Clots and Clots of Fun Diseases
I don't get irony...I'm anemic
Platelets and Reversals
Luke-emia...I am your Father!....and Lymphoma
Mis-blood cell-aneous
100
One week old presents to their pediatrician with ecchymoses. No prenatal care and they were born at home in their bathtub. They not receive this at birth
What is a Vitamin K Injection?
100
25 year old patient presents with fatigue, no previous medical history and these labs:
Hemoglobin: 8.5
HCT: 26
MCV: 85
What is Iron Deficiency Anemia
100
Warfarin
What is FFP
100
What is AML
100
Hypercalcemia, renal failure, anemia and back pain. Patient is SPEP + for IgG with an M-Spike. Marrow biopsy shows monoclonal plasma cells. Diagnosis...
What is Multiple Myeloma
200
40 year old woman with multiple spontaneous abortions and a history of numerous arterial and venous clots. Immunologic labs show?
What is anti-cardiolipin, lupus anticoagulant, anti-beta2 GP and anti-phospholipid Ab
200
29 year old Mediterranean male presents for routine follow up. His CBC shows a Hemoglobin of 11, MCV of 86 and normal iron studies. He denies any symptoms of fatigue or pallor. His HgB electrophoresis confirms diagnosis. And genetic testing confirms deletion on chromosome 11. (Thomas has this)
What is beta thalassemia minor
200
Patient in heparin drip needs surgery urgently. Reversal is this.
What is protamine sulfate?
200
Patient diagnosed with CML. They inquire about the genetic abnormalities associated with their condition and want to know what chromosomes and genes are involved. You astutely answer them by saying this.
BCR-ABL, t (9,22)
200
30 year old trauma patient receives two units of pRBCs due to blood loss. 8 hours later they are noted to have SOB and diffuse crackles are noted on auscultation of the lungs. It is determined this is a reaction to their blood transfusion. They subsequently are treated with 40mg of Lasix. The diagnosis is most likely this.
TACO
300
18 year old female goes to her dentist and mentions that her gums bleed every time she brushes her teeth. Several days later she goes to her PCP and genetic testing is performed. She is diagnosed with VWD. Name one test they did to come to such a diagnosis.
What is risocetin assay/cofactor, bleeding time (increased), PTT (prolonged)?
300
15 year old female presents to her pediatrician for evaluation of new onset fatigue and weakness. Detailed history reveals she recently had a viral illness one month ago with red face cheeks. CBC reveals pancytopenia. This is the viral illness associated with the diagnosis
What is Parvovirus B19? (aplastic anemia)
300
30 year old female with petichiae and a recent viral illness. Platelet count is 40,000. They are diagnosed with ITP. This is the treatment?
What are steroids or IVIG
300
Virus associated with this
What is EBV
300
28 yo male presents to the ED after running into a burning pet store. He has several full thickness burns (BSA involvement 37%) and during his heroics of saving a snake he sustained several bites to his forearm which are visible on examination. While starting his IVs there is blood noted to be oozing from his puncture sites and diffuse ecchymosis. Labs will likely show?
What is elevated PTT, PT, bleeding time, D-dimer, fibrin, and decreased platelets and fibrinogen?
400
20 year old patient with new onset a.fib is started on warfarin and several days later presents complaining of new onset skin necrosis. They have a diagnosis of this clotting factor deficiency
What is protein C or S?
400
37 year old female S/P Roux-en-Y gastric bypass surgery 2 years ago presents for follow up visit with a complaint of numbness in her hands and feet along with balance issues. CBC shows MCV of 115. This additional lab value would be elevated
What is Methylmalonic Acid
400
20 year old female s/p external fixation of the R knee 7 days ago. She has been on DVT PPx since the surgery and today her CBC reveals a platelet count of 80, 000 (decreased from 200,000 yesterday). This is your next best step in management
What is immediately stop heparin? (and change to a direct thrombin inhibitor, like bivalirudin)
400
A 55 year old male is diagnosed with hairy cell leukemia on CBC with peripheral smear. This is the next initial test. And this is the best treatment.
Test- TRAP (tartrate resistant acid phosphatase)
Treatment- Cladribine
400
55 year old male with known history of Waldenstrom Macroglobulinemia. Presents with new onset fatigue, dizziness on standing and palpitations. CBC reveals HgB of 7, MCV of 95, direct Coombs + and peripheral smear shows spherocytes. They are diagnosed with hemolytic anemia secondary to their disease state. This blood test would delineate the type of anemia they have
What is Cold Agglutinin and IgM
500
30 year old male with a history of Hemophilia A presents with his wife for genetic counseling. They want to know the likelihood of them having a child with the disease, knowing she is not a carrier.
What is 0% for both male or female kiddo
500
A 5 year old African American child is diagnosed with sickle cell anemia and subsequently started on hydroxyurea. This additional supplement is also necessary for prevention of complications.
What is folate? (risk of macrocytosis from fragmentation of RBCs)
500
12 yo F presents to the ED with her parents for evaluation of bloody diarrhea. She is found to have a mild fever of 102.1 F, thrombocytopenia and schistocytes on peripheral smear. She also has acute kidney injury. The best treatment is this. (BONUS- this is contraindicated)
Dialysis for AKI and Plasma exchange (if not improving after several days).
BONUS- platelet transfusion
500
"Cellulitis" not improving after 3 rounds of antibiotics, biopsy shows cerebriform lymphoid cells. This cell matures here in the body
What is the Thymus
500
65 year old female with a history of tobacco abuse (50 pack years) comes in with 1 month of hemoptysis. She also notes she has had several months of depression and abdominal pain recently and significant bone pain for no apparent reason. She undergoes evaluation and diagnosis is confirmed with a CT and CT guided biopsy of a lesion. The diagnosis is most likely this.
Squamous cell carcinoma of the lung