High Yield Information for Exam 1 Flashcards
Oral Iron Dosage
200-400mg ferrous iron/day in a single dose
Treatment for iron poising
Deferoxamine (iron-chelating compound)
How is Deferoxamine given
Subcutaneous
Dose for Oral B12 with pernicious anemia
1-2mg/day for 2 weeks then 1mg daily (~500X daily needed)
If neurological symptoms are present in a pt that has megaloblastic anemia what is the dosage
1) 1000ug/day for 1 week
2) Weekly for 1 month
3) Monthly
Adverse events with B12
None
Treatment for Folate Def.
Oral Folate: 1mg/day for 4 months
*** Malabsorption present, dose 1-5mg/day
High Doses of Folate can cause ___ and ___
Hypotension and Hypoglycemia
What drug increases reticulocyte count <10 day
Epoetin Alfa
Adverse events for Epoetin Alfa
1) Death
2) MI
3) Stroke
4) Venous thromboembolism
5) Tumor Progression
How is Epoetin Alfa administrated
IV or Subcutaneously
Indications of Epoetin Alfa
1) Chronic Kidney Disease
2) Cancer Chemotherapy
3) HIV Treatment
What is used for sickle cell anemia treatment
1) Hydroxyurea
MOA of Hydroxyurea
Boosts Fetal Hemoglobin
What is the only disease modifying therapy approved for sickle cell disease
Hydroxyurea
How is Hydroxyurea delivered
Orally
What drug treats PNH
Eculizumab
MOA of Eculizumab
Inhibits its cleavages to C5a and C5b
How would you treat atypical hemolytic uremic syndrome
Eculizumab
How does Eculizumab treat atypical hemolytic uremic syndrome
Inhibits complement mediated thrombotic microangiopathy
Eculizumab is only available under
REMs (Risk evaluation and mitigation strategy)
Eculizumab is administered via ___. Why?
1) IV
2) Antibody
Dosage of Eculizumab
1) Once per week for 1st 4 wks
2) Maintenance dose given every two weeks
Toxicities of Eculizumab
1) Viral Infections
2) Life-Threatening Meningococcal Infections
3) Headache
What vaccine must you give to a pt 2 weeks before starting Eculizumab
Meningococcal Vaccine
What is the brand name for G-CSF
Filgrastim
Toxicities of Filgrastim
1) Allergic Rxn
2) Bone Pain
How do you treat the bone pain associated with Filgrastim
NSAIDs
How long do you have to wait after chemotherapy to admin filgrastim
24
How is Filgrastim administrated
1) IV
2) SC
Indications for Filgrastim
1) Nonmyeloid Malignancies recieving myelosuppressive anticancer drugs
2) Bone Marrow Transplant
Which drug that treats neutropenia can cause Edema
Sargramostim (GM-CSF)
Sargramostim will increase the production of
Neutrophils, Eosinophils, and Monocytes/Macrophages
How is Sargramostim delivered
IV or SC
Toxicities of Sargramostim
1) Edema and Fluid Retention
2) Dyspnea
3) Renal and Hepatic Dysfunction in pts already w/ those problems
4) Gasping Syndrome in premature infants
Why Sargramostim cause Gasping Baby Syndrome
Benzyl Alcohol
MOA of Plerixafor
1) Partial agonist of CXCR4 receptor
MOA of Oprelvekin (IL-11)
1) Unknown
Effects of Oprelvekin
Formation and Maturation of Megakaryocytes
Toxicities of Oprelvekin
1) Significant Edema
2) Cardiac Dysrhythmias
3) Blood Shot eyes
4) Severe Allergic Rxn
How is Romiplostim Administered
SC weekly
Effect of Romiplostim
Increase Platelet Count in Pts with ITP
MOA of Romiplostim
Bind TPO receptor
Indications of Romiplostim
1) ITP
- Used after failure of glucocorticoids and immune globins
Toxicity of Eltrombopag
Hepatotoxicity
MOA of Eltrombopag
Non-peptide TPO receptor agonist
How is Eltrombopag administered
Orally
Dose of Eltrombopag
Once a day
Indications of Eltrombopag
1) ITP
2) Cirrhosis due to Hep C
Causes of Drug-induced thrombocytopenia
1) Myelosuppression
2) Quinidine, Vancomycin, Heprin
How does Asprin decrease thromboxane A2
Cyclooxygenase-1
In Chronic Immune Thrombocytopenia there will be an increase of what cell type in the bone marrow?
Megakaryocyte
Antibodies are against what in Chronic Immune Thrombocytopenia
GPIIbIIIa
What are the two acquired forms of decreased platelet function disorders
1) Asprin Use
2) Uremia
Inheritance of Kostmann Syndrome
Autosomal Recessive
Clinical Features of Kostmann Syndrome
Early Life Threatening Pyogenic Infection
How is Kostmann Syndrome associated with cancer
AML risk
What is known as a severe congenital neutropenia
Kostmann Syndrome
Cyclic Neutropenia has an ANC < ___ every __ - __ days
1) 200
2) 15
3) 35
Clinical Presentation of Cyclin Neutropenia
Cyclic Fever with Oral Ulcers
Inheritance of Cyclic Neutropenia
1) Autosomal Dominant or Sporadic
Risk for malignancy in Cyclic Neutropenia
None
Triad seen in schwann-diamond syndrome
1) Neutropenia
2) Exocrine pancreas insufficency
3) Skeletal abnormalities
Inheritance of Schwann-Diamond Syndrome
Autosomal Recessive
Risk for cancer in Schwann Diamond Syndrome
1) MDS or Leukemia
Malignancy association with Fanconi Anemia
1) AML
2) Brain Tumor
3) Wilms Tumor
When does Fanconi Anemia present
1) 1st 10 yrs of life
Clinical presentation of Fanconi Anemia in children
1) GU and Skeletal Abnormalities
Inheritance of Fanconi Anemia
Autosomal recessive
Malignancy association with Leukocyte Adhesion Def.
None
Clinical Presentation of Leukocyte Adhesion Def.
1) Delayed umbilical cord stump (>3wks)
2) Recurrent bacterial and fungal infections W/O PUS
3) Poor Wound Healing
Child has recurrent bacterial infections w/o pus. you sus. that the disease he has is ___ inheritance pattern.
1) Leukocyte Adhesion def.
2) autosomal recessive
Another name for Hyper IgE Syndrome is
Job Syndrome
Triad of symptoms in Job syndrome
1) Severe Excezma
2) Recurrent Bacterial Infections (Staph) on skin
3) Pulmonary Infections
Job Syndrome is what type of inheritance
Autosomal Dominant
Malignancy association with Job Syndrome
Increaased Hodgkin Lymphoma
Triad of symptoms in Wiscott-Aldrich Syndrome
1) Recurrent Sinopulmonary and Ear Infections
2) Severe Atopic Dermatitis
3) Bleeding
Wiscott-Aldrich is associated with what type of cancer
Non-Hodgkin Lymphoma
-ESP. B Cell
Vaccinations after Splenomegaly
1) Streptococcus Pneumoniae
2) Neisseria Meningitidis
3) Herophilus Influenzae B
What is Kehr Sign. Describe position
1) LUQ pain due to phrenic nerve irritation
- Splenic rupture below diaphragm
2) Elicited in recombinant position (laying down) with legs raised
Where is Castell’s Point
1) Inferior interspace along left anterior axially line