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Heme Onc 1 Anemia I

Anemia Part I

QuestionAnswer
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
Created by: sarah3148
 

 



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