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42 Cards in this Set

  • Front
  • Back
vWD inheritance and Tx
– AD
– FFP or cryoprecipitate for major bleeding
– DDAVP in mild
– e-aminocaproic acid in minor procedures
– avoid ASA
Adult ITP Tx
– ovserve if > 50
– then think prednisone (do BM bx to r/o leukemia)
– Rhogam for < 10,000
– platelets if really bad
ALL labs
– LDH and Uric acid are increased
– PAS, TdT, and CALLA are positive
ALL cytogenetics
– Phili and (4,11) are bad
– B is CD 10 (CALLA) 19 and 20
– T is 2, 5, 7
ALL tx
– vincristine, prednisone, daunorubicin, L-asparaginase, cyclophos
– Philadelphia chromosome is bad and needs BMT
– skin and lung infections
– leukostasis
– marrow failure but rarely HSM or LA
AML diagnosis
– Sudan black and myeloperoxidase
– Auer rods
AML cytogenetics
– (8,21) and (15,17) have a good prognosis
– monosomies do not
AML treatment
– Cytarabine and anthracycline
– can do stem cell
– leukopharesis is high white count
– do NOT transfuse if WBC > 50,000
CLL hx
– mainly B’s
– usually Asx but maybe increased infections
– isolated lymphocytosis (RBC’s and platelets normal) up to > 100,000
– smudge cells
– cytogenetics shows CD 19 and 5
– hypogammaglobulinemia in more advanced
– low platelets is a bad sign
CLL chemo
– Fludarabine, unless AIHA then give Rituximab
– Chlorambucil in older pts
CLL complications
– AIHA and thrombocytopenia treated w/ prednisone and splenectomy
– Richter’s syndrome is transformation into large cell lymphoma
CML hx
- 3 phases
– chronic is increase WBCs w/ HSM
– Accerlated is decreased RBCs and platelets w/ systemic signs
– blast phase is > 20% blasts in BM
CML dx
– usually Philadelphia
– WBC > 150,000
– decreased LAP
CML treatment
– Gleevec
– IFN-a
– Hydroxyurea if they cant tolerate
– BMT if < 60 and no response to gleevec after 6 months
Multiple Myeloma treatment
– Thalidomide
– if refractory, do alkylating agent (melphalan or cyclo) plus prednisone or VAD (vincristine, doxorubicin, dexamethasone)
Non-Hodgkins tx
– cytoxan, adriamycin, oncovin (vincris), prednisone
Hodgkins Tx
– adriamycin, bleomycin, vincristine, dacarbazine
Normocytic anemia causes
– uremia
– hypothyroid
– bone marrow failure
Burr Cell
– seen in ARF or uremia
Heinz Body
– Thalasemia, SS, G6PD
What kind of anemia does B6 deficiency cause?
– sideroblastic w/ increased TIBC and iron
- HUS is dialysis if ARF
– TTP is plasmapheresis w/ steroids, ASA and splenectomy
– DIC is platelets and cryoprecipitate
Cooley’s anemia tx
– B-thal
– transfusion, splenectomy, BMT
– deforxamine to increase iron excretion
Polycythemia vera Tx
– phlebotomy
– hydroxyurea for myelosupression
– can transform to CML, AML, or myelofibrosis
Acute vs. Chronic GVHD
– pruritic maculopapular rash w/ HSM and diarrhea before 100 days
– keratoconjunctivitis sicca and lichenoid changes of cheek after 100 days
– cyclosporine
– tacrolimus
– methotrexate
Turcot’s syndrome
– brain tumors w/ HNPCC or FAP
Gardner’s syndrome
– polyps w/ desmoid tymors, cysts, lipomas, osteomas
Cronkite-Canada syndrome
– polyps w/ ectodermal problems
Cowden’s syndrome
– polyps w/ breast and thyroid cancers
– gingival hyperplasia
Maltoma w/out mets Tx
– just eradicate H. pylori
Bernard Soulier
– Giant platetes w/ mild thrombocytopenia
– won’t aggregate w/ ristocetin but normal vWF
Glanzmann’s thromboblasthenia
– normal count but qualitiatve problems
– abnormal ADP agglutination
What tumors don’t go to the brain
– skin cancer that’s not melanoma
– prostate
– esophageal
– OP cancer
Acute cord compression from cancer mets
– give steroids immediately
Cancer anorexia tx
– megestrol acetate
Febrile neutropenia tx
– blood culture and ceftazadine of cefepime
Fanconi’s anemia
– chromosomal breaks lead to macrocytic anemia
– fatigue and pounding ears
– poor growth and hypopigmented spots
– do stem cell Tx
Hairy cell staining and Tx
– TRAP + and treat w/ cladribine
Paroxysmal Nocturnal Hemogolbinuria
– membrane defect -> increased binding of compliment and hemolysis w/ hypoventilation at night
– can get hepatic vein thrombosis