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hematology/oncology

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4 causes of microcytic anemia
TICS
thalessemia
iron deficiency
chronic disease
sideroblastic anemia
elderly male with hypochromic, microcytic anemia is asymptomatic
FOBT and sigmoidoscopy - colon ca until proven otherwise
precipitants of hemolytic crisis in patients with G6PD deficiency
sulfonamides, antimalarials, fava beans
most common inherited hemolytic anemia
hereditary spherocytosis
diagnostic test for hereditary spherocytosis
osmotic fragility test
pure rbc aplasia
diamond-blackfan anemia
anemia associated with absent radii and thumbs, diffuse hypopigmentation, café au lait spots, microcephaly, and pancytopenia
fanconi's anemia
medications and viruses that cause aplastic anemia
chloramphenicol, sulphonamides, radiation, HIV, chemo, hepatitis, parvo B19, EBV
how to distinguish polycythemia vera from secondary polycythemia
both have increased hct and rbc mass, but PV should have normal SaO2 and low erythropoietin
TTP pentad
FAT RN
fever
anemia/splenomegaly
TCP
renal failure (acute)
neurologic changes
HUS triad
anemia
TCP
ARF
treatment for TTP
emergent large volume plasmapheresis, corticosteroids and anti-platlet drugs
which of the following oare elevated in DIC: fibrin split products, D-dimer, fibrinogen, platelets, hct
d-dimer and fibrin split products
treatment for ITP in children
usually resolves spontaneously - may require IVIG or steroids
8 y/o boy presents with hemarthrosis, increased PTT with normal PT and BT
Dx? Rx?
hemophilia A or B: consider desmopressin (for hemophilia A) factor VIII or IX supplements
14 y/o girl presents with prolonged bleeding after ddental surgery and with menses, normal PT, normal/increased PTT, increased BT. Dx? Rx?
vWF disease - desmopressing, FFP, or cryoprecipitate
60 y/o African-American male presents with bone pain. w/u for myeloma might reveal...?
monoclonal gammopathy, bence-jones proteinuria, 'punched out' lesions on Xray
reed-sternberg cells
Hodgkin's lymphoma
10 y/o boy presents with fever, wt loss, and night sweats. Exam shows ant. mediatstinal mass. suspected Dx?
NHL
microcytic anemia with decreased serum iron, decreased TIBC, normal/increased ferritin
anemia of chronic disease
microcytic anemia with decreased serum iron, decreased ferritin, increased TIBC
iron defeciency anemia
80 y/o male with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. suspected Dx?
CLL
late, life-threatening complication of CML
blast crisis - bone pain, fever, splenomegaly, and pancytopenia
auer rods on blood smear
AML
AML subtype associated with DIC
M3
electrolyte changes in tumor lysis syndrome
decreased Ca
increased K, PO4, uric acid
treatment for AML M3
retinoic acid
50 y/o male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Dx?
CML
Heinz bodies
intracellular inclusions - thalassemia, G6PD, and post-splenectomy
autosomal-recessive disorder with a defect in GPIIbIIIa platlet receptor and decreased platlet aggregation
Glanzmann's thrombasthenia
virus associated with aplastic anemia in patients with sickle cell anemia?
parvovirus B19
25 y/o African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
O2, analgesia, IV fluids, transfusion if severe
significant cause of morbidity in thalassemia patients. treatment?
Iron overload - deferoxamine

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