Misc Flashcards
normal PO2 + low pulse ox = ?
methemoglobinemia (O2 dissociation curve is shifted to the left)
treatment of methemoglobinemia?
methylene blue, vitamin C
Tx for WARM autoimmune hemolytic anemia
steroids, danazol, RITUXIMAB, splenectomy, immunosuppressive drugs
Tx for COLD agglutinins
cyclophosphamides, chlorambucil --> Rituximab. NO steroids (unlike WARM AIHA)
Antigen and Ab involved in WARM AIHA
antigen = Rh;
IgG +/- C3
Antigen and AB involved in COLD agglutinins
antigen = iAg; IgM, DEFINITELY C3
how to diagnose Paroxysmal Nocturnal Hemoglobinuria
(DAF) assay/ Flow cytometry of CD55/59
Treatment of PNH
Allogeneic bone marrow transplant/ ECULIZUMAB
what to give 2 weeks prior to PNH treatment with eculizumab?
meningococcal vaccine
diagnosis of acute intermittent porphyria
spot urine porphobilinogen (due to decreased PBG deaminase activity, will get a buildup of PBG)
Hereditary spherocytosis is due to?
cytoskeletal membrane defect
treatment of hereditary spherocytosis?
folate supplements –> splenectomy
Re: prothrombin complex concentrates (PCCs), specifically, four-factor PCC, is a combination of?
inactivated factors II, VII, IX, and X.
In patients with INR elevation and bleeding associated with warfarin administration, urgent reversal of anticoagulation should be accomplished using vitamin K and prothrombin complex concentrates.
Patients with a Pulmonary Embolism Severity Index score of less than 65 are at low risk of death and may be managed in the outpatient setting with a non–vitamin K antagonist oral anticoagulant, such as?
apixaban or rivaroxaban
clinical features of polycythemia vera
- EPO-independent (LOW EPO) proliferation of erythrocytes in the setting of erythrocytosis
- Hgb > 16.5 g/dL in men and >16 in women after secondary causes are excluded
how to diagnose polycythemia vera
JAK2 mutation
treatment of polycythemia vera
therapeutic phlebotomy (lower hct to <45%), hydroxyurea for patients at high risk for thrombosis (>60 yo, previous thrombosis, leukocytosis), LOW dose ASA (high dose can cause increased bleeding)
hepatic vein thrombosis (Budd-Chiari syndrome) or portal vein thrombosis should prompt consideration of?
Polycythemia vera –> test for JAK2 mutation or
Paroxysmal nocturnal hemoglobinuria –> screening flow cytometry CD55 and CD59 ABSENT
Patients with pancytopenia, macrocytic erythrocytes, hypersegmented neutrophils, and findings consistent with intramedullary hemolysis should be checked for?
vitamin B12 and folate levels to determine the cause of megaloblastic anemia
Tx in essential thrombocythemia for:
- low risk (< 60 YO, no previous thrombosis, leukocyte count <11k)
- high risk
- life threatening
- low risk: low dose ASA
- high risk, non pregnant: hydroxyurea + ASA
- life-threatening (TIA, stroke, MI, GI bleed): Plateletpheresis
aspirin and hydroxyurea - ET is the most common myeloproliferative neoplasm
