IM HemOnc - Rd 2 Flashcards
What is the Gold standard test to diagnose HIT?
Serotonin release assay
Empiric anticoagulation should only be started in what setting of a blood clot?
PE
NOT a DVT w/no symptoms of PE
Lupus anticoagulant (anti-phospholipid Ab) presents w/what lab abnormality?
Prolonged PTT
Treatment for TTP?
Plasma exchange
Middle-aged Pt that has hemolysis, cytopenias, and hypercoaguable state (portal vein thrombosis) has what?
PNH
Pt with blanching ruby-colored papules on the lips, unremitting epistaxis, increased Hct, has what?
AV shunting d/t Osler-Weber-Rendu (hereditary telangiectasia)
AD
Pt with mild hypercalcemia in the setting of metastatic breast cancer should be treated how?
Bisphosphonates
Pt that has blood transfusion and then develops DIC is d/t what etiology?
Acute hemolytic transfusion d/t ABO incompatibility
HIT can cause what unexpected problem?
Arterial thrombosis
OSA causes transient periods of hypoxia, what is the result?
Increased EPO
How do you diagnose CLL?
Shows what?
Flow cytometry
Clonalality of mature B cells
Pt that has ESRD, retinal hemorrhages, HA, and Very high HTN, what is going on?
D/t what?
HTN crisis
SE of EPO therapy
Pt that has unexplained ITP after all else has been ruled out, what else must you consider?
HIV
HepC
vWF deficiency presents w/what lab values?
Prolonged bleeding time
Inc PTT
What is a hemoglobinopathy?
Sickle cell or thalassemia
Anemia in old man that has arthritis most likely has what?
Fe deficiency anemia 2/2 chronic NSAID use and GI Bleed
What is the mechanism of pancytopenia in SLE?
Peripheral immune-mediated destruction
What presents w/HTN, transient vision disturbances, aquagenic pruritus, facial plethora and splenomegaly?
Treat how?
Polycythemia Vera
Serial phlebotomy
Also can add Hydroxyurea
Tumor lysis syndrome presents how with the following electrolytes?
Ca
PO4
K+
WHY?
Dec
Inc
Inc
Cell contents are freed when cell dies and PO4 and K+ are high INTRACELLULARLY, thus when they are released Ca binds PO4 and becomes LOW
Pt that presents w/HA, N, dizziness and polycythemia most likely has what?
Look out for what?
Chronic CO poisoning
Environmental work exposure
Anemia of lymphoproliferative disorders is d/t what?
Bone marrow infiltration w/cancerous cells
GVHD involves activation of what cells?
Donor T lymphocytes
Pt that has fatigue and dyspnea following a respiratory infection treated w/Amoxicillin that has anemia and reticulocytosis has what?
Treatment?
Autoimmune hemolytic anemia —> warm agglutination
High dose glucocorticoids
Hereditary Spherocytosis presents how?
At increased risk for what?
Lab studies show what?
Hemolytic anemia, jaundice, splenomegaly
Bilirubin gallstones, Parvo B19
high MCHC, high RDW
Pt that is acutely ill and has underlying liver disease has an increased risk of developing what in as little as 7-10 days?
What lab values?
Vit K deficiency
Inc PT and PTT
What presents w/progressive fatigability and lab studies that show increased Iron?
Sideroblastic anemia