Heme/Onco Flashcards
Reed Sternberg Cells?
Hodgkins Lymphoma
Also, night sweats
Treatment for splenic sequestration??
Serial Abd exam
IVF/fluid resuscitation
RBC transfusion
In severe cases, exchange transfusion
Transfusion w/ caution, autotransfusion may occur
High retic, low Hgb
Enlarged spleen
Treatment for acute chest syndrome?
IVF Infiltrates on X-ray O2 Incentrive spirometry, bronchodilators IV abx (cephalosporin and macrolide) Analgesics Blood transfusion
Patient with sickle cell is having fever, is hypoxic and has chest pain. You are suspicious that he has what?
Acute chest
Patient w/ splenic sequestration has a high or low retic and a high or low Hgb?
High retic
Low Hgb
Your 1yo pts CBC shows hypochromic microcytitic anemia w/ an elevated RDW and a low retic. What do you suspect? and how do you treat?
Iron deficiency anemia
Treat w/ iron supplements for 3 months
Limit cows milk
If you see target cells on a smear, your patient has …
Thalassemia
Your patient has hypochromic microcytic anemia on CBC. Decreased MCV and basophilic stippling, you are suspicious that he has….
Thalassemia
Basophilic stippling also seen in Lead Poisioning :)
What is the treatment for Thalassemia?
Blood transfusion
Folate
This is serious, they can have CHF and early death
A normal WBC count Hgb level peripheral smear with a decrease in platelets is suggestive of….
ITP
A normal healthy 3 year old p/w bleeding gums and a normal hemoglobin and normal labs. She just recovered from a URI. She has petechiae. You notice mego-thrombocytes on peripheral smear. How do you treat?
IVIG
Corticosteroids
Rituximab
Platelets (for severe bleeding)
PCN doses for sickle cell prophylaxis
2months-3 years: 125mg PO BID
3-5 years: 250mg PO BID
Start once diagnosed
Stop at age 5 if no spleenectomy or no pneumococcal infection
Folic acid supplementation for sickle cell patient?
Start at age 1
Frequency of trans cranial Doppler evaluation for sickle cell
2 years-16 years. annually
Geoff is a 7 year old male with sickle cell disease. He p/w R hand numbness and weakness. His speech is slurred. He has had a stroke confirmed by an MRI. How do we treat his CVA?
Exchange transfusion
NO ANTICOAG
Prevention: Chronic/monthly PRBCs to keep Hgb SS down less than 30%
How does hydroxyurea work??
Increases fetal hemoglobin. Hgb F!
What are examples of causes of an ischemic stroke?
Clot Cardiac Sickle cell Lipid abnormalities Metabolic abnormalities Dehydration
What is the treatment for Von Willebrand disease?
DDAVP
Prevention of bleeding, avoid contact sports
Joint strengthening exercises
Treatment for hemophilia?
GIVE THE FACTOR first
Where does osteosarcoma usually arise?
Distal femur, proximal tibia
Long bones (also scan lung fields, look for mets on CXR)
Age: teenagers
What is HSP?
Hendrich Schonlein Purpura
Bleeding in small vessels in intestines, kidneys, joints
Abdominal pain, blood in urine
Treatment: corticosteroids.
In DIC, the following lab values…
D-dimer, PT/PTT, INR, Fibrinogen, and platelets.
D-dimer- high
PT/PTT - high
INR- high
Fibrinogen- low
Platelets- low
Treatment: Give FFP (10-15ml/kg), platelets, cryo, Vit K, treat underlying cause
HIT
Heparin induced thrombocytopenia
Stop all Heparin
Red flag: low platelet on heparin therapy
Patient will have CLOTTING, NOT BLEEDING. Will have DVT and PE
Patient comes in with bloody diarrhea, abdominal pain and fever. He recently ate a hamburger at a picnic. BUN=30, Cr=2. Also c/o hematuria. What do we think he has and how do we treat?
HUS
Treatment: supportive, diuretics, fluids/electrolyte management, maybe dialysis
Caused by E COLI
