasia: normocellular
myelodysplasia: hypercellular

Question 24

compare organ size of aplastic anemia, pure red cell aplasia, myelodysplasia

Answer 24

aplastic anemia: no organomegaly
pure red cell aplasia: no organomegaly
myelodysplasia: splenomegaly

Question 25

IgM binds RBC antigen in lower temps

Answer 25

cold agglutinin disease

Question 26

IgG binds RBC antigen at body temp

Answer 26

autoimmune hemolytic anemia

Question 27

onset around 6 mos old

Answer 27

beta thalassemia; sickle cell disease

Question 28

anemia definition

Answer 28

hct < 41 (male) <36 (female)

Question 29

basophilic stippling

Answer 29

beta thalassemia

Question 30

“bite” cells

Answer 30

G6PD disease

Question 31

3 platelet inhibitors

Answer 31

aspirin, clopidogrel, ticlopidine

Question 32

3 anticoagulants

Answer 32

warfarin, dabigatran, heparin/LMWH