Im Heme Rbc Usmle 2

Front 1

Symptoms of Iron deficiency Anemia
(5)*

Back 1

Fe KAP:

Fatigue;
Exercise tolerance decrease;
Koilonychia (spoon nails);
Angular Cheilosis (cracking at mouth corners);
Pica (eating clay or ice); Pallor

Hint 1

Fe KAP

Front 2

Iron Deficiency Anemia labs (high or low):

1. Hemoglobin/hematocrit

2. MCV

3. TIBC, ferritin

Back 2

1. low

2. low

3. low

Front 3

Dx:
38-yo male w/ HIV on HAART w/ macrocytosis. What is cause?

Back 3

AZT

Front 4

Dx:
28-yo alcoholic w/ diarrhea, cheilosis and glossitis

Tx?

Back 4

Folate deficiency


Tx: oral folate

Front 5

what is seen in Blood smear w/ Folate deficiency or Vitamin B-12 deficiency?
(3)

Back 5

1. Macrocytosis (inc MCV)

2. Basophilic stippling

3. Hypersegmented PMN

Front 6

Etiology of Vitamin B-12 deficiency?
(8)*

Back 6

VITAMIN B:
Vegan;
Ileal resection;
Tapeworm (D. Latum);
Autoimmune (pernicious anemia);
Megaloblastic anemia;
Inflammation of terminal ileum;
Nitrous Oxide;
Bacterial overgrowth

Hint 6

VITAMIN B

Front 7

Dx:
Anemic patient w/ paresthesias, positive Rhomberg, slowed reflexes, ataxia, dementia and glossitis

Tx?

Back 7

Vitamin B-12 Deficiency


Tx: B-12 replacement IM

Front 8

Definition:
Absence of Intrinsic Factor due to Ab against parietal cells, causing Vitamin B-12 anemia

Back 8

Pernicious Anemia

Front 9

(2) Dx tests for Pernicious Anemia

Back 9

1. Anti-IF Ab levels


2. Schilling Test

Front 10

What can Pernicious anemia lead to?

Back 10

Gastric Cancer

Front 11

Causes of Normochromic normocytic anemia
(3)

Back 11

Bone marrow problems

Anemia of Chronic dz

Early deficiency in Iron, B-12 or Folate

Front 12

Definition:
X-linked condition resulting in reduced Glutathione; leads to hemolysis of RBC w/ oxidative stresses

Back 12

G6PD Deficiency

Front 13

Dx:
35-yo Italian male presents w/ weakness, back pain and jaundice. He was started on Cipro 2 days ago for pneumonia

Back 13

G6PD deficiency

Front 14

Smear Dx:

Microcytosis; schistocytes; Heinz Bodies

Back 14

G6PD deficiency

Front 15

Dx:
Marrow failure resulting in severe pancytopenia

Back 15

Aplastic Anemia

Front 16

Dx:
normochromic, normocytic pancytopenia; low reticulocyte count, weakness, fatigue, mucosal bleeding, pallor

Back 16

Aplastic Anemia

Front 17

What patients need to avoid Parvovirus B-12?
(2)

Back 17

Sickle cell anemia pt


Immunocompromised pt

Front 18

Tx of choice for Aplastic Anemia

Back 18

Bone marrow (stem cell) transplant

Front 19

Etiology of Anemia of Chronic Dz
(3)

Back 19

TB;

Malignancies;

Rheumatologic disorders

Front 20

Dx:
Ferrin is normal -> increased;
Iron, TIBC and transferrin are decreased;
Erythropoietin is high

Back 20

Anemia of Chronic Dz

Front 21

Thalassemia trait (genetic defect of the alpha chain)most common in:

1. Asians

2. Africans

Back 21

1. aa/--

2. a-/a-

Front 22

AA substitution in Sickle cell

Back 22

Valine for glutamine on Beta-chain

Front 23

Indication for exchange transfusion in Sickle cell Dz
(5)*

Back 23

SAP IT:

Stroke/TIA;
Acute Chest syndrome;
Priapism;
Intractable vaso-occlusive crisis;
Third-term pregnancy

Hint 23

SAP IT

Front 24

Signs of Sickle cell
(6)*

Back 24

SICKLE:

Splenomegaly;
Infection;
Cholelitiasis;
Kidney - hematuria;
Liver congestion; Leg ulcers;
Eye changes

Hint 24

SICKLE

Front 25

Smear Dx:

Howell-Jolly bodies; odd-shaped RBC

Back 25

Sickle cell

Front 26

What should be given to reduce the recurrence of a sickle cell crisis?

Back 26

Hydroxyurea

Front 27

Difference b/t Warm and Cold Hemolytic anemia

Back 27

Warm:
IgG to Rh factor;
no complement involvement

Cold:
IgM antibodies;
Fixes complement

Front 28

Tx for Warm or Cold hemolytic anemias

Back 28

Steroids

Front 29

With what Dx do you see Cold Hemolytic Anemias?
(3)*

Back 29

MMM:

Mycoplasma;

Mononucleosis;

Myleoproliferative disorders

Hint 29

MMM

Front 30

What causes acute hemolytic transfusion reactions?

Back 30

ABO incompatability

(usually human error)

Front 31

Definition:
Myeloproliferative Dz that results in an increase in RBC in addition to mild increase in Leukocytes and Platelets

Back 31

Polycythemia vera

Front 32

Etiology of Primary (1) and Secondary (3) Polycythemia vera

Which has low vs. high erythropoietin?

Back 32

Primary:
Bone marrow cause
(low erythropoietin)

Secondary:
Hypoxia (high altitdues, lung dz);
Smoking;
Renal Cell CA
(high erythropoietin)

Front 33

Dx:
pruritus, plethora, splenomegaly, epitaxis, neuro symptoms (vision changes), inc RBC

Back 33

Polycythemia vera

Front 34

Tx for polycythemia vera
(2)

what additional Tx for Primary type?

Back 34

Both types:
Serial Phlebotomy (dec blood volume);
Aspirin (prevent thrombosis)

Primary only:
Hydroxyurea (myelosuppression)

Front 35

What is a late complication of polycythemia vera?

Back 35

Bone marrow fibrosis

Front 36

Most accurate test if suspecting B-12 or folate deficiency?

Back 36

B-12 and Folate levels

Front 37

Dx:
middle-aged man w/ gradual onset of fatigue, massive splenomegaly, enlarged liver and Pancytopenia

Most accurate test?

Back 37

Hairy Cell Leukemia

test:
Tartrate-Resistant Acid Phosphase (TRAP)

Front 38

Dx:
Pancytopenia and blasts in peripheral smear; greater then 20% blasts in bone marrow; Auer Rod on smear

Back 38

Acute Myelogenous Leukemia
(AML)

Front 39

What hemolytic disorder creates "Bite Cells"?

Hemolytic anemia can occur with this d/o in response to what type of drugs?

Back 39

G6PD Deficiency

(formed when Heinz bodies are removed from the cells by the spleen)

drugs causing it: Sulfonamides
(Dapsone and Sulfasalazine)

Front 40

With what disorders do you see fragmented cells like Schistocytes and Helmet cells?
(7)*

Back 40

SHIT PAD:

Snake bites;
HUS;
Incompatible blood groups;
TTP;
PNH;
Artificial heart valves;
DIC

Front 41

Dx:
microcytic anemia w/ elevated serum iron level in an alcoholic

Dx test?

Back 41

Sideroblastic Anemia

Dx test: Prussian Blue stain

Front 42

Dx:
recurrent hemolysis, big spleen, family history of anemia. CBC reveals anemia and high MCHC.

most accurate test?

Back 42

Spherocytosis


most accurate test: Osmotic Fragility test

Front 43

Most accurate test to Dx Sickle Cell?

Back 43

Hemoglobin Electrophoresis

Front 44

what hemoglobinopathies are assoc w/ Target cells?
(4)*

Back 44

HITS the target:

Hemoglobin C disese (MC Dx);
Iron Deficiency anemia;
Thalassemia;
Sickle cell Dz

Front 45

What do Tear Drop cells indicate?

Back 45

a Bone Marrow Disease

(such as Myelofibrosis)

Front 46

What (2) antibodies are seen w/ Pernicious Anemia?

Back 46

1. Anti-Intrinsic Factor Ab

2. Anti-Parietal Cell Ab

Front 47

What does "Bleeding Time" test specifically?

Back 47

Tests the ability of the platelets to adhere to the endothelial lining of the capillary

Front 48

A patient has abnormal bleeding that stems from a platelet disorder but the platelet count is normal. What test?

what (2) possible Dx?

Back 48

Bleeding time

possible Dx:

1. Von Willebrand's Disease

2. Uremia-induced platelet dysfunction

Front 49

Dx:
patient has intermittent dark urine in the morning, pancytopenia and large vessel thrombosis

Most accurate test?

Back 49

Paroxysmal Noctournal Hemoglobinuria (PNH)

most accurate test:
Decay-Accelerating Factor (DAF)
(also known as CD55/59)