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MJ- Family Med EOR > heme/onc misc > Flashcards

heme/onc misc Flashcards

1
Q

What 2 things will be low in von willibrand disease

which factor will be low?

A

low von Willebrand factor and low factor VIII

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2
Q

antiphospholipid syndrome is associated with what other disease?

A

SLE

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3
Q

How do you dx antiphospholipid syndrome (5)

A
  • w/ lupus anticoagulant
  • prolonged dilute Russell viper venom time (DRVVT) test
  • prolonged PTT
  • anti-B2 glycoprotein
  • anticardiolipin (IgG and IgM)
    *
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4
Q

MC genetic hypercoagulable state

A

Factor V leiden mutation

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5
Q

MC genetic bleeding disorder, autosomal dominant

A

Von Willebrand Disease

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6
Q

what is LMWH dosed based on

A

patients weight

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7
Q
  1. what is used to monitor anticoagulant medications?
  2. What is used to monitor warfarin efficacy
  3. What is used to monitor heparin use (but not to determine dosage?
A
  1. monitor anticoags- INR
  2. Monitor warfarin efficacy- PT
  3. Monitor heparin use- PTT
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8
Q

What is virchows triad

A
  • blood stasis
  • hypercoagulable state
  • vascular injury
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9
Q

how do you dx Factor V Leiden

A

activated protein C resistance assay (Factor V Leiden specific functional assay)- if positive confirm w/ DNA testing

Normal PT/PTT

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10
Q

Patients with Protein C deficiency are at an increased risk of what on warfarin

A

skin necrosis

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11
Q

What is the name of the condition:

autoimmune rxn to platelets usually after a viral illness (onset is insidious and chronic)

A

Idiopathic thrombocytopenic purpura (ITP)

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12
Q

How do you diagnose idopathic thrombocytopenic purpura

A

Dx of exclusion

CBC normal except low platelets (+ direct coombs test)

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13
Q

ITP is associated with what 4 conditions

A

HIV

HCV

SLE
CLL

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14
Q

Is direct Coombs test positive or negative in ITP

A

positive

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15
Q

Differency b/w ITP and TTP

A

ITP-

  • insidious and chronic
  • CBC nml except low plts
    • direct coombs

TTP-

  • acute, F, multi-organ thrombosis
  • decr. plt + anemia + schistocytes
    • coombs
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16
Q

which 2 drugs cause TTP

A

Quinidine, cyclosporine & pregnancy

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17
Q

presentation of what?

Purpura and “FAT RN” (Fever, anemia, thrombocytopenia, renal failure, neuro sxs)

A

TTP

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18
Q

child

low plts

anemia

renal failure

post-infection (E.coli or shigella

A

Hemolytic uremic syndrome

19
Q

is coombs test positive or negative in immunologic hemolytic anemia

A

positive

20
Q

anemia of chronic disease: low or high?

ferritin

serum Fe

TIBC

A

high ferritin

low serum Fe

Low TIBC

21
Q

which anemia has + osmotic fragility test

A

hereditary spherocytosis

22
Q

low Microcytic, hypochromic

normal TIBC and ferritin

elevated iron

A

Thalassemia

23
Q

macrocytic andemia

hypersegmented neutrophils

decreased vibratory position sense

elevated homocysteine

A

vitamin B12 deficiency

24
Q

What are the 2 MCC of anemia of chronic disease

A

chronic renal failure

connective tissue disorders

also: RA, SLE, HIV, CA, Cirrhosis, chronic infections, etc

25
Q

Normal or ↓ MCV

↓ TIBC

Normal or ↑ Ferritin (because it is not being transported and utilized)

+/- decreased EPO

A

Anemia of chronic disease

decr. EPO in anemia of renal failure

26
Q

What 5 drugs can aplastic anemia

A

ACE-I

sulfonamides (busulfan)

chloramphenicol

Azathioprine

phenytoin

27
Q

is reticulocytosis seen in aplastic anemia

A

no

you see reticulocytoPENIA

28
Q

what is the only anemia where all 3 lines are decreased (WBC, RBC, plt)

A

aplastic anemia

29
Q

what is the most accurate test for aplastic anemia? what is seen

A

bone marrow bx:

normal cell morphology

hypocellular bone marrow with fatty infiltration

30
Q

methylmalonic acid and homocysteine are elevated in which anemia?

A

Vitamin B12 deficiency

31
Q

What 4 laboratory findings are seen in all hemolytic anemias

A

↑ Retic, ↑ LDH, ↓ Haptoglobin, and ↑ Bilirubin (indirect)

32
Q

What 6 drugs commonly cause hemolysis in patients with G6PD deficiencyt

A

antimalarials: primaquine, pamaquine

phenacetin, ASA, sulfonamides, dapsone

33
Q

Ferritin less than what is diagnositc for iron deficiency anemia

A

15

34
Q

At what 3 ages should you check hgb and hct for iron def anemia

A

12mo, 18mo and 12y/o (female)

35
Q

iron deficiency anemia-

how long does it take to correct anemia?

to replete iron stores?

how often should you recheck blood counts?

A

how long does it take to correct anemia? 6 weeks

to replete iron stores? 6 months

how often should you recheck blood counts? q3mo x1yr

36
Q

What is the most useful test to initially monitor the response of a pt w/ iron deficiency anemia to iron therapy is

A

retic count

(retic response to iron therapy is usualy evident w/in a wk)

37
Q

T/F: iron deficiency anemia can be caused by zinc deficiency

A

true

38
Q

is the retic count in iron def. anemia low, normal or high

A

low or inappropriately normal

39
Q

what are 2 common neuro findings in pernicious anemia

A

loss of position and vibratory sensation

40
Q

What mutation is found in polycythemia vera

A

Jak2

41
Q

pruritis after hot baths

rubor of hands and feet

A

polycythemia vera

42
Q

What are secondary causes of polycythemia

A

altitude related

COPD

sleep apnea

genetic

neoplasms (pheochromocytoma, liver tumors)

43
Q

patients with polycythemia vera may also have what other condition

A

gout due to hyperuricemia

MJ- Family Med EOR (17 decks)

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