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71 Cards in this Set
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- Back
- 3rd side (hint)
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O2 content eqn
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Hb + PO2
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chronic adjustments to hypoxia made by the body
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skeletal muscle inc mitochondria
secrete EPO clubbing |
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when will someone become cyanotic?
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when 5g of Hb are FULLY desaturated
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who's more likely to appear cyanotic - anemic or polycythemic?
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polycythemic
why? |
b/c the body can allow 5g of Hb to be desaturated since it has so much available
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what causes a low reticulocyte count?
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something wrong in the bone marrow - something missing or it's suppressed
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what causes a high reticulocyte count?
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hemolytic anemia - something wrong in the periphery
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MCC of extravascular hemolysis
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autoimmune
what test to run? |
coombs
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drugs that cuase extravascular hemolysis
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penicillins
cephalosporins sulfa drugs dapsone alpha methyl dopa PTU HIPPPE drugs |
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issue associated with HAMS test
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Paroxysmal nocturnal hemoglobinuria
problem? |
RBCs sensitive to hemolysis by acidosis
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issue associated w/ osmotic fragility test?
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hereditary spherocytosis
problem? |
spectrin defect
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only anemia that's microcytic hyperchromic
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hereditary spherocytosis
test? |
osmotic fragility
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2 anemias that are autosomal dominant
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hereditary elliptocytosis
hereditary spherocytosis |
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what does it mean if the reticulocyte count is >1%
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BM is being revved up - problem in the periphery
what if it's low? |
BM not working - problem is there
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type of bld cell you'll see w/ a vasculitis
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schistocyte
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reasons for a tear drop cell
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squeezed out by BM - can be due to hemolytic anemia or cancer of the bone marrow
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issue with a heinz body?
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G6PD deficiency
what causes heinz body? |
protein precipitated on the side
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issue w/ basophilic stippling
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lead poisoning
what causes the stippling? |
many proteins precipitated
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what are acanthocytes?
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RBCs coated w/ fat
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what are howell jolly bodies?
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nuclear remnants left in the RBC
reason for them? |
BM isn't working or the spleen isn't working
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what is anisocytosis or poikylocytosis?
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aniso = diff cell sizes
poikylo = diff cell shapes reasons for these? |
2 anemias or 1 anemia that's been treated before and so is in diff stages
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causes of microcytic hypochromic anemias (6 of em)
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iron deficiency
late chronic dz lead poisoning thallessemia hemoglobinopathies sideroblastic anemias |
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MCC of iron deficiency anemia
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poor intake
treatment? |
ferrous sulfate
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what will be the labs of iron deficiency anemia?
(total iron, ferritin, saturation, TIBC) |
total iron decr
ferritin decr saturation decr TIBC inc |
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4 kinds of normocytic normochromic anemias
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acute hemorrhage
early chronic dz renal faiulre hypothyroidism (early) |
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at what day do reticulocytes show up?
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day 4
at what day do they peak? |
day 7
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7 causes of macrocytic anemias
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B12 def
folate def severe hypothyoidism reticulocytosis alcohol chemo drugs anticonvulsants |
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MCC B12 deficiency
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pernicious anemia
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MCC folate deficiency
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overcooked veggies
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MOA of phenytoin
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blocks folate
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MOA of ethosuximide
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blocks Ca++ so blocks nuclear division
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MOA of valproic acid
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blocks Ca++ and folate
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MOA of carbamezapine?
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blocks Ca++
side effect? |
agranulocytosis
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by when does HbF disappear?
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6 months
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when can sickle cell crisis begin
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6 months
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when does erythropoiesis begin?
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4 mo gestation
where? |
yolk sac
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what places does erythropoiesis occur?
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yolk sac
liver, spleen, flat bones long bones at what ages? |
yolk sac: 4 mo gestation
liver, spleen, flat bones: 6 mo gestation long bones: 8 mo gestation |
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what does it mean if a child has MASSIVE splenomegaly
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the bone marrow has stopped working and the spleen now has to take over
what else will you see? |
teardrop cells because of myelofibrosis
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what is methemoglobinemia?
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Fe that is now 3+ instead of 2+
MCC causes? |
virus
sulfa drugs (antimalarials, metronidazole, INH) |
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MCC iron deficiency anemia in ppl 20-40?
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IBD
>40? |
mucosal bleeding
female = endometrium male = GI |
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which enz does lead inhibit?
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delta ALA dehydratase
MCC ? |
old buildings
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MCC mental retardation?
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Fetal alcohol syndrome
fragile X Down's syndrome |
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normal lead levels?
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<10
What to do if >10, >30, >50? |
>10: notify health dept - Rx w/ succimer
>30: notify health dept - hospitalize - do CaEDTA challenge - Rx w/ penicillamine and dimercaprol >50: same, but w/o EDTA challenge |
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MC porphyria
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acute intermittent porphyria
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recurrent severe abdominal pain and neuropathy (anything neurological)
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acute intermittent porphyria
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every time pt goes outside they get burned - problem?
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prophyria cutanea tarda
MCC death? |
skin infection
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MC reason for attack of acute intermittent porphyria?
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stress
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amino acid change in sickle cell
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glutamate to valine - goes from charged to uncharged
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4 things involved in vaso occlusive crises of SCD
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CVA
pulmonary infection splenic sequestration priapism RX? |
O2
exchange transfusion |
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MCC aplastic crisis in SCD
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parvo B19
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by when is a pt's spleen removed when have SCD
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6 y/o
consequence of that? |
susceptible to infections from encapsulated organisms
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MCC crisis in SCD
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infection
MC organism? |
S. pneumonia
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usually healthy patient comes in b/c of painless hematuria after being on a plane - sometimes it happens when it's smoky - dx?
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sickle cell trait
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substituting lysine for glutamate - dx?
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Hb C dz
sickling? |
no - both are charged
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when will a person become symptomatic if has alpha minor thalessemia?
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when has at least 2 genes missing and is active or has 3 genes missing
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baby dies in utero due to heart failure - huge bag of water - problem?
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hydrop fetalis - couldn't make any hemoglobin at all = alpha thalassemia major
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inc HbA2 and HbF - dx?
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beta thalessemia minor
problem? when will symptoms appear? |
problem: ineffective EPO
symptoms when active |
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previously healthy baby comes in at 6 mo b/c face is starting to look extra fat - see spikes on skull on x-ray - dx?
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beta thalassemia major
rx? |
transfusions!
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big forehead, wide sternum, painful bones - dx?
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cooley's anemia
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when do you do bld transfusions?
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when patient is symptomatic, no matter the level of anemia
6 types? |
whoe bld
packed RBC FFP cryoprecipitate DDAVP IgG albumin |
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pt comes in after severe car accident and needs bld - what kind of transfusion?
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whole RBC
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SCD pt comes in needing transfusion - what kind?
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packed RBC
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pt on warfarin comes in bleeding all over the floor - what kind of transfusion to stop bleeding immediately?
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FFP
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types of pts to give cryoprecipiate
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hemophilia A (as factor 8)
vWF dz (has vWF) DIC (has fibrinogen) |
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mild bleeding hemophilia A or vWF dz - what can you give?
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DDAVP
what else is this used for? |
severe bedwetting
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see slight color on the skin - liver has spots on biopsy - heart is having problems beating - pt also has painful joints - dx?
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hemochromatosis
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type of hemochromatosis due to genetics?
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primary
what's the genetic issue and the consequence? |
genetic = HLA A3
consequence = inc iron absorption in the duodenum |
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MCC death in first 10 yrs of 2ry hemochromatosis
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transfusion related infections
after 10 yrs? |
CHF
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pt has flushing and wheezing after transfusion - dx?
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anaphylaxis
cause? Rx? |
selective IgA deficiency
Rx: stop transfusion, then give epi |
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pt has inc fever after transfusion that lasts a few hrs and then goes away - dx?
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febrile rxn
cause? Rx? |
WBC Ags
Rx: acetaminopehen and washed packed RBCs |
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fever and sudden back pain after transfusion - dc?
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ABO incompatibility
rx? |
stop transfusion - retype and cross
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10 transfusion related infections
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HIV
Hep B Hep C Hep D EBV CMV hemorrhagic viruses malaria babesiosis syphilis |
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