Transfusions
Bleeding Disorders
Anemia
Blood Smears
Mixed
100
The most likely decreased electrolyte after massive blood transfusion
Calcium
100
This disorder of secondary hemostasis will have normal PT, elevated PTT, with bleeding corrected with 1:1 mix of normal plasma
What is factor deficiency (Hemophilia A - Factor VIII)
100
The next step for an elderly patient with forgetfulness, positive romberg sign, HGB 13, MCV 103, B12 level 310 (normal 200 - 800)
What is methylmalonic acid?
100
Name the abnormal cells and an associated condition:
Howell Jolly bodies
Splenectomy or functional asplenia
100
Treatment for polycythemia vera
What is phlebotomy (keep HCT < 45) and low dose ASA
200
Name the likely transfusion reaction:
Within one hour of blood transfusion, patient becomes dyspnic, complains of back pain, fevers, chills. Temp 101, HR 110. Urine is dark red. HGB dropped from 9 to 7.
What is ABO incompatibility?
200
The most likely diagnosis for the following patient: 36 yo F with menses now lasting 10 days after starting aspirin a month ago.
Bleeding time increased, PTT increased, PT normal, Ristocetin cofactor assay decreased
What is Von Willebrand disease?
200
The diagnostic test to confirm alpha thalassemia trait
What is DNR PCR analysis? (Not HGB electrophoresis)
200
Name the abnormal cells and an associated condition:
Bite cells
G6PD deficiency
200
The pharmacologic treatment for methemoblobinemia
What is methylene blue?
300
Name the likely transfusion reaction:
Patient gets fevers and chills every time he is transfused. No change in HGB.
What is febrile nonhemolytic reaction
300
The infection you must rule out whenever you suspect ITP
HIV
300
The next therapeutic step in a patient with SSD acute chest syndrome and persistent hypoxia despite IVF, IV antibiotics, oxygen, and pRBCs
What is exchange transfusion?
300
Name the abnormal cells and an associated condition:
Spherocyte
Hereditary spherocytosis or warm autoimmune hemolytic anemia
300
The reversal agent for rivaroxaban (Xarelto)
What is andexanet alfa?
400
You should use this special type of blood products when transfusing a patient on chemo for AML (to prevent transfusion associated graft vs host disease)
Irradiated blood products
400
Most likely diagnosis in a patient who is started on warfarin for DVT and then a week later develops weakness and gangrenous fingers
What is protein C deficiency?
400
The hemoglobin target for EPO treatment in patients with CKD
What is 10-11.5?
400
Name the abnormal cells and an associated condition:
Tear drop cells
Myeloid metaplasia w/ myelofibrosis or thalassemia
400
The most likely diagnosis for a patient with sudden onset fever, leukocytosis, and tender erythematous plaques and nodules on the face and extremities. Biopsy shows dense neutrophilic infiltrate
What is Sweet's syndrome?
(Next step to perform bone marrow biopsy to r/o AML)
500
You should use this special type of blood products for patients with severe IgA deficiency
What is washed pRBCs
500
Next step in young pregnant patient in third trimester of pregnancy with plts 85,000
What is monitor plts every 1-2 weeks (no plt transfusion or IVIG)
(Gestational thrombocytopenia)
500
The test you would perform next for a patient who presents with lethargy, nausea, abdominal pain, diarrhea, confusion, abnormal gait and decreased vibration sensation. Patient recently moved into a new house built in 1905. HGB 9. MCV 78.
What is urine heavy metal screening?
500
Name the abnormal cells and an associated condition:
Burr cells
anemia of uremia
500
The most likely diagnosis in a patient with burning sensation in the foot at night. On exam, there is erythema, warmth and tenderness in the foot. Plts 800,000.
erythromelalgia
Treat with ASA