Heme Review Flashcards
Normocytic anemias
Anemia of chronic disease
thallassemias
What diseases can cause anemia of chronic disease?
Rheumatoid conditions Inflammatory Bowel Disease Cancer Chronic infections Chronic liver disease
Best lab finding for iron deficiency
iron to TIBC ratio of less than 10%
Causes of cold hemolytic anemia
Post mono or post mycoplasmal infection
Difference in immunoglobulins between warm and cold hemolytic anemias
IgG- warm
IgM- cold
Disease where sulfa drugs causes hemolytic anemia
G6PD deficiency
difference in symptoms between B12 and folate deficiencies
B12- neurologic findins
Folate- no neurologic findings
Mechanism of thallassemias
reduction in synthesis of globin genes
Best lab test of B12 deficiency
elevated methylmalonic acid and homocysteine
High iron:TIBC
Low MCV
Target cells
Thallassemia
Mechanism of anemia of chronic disease
Sequestration of iron in the reticuloendothelial system
Antibody produced in pernicious anemia
Anti-intrinsic factor
Mild anemia
High MCHC
splenomegaly
family history
Hereditary spherocytosis
Sickle cell patient
profound anemial
hyperhemolytic crisis
What infection causes sickle cell patients to have aplastic anemia
parvovirus B19
Three sickle cell complications
Acute chest syndrome
Salmonella ostetomyolitis
avascular necrosis of femoral head
What vaccines should be given to a patient after a splenectomy
Encapsulated bacteria:
pneumoccocal
meningitis
Hib
ruddy skin itching cyanosis of finger tips splenomegaly high platelets
Polycythemia vera
Mutation present in polycythemia vera
JAK2
Complication of heparin induced thrombocytopenia
PE and DVT-> makes patient hypercoagulable
AE after being on heparin for several days
heparin induced thrombocytopenia
Mechanism of Paroxysmal Nocturnal Hemaglobinuria
Loss of GPI linked proteins on the cell surface (CD55, 59)
History of bleeding
Elevated PTT
Increased bleeding time
von Willebrand’s disease
Recent URI
petechiae on legs, arma, and trunk
profound thrombocytopenia
Normal WBC and HCT
Idiopathic thrombocytopenic purpora
Mechanism of Bernard-Soulier
platelets can’t clump
Mechanism of Idiopathic thrombocytopenic purpora
Autoantibodies against platelets
bruises on upper and lower extremities palatal petechiae fever low HCT elevated LDH thrombocytopenia schistocytes on blood smear
TTP
Vertebral compression fracture high calcium kindey failure anemic high protein/albumin narrow anion gap
multiple myeloma
defect in TTP
ADAM TS-13
Older pt
massive lymphadenopathy
palpable spleen
WBC 30k with lymph
CLL
High WBC (all cell lines) mild illness
CML
What is the mutation of CML
9:22 translocation of BCR-ABL proteins
Treatment for CML
imantinib
What is the mutation in acute promyelocytic leukemia
15:17, retinoic acid receptor
Treatment for APL
ATRA: all-trans-retinoic-acid
Why is calcium high in Multiple Myeloma
Osteoclase Activating factors
Bone biopsy finding in ITP
megakaryocytes on bone marrow biopsy
child
bloody diarrhea followed by AKI
thrombocytopenia
anemia
HUS
Pentad of TTP
Microangiopathic Hemolytic Anemia Thrombocytopenia Decreased renal function Disturbed NEUROLOGICAL function: Fever
