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Internal Med > OME - HemOnc > Flashcards

OME - HemOnc Flashcards

1
Q

What meds induce G6PD?

A

Dapsone
TMP-SMX
Nitrofurantoin

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3
Q

Antiphospholipid Ab Syndrome does what?
Presents how?

Dx:

Tx?

A

Arterial and venous thrombosis
Recurrent early miscarriages

Russell Viper Venom Assay

Warfarin 2-3

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4
Q

In ACD, what are the lab values:

Fe
Ferritin
TIBC

A

Dec
Inc
Dec

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5
Q

When do you transfuse platelets in a pt w/low platelets?

A

< 20,000
OR
< 50,000 AND bleeding

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7
Q

Pt w/thrombocytopenia d/t inc destruction is bc of what?

A

ITP
TTP
DIC

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9
Q

NHL presents how?

Spreads how?

What kind of disease normally?

Treated how?

A

IIb or worse

Hematogenously

Extranodal

RCHOP

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11
Q

Bleeding w/normal platelet count is d/t what?

A 
vWD
Glanzmann’s - IIb/IIIa
Bernard-Soulier - In
Uremia
Drugs
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13
Q

Treatment of chemo for HL is done with what?

Normally presents in what stage?

A

ABVD or BEACOPP

IIa or better

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14
Q

Why do sickle cell pts need an annual DEXA scan?

A

Aseptic necrosis of hip/femur

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15
Q

Thrombocytopenia is d/t what 3 main categories?

A

Dec Production

Inc Destruction

Sequesteration

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16
Q

Pt w/thrombocytopenia d/t dec production is bc of what?

A

Aplastic anemia

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18
Q

How does Chronic Leukemia present?

Next step is to get what?

Then what?

A

ASx, wbc > 60

Differential
PMN = CML
Lymph = CLL

Bone marrow bx

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20
Q

What is the antidote to heparin?

A

Protamine

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21
Q

What are the sx of HIT?

Treat with what?

A

Plt drops and NEW thrombus formation

Direct Thrombin Inhibitor - Lepirudin

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22
Q

Pt w/CLL, what will you see?

Treat if > 65 and have sx?

< 65 + donor?

A

Smudge cells

chemo: Fludarabine or Rituximab

HSCT

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23
Q

ITP is treated how?

A

Steroids, IVIG

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24
Q

What presents w/thrombocytopenia, fever, AMS, RF, and microangiopathic hemolytic anemia?

Treat how?

A

TTP

Exchange transfusion

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27
Q

Multiple myeloma what kind of scan should you get?

Shows what?

A

Skeletal survey

Lytic lesions

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28
Q

Pt that has HL or NHL, what are some uncommon findings that are non-specific?

A

Pel-Epstein fevers that come and go over weeks or painful LAD w/EtOH and HSM

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33
Q

Sickle cell pt in vasoocclusive crisis with MCV of 105, what is the cause?

A

Folate deficiency, v common in these pts

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34
Q

Quick summary:
Primary hemostasis deals with what?

Secondary?

A

Platelets

Factors

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35
Q

Sideroblastic anemia has what values?

Fe
Ferritin
TIBC

Treatment?

A

Inc
Normal
Normal

Give B6, look for cancer

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36
Q

What presents w/thrombocytopenia in a female w/no other sx?

Treatment?

A

ITP

Plt < 20 or bleeding give IVIG
Plt > 20 give steroids
Refractory - splenectomy

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37
Q

When does HIT occur?
Presents how?

Dx how?

Tx?

A

7-14 days
Low Plts

HIT Ab+

Stop heparin
Give argatroban
Bridge to warfarin

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39
Q

What are the 3 stages in order of primary hemostasis?

A

Adhesion

Activation

Aggregation

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43
Q

HS diagnosed how?

Confirm how/Best test?

Treatment?

A

Smear

Osmotic fragility

Folate > Fe and if severe splenectomy

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44
Q

Pt w/thrombocytopenia d/t sequestration is bc of what?

A

Cirrhosis

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46
Q

Autoimmune ABs for Warm will show what?

Caused by what?

Treat how?

A

IgG - WG

Autoimmune disease (R.A.), PCN, sulfa, Rifampin, Cancer

Steroids, IVIG, Rituximab, splenectomy

47
Q

HbSS pts should be on what?

Treat how?

A

Daily folate and Fe

Hydroxyurea

48
Q

After finding cancer on biopsy how do you stage?

A

1) CXR
2) CT
3) BM Bx

50
Q

What is the path behind TTP?

Pt presents how?

A

Hyaline clot d/t def of ADAMTS-13

FAT RN
Fever, anemia, thrombocytopenia, Renal failure, neuro sxs

51
Q

After you see PT/PTT is increased, what is the next step?

A

Get mixing study

53
Q

If mixing study does not correct the PT/PTT do what?

If it does correct, what does it mean?
D/t what?

A

Inhibitor, do nothing

Factor Def
Hemophilia A/B, Vit K Def, Warfarin, DIC, vWD/Factor 8

54
Q

Pt w/peripheral neuropathy and on BM bx there is > 10% lymphocytes, what does the pt have?

Treat how?

What special feature does it have?

A

Waldenstrom’s

Plasmapheresis and Rituximab

Serum viscosity > 5-6

57
Q

What starts primary hemostasis?

What happens 1st?

What is this process called?

A

Endothelial injury

vWF is released, grab Glycoproteins-Ib

Adhesion

61
Q

What random things can cause nonmegaloblastic macrocytic anemia?

A

Liver disease
EtOH
Meds
Metabolic conditions - Lesch-Nyah’s, Orotic Aciduria

63
Q

Pt w/ HIT, treat how?

A

Stop heparin

Give Tirofiban

64
Q

Pt that has MCV of 124, Hg of 10 and drinks a pint of liquor a day and eats a good diet, what will be seen on peripheral blood smear?

A

Microcytic rbcs alone

Does NOT have B12/folate def

65
Q

Treatment for AML M3?
See how?

Everything else?

A

All-trans retinoic acid
Auer rods

Chemo

67
Q

Avg age for pt w/ALL?

Treat how? For what?

A

7

Intrathecal ppx chemo w/Ara-C or MTX
Bc the cancer hides in the CNS

68
Q

Autoimmune ABs for Cold will show what?

Caused by what?

A

IgM - CM

Mycoplasma, Mono

69
Q

Chemo treatment for Multiple myeloma?

A

Melphalan + Prednisone + Thalidomide/Bortezomib

70
Q

What are the Emergent conditions to look for in sickle cell crisis?

Treatment?

A

Acute chest - MI, CHF
Acute brain - CVA
Priapism

Exchange Transfusion

71
Q

Pt w/thalassemia has what iron studies?

What sx?

A

Normal Fe studies

Anemia

72
Q

TTP CBC shows what?

Smear shows what?
Means what?

A

Low Plts

Schistocytes
Microangiopathic hemolytic anemia

73
Q

Non-cardiogenic pulmonary edema and a fever following transfusion = ?

A

TRALI

74
Q

Pt that has multiple myeloma and is under 70 y/o, what is the goal?

A

Stem cell transplant, even if they are doing well on chemo

75
Q

Microcytic anemia has what kind of RI?

Describe it

A

RI > 2%, high

Production anemia

77
Q

Secondary hemostasis ends w/ what?

A

Fibrinogen mesh turning into fibrin

78
Q

85 y/o pt w/Spep +, Upper -, skeletal survey - w/BM Bx < 10% is what?

Treatment?

A

MGUS

Observe

79
Q

How to confirm multiple myeloma?

Shows what?

A

BM biopsy

> 10% plasma cells

84
Q

Pt that has a BM biopsy that shows < 10% plasmacytosis, + Mspike but with NO symptoms what is the management?

A

Repeat labs in 6 months

If abnormal, re-biopsy

85
Q

CML avg pt age?

CLL?

A

47

87

87
Q

Avg pt age in AML?

Exposure?

+ for what?

A

67 y/o

Benzene, radiation, blast crisis in CML

MPO

91
Q

Pt presents w/Non-tender LAD, next step?

A

Excisional biopsy

93
Q

Dx G6PD how?

Confirm how?

A

Blood smear shows Heinz bodies and Bite cells

G6PD 6-8 weeks after attack

95
Q

Multiple myeloma pt presents with what?

1st step in Dx?

A 
CRAB
Calcium (hyper)
Renal Failure
Anemia
Bone pain

Spep for Mspike and a Upper for Bence Jones

97
Q

Stage 3 Cancer means LNs located where?

A

Above and below diaphragm

98
Q

Old Pt that is slowly developing anemia but is mostly asymptomatic that is suspicious for cancer may have what causing the anemia?

How to work up?

A

Sideroblastic

Bone marrow Bx

100
Q

What meds causes B12 deficiency?

A

AZT
5-FU
ARA-C

105
Q

How do acute leukemias present?

1st step in w/u?

Next step?

Diagnose how?

A

Fever, bone pain, infxn, anemia, bleeding

Blood smear

BM bx

> 20% blasts on peripheral blood

106
Q

Pt that has PNH presents how?

Dx PNH how?

Treat how?

A

ABD pain and morning hematuria

Flow cytometery CD55 Negative

Supportive or Eculizumab if really severe

107
Q

Normocytic anemia has what level of RI?
Describe it

What indicates hemolysis?

A

RI > 2%
Destruction anemia

Inc Retic count, Inc LDH, Inc bili
Dec Haptoglobin

112
Q

SS anemia occurs d/t what mutation?

Occurs when?

A

AR in B-Globin

Hypoxia, infection, dehydration, DKA

113
Q

What diseases can cause B12 deficiency?

If untreated can cause what?

A

Pernicious anemia
Crohn’s
Gastric bypass

Irreversible subacute combined degeneration of the cord

116
Q

Treatment of severe thalassemia?

What else do you need to give?

A

Transfusion

Give Deferoxamine

123
Q

What kind of pt has ACD?

Treatment?

A

SLE, R.A.

usually nothing, but if severe give EPO

130
Q

What are the microcytic anemia?

What is the 1st test you should order?

RI will be low or high? Describe it

A

ASLIT - ACD, Sideroblastic, Lead, Iron Def, Thalassemia

Ferritin

Low - production anemia (bone cannot make rbcs)

Internal Med (7 decks)

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