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

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
Normal or ↓ MCV ↓ TIBC Normal or ↑ Ferritin (because it is not being transported and utilized) +/- decreased EPO
Anemia of chronic disease decr. EPO in anemia of renal failure
26
What 5 drugs can aplastic anemia
ACE-I **sulfonamides** (busulfan) **chloramphenicol** Azathioprine **phenytoin**
27
is reticulocytosis seen in aplastic anemia
no you see reticulocytoPENIA
28
what is the only anemia where all 3 lines are decreased (WBC, RBC, plt)
aplastic anemia
29
what is the most accurate test for aplastic anemia? what is seen
bone marrow bx: normal cell morphology **hypocellular bone marrow** with **fatty infiltration**
30
methylmalonic acid and homocysteine are elevated in which anemia?
Vitamin B12 deficiency
31
What 4 laboratory findings are seen in all hemolytic anemias
↑ Retic, ↑ LDH, ↓ Haptoglobin, and ↑ Bilirubin (indirect)
32
What 6 drugs commonly cause hemolysis in patients with G6PD deficiencyt
antimalarials: primaquine, pamaquine phenacetin, ASA, sulfonamides, dapsone
33
Ferritin less than what is diagnositc for iron deficiency anemia
15
34
At what 3 ages should you check hgb and hct for iron def anemia
12mo, 18mo and 12y/o (female)
35
iron deficiency anemia- how long does it take to correct anemia? to replete iron stores? how often should you recheck blood counts?
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
What is the most useful test to initially monitor the response of a pt w/ iron deficiency anemia to iron therapy is
retic count (retic response to iron therapy is usualy evident w/in a wk)
37
T/F: iron deficiency anemia can be caused by zinc deficiency
true
38
is the retic count in iron def. anemia low, normal or high
low or inappropriately normal
39
what are 2 common neuro findings in pernicious anemia
loss of position and vibratory sensation
40
What mutation is found in polycythemia vera
Jak2
41
pruritis after hot baths rubor of hands and feet
polycythemia vera
42
What are secondary causes of polycythemia
altitude related COPD sleep apnea genetic neoplasms (pheochromocytoma, liver tumors)
43
patients with polycythemia vera may also have what other condition
gout due to hyperuricemia