MKSAP HemeOnc III Flashcards
__ should be considered as the initial therapy for patients with iliofemoral deep venous thrombosis with acute limb ischemia.
Thrombolysis (tPA)
In patients with severe symptomatic autoimmune hemolytic anemia, the autoantibody typically reacts against all erythrocytes, and a completely crossmatch-compatible unit may be impossible to find; these patients should receive ____ blood.
ABO and Rh-matched blood even if it is not crossmatch compatible.
The autoantibodies are of sufficient concentration in the serum or plasma to cause an incompatible crossmatch with donor erythrocytes because the autoantibody is directed against a core antigen on erythrocytes that is present not only on the patient’s erythrocytes but also on all donor cells. Although the autoantibody will shorten the survival of transfused cells, they will still survive for days or even weeks and should provide effective therapy for problems related to acute anemia until immunosuppressive therapy becomes effective. A response to immunosuppressive therapy takes 1 to 2 weeks.
The most common concern in patients who have undergone HSCT is the increased risk of infection, which persists for ___ after HSCT.
6 to 12 months
Smoldering multiple myeloma (MM) is characterized by a serum M protein level of ____ or greater (or ≥500 mg/24 hr of urinary monoclonal free light chains) or bone marrow plasma clonal cells of 10% or greater and no evidence of myeloma-related signs or symptoms requiring therapy.
3 g/dL
recommends that all patients with smoldering multiple myeloma undergo ___ to assess for lytic lesions.
whole body MRI
Bone scans only detect osteoblastic lesions whereas MM is osteolytic
What does four-factor PCC stand for?
prothrombin complex concentrate (combination of inactivated factors II, VII, IX, and X)
For patients with an INR of __ to ___ and with no evidence of bleeding, routine use of vitamin K is not recommended. For patients with an INR greater than ___ and with no evidence of bleeding, oral vitamin K is recommended.
4.5 to 10; 10
What is deferasirox?
iron chelator used for secondary iron overload from chronic transfusion
At what level of ferritin is chelation therapy considered?
Levels greater than 1000
Patients with symptomatic anemia of chronic kidney disease may be treated with erythropoiesis-stimulating agents to reduce transfusion requirements with a target hemoglobin level of ____ to avoid increased risk of adverse cardiovascular events.
11 to 12 g/dL
In a sickle cell patient with Hgb baseline 5-6.5, simple transfusion to achieve a hemoglobin level of ___ in patients having low- to moderate-risk surgery reduces surgical complications equivalent to exchange transfusion with less risk and cost.
10
Indications for exchange transfusion in HbSS?
Acute stroke, retinal artery occlusion, severe acute chest (Hgb S level goal 30%)
_____ is associated with warfarin-associated skin necrosis.
Protein C or S deficiency
