Hematology Most Common

Front 1

MCC of anemia in the world

Back 1

Iron deficiency

Front 2

Pt presents with cheilitis, PICA, brittle nails, koilonychia, smooth tongue and formation of esophageal webs (Plummer-Vinson syndrome).

DX?

Back 2

Fe deficiency anemia

Front 3

Most reliable lab value to DX Fe def anemia?

TX?

Back 3

Plasma ferritin is LOW

TX with PO ferrous sulfate

Front 4

This type of anemia is found in persons of Southeast Asia and Chinese origin?

This type of anemia is found in Mediterranean populations?

Back 4

alpha-Thalassemia

beta--Thalassemia

Front 5

What lab values tell you it is Thalassemia instead of Fe deficiency anemia?

How is DX confirmed?

Back 5

Ferritin levels are normal in Thalassemia, and low in Fe def

DX by hemoglobin electrophoresis

Front 6

Chronic alcoholism or lead poisoning are two causes of this acquired anemia?

What do you see on blood smear that confirms its lead poisoning?

Back 6

Sideroblastic anemia

Basophilic stippling of red cells

Front 7

Lab values seen in Anemia of chronic dz:
ferritin?
serum Fe?
TIBC?

Back 7

-Normal ferritin
-Decreased serum Fe
-Decreased TIBC

Front 8

What is the hallmark of aplastic anemia?

Back 8

Pancytopenia

and bone marrow is hypocellular

Front 9

Macrocytic anemia is due to ___ or ___

Back 9

Folic acid deficiency

Vit B12 deficiency

Front 10

An alcoholic pt presents with sore tongue (glossitis), vague GI symptoms.
Blood smear shows macro-ovalocytes, hypersegmented PMN's, and Howell-Jolly bodies.

DX?
TX?

Back 10

Folic acid deficiency anemia

Oral folic acid

Front 11

MCC of Vit B12 deficiency

Back 11

Pernicious anemia, which is lack of IF (intrinsic factor)

B12 must be bound to IF to be absorbed. Not enough IF leads to B12 def

Front 12

Pt presents with glossitis, vague GI symptoms, stocking-glove paresthesias, gait disturbances, decreased position and vibratory sense.
Blood smear shows macrocytic anemia with hypersegmented neutrophils.

DX?
TX?

Back 12

Vit B12 deficiency anemia

TX with B12 supplements

Front 13

Why is it important to always check both folate and B12 levels in megaloblastic anemia?

Back 13

If you Tx a pt for folate def (when they really have B12 def), the anemia will correct itself but the neuropathy will progress and become permanent

Front 14

Intrinsic causes for hemolytic anemia.
How are they acquired?

Back 14

G6PD deficiency (X-linked recessive)

Spherocytosis (Autosomal dominant)

Sickle cell anemia (Autosomal recessive)

Front 15

Peripheral smears shows bite cells or Heinz bodies.

DX?

Back 15

G6PD deficiency

Front 16

Pt presents with splenomegaly, generalized pruritis after bathing, HA, tinnitus, blurred vision.

DX?
TX?

Back 16

Polycythemia vera

Phlebotomy

Front 17

80% of all leukemias in childhood, 3-7yo presents with gingival bleeding, epistaxis, menorrhagia, fatigue, abrupt onset of fever, lethargy, HA and bone/joint pain. WBCs 180,000 with 90% of them lymphoblasts

DX?

Back 17

ALL

Acute lymphocytic Leukemia

Front 18

What is the hallmark of acute leukemia?

Back 18

Pancytopenia with circulating blasts.
Blasts make up at least 20% of nucleated cells in bone marrow

Front 19

Pt (~60yo) presents with acute onset of bleeding (epistaxis, gingiva), bone/joint pain, purpura/petechiae.
WBCs are super high, >20% are blasts and (+) Auer rods.

DX?

Back 19

AML

Acute Myelogenous Leukemia

Front 20

55yo pt presents with fatigue, anorexia, wt loss, low grade fever, excessive sweating, splenomegaly. Can present with a "blast crisis"
Increased WBCs (>150,000) with a L shift and mainly mature cells. (+) Philadelphia chromosome.

DX?

Back 20

CML

Chronic Myelogenous Leukemia

Front 21

~60yo pt presents with few complaints, but has recurrent infections, splenomegaly.
Labs show WBCs >20,000 (leukocytosis) with an isolated lymphocytosis (98% are lymphs). Smudge cells are also seen

DX?

Back 21

CLL

Chronic Lymphocytic Leukemia

Front 22

Pt presents with fever, night sweats, wt loss, pruritis, fatigue, and painless cervical supraclavicular and mediastinal lymphadenopathy. Reed-Sternberg cells present on LN biopsy.

DX?

Back 22

Hodgkin's Lymphoma

TX with combination chemo

Front 23

Pt presents with diffuse painless lymphadenopathy, wt loss, night sweats, CBC is normal.

DX?

Back 23

Non-Hodgkin's Lymphoma

Front 24

>65yo presents with bone pain, renal failure, spinal cord compression, bone fractures.
"Punched out" (lytic) lesions are seen on skull xray; a monoclonal spike is seen on serum electrophoresis; 10% plasma cells in BM; and a (+) Bence Jones Protein in 24hr urine.

DX?

Back 24

Multiple Myeloma

Front 25

This condition is self-limited, usually mild, occurs after a viral URI. Abrupt appearance of petechiae, purpura, and hemorrhagic bullae on skin and mucous membranes. May c/o epistaxis, oral bleeding, menorrhagia.
Coag studies are normal, platelets are decreased (10,000-20,000)

DX?

Back 25

Acute ITP

Idiopathic Thrombocytopenic Purpura

Front 26

20-50yo, acutely ill, febrile, purpura, petechiae, epistaxis, HA aphasia, AMS. Microangiopathic hemolytic anemia, red cell fragments, (+) schistocytes, severe thrombocytopenia, normal coag panal.

DX?

Back 26

TTP

Thrombotic Thrombocytopenic Purpura

Front 27

Condition found primarly in children with similar symptoms of TTP but pt has acute renal failure and a recent infection with E. coli. Normal coag panal, microangiopathic hemolytic anemia, thrombocytopenia

DX?

Back 27

HUS

Hemolytic-Uremic Syndrome

Front 28

This condition is always precipitated by a serious illness, have skin/mucous membrane continuous bleeding, shock, and thrombosis, all coag labs are abnormal.
Low platelets, increased PT, INR, +fibrin split products (increased D-dimer).

DX?

Back 28

DIC

Disseminated Intravascular Coagulation

Front 29

Problem in Von Willebrand's Disease?
Acquired how?

Symptoms?
TX?

Back 29

Deficient vWF factor, which leads to decreased levels of Factor VIII
Autosomal dominant

bleeding gums, epistaxis, menorrhagia
Increased BT

TX with desmopressin for mild dz; Factor VIII 2nd line

Front 30

Problem in Hemophilia A?

Passed on how?

Symptoms?
TX?

Back 30

Factor VIII deficiency

X-linked recessive

Repeated spontaneous hemorrhagic episodes WITH hemarthroses

PTT is increased, F VIII is decreased
TX with factor VIII concentrates

Front 31

Problem in Hemophilia B?

Passed on how?

Back 31

Factor IX deficiency (Christmas disease)

X-linked recessive

Front 32

Factor XI deficiency-

passed on how?
what types of people get it?
TX?

Back 32

autosomal recessive

Ashkenazi Jews

TX with FFP

Front 33

What is used to reverse the effects of Warfarin?

Back 33

Vitamin K

Front 34

Vit K deficiency seen in what kinds of pts?

Back 34

Malnurished pts, post-op, chronic antibiotic use

Front 35

MC congenital cause of thrombosis?

Back 35

Factor V Leiden

Front 36

PT/INR monitors which clotting pathway?

PT/INR is increased by administration of what?

Back 36

Extrinsic pathway

Warfarin

Front 37

PTT monitors which clotting pathway?

PTT is increased by administration of what?

Back 37

Intrinsic pathway

Heparin

Front 38

Bleeding time is an indication of what?

BT can be increased by administration of what?

Back 38

Platelet function

ASA

Front 39

Hair-like cytoplasmic projections on lymphocytes

DX?

Back 39

Hairy cell Leukemia

Front 40

Spontaneous hemarthroses

Back 40

Hemophilia

Front 41

What drugs, when given to a G6PD deficient pt, causes an acute massive hemolysis?

Back 41

-Anti-malarials (quinidine, hydroxychloroquine)
-Sulfa drugs
-Nitrofurantoin (MacroBid)