Hem

Question 1

What is the pathophys behind anemia of chronic disease? especially _______

Answer 1

The underlying pathophysiology involves inflammatory cytokine-mediated suppression of red blood cell production through increased hepcidin production, resulting in impaired iron availability that reduces both erythropoietin production and bone marrow responsiveness to erythropoietin.

think chronic inflammatory conditions especially CKD

Question 2

What component of a CBC with help you differentiate between iron deficiency anemia and thalassemia?

Answer 2

Red blood cell distribution width (RDW)

The RDW is usually increased in iron deficiency and within normal range in thalassemia.

Question 3

What hem disorder can be assessed by running a ristocetin assay?

Answer 3

von willebrand

Question 4

What test will appropriately determine the correct amount of RhoGam that should be given?

Answer 4

Kleihauer-Betke test

Question 5

What seizure med is known to cause aplastic anemia?

Answer 5

carbamazepine

Question 6

macrocytic anemia and caused by phenytoin, methotrexate or bactrim. What vitamin do you need to supplement?

Answer 6

folic acid

Question 7

cobalamin is what vitamin?

Answer 7

vit B12

Question 8

What is the treatment of choice for patients with thrombotic thrombocytopenic purpura (TTP)?

Answer 8

plasmapheresis and fresh frozen plasma infusions

Question 9

What does a positive direct Coombs test indicate?

Answer 9

strongly suggests the presence of an AUTOIMMUNE hemolytic anemia

Question 10

What is the strongest risk factor for developing non-Hodgkin lymphoma?

Answer 10

immunodeficiency

Question 11

minimal change disease when seen in adults is associated with what 3 types of cancer?

Answer 11

Hodgkin lymphoma
non-Hodgkin lymphomas
leukemia

Question 12

What should you order to confirm the diagnosis of multiple myeloma?

Answer 12

presence of monoclonal immunoglobulin on serum protein electrophoresis and bone marrow biopsy

Question 13

What test can be done to confirm the presence of spherocytes in the blood?

Answer 13

osmotic gradient ektacytometry test, which uses a laser diffraction viscometer to increase osmolality and detect deformability of RBCs.

Question 14

Hem A and B will have what abnormal lab finding?

Answer 14

abnormal aPTT

both part of the intrinsic pathway

Question 15

ADAMTS13 deficiency should make you think of what dx?

Answer 15

thrombotic thrombocytopenic purpura (TTP)

Question 16

microangiopathic hemolytic anemia, thrombocytopenia, fever, acute kidney injury, and severe neurologic findings, should make you think of what dx?

Answer 16

thrombotic thrombocytopenic purpura (TTP)

Question 17

Define a neutropenic fever

Answer 17

as a single oral temperature of 101°F or a temperature of 100.4°F sustained over a 1-hour period in a patient with a decreased absolute neutrophil count (ANC)

Question 18

define neutropenia

Answer 18

Neutropenia is defined as an ANC < 1,000–1,5000/µL, severe neutropenia is defined as an ANC measured at or expected to drop to < 500/µL, and profound neutropenia is defined as an ANC < 100/µL.

Question 19

When is the nadir in an absolute neutrophil count likely to occur after chemotherapy?

Answer 19

7-14 days after chemo

Question 20

What serum blood test helps determine the degree of hemolysis?

Answer 20

haptoglobin

Question 21

What dx is Howell-Jolly bodies associated with? What does there presence signify?

Answer 21

sickle cell anemia

a damaged or absent spleen

Question 22

Which type of hemoglobin is a powerful modulator of the symptoms of sickle cell anemia?

Answer 22

hemoglobin F

Question 23

What is important to remember about fondaparinux?

Answer 23

subcutaneous direct-acting anticoagulant

(like Eliquis/Xarelto but subq)

Question 24

What is important to remember about enoxaparin?

Answer 24

it is a low-molecular weight heparin

do NOT use in HIT

Question 25

Pt who experience HIT and still need anticoagulation, what 2 medications should be used?

Answer 25

Argatroban and bivalirudin are direct thrombin inhibitors that require intravenous administration, have a short half-life,

Question 26

What is the underlying cause of HIT?

Answer 26

Heparin-induced thrombocytopenia (HIT) is caused by IgG antibodies recognizing antigens on platelet factor 4, creating an immune complex that, when activated, alters endothelial cells, activates platelets and monocytes, and increases thrombin generation.

Question 27

What diagnostic study should be ordered for a patient taking chloroquine who presents with a new onset of fatigue and anemia?

Answer 27

G6PD deficiency

Question 28

Blood smear shows enlarged erythrocytes that have enlarged central pale areas. Some of the neutrophils have hypersegmented nuclei. Which of the following is the most likely diagnosis

Answer 28

Vit b12 deficiency

Question 29

Why should a mixing study of patient and control plasma be performed in patients with suspected hemophilia A with prolonged PTT values?

Answer 29

To identify patients with acquired factor VIII deficiencies due to autoantibodies, as mixing patient and control plasma corrects the PTT in those with inherited hemophilia A but not in those with acquired deficiencies

Question 30

Which of the following types of hemoglobin does hydroxyurea increase?

Answer 30

hemoglobin F

Question 31

What 2 abx are most likely to trigger jaundice in a pt with G6PD deficiency?

Answer 31

**nitro <- this one is the big one them bactrim

Question 32

laboratory findings include a median white blood count of 150,000/µL and peripheral blood showing a left-shifted myeloid series. What dx?

Answer 32

chronic myeloid leukemia (CML)

Question 33

What translocation is CML?

Answer 33

a reciprocal translocation between the long arms of chromosomes 9 and 22.

Question 34

What is the most common hematologic manifestation in the patient with chronic alcohol use?

Answer 34

macrocytosis

Question 35

What is a known complication of long-term heparin use?

Answer 35

osteoporosis

Question 36

What anti-lipid agents are most effective in raising the HDL cholesterol?

Answer 36

niacin

Question 37

What lab value when elevated in a pt with Non-Hodgkin lymphomas is associated with a worse prognosis?

Answer 37

LDH elevated above the reference range is associated with a worse prognosis

Question 38

What type of anemia will hypersegmented neutrophils be reported on the blood smear?

Answer 38

vit B12 def

Question 39

Describe wet purpura

Answer 39

Wet purpura is consistent with thrombocytopenia. Wet purpura refers to purpura that occurs on a mucosal surface. Patients will commonly refer to these as blood blisters. Wet purpura is a sign of more serious bleeding, as platelet counts are typically low in order for wet purpura to occur.

Question 40

Would the platelet count, prothrombin time, and activated partial thromboplastin time be elevated, normal or low in a pt with von Willebrand disease?

Answer 40

all will be normal normal platelets, normal prothrombin time and normal activated partial thromboplastin time