Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
20 Cards in this Set
- Front
- Back
|
101. Paroxysmal nocturnal hemoglobinuria presentation?
|
a. Presents with pancytopenia and recurrent episodes of dark urine, particularly in the morning.
b. The most common cause of death is large vessel Venus thrombosis, such as portal vein thrombosis. |
|
|
102. Into what two conditions can PNH transform?
|
a. Aplastic anemia
b. acute myelogenous leukemia (AML). |
|
|
103. Most accurate diagnostic test for paroxysmal nocturnal hemoglobinuria?
|
a. CD 55 and CD 59 antibody (also known as decay accelerating factor).
b. These screening tests that are NOT accurate: the sugar water chest and Ham's test. These tests are for the activation of complement, which leads to hemolysis. |
|
|
104. Treatment of PNH?
|
a. Glucocorticoids, such as prednisone ( best initial treatment)
b. transfusion dependent patients with severe illness are treated with Eculizumab. |
|
|
105. A pregnant woman comes with weakness and elevated liver function tests.she's in her 35th week of pregnancy. The prothrombin time is normal. The smear of blood shows fragmented red cells. Platelet count is low. What is the treatment?
a. Transfuse platelets b. plasmapheresis c. fresh frozen plasma d. delivery of the baby e. . Prednisone |
1. answer: D- delivery of the baby with the HELLP syndrome. HELLP syndrome stands for hemolysis, elevated liver function tests, and low platelets.
2. This disorder is idiopathic and can be distinguished from DIC by the normal coagulation studies such as the prothrombin time and aPTT. |
|
|
106. Presentation of methemoglobinanemia?
|
a. The key to recognizing this condition is that the patient presents with shortness of breath, for no clear reason with clear lungs on exam and a normal chest x-ray.
b. methemoglobinanemia is blood locked up in an oxidized state that cannot pick up oxygen. c. Look for exposure to drugs, such as nitroglycerin, amyl nitrate, nitroprusside, dapsone, or any of the Anesthetic Drugs that end in -caine (e.g., lidocaine, buvicaine, tetracaine). d. Methemoglobinanemia can occur with a little exposure as to a topical anesthetic administered to a mucous membrane. e. Look for brown blood in the case description! |
|
|
107. Treatment of methemoglobinanemia?
|
a. Methylene blue.
|
|
|
108. Mechanism of action of Eculizumab?
|
a. Inhibits C-5 and prevents complement activation.
b. PNH is treated with Eculizumab. |
|
|
109. Match the most likely diagnosis with each of tThefollowing cases:
|
a. ABO incompatibility
b. Transfusion-related Acute Lung Injury (TRALI) or “leukoagglutination reaction”. c. Urticarial reaction d. IgA deficiency e. febrile non-hemolytic reaction f. minor blood group incompatibility |
|
|
110. Case one: 20 minutes after a patient receives a blood transfusion, the patient becomes shorter breath. There are transient infiltrates on the chest x-ray. All symptoms resolve spontaneously
|
a. Answer: Transfusion-related Acute Lung Injury (TRALI) or “leukoagglutination reaction”. TRALI presents with acute shortness of breath from anybody's in the donor blood against recipient, white cells. There is no treatment, and a resolve spontaneously.
|
|
|
111. Case two: as soon as a patient receives a transfusion, he becomes hypotensive, short breath, and tachycardic. The LDH and bilirubin levels are normal.
|
a. Answer-IgA deficiency. IGA deficiency presents with anaphylaxis. In the future, use blood donations from an IGA deficient donor or washed red cells.
|
|
|
112. Case three: during a transfusion, patient becomes hypotensive and tachycardic. She has back and chest pain, and there is dark urine. The LdH and bilirubin are elevated, and the haptoglobin level is low.
|
a. Answer: ABO incompatibility. ABO incompatibility presents with acute symptoms of hemolysis of the transfusion is occurring.
|
|
|
113. Case Four: a few days after a transfusion, a patient becomes jaundiced. The hematocrit does not rise with transfusion and he is generally without symptoms.
|
a. Answer: the minor blood group incompatibility to Kell, Dufffy, Lewis, or KIDD antigens or Rh incompatibility presents with delayed jaundice. There is no specific therapy.
|
|
|
114. Case Five:A few hours after a transfusion, a patient becomes febrile with a rise in temperature of about 1°. There is no evidence of hemolysis.
|
a. Answer: E- febrile nonhemolytic reactions result in a small rise in temperature. They need no therapy. They are prevented by using filtered blood transfusions in the future to remove the white cell antigens.
|
|
|
115. Presentation of acute leukemia?
|
a. Presents with signs of pancytopenia, such as fatigue, bleeding, and infections from white cells that don't work.
b. Patients have a functional immunodeficiency. |
|
|
116. Best initial test for leukemia?
|
a. Peripheral smear showing blasts.
|
|
|
117. What is the most important prognostic finding in acute leukemia?
|
a. Cytogenetic abnormalities, such as specific karyotypic abnormalities.
b. Cytogenetics tell who will relapse. c. If the patientis a high risk for relapse after chemotherapy, bone marrow transplantation should be performed as soon as chemotherapy induces remission. |
|
|
118. Treatment of leukemia (AML)?
|
a. Chemotherapy with:
1. Idarubicin (or daunorubicin) and 2. cytosine arabinoside. |
|
|
119. What should be added for the treatment of M3 ( acute Promyelocytic) leukemia?
|
a. All trans retinoic acid (ATRA).
|
|
|
120. What should be added for the treatment of acute lymphocytic leukemia (ALL)?
|
a. Intrathecal methotrexate.
|
