CBC 2

Question 1

what is main DDx in ertethrocytosis

Answer 1

1. increased mass

2. relative - decreased plasma

Question 2

what to measure to assess red cell mass

Answer 2

EPO
low - RBC prod. indep of EPO
high - EPO driven

Question 3

2 causes of high RBC and low EPO

Answer 3

1. polycythemia vera - bone marrow myeloproliferative disorder
2. mutation of EPO-r gene

Question 4

2 general causes of high EPO with high RBC

Answer 4

1. hypoxia
   - high altitude
   - abnormal Hb
2. increased EPO production
   - CA
   - renal cysts
   - doping

Question 5

Sx of high RBC

Answer 5

HA

• redness
• SOB
• numbness and tingling

Question 6

3 treatments of polycythemia vera

Answer 6

1. phlebotomy or chemo
2. ASA to prevent thrombosis
3. JAK2 inhib

Question 7

treatment of EPO mutation

Answer 7

phlebotomy

Question 8

what is first question in leukopenia

Answer 8

isit real?

• cultral variations
• which leukocytes

Question 9

3 cause of neutopenia and critical levels

Answer 9

1. low prod
2. incr. dest
3. sequest
   below .5 is major risk of infection

Question 10

4 causes of low production

Answer 10

1. DRUGS
2. bone marrow dis
3. benign cyclic neutopenia
4. congenital

Question 11

2 causes of destruction

Answer 11

autoimmune

alloimune

Question 12

cause of sqesuestration

Answer 12

Felty’s seen in RA

Question 13

what is febrile neutopenia

Answer 13

1. ANC 38.3 - immed. ABs

Question 14

3 types of neutophilia

Answer 14

1. demarginalziation - push into blood - exercise, stress, indfection
2. reactive
   - left shift and out of marrow
3. malignancy in marrow

Question 15

4 causes of lymphopenia

Answer 15

1. infections
2. Chemo/drugs
3. congenital
4. mild is common on CBC

Question 16

2 types of lymphocytosis

Answer 16

1. reactive
   - viral
   - stress
   - smoking
2. lymphoid malig

Question 17

what is first questionn in lymphocytsis

Answer 17

1. polyclonal or monoclonal

Question 18

3 causes of eosinophilia

Answer 18

1. alleric
2. paracytic infection
3. malig.

Question 19

3 causes if monocytosi

Answer 19

1. chronic infections
2. chronic inflammation
3. malig

Question 20

2 questions in thrombocytopenia

Answer 20

1. is it true?
   - bleed Hx
   - blood film
2. other line affected?

Question 21

2 causes of pseudothrombocytpenia

Answer 21

1. clumping

2. satellitism

Question 22

3 features of throbopenia

Answer 22

1. disorder of PRIMARY hemostatis

2. no Sx until

Question 23

what to ask for on Hx and Phx

Answer 23

1. bleeding Hx
2. recent infection (HIV, hep)
3. systemic Sx
4. other autoimmune
5. past med, surg, transfusion
6. fam Hx
7. alc
   exam
8. petechiae
9. nodes

Question 24

cutoff for levels and treatments of platelets

Answer 24

50 - don’t need to treat

Question 25

4 causes of low platetle prod.

Answer 25

1. primary marrow disorder 2. marrow toxin - alc and drugs 3. infection 4. B12 or folate def.

Question 26

2 main classes of platelet dest.

Answer 26

1. immune - infections, drugs, ITP, HIT, HIV 2. non-immune - DIC, TTP

Question 27

2 immune types

Answer 27

1. primary ITP - diagnosis of exclusion 2. secondary - viral - SLE - drug - heparin - post transfusion

Question 28

4 investigations for ITP

Answer 28

1. repeat CBC 2. review film to look at platelets 3. HIV and hep testing 4. thyroid, liver, renal testing

Question 29

what is ITP

Answer 29

- immune mediated early destruction - inappropriate TPO response - plats. less than 20 typically

Question 30

treatment of ITP

Answer 30

immed - steroids, IVIG | longterm - splenectomy, immune supression

Question 31

5 non-immune cause of plate dest.

Answer 31

1. drugs 2. DIC/sepsis 3. mechanical 4. TTP clotting activation 5. pre-eclampsia

Question 32

what is TTP

Answer 32

thrombotic thromobocytopenia pupura - high platelet consumption - high mortality - clots in small vessels and uncontrolled VWF - bleed and clot

Question 33

3 causes of thrombocytosis

Answer 33

1. reactive - infection/inflammation - marrow inflammation 2. malignancy 3. redistributive

Question 34

main microcytic

Answer 34

1. Fe #1 2. Thal 3. sideroblastic

Question 35

2 main causes of Fe def,

Answer 35

1. blood loss - menstrual then GI 2. diet def.

Question 36

5 lab tests for Fe

Answer 36

1. ferritin 2. TIBC up 3. high transferritin 4. lowe serum iron 5. microcytic hypochromic cells on smear

Question 37

3 way to Tx Fe def.

Answer 37

1. oral Fe replacement 2. paraenteral replacement 3. transfusion

Question 38

main issue in thal

Answer 38

inheritied inadequate production of a or B chain of Hb

Question 39

2 main types of thal

Answer 39

a - can be sever to carrier depending on number of gene loci | B - most often in mediteranian

Question 40

Sx of B thal

Answer 40

- severe anemia - massive hepatospleno - expansion of marrow space- distorted bones - growth retard

Question 41

Dx of thal B

Answer 41

1. electrophoresis - high HbF | 2. smear - microcytic hypochromic anemia

Question 42

4 classes of a thal

Answer 42

1. silent carrier - one loci 2. trait - two loci - mild and no Tx 3. HbH - 3 loci - sig anmeia 4. all 4 - death

Question 43

what is sideroblastic

Answer 43

abnormality in RBC production - hereditary or acquired -

Question 44

2 main normocytics

Answer 44

1. anemia of chronic disease - may also be microcytic 2. aplastic

Question 45

what is mech in anemia of chonic disease

Answer 45

chronic infection leads to cytokine release which have suppressive effects on production

Question 46

what is aplastic

Answer 46

bone marrow makes none - pancytopenia

Question 47

5 main causes of aplastic

Answer 47

1. idiopathic 2. rads 3. meds 4. viral 5. chemical

Question 48

3 Tx of aplastic

Answer 48

1. bone marrow transplant 2. transfusion 3. immunsupression

Question 49

2 main macro causes

Answer 49

1. B12 def | 2. folate def.