-
how do you follow rX for hypothyriodism
Hyperthryoidism
-
polychromasia on smear means what
relics are elevated
-
when do you do G6PD testing
3 months after the event
-
rx for dermatitis herpetiformis
dapsone
-
rx for RLS
iron or dopamine antagonist
-
most sensitive test for ID
- transferrin receptor index
- >2 IDA
- <1 AOCD
-
when you give acluzimab, give what vaccine
meningococcal
-
decluzimab is for what
MS
-
testing for PNH
CD55 and 58
-
what precautions for meningococcal
droplet
-
ferritin of what rules out IDA
100
-
ferritin level rules in IDA
-
after how many weeks does AOCD develops
2 weeks
-
what happens to platelets in IDA
increased
-
-
what to check after giving iron supplementation?
reticulocyte count
-
what decreased the aortic root dissection in marfan
Losartan
-
gait abnormality, anemia, low MCV, next step
check urine for heavy metals---> sideroblastic anemia
-
Hgb A is made of what chains
Hgb A2 is made of what chains
Hgb F
-
out of Sickle cell disease,trait, SC dz, what gives you
plenic sequestration
crisis with severe hypoxia
Hematuria
trait
-
what gives you functional asplenia
vasoocclusive crisis
disease
-
what gives you avascular necrosis, retinal intact,
SC
-
what is the Hgb SS in trait
disease
50
disease 70-90%
-
out of Hgb SC, SS or trait, which one has Hgb F
disease
-
meperidine can have what SE
seizures
-
ss with CP, infiltrate, fever
acute chest syndrome
-
SS with hypoxia despite O2 and PRBC, next step
exchange transfusion
-
how to diagnose parvob19 bone marrow suppression
IgM or PCR
-
rx for parvob19 anemia
IV Ig
-
OM in SS, cause
salmonella
-
MCV>115, + anemia, etiology
Vit B12 or Folate def
-
high MCV + high lDH, low relic, high bill
Marocytic anemia
-
what 2 meds cause B12 def
-
folate therapy increase plt, wtd
continue
-
best way to differentiate between B12 and B6 def
high MCV
-
chronic hemolysis can cause what
high mcv
-
hemolysis causes what MCV
high
-
myelodysplastic syndrome has what mutations
5q
-
myelodyspalstic syndrome with >10% blasts, can do what
transform to AML
-
rx for myelodysplasia age <55
>55
Rx for 5q deletion
Allogenic
>55-azacitidine + transfusions
Lenalidomide
-
phlebotomy rx for what 2 disorders
hemochromatosis + P.vera
-
what does BM show in myelodysplastic syndrome
dysplasia + ringed sideroblasts
-
copper def is commonly seen when
post bariatric sx
-
aplastic anemia
RX if <55
>55
- hypocellular BM
- <55-allogenic BMT
- >55 cyclosporine + anti-thymocyte globulin
-
causes of pancytopenia
- v12 def
- copper
- HIV
- hepatitis
- MDS
- hypersplenism
- hairy cell leukoplakia
- bactrim
-
pt on ESRD, anemia and Burr cells on smear
anemia of renal failure
-
cirrhosis + anemia, high retic and bili, rbc with irregular speculations
spurr cell anemia-bad prognosis
-
a clue to methemoglobinemia
normal pAo2 and low SPO2
-
contact again measles
airborne
-
cyanosis and dyspnea after iv nitrates, benzocaine
methemoglobinemia
-
what ig, in cold hemolytic anemia
IgM
-
rx for warm hemolytic anemia
- steroids
- danazol
- rituximab
- splenectomy
-
rx for cold hemolytic anemia
- cyclophosphamide
- rituximab
- NO STEROIDS
-
Drugs, SLE, usually give cold or warm hemolytic anemia
warm
-
CLL and lymphoma give what type of hemolytic anemia
cold and warm hemolytic anemia
-
infections give what type of hemolytic anemia
cold agglutinins
-
hemolytic anemia + thrombosis
PNH
-
dx for PNH
DAF assay-CD55 and CD58
-
rx for PNH
allogenic BMT or eculizumab
-
what vaccine before eculizumab
meningococcal
-
eosin 5 maleimide tests for what
hereditary spherocytosis
-
PCN give what type of hemolytic anemia
warm hemolytic IgG
-
rasburicase can give what type of anemia
G6PD
-
All juices can give what
gout
-
all sodas can give what
kidney stones
-
rx for TTP
plasmapheresis
-
if No plasmapheresis for TTP, WTD
FFP
-
how does a major hemolytic ABO reaction occurs
fever,dyspnea, urine is dark red, IgG is +
-
how does a late hemolytic reaction occur
a few days after transfusion
-
etiology of late transfusion rxn
rh incompatibility
-
what electrolyte is given after plasmapheresis
calcium
-
seizure after rbc transfusion, cause
citrate toxicity
-
pt with urticaria or IgA def, needs what type of RBC
washed
-
fever and chills everytime with transfusion
pt needs leukocyte reduced prbc
-
abo incompatibility needs to have what 2 features
- +direct coombs test
- dark red urine
-
cause of TRALI
anti leukocyte ab from donor
-
purpura 1 week after prbc transfusion, dx
post transfusion purpura
-
rx for post transfusion purpura
IVIG
-
after many units pr PRBC and FFP, pt has low plt, cause
dilution thrombocytopenia
-
Pt with PIOR HIT and ELISA for heparin platelet 4 ab -ve, needs anticoagulation
If + platelet 4 antibodies
heparin then fondaparinaux
Bivalirudin
-
primary hemostasis vs secondary
- primary is plt
- secondary is FFP
-
secondary hemostasis problems present how
joint bleeds or hematoma
-
how is HIT diagnoses essentially
plt decrease by 50% on day 5-10
-
when do you treat gestational thrombocytopenia?
<70
-
dx of Von Willebrand dz
Ristocetin cofactor assay is decreased
-
rx for mild von willebrand
severe
what do you not give
- mild-ddavp
- severe- factor 8 concentrate
cryoprecipitate
-
what plt disorder gives giant plt
bernard soulier
-
GPIIB/IIIA disease with abnormal plt aggregation
Glanzmann's dz
-
pt recently started on asa, not has heavy menses, dx
von willebrand
-
-
rx for ITP
steroids, IVIG, cyclophosphamide, splenectomy?
-
how many plt you need for TLC, spinal tap/abdominal tap
-
pt with ITP, going for surgery, plt <50
<50 and bleeding
<100K with intracerebralbleed
ivig and plt
-
what is seen on smear with ITP
megakaryocytes
-
Plt count less than 10K in ITP, next step
IVIG
-
what should you test for in pt with ITP
HIV and Hep C
-
can heparin increase K
yes
-
test for lupus anticoagulant
russel viper test
-
high PTT but no bleeds with what two factor def. 12 and 11
-
rx for lupus anticoagulant
warfarin
-
no bleeding but dilute test did not correct
lupus anticoagulant
-
clot retraction test abnormal, def of factor
13
-
INH can cause def of what factor
13
-
what factor def does not give excessive bleeding
XII or XI
-
pt with hemophilia A, needs surgery or has intracranial trauma, wtd
factor 8
-
pt with hemophilia a needs dental work, wtd
desmopression
-
antibody to factor 8 in a pt with hemophilia
give factor 7A
-
any bleed with INR>2, wtd
PCC + VIT K
-
INR 1.6, pt needs surgery
clear
-
when to stop xarelto prior to sx
48 hrs
-
pt with ischemic stroke on apixaban, wtd
thrombolectomy
-
wtd for pt with abuptio, placenta and DIC
surgery
-
pt heterozygous for factor 5 leiden mutation, needs to take a flight
leg exercise and hydration
-
pt with DVT in the past, how long to wear graduated knee high compression stockings,
2 years
-
when to measure protein C level,
3 months of anticoagulation and 2 weeks of warfarin
-
when to measure protein C in pt on apixaban
after stopping apixaban for 24 hours
-
pt found to have lupus anticoagulant, wtd
monitor, if develops clot, warfarin indefinitely
-
pregnant patient has DVT, how long you anticoagulant
through pregnancy and 6 weeks after
-
DVT after surgery. No pregnant, wed
6 weeks postpartum anticoagulate
-
pt with antiphospholipid ab, tryin to conceive, when to anticoagulate
when pregnant
-
pt getting prophylaxis dose of lovenox, needs LP, how long to wait
12 hours
-
when can you resume lovenox after LP
4 hours
-
skin necrosis and pt on warfarin, dx
protein C def
-
rx for skin necrosis with protein C def
FFP
-
PCV can burn out and become
meylofibrosis
-
rx for PCV
- phlebotomy
- hydroxyura
- low dose ASA
-
splenomegaly is seen with what myeloproliferative disorder
PCV
-
JAK2 mutation neg, but suspecting PCV or essential thrombocytosis, next step
test for CALR
-
rx for essential thrombocytosis
plt count goal
- hydroxyurea or anagrelide,
- ASA
- <600K
-
what needs to be ruled out before starting asa with essential thrombocytosis
rule to vWF
-
what plt count for reactive thrombocytosis
>800K
-
etiology of reactive thrombocytosis
- FE def
- neoplasm
- chronic infection
- neoplasm
- post megaloblastic anemia
-
rx for erytheromelelgia
asa
-
plt count >600, ET but Plt >800Km
-
what can transform in to AML
CML
-
invasive aspergillosis affects pt with what hematologic disorder
AML
-
timeline of who gets ALL, AML, CML, CLL
- 0-15 ALL
- 15-30 AML
- 30-60
- CML
- >60 CLL
-
for most hematologic neoplasms, if <50 or 55 what is the rx
BMT
-
which hematological disorder has + myeloperoxidase
M2 to M5
-
translocation 9:22 in AML is good or bad prognosis
bad
-
rx for AML if >50
are-C and daunorubicin
-
renal failure after starting ATRA for AML
ATRA differentiation syndrome, rx is dexamethasone
-
+, erythematous plaques, leukocytosis, neutrophilic infiltrate on biopsy, dx
sweet syndrome , rx is steroids
-
sweet syndrome is associated with what malignancy
AML
-
rx for asymptomatic CLL
- nothng
- if treated then fludarabine, chlorambucil , rituximab,
- IVIG for infection
-
when to treat CLL
if anemia or thrombocytopenia
-
CLL stages
- I-high WBC
- II- LAD
- III-spleen
- IV- anemia
- V- thrombocytopenia
-
how to prevent infections in CLL
monthly IVIG
-
rx for AIHA with CLL
steroids, if not effective rituximab
-
if no response to steroids and rituximab for AIHA with CLL, next step
steroids, cyclophosphamide, rituximab
-
BRAF V600E mutation + in what hematologic problem
hairy cell leukemia
-
rx for hairy cell leukemia
cladribine, add rituximab
-
out of all the hematologic diseases, what is most likely to go to AML
CML
-
complication of lenalidomide
DVT, PE
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