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42 Cards in this Set
- Front
- Back
pt/ with enlarged lymph node presenting with anemia
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autoimmune hemolytic anemia 2/2 lymphoproliferative malignancy
- often warm AHA - tx: prednisone, if not effective then splenctomy |
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microangiopathic hemolytic anemia?
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= HUS
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HUS vs thalassemia vs DIC vs ITP?
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- HUS: young pt s/p diarrheal illness (E. Coli, shigella, salmonella, yersinia, campy) ==> thrombocytopenia purpura, schistocytes, giant platelets, renal failure, normal PT, PTT; UA = hemoglobin, hemosiderin, albumin, RBC, WBC, casts
- thalassemia: hepatosplenomegaly, blood smear: target cells, microcytosis, hypochromia, anisopoikilocytosis, no schitocytes - DIC: increased PT, PTT - ITP: isolated thrombocytopenia, rest of blood smear is normal |
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what do you see in blood smear in mono?
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atypical lymphocytes or variant lymphocytes
- heterophile Ab may be negative early on |
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ALL vs CLL vs CML?
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- ALL: young, see blasts
- CLL: old, see mature small lymphocytes - CML: adult: see basophilia, splenomegaly; NO lymphadenopathy |
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tx of increased homocyteine?
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pyridoxine (B6) and folate to help metabolize homocysteine
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ddx HUS and DIC and TTP?
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- HUS: young, s/p diarrhea, NORMAL PT, PTT; DIC has high PT, PTT; TTP is HUS PLUS NEUROLOGICAL FEATURES
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transfuse w/ blood, dvlp fever, chills. - antiglobulin test? if it had been Coombs +?
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- febrile transfusion reaction
- don't see hemodynamic abnormalites, no renal dysfunction - 2/2 ab in pt reacting to donor's leuk - prevent by leuk depletion technique (filter or cell washing) - tx acetaminophen - if coombs+: bad crossmatching |
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paget's dz? path? which ca?
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breast papillomas- large cells surrounded by halos (clear area)
- adenocarcinoma |
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horner's syndrome?breast ca associated with nipple discharge?
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ptosis, aniosis, anhidriosis
- get CXR |
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glossitis and increased MCV?
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b12 deficiency
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pernicious anemia is associated with which ca?
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- pernicious anemia = b12 def
- gastric carcinoid tumor |
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what test for paroxysmal nocturnal hemoglobinemia?
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- sugar water test
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MCV and basophilic stipling?
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- low mcv = lead
- high mcv = b12/folate macrocytic anemia |
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pt with nonspecific complaints, low MCV, anemia, increased Cr?
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lead poisoning 2/2 occupational exposure
- lots of nonspecific complians: abd pain, constipation, decraesed concentration - give EDTA |
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anemia of chronic disease is 2/2
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- infx, cancer, autoimmune dz (rheumatoid arthritis)
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when to start screening for CRC in UC?
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- after 8 years of the disease and then every eyar
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soap bubble appearance of end of long bone?
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giant cell tumor, benign but locally aggressive
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9:22?
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philadelphia chromosome, BCR-ABL, tyrosine kinase associated with CML, imatininib
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acute promyelocytic leukemia
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- subtype of AML
- tx by targeting retinoic acid receptor |
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pt with hereditary spherocytosis?
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increased MCHC, normal MCH, increased or normal MCV
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Anemia in SLE?
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- Ab against RBC = peripherally destroyed
- spherocytosis and +coombs |
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colon polyps +
- dermoid tumors? - gingival hyperplasia? - glioblastoma? |
- gardner
- multiple harmartoma - Turcot |
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path on IBD?
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- neutrophilic cryptisis
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what does gaucher's dz present w/?
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- bone pain, animea, thrombocytopenia, hepatosplenomegaly
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asplenia?
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- impaired phagocytosis
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trousseau's syndrome?
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pt with migratory thrombophlebitis: pain, redness, itching in arm and chest, cord like veins
- do CT abdomen: most likely adenocarcinoma of pancreas, lung., prostate, stomach |
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pt with well defined solitary met to lung?
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- surgery, no chemo
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lupus anticoag?
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- IgG or IgM that prolongs PTT by binding phospholid in LAB only
- increases risk of thrombosis, abortion |
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serum protein electrophoresis shows IgM spikes?
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- Walderstrom's macroglobulinemia; see dilated retinal vessels
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Walderstroms vs MM vs MGUS, heavy chain dz?
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- W: IgM spike, dilated retinal vessels
- MM: IgG or IgA, no retinal dilation - MGUS: asympt - heavy chain dz: abd lymphoma, IgA |
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athlete with increased Hct?
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steroid abuse (will have normal WBC)
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whento dx pernicious anemia vs diet b12 deficiency?
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- pt with signs of autoimmune dz (vitiligo) = pernicious
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pt with increased PTT w/ signs of stroke?
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- SE of heparin therapy = thrombocytopenia along with thrombosis = acute ischemic stroke
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fibrin degredation products?
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- DIC
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smudge cells
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= leukocytoes that have partially broken b/c increased fragility
- seen in CLL |
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poor dx in CLL?
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- if associated with thrombocytopenia
- intermeidate dx: anemia |
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pt with sickle cell dz presents with neuro/stroke sx?
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- exchange transfusion
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role of G6PD? B12 deficiency?
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- glutatione synthesis ==> anemia
- purine/DNA synthesis ==> anemia |
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best initial test for SCC of head and neck?
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- PANendoscopy: look at esoph, bronch, larynx
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tx of low grade gastric mucosa associated lymphoid tissue lymphoma (MALT)?
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- tx h. pylori: omep, amox, clarith
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leukocytosis w/ increased mature granulocytic forms?
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- increased neutrophils, bands)
- CML - ALSO SEE LOW LEUK ALK PHOS |