Putthoff, final CIS Flashcards
52 y.o with low Hb low MCV and high RDW high platelets constipation, abdominal pain, weakness, malaise general pallor with pale conjunctiva most likely?
chronic blood loss anemia
what would blood look like with marrow replacement
leukoerythroblastocytes
37 y.o F with low Gb low MCV and norm RDW low low platelets weakness, malaise, dysfunctional uterine bleeding and enorrhagia general pallor with pale conjunctiva sparse petichiae on chest and lower extremity serum ferritin low most likely? -IDA Fe deficiency anemia -Primary chronic ITP -secondary chronic ITP -chronic blood loss anemia -HUS
primary chronic ITP
37 y.o F with low Gb low MCV and norm RDW low low platelets weakness, malaise, dysfunctional uterine bleeding and enorrhagia general pallor with pale conjunctiva sparse petichiae on chest and lower extremity serum ferritin low most consistent with? -massive splenomegaly -sequestration -increased normal megakaryocytes -high TIBC -abnormally large platelets -poikilocytosis -enlarged soft spleen with focal abscesses dysplastic megakaryocytes normal hemosiderin deposits
increased normal megakaryocytes
37 y.o F with low Gb low MCV and norm RDW low low platelets weakness, malaise, dysfunctional uterine bleeding and enorrhagia general pallor with pale conjunctiva sparse petichiae on chest and lower extremity serum ferritin low ITP or B cell neoplasm what correlates with B cell neoplasm? -abnormally large platelets -splenomegaly/lymphadenopathy -circulating autoAb -cold agglutinis, IgA -target cells and spherocytes
splenomegaly/lymphadenopathy
iron panel in IDA
free iron low transferrin sat low TIBC high serum ferritin low hepcidin low
iron panel in anemia of chronic disease
low free iron high transferrin sat low TIBC high serum ferritin high hepcidin
when do you see increased # megakaryocytes
myeloproliferative disease
primary ITP
Tx primary ITP
splenectomy
30 y.o M fatigue mild Lb loss low grade fevers itchy dry skin anemia with MCV 86 MCHC 35 PE mild spenomegaly and L axillary adenopathy large cells!!! CD30- CD19+ BCL6+
HL, lymphoproliferative
42 y.o japanese F fever 102.2 and productive cough. right lower lobe pneumonia on CXR
mother had RA at 40 y.o
painful swollen joints especially at small articulations
RF+ and erosive, inflammatory arthritis of hands an elbows
elevated WBC with L shift and thrombocytosis
n/n anemia
most likely?
-splenic infarcts
-hemoglobulinuria
-inherited telomerase defects
-high serum ferritin level
-thymoma
- high serum ferritin level
anemia of chronic disease
47 y.o F with malaise weakness. takes betaine supp and has ataxic gait
CBC shows macrocytosis and PS show multiple hypersegmented PMNs
elevated homocysteine and methymalonate
most likely?
B 12 deficiency
24 y.o F with weakness lethargy low libido moderate microcytic hypochromic anemia PS show target cells and nucleated RBC basophilic stippling high serum ferritin increased HbA2, small HbF most likely Dx?
Beta thalassemia minor
14 y.o M with epsodic blood transufions for beta thalassemia major severe microcytic hypochromic anemia HSM with anterior painless cervical adenopathy thymus discernable low temp with lymphocytosis Hct low and high platelets -TRALI -myelodysplastic syndrome -viral syndrome -thymoma -early aplastic anemia
viral syndrome
characteristic aplastic anemia on CBC
pancytopenia
57 y.o M with weakness lethargy n/n anemia enlarged spleen and high WBC immature myeloid cells and high platelets 15% blast in BM myeloperoxidase is negative BCR-ABL fusion genes most likely -CMML -lymphoid blast crisis -hairy cell leukemia -Richter syndrome -CML
CML
what marks lymphoid blast crisis
tDt, CD 19 all those markers
6 y.o M with easy bruising, epistaxis and ED visits requiring anterior posterior packs and vasoconstrictors
pain and swelling of R knee after playing with friends
significant bleeding into joint
PT normal PTT prolonged
most likely?
hemophilia A or B
20 y.o M with fever, night sweats and 10Lb weight loss
bulky cervical lymphadenopathy and moderate splenomegaly
binucleated fiant cells with large circumscribed nucleoli
CD15+ and 30+
rare, reactive-appearing lymphoid cells
disorder is most likely
-DLBCL
-extranodal NK/T cell lymphoma
-EBV+
-Burkitt
-Sezary
EBV +
binucleated giant cells with circumscribe nucleoli- hodgkins. reed sternberg
67 y.o M with fever night sweats weight loss splenomegaly binucleated giant cells CD15+ 30+ most likely? -T cell neoplasm -rapidly transforms to DLBCL -presents extranodal -poor prognosis -more common in adolescents
poor prognosis
first 4 hodgkin marker
CD30 and 15+
lymoho histiocytic cells, and CD markers assoc?
lymphocyte predominance HL
CD30- BCL6+
