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Heme Onc 1 Anemia I
Anemia Part I
Question | Answer |
---|---|
Which is more ethically unfavorable in a DNR pt: withdrawing life-sustaining care or withholding care? | Doesn't matter. Both are equal in terms of ethics. |
A 25yo man is dx with a solitary testicular mass by US. What is the next step in mgmt? | Orchiectomy |
What are the classic findings of Henoch-Schonlein purpura (HSP)? | Palpable LE purpura, renal dz (hematura and proteinuria), transient LE arthralgias/arthritis, GI sx (abd pain, vomiting, guaiac + stools, intussusception) |
Increased body temp, acidosis, and exercise shift the hemoglobin-oxygen dissoc'n curve in which direction? What effect does this have on oxygen delivery to the tissues? | R. Unloads O2 to tissues |
Elderly man seen in the ER w/CC of HA. Since the weather has turned cold and he had to begin using his kerosine heater, he has felt fatigued and a little nauseated along with the HA. On PE, lips are red. Expected pulse ox? Tx? | Pulse ox will likely be normal. Give 100% O2 or hyperbaric O2 if you're hospital is ballin outta control. :) |
WIll anemia of chronic dz give a microcytic or normocytic anemia? | Both |
What are the characteristic findings of hereditary spherocytosis? | Jaundice and gallstones, splenomegaly, anemia with reticulocytosis and increased mean corpuscular [Hgb] (MCHC) |
What kind of hyperkalemia might be seen in a pt with hemolytic anemia? Why? | Pseudohyperkalemia b/c RBCs lyse after blood is drawn, releasing intracellular postassium |
WHat does a peripheral smear show in hemolytic anemia? | Spherocytes |
What test using hypertonic saline shows hemolytic anemia? | Positive osmotic fragility test |
What is the tx for hereditary spherocytosis? | folic acid daily, RBC transfuion if extreme anemia, and splenectomy in mod-severe dz |
What is the cause of anemia that develops after taking a sulfa drug? | G6PD deficiency |
What lab markers suggest anemia due to hemolysis? | Incr retic ct, incr unconj bili, incr LDH, decr serum haptoglobin, decr H/H, norm MCV |
In hemolytic anemia, why is the serum haptoglobin level decreased? Why is the serum LDH increased? | Haptoglobin is a Hgb scavenger that picks up free Hgb in the blood. THe hapto-Hgb complex is removed mostly by the spleen thereby decr its [] in the blood. LDH is found inside RBCs. RBCs lyse and release it into circulation |
A 25yo woman is seen in clinic w/complaint of fatigue and chronic joint pain. PE and labs show malar rash, mildly elev temp, and anemia. Unclear whether anemia is hemolytic or autoimmune or 2/2 menstruation. What test can be used to distinguish? | Direct Coomb's test |