MKSAP - Hematology Flashcards
Patient with prolonged bleeding time and mild coagulopathy – diagnosis?
Von Willebrands disease
In the absence of inflammation, lower and upper limit of normal ferritin?
In patients with inflammatory disorder, and ferritin lower than 120, likely cause of anemia?
15; 30
Iron deficiency in setting of inflammatory anemia
Normal bleeding time, PT, PTT?
<10 minutes, 11–13 seconds, ??
Prior to surgery, only need to test for coagulation disorders if?
Positive family history, liver disease, anticoagulation therapy
Patient with suspected avascular necrosis/osteonecrosis – test?
- Plain radiograph
2. If normal X-Ray: MRI (if MRI contraindicated use radionuclide bone scan)
Patient with suspected HIT – management? Gold standard for diagnosis?
Stop heparin, start agatroban/lepirudin. Serotonin release assay.
Pseudo-thrombocytopenia?
Platelets agglutinate in clumps and are not recognized by blood counters
ITP – treatment?
Corticosteroids
Patient with previous PE who just finish a course of warfarin. Family history of DVT’s – next step?
Thrombophilia screening two weeks after completion of warfarin
Hypercalcemia in presence of acute kidney injury suggests?
Most common initial finding these patients?
Multiple Myeloma
Renal failure
G6PD deficiency – symptoms? Smear findings? Lab findings?
Jaundice and dark urine (with or without abdominal/back pain)
Bite cells and Heinz bodies
Increased reticulocytes
Spherocytes on peripheral blood smear suggest? Test to differentiate?
Hereditary spherocytosis or warm antibody-mediated hemolysis
Direct antigobulin test is positive in warm antibody-based mediated hemolysis
Symptoms of macroangiopathic versus microangiopathic hemolytic anemia?
Appears well, no evidence of organ dysfunction, normal platelet count versus opposite
Warm antibody-mediated hemolytic anemia – common complication of?
Lymphoid malignancies
Mixing studies differentiate between?
Factor deficiency versus presence of inhibitor
How to differentiate between DIC and TTP/HUS?
DIC has Elevations in PT, PTT, D-dimer, and low fibrinogen levels
Signs of pulmonary hypertension?
Fix splitting of S2, tricuspid regurgitation, right ventricular heave, clear lungs
Treatment of acute chest syndrome?
Exchange transfusion
Evans syndrome?
Combination of ITP and warm autoimmune hemolytic anemia
Patient with antiphospholipid antibody syndrome – criteria for diagnosis? Test to confirm? Length of coagulation?
History of thrombotic event and persistent lupus anticoagulant/IgG anti-cardiolipin/beta-2-glycoprotein one antibodies
Two positive laboratory tests (anti-cardiolipin antibody or lupus inhibitor assay) 12 weeks apart
lifelong anticoagulation
Factor V Leiden mutation?
Factor V is resistant to cleavage by protein C
Hyper homocystinemia increases risk for?
Venous and arterial thrombosis
Monoclonal gammopathy of undetermined significance – characterized by?
M-protein and t deficiency
Waldenström’s macroglobulinemia involves?
Bone marrow, lymph node, splenic involvement and hyperviscosity syndrome
Diagnose CLL with?
Flow cytometry
Leukemia with increased numbers of granulocytic cells? Oncogenes?
CML; BCR-ABL
Treatment for AML? APL?
Azacitidine;
all-trans-retinoic acid and arsenic trioxide
