IM：血液

36 flashcards · Other · by Wanying Koh

1. MCV (fL) / RBC (millions per microLiter 10^6/mm3) MCV/RBC <13: MCV/RBC >13:

   MCV/RBC <13: thalassemia MCV/RBC >13: IDA

2. MCV <70 MCV < 80

   thalassemia IDA

3. what kind of blood cell is seen characteristics present in what dz

   spherocytes no central pallor of RBC seen in : hereditary spherocytosis autoimmune hemolytic anemia

4. paroxysmal nocturnal hemoglobinuria gene mutation which CD

   PIG-A gene mutation CD55, CD59

5. males + chronic anemia suspect 哪裡 bleeding and what dz

   suspect chronic GI bleeding => GI malignancy

6. supraclavicular LAP indicative of what

   virchow's node indicates gastric ca (胃癌特殊meta部位)

7. 35y/o F , no systemic dz 4 years ago, MCV = 90 , Hb = 13 now MCV = 65 , Hb = 11 no RBC details WBC, plt normal Dx?

   IDA adult age 4 years ago still normal

8. long-term transfusion AE cardiomyopathy DM liver cirrhosis cataract

   在問 iron hemosiderosis 的 clinical manifestations cardiomyopathy DM liver cirrhosis (NO cataract)

9. paroxysmal nocturnal hemoglobinuria blood abnormalities

   indirect hyperbilirubinemia LDH inc. low LAP score

10. prolonged PT/INR means 用了什麼藥物

    Wafarin (Coumadin, Jantoven)

11. patient w chronic hep B history, with pancytopenia dx?

    hypersplenism

12. 那些藥物 加快 warfarin 代謝 (need to inc warfarin dose) 減緩 warfarin 代謝 (need to dec warfarin dose)

    加快代謝 barbiturate, phenobarbital, rifampin 【seizure 病人開車 快到 綠 燈 加快速度】 減緩代謝 cimetidine, statin, erythromycin 【high cholesterol 病人 到 西門町 玩，快到 紅 燈 停下來】

13. most common leukemia in western elderly

    CLL

14. CLL CD markers

    CD5, CD23

15. WHO definition of acute leukemia: how high are blast forms numbers?

    >20%

16. APL characteristics chromosome abnormality what gene mutation DIC common or uncommon in these patients tx

    t(15;17) PML-RARa mutation (retinoic acid receptor gene) common all trans retinoic acid (ATRA) + chemo antracycline

17. gene mutation t(9;22) t(15;17) t(4;11) t(8;14), t(2;8)

    CML APL ALL Burkitt's lymphoma

18. peroxidase (-), CD10, D19 表現 dx

    CD10, CD19: B-Cell peroxidase (-): ALL (peroxidase (+) ==> AML T-Cell ALL ==> CD2,5,7

19. Dx

    Auer rods present hypergranulated cytoplasm ==> APL t(15,17)

20. essential thrombocythemia need to treat when asymptomatic? when to tx?

    asymptomatic ==> OBS, no tx needed treatment only when: age >60y/o hx of thrombosis plt > 150w

21. tx for essential thrombocythemia

    OBS ==> only when asymptomatic hydroxyurea anagrelide aspirin ==> prevent thombus fmt

22. dx

    mediastinal mass ==> Hodgkin lymphoma

23. MM ISS stages Stage I Stage II Stage III

    B2-microglobulin <3.5 & albumin >3.5 B2-microglobulin 3.5-5.5 ; or albumin <3.5 >5.5

24. multiple myeloma 如何評估 bones involvement what diagnostic tool

    xray only MM causes osteolytic lesion --> xray bone scan detects osteoblastic lesions --> used in other cancer ALP not specific to MM.

25. staging of Hodgkin's lymphoma

    Ann Arbor staging I - single LN II - >=2 LN + same side of diaphragm (either thorax only or abd only) III - multiple LN + both sides of diaphragm IV - extranodal

26. aplastic anemia tx

    stem cell transplantation

27. iron deficient anemia what age groups red cell distribution width dec / inc? serum iron levels, TIBC levels

    adolescent girls - period blood too much 9-24mo newborn - 製造新的RBC RDW inc - due to newly made RBC different sizes serum iron dec, TIBC inc

28. cafe au lait spots + pancytopenia + short stature + chromosome fragility dx

    Fanconi anemia - congenital aplastic anemia

29. 30yo female, fullness in throat Dx

    CT hyperdense, homogenous lesion: lingual thyroid (hemangioma - CT 看得到 phleboliths - venous malformation tongue base ca - CT heterogenous, irregular shaped, with possible lymphadenopathy

30. Warthin tumor most common location most common in which pts most common benign tumor of salivary gland? tx

    位於 parotid tail old male smokers 良性#1. plemorphic adenoma ; #2. Warthin tumor superficial parotidectomy

31. angiofibroma 好發族群 most common benign tumor of nasopharynx tx

    young males true. most common 良性 OP 切除

32. EPO indications in CKD pts

    Hb < 10g/dL ferritin > 200ng/mL

33. calculate corrected reticulocyte percentage

    = reticulocyte (%) x (HCT / 45) / reticulocyte lifespan based on HCT

34. uremic bleeding tx

    dialysis correct anemia - transfusion ADH - [a] vWF cryoprecipitate estrogen

35. warfarin caused INR prolong

    + severe bleeding: prothrombin complex concentrate / FFP / PCC + IV vitamin K INR>10, no bleeding: oral vit K INR 5-9: no bleeding: stop 2 doses + give vit K // if pt needs warfarin meds for valvular op 2-5 <INR < 5: dec dosage / stop next dose

36. hSCT cells come from

    umbilical cord blood peripheral blood stem cells - using G-CSF (most common) bone marrow cells amniotic fluid NOT adult spleen cells