Term
| What labratory tests should be ordered for anemic pts? |
|
Definition
| CBC, MCV, blood smear, reticulocyte count |
|
|
Term
| What type of blood matching tests should be ordered for pts with significant bleeds? |
|
Definition
|
|
Term
| Anemias with MCV values below 70 are of what to types? |
|
Definition
| Thalassemia or iron-deficiency |
|
|
Term
| What vales of serum ferritin suggest iron-deficiency anemia? |
|
Definition
|
|
Term
| Alpha-thalassemia is common to what two ethnic groups? |
|
Definition
| Asians and African-Americans |
|
|
Term
| Beta-thalasseemia (In addition to being in Asians and African-Americans) is more common in what ethnic group? |
|
Definition
|
|
Term
| What are the TICS (mneumonic) for causes of microcytic anemia? |
|
Definition
Thalassemia
Iron deficiency
Chronic disease
Sideroblastic anemia |
|
|
Term
| Which two types of anemia are considered for MCV less than 70? |
|
Definition
iron-deficiency
thalasesemia |
|
|
Term
|
Definition
| prenatal form of third-spacing as a result of heart failure |
|
|
Term
| A fetus with four alleles of alpha-thalassemia results in what? |
|
Definition
| hydrops fetalis (abortion, or still born) |
|
|
Term
| How do pts with only one or two alleles for alpha-thalessemia present clinically? |
|
Definition
|
|
Term
| How is beta-thalassemia major diagnosed? |
|
Definition
|
|
Term
| How is beta-thalassemia minor diagnosed? |
|
Definition
| increased HbA2 by gel electrphoresis |
|
|
Term
| What treatment is used in the cause of transfusion overload? |
|
Definition
| iron chelator (deferoxamine) |
|
|
Term
| With MCV values over 110 what are the two most likely causes? |
|
Definition
Vit B12 deficiency
folate deficiency
|
|
|
Term
| What are the CBC, RDW, and RBC characteristics of the thalassemias? |
|
Definition
CBC is microcytic
RDW is normal
RBC is increased |
|
|
Term
| What treatments are viable for thalassemia pts? |
|
Definition
| allogenic bone marrow transplant with folate supplementation |
|
|
Term
| What is the Schilling test in hematology? |
|
Definition
| study combining IM and oral B12 supplementation to determine cause of megaloblastic anemia |
|
|
Term
| What role does intrinsic factor play in anemia? |
|
Definition
| produced by parietal cells of stomach to facilitate B12 absorption (pts with megaloblastic anemia should be tested for intrinsic factor antibody) |
|
|
Term
| When is methylmalonic acid used in the evaluation of anemia? |
|
Definition
| to help determine if megaloblastic anemia is due to B12 deficiency |
|
|
Term
| How should B12 deficiency be treat? How about folate deficiency? |
|
Definition
Monthly injections
folate is supplemented orally |
|
|
Term
| What autoimmune test is negative in cases of hereditary spherocytosis? |
|
Definition
|
|
Term
| When should cold agglutinin antibodies be tested for? |
|
Definition
| in pts with evidence of hemolysis without other explanations |
|
|
Term
| What drug class is particularly well known to cause a hemolytic episode in G6PD pts? |
|
Definition
|
|
Term
| Descrube G6PD levels in G6PD deficient pts both in a hemolytic crisis and when there is no hemolytic crisis? |
|
Definition
Hemolysis: lvls may appear normal
non-hemolysis situation: lvls are low/depleted |
|
|
Term
| How is paroxysmal nocturnal hemoglobinuria diagnosed? |
|
Definition
|
|
Term
| What is different about the genetics of paroxysmal nocturnal hemoglobinuria? |
|
Definition
| it's an acquired genetic mutation rather than inheritted |
|
|
Term
| What is the treatment of choice for pts with hereditary sherocytosis? |
|
Definition
|
|
Term
| What are the three characteristics of hemolytic uremic syndrome? |
|
Definition
hemolysis
renal failure
thrombocytopenia |
|
|
Term
| What are the five characteristics of thrombotic thrombocytopenic purpura? |
|
Definition
HUS (hemolysis, renal failure, thrombocytopenia)
fever
fluctuating neurologic sings |
|
|
Term
| What type of bodies are seen in pts with sickle cell anemia? |
|
Definition
|
|
Term
| Which three vaccinations should all sickle cell pts receive? |
|
Definition
Strep pneumoniae
H. influenzae
HBV |
|
|
Term
| What is the role of hydroxurea in managing sickle cell disease? |
|
Definition
| serves to decrease number and severity of sickle crisis and increases circulating fetal hemoglobin |
|
|
Term
| A pt presenting to the ER in sickle crisis should have what three factors attended immediately? |
|
Definition
hydration
analgesia
supplemental oxygen |
|
|
Term
| What virus is well known to cause aplastic crisis in sickle cell pts? |
|
Definition
Parvovirus B19
support with transfusions |
|
|
Term
| Which antibiotics are commonly used in the treatment of sickle cell pts with suspicion of infection? |
|
Definition
| 2nd gen cephalosporin plus erythromycin |
|
|
Term
| What are the four big infections common to sickle cell pts? |
|
Definition
Strep pneumoneae
H. influenzae
Neisseria meningitidis
Gram-neg bugs |
|
|
Term
| What is the classic age group for polycythemia vera? |
|
Definition
|
|
Term
|
Definition
| large retinal veins on funduscopy |
|
|
Term
| What hormone can be evaluated to differentiated secondary erythrocytosis from polycythemia vera? |
|
Definition
| erythropoietin (which is low in PCV with elevated RBC and hematocrit) |
|
|
Term
| Once polycythemia vera is suspected what is done to clench diagnosis? |
|
Definition
|
|
Term
| What part of blood should be suspected of being deficient when petechiae are present? |
|
Definition
|
|
Term
| What are the three components of DIC blood profile? |
|
Definition
D-dimer
fibrinogen
blood smear |
|
|
Term
| What serum protein is deficient in a pt with an extended thrombin time? |
|
Definition
|
|
Term
| Bleeding time measures what? |
|
Definition
|
|
Term
| How is bleeding clinically different in platelet disorders vs. coagulopathies? |
|
Definition
platelet: excessive, prolonged bleeding which is immediately apparant
coagulopathy: slightly increased time for bleed, late bleed after trauma or surgery |
|
|
Term
| Which type of thrombocytopenia is due to acutely formed platelet-associated IgG antibodies? |
|
Definition
| ideopathic thrombocytopenic purpura |
|
|
Term
| What labs are ordered for a supposed case of DIC? |
|
Definition
PT (sig. prolonged)
PTT (sig. prolonged)
D-dimer (elevated)
fibrinogen (low) |
|
|
Term
| How many days after initiating heparin does heparin-induced thrombocytopenia usually manifest? |
|
Definition
|
|
Term
| What antibody is measure to make the diagnosis of heparin-induced thrombocytopenia? |
|
Definition
|
|
Term
| What lab should be ordered to diagnose the most common inherited bleeding disorder (hemophilia)? |
|
Definition
|
|
Term
| Blood factor II is known by what other name? |
|
Definition
|
|
Term
| Which factors are in the common pathway? |
|
Definition
|
|
Term
| When should labs be ordered to assess factors II, V, and X? |
|
Definition
| When coagulopathy is present and both PT and PTT are elevated without evidence of heparin use, DIC, liver disease, or Vit K deficiency |
|
|
Term
| Which factor is deficient in hemophilia B? |
|
Definition
|
|
Term
| What disease is the most common inheritable hypercoagulable disorder? |
|
Definition
| Factor V Leiden deficiency (in which factor V cannot be inactivated by protein C) |
|
|
Term
| How long should heparin be continued after initiating anticoagulation treatment? |
|
Definition
| until INR reaches therapeutic levels (usually 3-5 days) |
|
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