Heme- Rx Flashcards
What does transferrin saturation tell? level of transferrin in hemochromatosis?
transferrin saturation: serum iron/ transferrin
increased
CBC shows low erythrocytes, pancytopenia, leukopenia , but high lymphocytes. During smear prep, lymphocytes are destroyed during slide preperation. diagnosis?
CLL
smudge cell is fragile and easily get smashed during slide preperation
Patient developed HIT (heparin induced thrombocytopenia) with heparin. What is next step?
immediate discontinuation of heparin and start direct thrombin inhibitors (argatroban, bivalirudin).
- sketchy: alligator try to hunt beaver (factor 2) right next to HIT
epidemiology: alpha thalassemia vs. beta thalassemia
alpha: asian (cis) and african (trans)
beta: Mediterranian
How does Schilling test is used to diagnose pernicious anemia? stage 1? stage 2?
stage 1: radiolabeled B12 is administered and radioactivity is measure in urine. Due to no absorption of B12 in pernicious anemia, it will give low urine radioactivity
stage 2: Intrinsic factor is coadministered with radiolabeled B12, for this test, urine radioactivity is normal.
Pt comes with back pain. CT of spine reveals lytic lesion, partial collapse of vertebrae with abscess formation. Biopsy of bone shows caseating granuloma on histology. Diagnosis?
Pott disease from miliary disease.
- I thought multiple myeloma, but NO.
- Two key things that make Pott disease unique
- abscess and caseating granuloma
What is gold standard therapy for Hodgkin lymphoma?
3 drugs
BDV
- Belomycin
- Doxorubicin
- Vinblastine
Asplenia: Two findings on blood smear?
- Howell-Jolly bodies
- target cell
serum iron level in thalassemia major?
HIGH or normal
- why high? iron is not being used to make heme due to globulin deficit. Extra iron is haningout
What is MOA of protamine sulfate in reversing heparin?
protamine sulfate is positively charge molecule. It binds to negatively charged heparin and sequester it
Kid, recurrent otitis media had treatment with antibiotics. Later it turns out he gets easy bruising. Both PT and PTT are prolonged. what is going on?
antibiotics
- > depletion of gut flora
- > less vitamin K synthesis
- > reduced coagulation factor synthesis
How does Bence Jonese protien (Ig light chain) in multiple myeloma cause renal insufficiency?
formation of EOSINOPHILIC CAST that obstructs renal tubule and induce inflammation
Rituximab can be used to what type of neoplasm?
Rituximab: monoclonal antibody against CD20
=> most of B cell lymphoma
Azathioprine can be used to what condition?
to prevent organ rejection
- also SLE, IBD, RA
neonate has some bleeding issue (ex: GI bleeding- melana). What should I think in possible hematologic condition?
neonatal vitamin K deficiency
: gut flora is not well established yet.
- > labs will show increased PT/PTT with normal BT
- keyword: NEONATE
Does methotrexate have teratogenic effect?
yes. it can cause neural tube defects
* In fact, other folate antagonists (TMX, phenytoin) also cause neural tube defects
tPA is released from where?
endothelial cell
Of anti-neoplastic drugs that cause myelosuppression, which drug has minimal myelosuppression?
bleomycin
How does ATRA works for AML?
AML: t(15;17) => retinoic acid receptor DISRUPTION
ATRA: consititutively active retinoic acid receptor
-> maturation of blasts
- remember that ATRA is vitamin A derivative. vitamin A is essential for normal development of cells
multilobular nucleus with large, spherical, azurophilic granules: what cell is this?
neutrophil
bilobular nucleus with PINK granules on hematoxylin and eosin stain: what cell is this?
eosinophil
*eosinophilic inclusion means pink color.
Thus pink=eosinophil
bilobular nucleus with PURPLE granules on hematoxylin and eosin stain: what cell is this?
basophil
what is hemophagocytic lymphohistocytosis?
macrophage engulfing RBC
- can be seen on smear
Which drug can be used to slow down dilated cardiomyopathy by doxorubicin?
dexrazoxane
