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Clinical Pathology > UA Hematology Leukemia Erythrocytosis Seropositive together > Flashcards

UA Hematology Leukemia Erythrocytosis Seropositive together Flashcards

1
Q

SSx of erythromelagia and spontaneous brusing
What is the most likely DX

A

Polycythemia vera

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2
Q

CBC shows:
Erythrocytosis
Normal WBC and platelets
Increased EPO
What is the most likely DX

A

Secondary Erythrocytosis

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3
Q

What would you expect with EPO in Relative Erythrocytosis?

A

Normal

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4
Q

What is the charachteristic cell of Lymphoma?

A

Reed Sternberg cell

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5
Q

Alcohol induced pain is a classic symptom of?

A

Lymphoma

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6
Q

What is the Dx Triad for Lymphoma?

A

Pel ebstein fever
Pruitis
Lymphadenopathy

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7
Q

CBC shows:
Slight anemia
Leukocytosis
Neutrophilia
Lymphocytopenia
And small amounts of Eosinophilia
What is the most likely DX

A

Lymphoma

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8
Q

For someone with suspected Leukemia, What follow up test would you do and what are you likely to see?

A

Comprehensive blood panel
Increased LDH and uric acid
ESR noticable increase

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9
Q

CBC shows:
Anemia
Leukocytosis 15k-50k
Thrombocytopenia
Lymphoblasts >25%
What is the most likely DX

A

ALL

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10
Q

CBC shows:
Anemia
Leukocytosis
Thrombocytopenia
Myeloblasts with auer rods
What is the most likely DX

A

AML

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11
Q

CBC shows:
Anemia
Leukocytosis >15000
Lymphocytosis >50%
Thrombocytopenia
Smudge cell
Absolute monotonous lymphocytosis
What is the most likely DX

A

CLL

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12
Q

What follow up test would you use on someone suspect to have CLL? And what would you expect to find?

A

Chem panel
Hypogammaglobulinemia

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13
Q

CBC shows:
Anemia
Leukocytosis 200k-1 million
Thrombocytosis
Eosinophilia
Basophilia
Variety of myeloid cells in periphery of all stages of development.
What is the most likely DX

A

CML

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14
Q

What follow up test would you use if someone is suspect to have CML? And what would you expect to find?

A

Special test for Philadelphia chromosome
Abnormal

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15
Q

Dx triad for Ebstein-Barr?

A

High fever (101-104)
sore throat
lymphadenopathy (ANT cervical chain)

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16
Q

CBC shows:
WNL RBC
Leukocytosis
Lymphocytosis >50%
Reactive lymphocytes >10%
Abnormal monocytes
Thrombocytopenia
What is the most likely DX

A

Mononucleosis/Ebstein Barr virus

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17
Q

What follow up tests would you use when suspecting Mono? And what would they show if the patient indeed did have mono?

A

Chem panel- Elevated Liver Fx tests
Heterophile antibody test/Monospot
Epstein Barr virus titers:
Anti VCA antibody- IgM early and IgG post 2-4 weeks
Anti EBNA antibody- elevated post 2-4 months

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18
Q

If a patient was sick with Mono, but it has been 2 months since onset of symptoms, and you did an Epstein Barr titer. What would you expect to see?

A

Anti VCA antibody positive with IgG and Anti EBNA antibody positive

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19
Q

SSx: subcutaneous nodules, heart murmur, erythema marginatum, chest pain.
What is the most likely DX

A

Acute rheumatic fever

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20
Q

CBC shows:
Leukocytosis
Neutrophilia
What is the most likely DDx?

A

bacterial infection
acute rheumatic fever

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21
Q

If you suspect bacterial infection of ARF given CBC results, what follow up tests can be done? And what would you expect to see?

A

GABHS cultures (although often negative by the time ARF develops)
ASO titer/Anti Streptolysien O- Elevated
DNAse B/ Anti-Deoxyribonuclease- elevated after one week
EKG

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22
Q

What is the Tx plan for someone with ARF?

A

Moniter symptoms for 5 years or till age 21 (whichever is longer) or 10 years if carditis symptoms are present

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23
Q

What are the Jones criteria?

A

Carditis
arthritis
chorea
erythema marginatum
subcutaneous nodules

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24
Q

CBC shows:
Anemia (hypochromatic microcytic)
Leukopenia
Lymphopenia
Thrombocytopenia
What is the most likely DX

A

Systemic Lupus Erythematosus/ SLE

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25
Q

What would you see on a chem panel with someone suspect to have SLE?

A

Elevated BUN and creatinine /Kidney Fx tests

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26
Q

What special tests would you do for someone you suspect to have SLE?

A

ANA/Anti Nuclear antibody test
Anti-dsDNA
UA- Proteinuria MC and hematuria

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27
Q

What SLE special test is more used for Dx due to decreased sensitivity but increased specificty?

A

Anti-dsDNA

28
Q

What is the sensitive but not specific screening test for SLE?

A

ANA

29
Q

How many symptoms out of the list of 11 must someone have to be Dx with SLE?

A

4

30
Q

SSx:
Fatigue
HA
Joint pain in hands and wrist (although it appears non-erosive with imaging)
photosensitivity
alopecia
Many miscarriages
What is the most likely DX

A

SLE

31
Q

How might SLE effect:
Vascular
GI
Reproductive

A

Vascular- Raynauds
GI- Ulcers
Reproductive- increased risk of miscarriages

32
Q

What disorders will cause Macrocytosis?

A

Folate/B12 deficiency anemia
Liver disease
Myxedema
Reticulocytosis
Alcoholism

33
Q

Complications of strep infections can lead to what conditions?

A

Rheumatic fever
AGN

34
Q

BL hand and wrist pain.
Xrays are negative
What is the most likely DDX?
and what are follow up tests to determain between?

A

RA - RF
other autoimmune disorders- HLA B 27
ARF- Anti-dsDNA or ANA

35
Q

Leukocytosis with Lymphocytosis should ring bells for what condition?

A

Infectious Mono

36
Q

Heterophile antibody test is for what condition?
What is the pros and cons of this test?

A

Infectious mono
Pro- inexpensive and rapid
Con- Not specific or sensitive, unreliable within the first week and under age 5

37
Q

what is a flat painless rash MC on trunk or proximal extremities?

A

Erythema Marginatum

38
Q

What is a late finding for SLE?

A

Sydenham chorea

39
Q

Normal rages for Hct?

A

women: 37-47
men: 40-54

40
Q

DDX for Microcytosis?
<80FL

A

Iron deficiency anemia
Thalassemia
Sideroblastic anemia
Anemia of chronic disease

41
Q

DDX for Macrocytosis?
>100FL

A

B12/Folate deficiency
Liver disease
Alcoholism
Myxedema
Reticulocytosis

42
Q

What is the earliest identification of anemia?

A

RDW 11-15 %
** Will never decrease

43
Q

Hyper-segmented neutrophils can indicate?

A

B12/Folate deficiency

44
Q

Basophilia is bad until proven otherwise.
What could potential causes be?

A

Hypersensitivity Rx
Myxedema
Myeloproliferative condition

45
Q

What are complications to watch out for when someone has PV?

A

Stroke
DVT
Heart attack
Pulmonary emboli

46
Q

Hypochromic microcytic will lead you to what two conditions?

A

SLE
Hodgkins lymphoma

47
Q

Pepsi color urine is a sign of?

A

AGN
post strep infection

48
Q

Red/smoky brown urine is a sign of?

A

Hemtauria

49
Q

Yellow foam in urine indicates?

A

Bile
never normal

50
Q

White foam in urine indicates?

A

Albumin
Small amounts ok

51
Q

Stale water smell in urine indicates?

A

Advanced kidney disease

52
Q

Low specific gravity could indicate?
Whereas High SG indicates?

A

Low- Diabetes Insipidus
High- Diabetes Malidus

53
Q

High protein diets would show what in a UA?

A

Possible white foam
acidosis (<4.5pH)

54
Q

Cystitis would show what in UA?

A

Hematuria
Alkalosis (>8pH)

55
Q

What type of bacteria produce nitrites causing Nitrituria?

A

Gram Negative

56
Q

Bilirubinuria indicates?

A

Cholelithiasis
Liver disease

57
Q

What form of bilirubin is found in urine?

A

Conjugated
Unconjugated is not water soluble so it will not show up.

58
Q

DDX for hematuria?

A

Nephrolithiasis
AGN
GU malignancy
benign prostatic hyperplasia
Cystitis
Pyelonephritis
Contamination

59
Q

Waxy casts indicate?

A

Advanced renal failure

60
Q

RBC casts indicate?

A

AGN

61
Q

WBC casts indicate?

A

Acute pyelonephritis

62
Q

Fatty casts indicate?

A

Advanced renal disease/Nephrotic syndrome

63
Q

Pseudocasts indicate?

A

Fibers or dust

64
Q

Hyaline casts indicate?

A

little concern

65
Q

What are reasons one may have proteinuria that is not pathonemonic?

A

Muscle break down due to extreme exercise
Orthostatic
Pregnancy
High protein diet

66
Q

Explain UA findings for DM and DI.

A

DM Type 1= Glucosuria and Ketonuria
DM Type 2= Glucosuria
DI= Low SG
Glucose >180 if shows up on UA

Clinical Pathology (9 decks)

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