Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CAM III > Heme Part 1 > Flashcards

Heme Part 1 Flashcards

1
Q

Reticulocytes

A

Slightly immature RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nl reticulocyte count

A

0.5-1.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Plasma cell

A

A type of B lymphocyte that is differentiated

Makes all the antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two main categories of blood disorders of hematopoietic stem cells?

A 
Hematopoietic stem cells level
More differentiated level
-Myeloid
-Lymphoid
-Erythroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristics of aplastic anemia

A

Pancytopenia
Severely hypocellular bone marrow
Usually acquired- secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of aplastic anemia

A

Toxic
Viral
Autoimmune mechanisms- dominant causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medication causes of aplastic anemia

A

NSAIDs
B-lactam antibiotics
Antiepileptic drugs
Psychotropic meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Aplastic anemia tx

A 
Immunosuppression (70%)
-Cyclosporine
-Antithymocyte globulin
HSC transplantation
-Allogenic HSCT is a potentially curative therapy and should be considered for those younger than 50 yrs who have compatible donors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pure red cell aplasia

A

Isolated, severe anemia without an adequate reticulocyte response
Bone marrow shows an absence or erythrocyte precursors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of pure red cell aplasia

A

Similar to aplastic anemia including parvovirus B19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dx of pure red cell aplasia

A

Requires bone marrow examination to exclude secondary causes, such as lymphoproliferative disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx of pure red cell aplasia

A

Immunosuppression
Prednisone
Cyclosporine
Cyclophsophamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Types of neutropenia

A

Isolated
Immune-mediated
Nutritional deficiencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Isolated neutropenia

A

Hereditary, toxic or immune causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Immune-mediated neutropenia

A

Connective tissue diseases
-SLE or RA
Treat with antirheumatic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nutritional disease neutropenia

A

Vit B12

Folate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Myelodisplastic syndromes-MDS

A

Bone marrow is most commonly hypercellular
Full bone marrow yields low blood counts because the cells are ineffectively formed and have limited survival
Peripheral counts are low because they’re staying in the bone marrow and not going in the periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Causes of myelodisplastic syndromes

A

Primary process- more common

Secondary process- radiation or chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Severity of myelodisplastic syndromes

A

Ranges from asymptomaatic with mild normocytic or macrocytic anemia to transfusion-dependent anemia heralding conversion to AML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When to suspect myelodysplastic syndromes

A

Suspect in pts with macrocytic anemia or pancytopenia in whom vit B12 or folate deficiency have been excluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx of myelodisplastic syndromes

A

Transfusions or erythropoiesis-stimulating agents
Prevent transformation to AML
-If pt has complex cytogenetics and a marrow blast count of greater than 10% __________
-Allogenic HSCT or hypomethylating chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Myeloproliferative neoplasms

A

Acquired genetic defects in myeloid stem cells that have deregulated production of leukocytes, erythrocytes, or platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Types of myeloproliferative neoplasms

A 
Chronic myeloid leukemia (CML)
-Too many white cells
Polycythemia vera (PV)
-Too many red cells
Essential thrombocytopenia (ET)
-Too many platelets
Primary myelofibrosis
Eosinophilia and hypereosinophilic syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Polycythemia vera

A 
D/o of the myeloid/erthyroid stem cell
-Mutation of JAK2 (JAK2 V617F)-97% present
Hgb >18.5 g/dL in men
Hgb >16.5 g/dL in women
Must r/o secondary causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Sx of secondary polycythemia vera- hypoxemia

A

Thrombosis, TIA

Erythromelalgia unlikely, pruritis unlikely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Conditions in which secondary polycythemia vera can happen

A

Sleep apnea
COPD
Congenital heart disease
Severe renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

PE of secondary polycythemia vera

A

Plethora

No splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Lab studies of secondary polycythemia vera

A

No basophilia, no leukocytosis
JAK 2 negative
HIGH epo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Sx of polycythemia vera

A

Pruritis after a warm shower
Erythromelalgia
TIA
DVT/PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

PE of primary polycythemia vera

A

Splenomegaly

Plethora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Lab studies of primary polycythemia vera

A

Basophilia, leukocytosis, thrombocytosis
JAK 2 pos
LOW epo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tx of polycythemia vera

A

Low-dose ASA
Phlebotomy
-Goal of Hct <45%
Hydroxyuria- antimetabolite chemotherapeutic agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Prognosis of polycythemia vera

A

5-10% evolve into AML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Essential thrombocytopenia

A

Suspect when platelets >600,000 on 2 occasions at least 1 mo apart in the absence of secondary causes (IDA, infections, etc)
JAK 2 mutation is present in 50% of pts
Philadelphia chromosome must also be excluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Sx of essential thrombocytopenia

A 
Asymptomatic
Digital ischemia
Erythromelalgia
TIA
Visual disturbances
Venous thromboembolism
Bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

International prognostic score for essential thrombocytopenia

A

Low- age <60, no thrombosis, WBC <11,000

High- score of 3-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Tx of essential thrombocytopenia

A

Low risk: low-dose ASA
High risk: platelet-lowering therapy
-Hydroxyurea
-Anagrelide: may exacerbate heart failure
-Interferon alpha: only agent safe in pregnancy
Plateletpheresis- temporary decrease
-Can be done in the hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Primary myelofibrosis

A

Abnl, proliferating megakaryoctyes that produce excess fibroblast growth factor
No dominant blood count
JAK2 present in 50%
Extramedullary hematopoiesis
-Blood production in sites that don’t usually make blood
–LNs, bone marrow, spleen, liver: places that usually make blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Sx of primary myelofibrosis

A

Asymptomatic
Cytokine-mediated sx
-Fever, chills, night sweats, malaise
Early satiety, weight loss, abd discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Tx of primary myelofibrosis

A

Hydroxyurea
Ruxolitinib- first JAK2 inhibitor
Allogenic hematopoietic stem cell transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Eosinophilia and hypereosinophilic syndromes

A

Eosinophilia >1500/microL and tissue infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Causes of eosinophilia and hypereosinophilic syndromes

A 
Collagen vascular dz
Helminthic infections
Idiopathic
Neoplasia (lymphomas MC)
Allergy, atopy, asthma (carbamazepine, sulfonamides)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Tx of eosinophilia and hypereosinophilic syndromes

A

Glucocorticoids (lytic effect)

Imatinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

G-CSF

A

Stands for granulocytic colony stimulating factor
Used to stimulate production of neutrophils in autoimmune neutropenia, to hasten neutrophil recovery after cytotoxic chemo, and for HSC mobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Recombinant erythropoietin

A

Indicated for chemo-associated anemia and CKD anemia

Target hemoglobin level of no more than 11 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Allogenic HSCT

A

HLA-matched sibling or matched unrelated donor
Chemo-less intense
Immunosuppression
Peripheral blood infusion of HSc
Donor immune cells recognize the pt’s cancer cells as foreign and mount T-cell/NK-cell mediated attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is an HSCT most helpful in treating?

A

Aplastic anemia
High-risk MDS
Acute leukemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the risks of an HSCT?

A 
Opportunistic infection
-Aspergillus
-Different viral and fungal infections
Graft-versus-host dz (GVHD)
-Severe treated with glucocorticoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Plasma cell dyscrasias

A

Clonal plasma or lymphoplasmacytic cell disorders characterized by the production of monoclonal antibody (M protein) detectable in serum or urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Plasma cell disorders

A

Monoclonal gammopathy of undetermined significance (MGUS)
-Not full-blown multiple myeloma
Multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

B-cell disorders

A

Waldenstrom macroglobulinemia

Chronic lymphocytic leukemia/small lymphocytic lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Lab diagnostics of multiple myeloma and related disorders

A 
CMP (calcium, creatinine, albumin)
CBC
SPEP/UPEP
Serum or urine immunofixation
Serum FLC (free light chain testing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Definition of monoclonal gammopathy of undetermined significance (MGUS)

A

M protein level < 3 g/dL
Clonal plasma cells comprising less than 10% of the bone marrow cellularity
Absence of PCD-related signs and sx

54
Q

F/u of monoclonal gammopathy of undetermined significance

A 
Reevaluate yearly with:
CBC
Serum calcium
Creatinine
Repeat M protein testing
1% risk of transformation into multiple myeloma yearly (or other conditions)
55
Q

Multiple myeloma

A

Plasma cell malignancy involving the bone marrow

56
Q

Asymptomatic multiple myeloma

A

Smoldering disease

M protein >3 g/dL or >10% bone marrow plasma cells

57
Q

Symptomatic multiple myeloma

A 
End-organ damage
Fatigue
Anemia
Rouleaux formation
Leukopenia
Osteopenia
Kidney dysfunction
58
Q

CRAB criteria for myeloma-related s/sx

A

HyperCalcemia: >11 mg/dL
Renal failure: serum Crt >2 mg/dL
Anemia: Hgb <10 g/dL
Bone disease: lytic bone lesion

59
Q

Additional diagnostic for multiple myeloma

A 
Skeletal survey
-X-ray
-CT
-MRI
Bx
-Bone marrow
- +/- kidney biopsy
60
Q

Tx for multiple myeloma

A

Induction chemo
Autologous hematopoietic stem cell transplantation
Surgical stabilization for pathologic fxs
Surgical stabilization for pathologic fxs
Pamidronate or zoledronic acid once very 3-4 wks for a minimum of 2 yrs in new pts with symptomatic myeloma
Hypercalcemia tx
Vaccinations- influenza, pneumococcal

61
Q

Anemia

A

Decreased circulating RBC mass or hemoglobin
Results from blood loss or underproduction or destruction of erythrocytes
Anemia is not a dx but a sign of an underlying condition

62
Q

General anemia s/sx

A

Fatigue
Dizziness
SOB
Palpitations

63
Q

Microcytic anemia

A

MCV <80
Iron deficiency
Thalassemia

64
Q

Normocytic anemia

A

Anemia of kidney dz
Inflammatory anemia
Hereditary spherocytosis
Sickle cell dz

65
Q

Marcrocytic anemia

A 
MCV >100
Vit B12 or folate deficiency
Liver dz
Hypothyroidism
Myelodysplastic syndrome
Autoimmune hemolytic anemia
66
Q

Iron deficiency anemia

A

Iron is absorbed in the duodenum

The most common nutritional deficiency worldwide

67
Q

Causes of iron deficiency anemia

A

Loss of iron- bleeding
Decrease uptake- decrease absorption
Increase requirements- pregnancy

68
Q

Ferritin in iron deficiency anemia

A

Low with iron deficiency anemia

May be in the nl range when associated with inflammatory conditions (RA, malignancy)

69
Q

Reticulocytes in iron deficiency anemia

A

Reflects bone marrow response to anemia

70
Q

Tx of iron deficiency anemia

A

Treat underlying cause
Replace iron
-Oral supplementation takes mos to correct, GI SEs
-IV infusion: good if malabsorption issues
-Erythrocyte transfusion: only if profoundly anemic and symptomatic

71
Q

Oral replacement for iron deficiency anemia

A

Ferrous sulfate: 65 mg per 325 mg tablet
Ferrous gluconate: 36 mg per 300 mg tablet
Ferrous fumarate: 33 mg per 100 mg tablet

72
Q

IV replacement for iron deficiency anemia

A

Ferric gluconate: 12.5 mg/mL
Iron dextran: 50 mg/mL
Iron sucrose: 20 mg/mL
Ferumoxytol: 30 mg/mL

73
Q

Inflammatory anemia

A 
AKA: anemia of chronic dz
Common in hospitalized pts
Infection, cancer, autoimmune diseases
-Chronic heart failure, DM
Usually mild
Often normocytic with a low TIBC
74
Q

Anemia of kidney disease

A

Very common with CKD

-Affects 90% of pts with GFR <30

75
Q

Components of anemia of kidney dz

A

Decreased epo
Decreased lifespan of RBC
Blood marrow suppression (from uremic toxins) and blood destruction during hemodialysis
Usually normochromic and normocytic with low retic count

76
Q

Vitamin B12 deficiency

A

Cofactor needed by 2 enzymes in human cells

Deficiency causes increased methylmalonic acid and homocysteine levels and affects myelopoiesis

77
Q

What does vit B12 deficiency result in?

A

Macrocytic anemia

Demyelinating nervous system disease

78
Q

Risk factors for vit B12 deficiency

A 
Vegetarians
Absorption issues
-IBD
-Gastric
-Bariatric or ileal surgery
Pernicious anemia
-MCC of severe deficiency
-Destruction of gastric parietal cells- makes intrinsic factor
Increased with autoimmune conditions
-Thyroid dz
-DM
-Vitiligo
79
Q

S/sx of vitamin B12 deficiency

A 
Anemia 
Neurologic dysfunction
Glossitis
Hyperpigmentation
Infertility
80
Q

Neurologic dysfunction in vit B12 deficiency

A 
Symmetric paresthesias
Numbness
Decreased vibratory sense
Gait problems
Neuropsychiatric sx
81
Q

Peripheral blood smear for vit B12 deficiency

A

Large oval erythrocytes
Hypersegmented neutrophils
Possible pancytopenia

82
Q

Other tests for vit B12 deficiency

A

Cobalamin level
Methylmalonic acid
Homocysteine level

83
Q

Tx of vit B12 deficiency

A

Oral replacement
-1000 to 2000 micrograms/d
Cobalamin injections
-IM or SC
-1,000 micrograms several times per week for 1-2 wks, then weekly until symptom relief or improved findings
-Monthly injections thereafter if pernicious anemia
-Usually corrects in 6-8 wks

84
Q

Folate deficiency

A

Megaloblastic anemia with impaired DNA synthesis

85
Q

Causes of folate deficiency

A 
Poor intake
Alcoholics
Malabsorption
Meds that accelerate folate metabolism
-Phenytoin
-Trimethoprim
-Methotrexate
86
Q

Lab findings of folate deficiency

A

Similar to cobalamin deficiency, except methylmalonic acid levels will NOT be elevated

87
Q

Tx of folate deficiency

A

Oral folate 1-5 mg/d

88
Q

Categories of hemolytic anemias

A

Inherited or acquired

Intravascular or extravascular

89
Q

Findings in hemolytic anemias

A

Compensatory reticulocytosis (usually)
Elevated indirect bilirubin and LDH
Free hemoglobin secretion (hemoglobinuria)

90
Q

Sx of hemolytic anemias

A 
Anemia
Jaundice
Dark urine
Cholelithiasis- chronic hemolysis
Extramedullary hematopoiesis
\_\_\_\_\_\_\_\_\_\_\_
LAD
91
Q

Hereditary spherocytosis

A

Mostly autosomal dominant (75%)
Osmotically fragile spherocytes
Splenomegaly

92
Q

Lab testing for hereditary spherocytosis

A

Osmotic fragility testing

Cryohemolysis, eosin-5-malemide binding

93
Q

Tx for hereditary spherocytosis

A

Folic acid supplementation

Splenectomy with vaccinations prior strep pneumo, hib, and meningococcal

94
Q

G6PD deficiency

A

X-linked disorder

Most common enzyme deficiency in humans

95
Q

Hemolysis triggers for G6PD deficiency

A

Sulfonamides, nitrofurantoin
Antimalarials
Infection

96
Q

Lab findings in G6PD deficiency

A 
Bite cells
Heinz bodies
-Denatured oxidized hemoglobin
Fluorescent spot screening test
Quantitative testing
97
Q

Tx of G6PD deficiency

A

Avoid offending agents

Supportive +/- blood transfusions

98
Q

Thalassemia

A

Mutation in either the alpha or beta globin
At least 1-5% of the world has a mutation
Most commonly in Mediterranean, Middle East, southeast Asia

99
Q

Lab findings in thassemia

A

Microcytic
Nl iron studies
Target cells
Electrophoresis

100
Q

Tx of thalassemia

A

Trait- education
Oral folic acid 1 mg/d
Hemoglobin H dz (deletion of 3 alpha genes)
-Occasional blood transfusions
–Higher risk of iron overload
Allogenic hematopoietic stem cell transplantation can be curative and should be considered with severe forms before the onset of end-organ damage

101
Q

Sickle cell syndromes

A

Hemoglobinopathy with mutation in the B-globin chain

102
Q

Pathophysiology of sickle cell syndromes

A 
Oxidative stress
Adhesion of cells to the endothelium
Inflammation
Decreased nitric oxide
Vasoconstriction
103
Q

Complications of thalassemia

A

Chronic hemolytic anemia
Infections- parvovirus B19, vaccines
Vit deficiencies- folate
ACS, PE, ischemic stroke, pulm HTN, CKD, hepatic crisis

104
Q

Tx of thalassemia

A

HSCT
Prophylactic transfusions
Hydroxyurea therapy- reduces vaso-occlusive episodes
Chronic pain

105
Q

Primary hemochromatosis

A

Autosomal recessive defect

Affects 1 in 400 persons of N. European ancestry

106
Q

S/sx of primary hemochromatosis

A 
Chronic fatigue
Weakness
Nonspecific abd pain
Athralgia
Mildly elevated liver enzymes
\+/- hypothyroidism
DM
Gonadal failure
Eventual hepatic fibrosis and chirrhosis (HCC)
107
Q

Lab findings in primary hemochromatosis

A

Fasting serum transferrin saturation

  • > 60% in men, >50% in women
  • Elevated ferritin
108
Q

Tx of primary hemochromatosis

A

Phlebotomy- 1 unit weekly until ferritin levels decrease to 10-50 ng/mL
Iron chelation if phlebotomy is contraindicated

109
Q

Platelet physiology

A

Made in the bone marrow from megakaryocytes
Lifespan is around 10 days
Nl range: 150K-450K/microL
Hormonal stimulus is thrombopoietin
Form the initial plug at the site of vascular injury
-Adhesion, aggregation, secretion
Activated glycoprotein IIb-IIIa allows the fibrinogen binding

110
Q

Thrombocytopenia sx

A

Mucocutaneous bleeding- epistaxis, gum bleeding, heavy menses, easy bruising, petechiae
Seldom seen if platelet count >30K

111
Q

Hx in thrombocytopenia

A 
Medications
TTP, HUS
ITP, HIT
Use hematology: purple top
Sodium citrate anticoagulant
112
Q

Meds associated with drug-induced thrombocytopenia

A 
Anticonvulsants
Anti-inflammatory agents
Antimicrobials
CV drugs
Chemotherapeutic agents
Glycoprotein IIb/IIIa inhibitors
Haloperidol
Ranitidine
Simvastatin
113
Q

What are the three causes of thrombocytopenia?

A

Disorders of underproduction
Peripheral destruction
Splenic sequestration

114
Q

Disorders of underproduction in thrombocytopenia

A

Marrow failure- aplastic anemia, B12/folate deficiency
Marrow invasion- leukemias
Marrow injury- drugs (EtOH, chemo), radiation

115
Q

Peripheral destruction in thrombocytopenia

A

Immune or non-immune mechanisms

116
Q

Non-immuned mediated thrombocytopenia

A

Thrombotic Thrombocytopenia Purpura (TTP)

Hemolytic Uremic Syndrome (HUS)

117
Q

Immune-mediated (platelet antibodies) thrombocytopenia

A

Immune Thrombocytopenia Purpura (ITP)

Heparin-Induced Thrombocytopenia (HIT)

118
Q

TTP

A

Congenical or acquired deficiency of protease ADAMTS-13
Abnl activation of platelets and endothelial cells, deposition of fibrin in microvasculature, and peripheral destruction of RBC and platelets

119
Q

Clinical pentad of TTP

A 
Thrombocytopenia
Anemia- Microangiopathic Hemolytic Anemia (MAHA)
Fever
Kidney disease
Neurologic findings
Abd pain
120
Q

Additional laboratory findings of TTP

A

Elevated bilirubin and LDH

Schistocytes

121
Q

Tx of TTP

A

Emergent plasma exchange

Platelet transfusions are contraindicated

122
Q

HUS

A

Frequently overlaps with TTP
Occurs more frequently in children
-Has MORE kidney and fewer neurologic manifestations
Can be precipitated by infectious diarrheal illnesses
-E. coli 0157:H7

123
Q

Tx for HUS

A

Plasma exchange

124
Q

ITP

A

Suspect with isolated new-onset thrombocytopenia

125
Q

Causes of ITP

A

Autoimmune conditions
Leukemia/lymphoma
Viral illnesses (Hep C, HIV)
Pregnancy

126
Q

What to r/o in ITP

A

Splenomegaly and thyroid dz

ANY new meds, supplements

127
Q

Tx of ITP

A

Reserve for platelet counts <30K or if the pt is bleeding
Glucocorticoids
-Prednisone 1 mg/kg then taper over weeks
-Dexamethasone 40 mg/d x 4 days
IVIG
Splenectomy
Off-label rituximab

128
Q

HIT

A

Drug-induced with antibody against the heparin/PF4 complex that can activate platelets causing thrombocytopenia +/- thrombosis
Platelet counts decrease by at least 50% 5-10 days after tx with heparin

129
Q

Lab testing for HIT

A

Serology for anti-heparin/PF4 antibodies

130
Q

Tx of HIT

A

STOP heparin
Begin Argatroban therapy
Baseline doppler u/s of all 4 extremities
Do not start warfarin therapy until platelet 100-150K
Pt education regarding heparin

131
Q

Acquired platelet dysfunction

A

Suspect in pts with clinical bleeding whose platelet count, PT, and aPTT are nl
Abnl bleeding time or platelet function analyzer- 100 result
Some disorders respond to desmopressin, whereas others require transfusions

132
Q

Causes of acquired platelet dysfunction

A 
Uremia
Liver dz
Myeloproliferative neoplasms
Post-cardiac bypass
Antiplatelet drugs
-IIb-IIIa inhibitors
-ASA
-Clopidogrel
-NSAIDs: temporary

CAM III (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions