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92 Cards in this Set
- Front
- Back
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heparin affects which coag test and which pathway?
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increase PTT, intrinsic pathway
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what test for warfarin and what pathway does it effect?
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increase PT, extrinsic pathway
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name the vitamin-K dependent factors
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II, VII, IX, X
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how is the bleeding time affected with hemophilia A/B versus vWF deficiency?
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normal with hemophilia, increased with vWF deficiency
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what should you give to mild hemophilia A patients prior to surgery?
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desmopressin
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most common bleeding disorder
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von Willebrands Disease
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what does petechiae indicate?
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low platelets
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bleeding into body cavaties or joints indicates what
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clotting factor deficiency
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most common inhereited cause of hypercoaguability
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factor V leiden mutation
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what is the treatment for mild to moderate hypercalcemia with breast cancer?
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bisphosphonates
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what preservatives is blood stored with that chelates with calcium?
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citrates
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what do the citrates in stored blood chelate with in the blood?
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calcium and magnesium
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what is the workup for suspected fibrocystic breast disease?
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aspirate the cyst for cytology, then monitor for 4 weeks
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smoking history + hypercalcemia + hilar mass in lungs = ??
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squamous cell carcinoma of the lungs
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what is HIT syndrome?
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heparin-antibodies activate platelets leading to DIC
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what is the typical rash with rubella?
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rash that starts on the face then moves to the trunk and extremities
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what is the treatment for primary syphilis? and if they are allergic what can you go to?
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penicillin G is first line, if allergic then go to doxycycline ro tetracycline
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what is the testing methods for HIV screening?
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screen with ELISA, then confirm with Western blot
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what causes neurocysticercosis?
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pork worm (Taenia solium)
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what is the rash erythema migrans associted with and how do you treat it?
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Lyme disease, treat with doxycycline
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what causes travellers diarrhea?
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E coli
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what do you see on CSF analysis with viral mengitis?
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pleocytosis with lymphocytic predominance
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what viruses cause viral mengitis?
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usually echovirus or coxsackie
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what do you see on CSF analysis with bacterial meningitis?
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increased cell count, neutrophil predominance, increased protein, decreased glucose
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male adolescent + epistaxis + localized mass + bony erosion = ??
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angiofibroma
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what is the most important prognositc factor for breast cancer?
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TMN staging
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what do you see with CLL?
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smudge cells, fragile leukocytes that break down on smear
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what is the worst prognostic factor with CLL?
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thrombocytopenia
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multiple myeloma results in overproduction of what cells?
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plasma cells
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vomiting + oliguria + solmnolence + hypercalcemia = ?? treatment??
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hypercalcemia crisis, treat with IV-NS
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what is Turcot's syndrome?
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association between brain tumors and FAP/HNPCC; usually medulloblastomas or glioblastomas
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elevated PT/INR + hepatic failure = ??
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likely vitamin K deficiency
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treatment for acute cord compression
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IV steroids
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what syndrome are giant platelets associated with?
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Bernard-Soulier syndrome
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what is MEN type I?
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Zollinger-Ellison syndrome + parathyroid adenoma
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decreased serum iron + decreased % iron saturation + increased TIBC = ??
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iron deficiency anemia
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what is monoclonal gammopathy of undetermined significance (MGUS) shows what on marrow testing?
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M-component (IgA, IgG,IgM) < 3000 and <10% plasma cells in marrow
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what is the treatment for monoclonal gammopathy of undetermined significance (MGUS)?
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reassurance and regular follow up
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Mediterranean descent + microcytic anemia without response to iron treatments you should think of what?
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must rule out beta-Thalassemia
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bone marrow failure + areas of hypopigmentation + congenital anomalies = what genetic disorder and how is it transmitted?
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Fanconi's anemia, autosomal recessive
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what is the initial treatment for a DVT?
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IV heparin
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anti-phospholipid syndrome can cause what test to be false-positive? how do you treat it during pregnancy?
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can cause false-positive for syphilis testing; during pregnancy treat with heparin and ASA
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two main causes of macrovascular hemolysis
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artificial heart valves or severely calicified aortic valves
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first step in treating SIADH
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water restriction
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what is the definitive way to diagnose iron-deficiency anemia?
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bone marrow iron stain
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what is the only cancer that has decreased in incidence over the past several decades?
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stomach cancer
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what does a Howell-Jolly body look like?
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RBCs with a single, round, blue inclusion on Wright stain
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what infection is hemolytic uremic syndrome often preceeded by?
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E coli gastroenteritis
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how do you coags look with HUS?
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normal PT, PTT
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what do you see on coags wtih TTP?
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normal PT/PTT, increased bleeding time
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what do you see on coags with DIC?
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increased PT/PTT, increased bleeding time
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sickle-cell disease affects which hemoglobin chain?
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beta-chain
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what is a thalssemia?
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a decrease in quantity of the alpha or beta-chains
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porphyria results from what?
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defect in heme synthesis
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most common cause of transfusion reactions
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ABO incompatibility due to clerical error
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elderly + anemia + renal failure + hypercalemia = ???
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multiple myeloma
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iron-deficiency anemia + fatty stools = what is the likely cause?
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malabsorption
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what is G6PD and what triggers hemolysis?
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x-linked disease that leads to hemolysis secondary to oxidative stress; most commonly induced by drugs or fava beans
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what is the most deadly cancer in men? women?
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lung cancer is the most deadly cancer in both men and women
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what do you see with iron-deficiency anemia for the following: TIBC, serum iron, serum ferritin, RDW, RI, MCV, % saturation, electrophoresis
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increased TIBC
decreased serum iron decreased ferritin increased RDW decreased RI decreased MCV decreased % sat negative electrophoresis |
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what do you see with anemia of chronic disease for the following: TIBC, serum iron, serum ferritin, RDW, RI, MCV, % saturation, electrophoresis
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decreased MCV
decreased serum inron decreased TIBC decreased % sat increased ferritin normal RDW normal electrophoresis |
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what do you see with Thalssemia anemia for the following: TIBC, serum iron, serum ferritin, RDW, RI, MCV, % saturation, electrophoresis
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decreased MCV
normal serum iron, TIBC, % sat, ferritin, RDW abnormal electrophoesis only with beta-thalssemia |
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how does a vitamin C deficiency initially present?
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often presents with gums that bleed easily; must suspect it in someone that is on a hot dog/soda or tea/toast diet
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what is a Rouleax formation and what is it a sign of?
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indicates a stacking of red blood cells in lab testing
a sign of Waldenstroms macroglobulinemia or multiple myeloma |
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name that classes of hypovolemic shock and at what point you usually need to consider transfusion
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Class I = 10-15% loss, <800mL, no change in pressure/pulse
Class II = 15-35% loss, 800-1500mL loss, pulse >100, drop in BP, delayed capillary refill Class III = 30-40% loss, 1500-2000mL loss, pulse >120, likely needs transfusion at this point Class IV = >40% loss, >2000mL loss, pulse >140 |
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how does hereditary hemochromatosis present? how does it affect the transferrin saturation?
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presents as diabetes, skin hyperpigmentation, cirrhosis of liver; elevated transferrin saturation
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what is ceruloplasmin used to diagnose?
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Wilsons disease
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name the leukemia type by age
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ALL = children
AML = 20-40 CML = 40-60 CLL = 65+ |
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best method for widespread screening for ovarian cancer
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pelvic exam
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what are the current prostate screening guidelines?
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DRE and PSA for all men yearly starting at age 50
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how does pernicious anemia present?
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chronic gastritis and low vitamin B12
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what imaging should you get and what must you rule out in a patient with hemochromatosis and liver cirrhosis?
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abdominal CT to rule out hepatocellular carcinoma
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what do you see for platelet count, PT, PTT for hemophilia A patients?
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normal platelet count, normal PT, increased PTT
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confirmation for suspected sickle cell
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hemoglobin electrophoresis
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how does scurvy affect the PT, PTT, bleeding time, platelet count?
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all normal
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how does hemophilia A affect the PT, PTT, bleeding time, platelet count?
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normal PT, increased PTT, normal bleeding time, normal platelet count
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how does VWF affect the PT, PTT, bleeding time, platelet count?
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normal PT, increased PTT, increased bleeding time, normal platelet count
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how does DIC affect the PT, PTT, bleeding time, platelet count?
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increased PT, increased PTT, increased bleeding time, decreased platelets
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how does ITP affect the PT, PTT, bleeding time, platelet count?
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normal PT, normal PTT, increased bleeding time, decreased platelets
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most common disease transmitted with blood transfusions
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Hepatitis B
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name the primary tumors that commonly metastasize to the brain
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lung, breast, skin, kidney, GI
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name the primary tumors that commonly metastasize to the liver
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colon, stomach, pancreas, breast, lung
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name the primary tumors that commonly metastasize to the bone
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prostate, thyroid, testicular, breast, lung, kidney
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what electrolyte abnormality do you see with multiple myeloma?
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hypercalcemia
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what ECG change does hypercalcemia cause?
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shortened QT
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what do tear-drop cells on blood smear indicate?
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myelofibrosis, leukoerythroblastic anemia, thalassemia major, severe iron deficiency
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what do spherocyte cells on blood smear indicate?
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autoimmune hemolysis, hereditary spherocytosis
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what do helmet cells, schistocytes cells on blood smear indicate?
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DIC, traumatic hemolysis
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what do target cells on blood smear indicate?
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HbC, asplenia, liver disease, thalassemia minor
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what do Burr cells on blood smear indicate?
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TTP, HUS
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most common cause of febrile, non-hemolytic transfusion reactions
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recipient antibodies against donor leukocytes
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non-tender midline mass in upper neck that moves with tongue
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thyroglossal duct cyst
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