Hematology Flashcards

1
Q

anemic patients with reticulocyte count > 2 indicates

A

working marrow, RBC loss is either from bleeding or hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

anemic patients with reticulocyte count > 2 indicates

A

working marrow, RBC loss is either from bleeding or hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

anemic with retic cound

A

bone marrow failure from lack of epo or nutrients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why does renal failure cause anemia

A

lack of EPO production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does high indirect bilirubin mean?

A

hemolysis or glibert syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

high indirect bilirubin, high LDH, and high corrected retic count all point to?

A

hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

everyone has a least _____types of hemoglobin

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

a decrease is what 2 type of hemoglobin leads to thalassemia?

A

alpha and beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

normal white blood cell count

A

4.5 -11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

normal platelet count

A

150-400

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

normal recticulocyte count

A

25-85

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Burr cells =

A

uremia (too much urea in the blood) kidney’s are not doing well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spur cells=

A

postsplenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Schistocytes =

A

DIC, vasulitis, and thrombotic thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tear drop

A

iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

target cells

A

thalassemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

basophilic stippling

A

lead toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

bite cells

A

G6PD deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

rouleaux formation

A

Multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

increased recticulocyte count =

A

hemolysis or hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

type of cells found in sideroblastic lead

A

dimorphic stippling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

who gets alpha thalassemia and who gets beta

A

Alpha; asian and Beta is meds and africans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

life long anemia and positive iron stores think….

A

thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what determines the severity of alpha thalassemia

A

how much chains are deleted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

another name for beta thalassemia?

A

Cooley’s anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

tx for thalassemia?

A

transfusions, but must be careful not to overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

iron overloading may result in

A

hemosiderosis, heart failure, cirrhosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what medication can be given to postpone hemosiderosis

A

deferoxamine or oral deferasirox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are iron store and hemoglobin levels like in thalassemia?

A

hemoglobin is low 3-6 and iron is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

definitive tx for thalassemia

A

bone marrow transplant or spenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the hallmark of Fe deficiency?

A

Pica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is plummer vinson syndrome

A

formation of esophageal webs due to severe iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what plasma ferritin level indicates iron insufficiency

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what if serum iron is decreased to

A

dx = iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what can be taken with iron to help with absorption

A

vitamin c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

treatment for iron defiency

A

325mg of ferrous sulfate, therapy should be continued for 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

anemia can be caused by chronic inflammation, what labs should you get

A

CRP and ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what type of screening is used for sideroblastic anemia and what are the causes

A

prussian blue stain show rings. lead, etoh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

treatment for lead poisoning

A

chelation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

anemia of chronic disease have what size cells

A

normocytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

anemia due to renal failure can be tx with?

A

Recombinant epo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

name a couple of folate acid antagonist

A

phenytoin, trimethoprim-sulfamethoxazole and sulfasalazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

lacking folic acid will you have neurologic symptoms?

A

no. but you may have a sore tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Macro-ovalocytes and hyper segmented polymorphonuclear cells are path gnomonic for ?

A

Folic acid deficiency (macrocytic anemia), keep in mind that B12 deficiency can also have this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Howell jolly bodies =

A

folic acid deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

name the buzz words for b12 deficiency of pernicious anemia

A

smooth tongue, stocking-glove paresthesia, dementia (neurologic problems)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

tx pernicious anemia

A

lifelong b12 injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

tx pernicious anemia

A

lifelong b12 injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

anemic with retic cound

A

bone marrow failure from lack of epo or nutrients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

why does renal failure cause anemia

A

lack of EPO production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what does high indirect bilirubin mean?

A

hemolysis or glibert syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

high indirect bilirubin, high LDH, and high corrected retic count all point to?

A

hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

everyone has a least _____types of hemoglobin

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

a decrease is what 2 type of hemoglobin leads to thalassemia?

A

alpha and beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

normal white blood cell count

A

4.5 -11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

a what age do sickle cell problems start

A

6 months when Hgb F starts to fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

normal recticulocyte count

A

25-85

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Burr cells =

A

uremia (too much urea in the blood) kidney’s are not doing well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Spur cells=

A

postsplenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Schistocytes =

A

DIC, vasulitis, and thrombotic thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Tear drop

A

iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

target cells

A

thalassemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

basophilic stippling

A

lead toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

bite cells

A

G6PD deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

rouleaux formation

A

Multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

increased recticulocyte count =

A

hemolysis or hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

type of cells found in sideroblastic lead

A

dimorphic stippling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

who gets alpha thalassemia and who gets beta

A

Alpha; asian and Beta is meds and africans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

life long anemia and positive iron stores think….

A

thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what determines the severity of alpha thalassemia

A

how much chains are deleted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

another name for beta thalassemia?

A

Cooley’s anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

tx for thalassemia?

A

transfusions, but must be careful not to overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

iron overloading may result in

A

hemosiderosis, heart failure, cirrhosis.

74
Q

what medication can be given to postpone hemosiderosis

A

deferoxamine or oral deferasirox

75
Q

what are iron store and hemoglobin levels like in thalassemia?

A

hemoglobin is low 3-6 and iron is normal

76
Q

definitive tx for thalassemia

A

bone marrow transplant or spenectomy

77
Q

what is the hallmark of Fe deficiency?

A

Pica

78
Q

what is plummer vinson syndrome

A

formation of esophageal webs due to severe iron deficiency

79
Q

what plasma ferritin level indicates iron insufficiency

A

less than 20

80
Q

what if serum iron is decreased to

A

dx = iron deficiency

81
Q

what can be taken with iron to help with absorption

A

vitamin c

82
Q

treatment for iron defiency

A

325mg of ferrous sulfate, therapy should be continued for 6 months

83
Q

anemia can be caused by chronic inflammation, what labs should you get

A

CRP and ESR

84
Q

what type of screening is used for sideroblastic anemia and what are the causes

A

prussian blue stain show rings. lead, etoh

85
Q

treatment for lead poisoning

A

chelation therapy

86
Q

anemia of chronic disease have what size cells

A

normocytic

87
Q

anemia due to renal failure can be tx with?

A

Recombinant epo

88
Q

name a couple of folate acid antagonist

A

phenytoin, trimethoprim-sulfamethoxazole and sulfasalazine

89
Q

lacking folic acid will you have neurologic symptoms?

A

no. but you may have a sore tongue

90
Q

Macro-ovalocytes and hyper segmented polymorphonuclear cells are path gnomonic for ?

A

Folic acid deficiency (macrocytic anemia), keep in mind that B12 deficiency can also have this

91
Q

Howell jolly bodies =

A

folic acid deficiency

92
Q

name the buzz words for b12 deficiency of pernicious anemia

A

smooth tongue, stocking-glove paresthesia, dementia (neurologic problems)

93
Q

are MMA and homocystenine levels increased in anemia due to vitamin b12?

A

YES

94
Q

tx pernicious anemia

A

lifelong b12 injections

95
Q

Acronym for hemolytic anemia

A

HIT

96
Q

what does HIT stand for

A

hereditary, immune attack and trauma

97
Q

Hereditary causes of hemolytic anemai

A

G6PD, thalassemia, sickle cell

98
Q

Immune attack causes of hemolytic anemia

A

TTP, HUS, DIC

99
Q

The direct coombs test id antibodies on______

A

the RBC

100
Q

the indirect test id antibodies in the______

A

patient’s serum

101
Q

Test for G6DP hemolysis

A

Heinz body test

102
Q

who does sickle cell affect in the US

A

blacks

103
Q

a what age do sickle cell problems start

A

6 months when Hgb F starts to fall

104
Q

what causes a sickle cell crisis

A

dehydration, altitude, acidosis, hypoxemia, stress, menses

105
Q

sickle cell patients are at an increased risk for

A

strep pneumo infection, ulcer, spleen and gallbladder issues

106
Q

what ortho issue is more common in sickle cell patients

A

AVN of the femoral and humeral head

107
Q

that method demonstrates the level of different hemoglobin in the red cells

A

electrophoresis

108
Q

findings of sickle cells on peripheral smear

A

Howell jolly bodies

109
Q

preventative tx for sickle cell

A

low dose penicillin daily from birth to 6 years old, pneumo vaccines and screening to prevent stroke. daily hydroxyurea should also be considered.

110
Q

what type of a genetic disorder is G6PD

A

X-linked (black males)

111
Q

what causes episodic hemolysis in G6PD

A

Fava beans and oxidative drugs like aspirin

112
Q

Coomb’s test results: Warm IgG positive = what causes?

A

CLL, NHL, Hodgkin, SLE

113
Q

Coomb’s test results: Cold IgM positive/ positive complement C3d =

A

infection, EBV, CMV, mono

114
Q

polycythemia vera is known to have what mutation

A

JAK2

115
Q

Poly..Vera might convert to…

A

myelofibrosis or chronic myeloid leukemia

116
Q

Upper GI issue associated with poly, vera

A

PUD

117
Q

what is the most commen complication of poly. vera

A

thrombosis

118
Q

signs of primary poly, vera

A

HTN, splenomegaly, thrombosis

119
Q

who is affected by AML

A

all mature lions (ADULTS) over 60 years old

120
Q

who is affected by ALL

A

all little lions 3-7 years old

121
Q

CBC for leukemia

A

pancytopenia, circulating blasts >20%

122
Q

Auer rods are seen in what type of leukemia

A

AML

123
Q

Terminal deoxynucleotidyl transferase is diagnostic for

A

ALL

124
Q

what are 3 stages of CML

A

chronic, accelerated and acute (blast crisis >30% blasts)

125
Q

tx for ALL

A

chemo (50% of children will be cured

126
Q

what should be contained on a hyper coagulation panal

A

protein S and C, antithrombin III, factor V leiden, HIT essay

127
Q

what test is used to defect lupus anticoagulant

A

russell’s viper venom

128
Q

treatment for lupus anti autoimmune causes

A

prednisone

129
Q

hallmark leukocytosis number > 20,000

A

CLL

130
Q

hallmark is leukocytosis with a WBC of 150,000

A

CML

131
Q

what replaced the search for the philly gene in CML

A

BCR-ABL

132
Q

a smudge cell are pathognomics for

A

CLL

133
Q

Reed strenberg cells found, associated with epstein barr virus and incident peaks in 20s and 50s

A

Hodgkins lymphoma

134
Q

B lymphocytes associated with HIV and occurs in 20-40 year olds

A

NON-hodgkins lymphoma

135
Q

treat for NON- hodgkins lymphoma if only 1-2 nodes involved

A

radiation

136
Q

treatment for NON-hodgkins lymphoma involves more than 1 node?

A

chemo

137
Q

treatment for hodgkins

A

chemo or chemo + radiation

138
Q

What are rouleaux formations

A

spike on serum protein electrophoresis, positive multiple myeloma

139
Q

bence jones, lytic lesions, replacement of bone marrow?

A

MM

140
Q

monoclonal paraprotein

A

MM

141
Q

most common bleeding disorder

A

vWD

142
Q

what clotting factor is missing in vWD

A

8

143
Q

PET vs PITT

A

extrinsic vs intrinsic

144
Q

next step if either PT or PTT is long?

A

Thrombin time (TT)

145
Q

what does thrombin time measure

A

conversion of fibrinogen to fibrin

146
Q

thrombocytopenia, post viral infection, autoimmune IgG disorder

A

ACUTE immune thrombocytopenia purpura (ITP)

147
Q

thrombocytopenia more common in females, associated with HIV, autoimmune and hep C

A

CHRONIC immune thrombocytopenia purpura

148
Q

Rare but fatal thrombocytopenia associated with HIV, pregnancy, and anti-clotting drugs

A

TTP

149
Q

thrombocytopenia that causes hemorrhage in pt w/ severe illness, sepsis, burns, and cancer

A

DIC

150
Q

thrombocytopenia similar to TTP, but found in children with toxicgenic e.coli

A

HUS

151
Q

if platelet count is below 50,000 symptoms include?

A

petecitea, purpura, bleeding gums

152
Q

Will PT/PTT be normal or abnormal in TTP, HUS, DIC and HIT

A

abnormal in DIC and HIT

153
Q

tx for HIT

A

stop heparin

154
Q

tx for TTP

A

FFP and plasma exchange, no platelets

155
Q

tx for HUS

A

support, no platelets

156
Q

tx for DIC

A

FFP cryo platelets

157
Q

dx study for TTP

A

autoantibodies against ADAMTS 13 lead to excessive platelet aggregation

158
Q

dx for HIT

A

ELISA is positive, PF4 heparin antibody enzyme

159
Q

tx for ITP

A

support, steroids or take out spleen

160
Q

what is more common acquired or congenital platelet dysfunction

A

acquired, due to aspirin and NSAIDS

161
Q

test for platelet function

A

platelet function testing (PFT) problems even though the platelet number is normal

162
Q

dx test for vWD

A

PT is normal and PTT may be prolonged & PFA prolonged, factor VIII is low, vWD is low

163
Q

abnormal pt and ptt

A

got to think DIC

164
Q

tx for vWD

A

desmopressin (DDAVP) nasal spray for prevention before procedures and Factor VIII concentrates

165
Q

is PTT or PT increased with hemophilia A

A

PTT, everything else is normal

166
Q

what is more common hemophila A or B

A

A

167
Q

most common acquired cause of inability to clot?

A

Vitamin K deficiency

168
Q

what studies are prolonged in Vit K deficiency?

A

PT and PTT, vita K level and factors II, VII, IX, and X (2.7,9,10)

169
Q

is Hyperhomocysteinemia venous of arterial

A

arterial

170
Q

What is the best treatment for hemophilia A?

A

Factor 8

171
Q

Which of the following thrombophilias may result from B 6 , B 12 , or folate deficiency?

A

Homocysteine is broken down in the body by Vit B 6 , B 12 , and folate. Thus, hyperhomocysteinemia may result from a deficiency in any of these compounds.

172
Q

A 65 year old female presents to your office with an acute onset of gingival bleeding, frequent epistaxis, and fatigue. She denies having night sweats. Physical exam reveals a slight fever, without lymphadenopathy. Complete Blood Count demonstrates WBC 50,000; hemoglobin 8.9; platelets 20,000; and peripheral smear shows myeloblasts. Which of the following findings is consistent with the likely diagnosis?

A

This patient is presenting with acute myeloid leukemia (AML). A CBC will show leukocytosis with anemia/thrombocytopenia. Bone marrow biopsy is the definitive test, which will reveal Auer rods, which is pathognomic for AML.

173
Q

Which of the following signs of metastatic disease is characterized by palpable pelvic nodes on pelvic or rectal exam?

A

Palpable pelvic nodes on pelvic or rectal exam are termed Blumer’s shelf, and may be a sign of metastatic cancer.

174
Q

Which of the following venous thrombophilias may lead to heparin resistance?

A

Can lead to heparin resistance since heparin activates on Antithrombin III.

175
Q

Which of the following is the most common cause of B 12 deficiency?

A

Atrophic gastritis, the autoimmune destruction of gastric parietal cells leads to a lack of intrinsic factor. Vitamin B 12 absorption is dependent on adequate levels of intrinsic factor.

176
Q

what two coag-pathies are people really sick?

A

TTP and DIC

177
Q

Do not give platelets in what 3 coag-pathies

A

TTP, HUS, and HIT

178
Q

the only coag-pathy with true venous and arterial clots?

A

HIT

179
Q

two coag-pathy with hemolytic anemia

A

TTP & HUS

180
Q

what is more serious ITP or TTP

A

TTP (may be CNS findings)

181
Q

what type of leukemia has the exam finding of Spenomegaly

A

CML

182
Q

Antithrombin III deficiency causes clots and is complicated by its possible resistance to _____

A

heparin