Rise up!
Just not too fast
Just not too fast
Hey babe. What's your sign?
To bleed, or not to bleed
Tiny telescopic work
Random stuff
100
The basic form for the treatment of pernicious anemia
What is Vitamin B12?
100
This skin finding is characterized by the abrupt appearance of multiple lesions and is most famously associated with (GI) malignancies.
What is the Leser-Trelat sign?
The sign of Leser-Trélat is a skin disorder characterised by the abrupt appearance of multiple seborrhoeic keratoses.
100
This man made hormone is effective in minor bleeding and before minor surgery in a certain subtype of patients.
What is Desmopressin?
Desmopressin causes release of preformed von Willebrand factor and factor VIII from endothelial cells and is effective in minor bleeding and before minor surgery in patients with type 1 von Willebrand disease.
100
The lifespan of a typical RBC (red blood cell).
What is 110-120 days?
+/-10
100
Transfusion of a single unit of platelets should raise the platelet count by around this amount.
What is 20,000 to 30,000/ul?
200
JVD on exam and an elevated BNP in the labs is concerning for this Mexican cuisine dish.
What is TACO?
Transfusion-associated circulatory overload can affect 1% to 8% of transfusion recipients. Signs and symptoms include respiratory distress within 6 hours of transfusion, positive fluid balance, elevated central venous pressure, elevated B-type natriuretic peptide, and compatible radiographic findings of pulmonary edema.
200
Sharing a name with the hometown of a famous movie boxer, it is most found in those with CML.
What is the Philadelphia Chromosome?
The Philadelphia chromosome is found in the bone marrow cells of almost all people with chronic myelogenous leukemia and some people with acute lymphocytic leukemia or acute myelogenous leukemia.
200
Treatment of a patient on warfarin with supratherapeutic INR >10 with low risk of bleed, and currently no active bleed.
What is hold the warfarin?
If the ІNR is >10 and the patient does not have clinically significant blееԁing, warfarin should be held until the ΙNR falls into (or just above) the therapeutic range. Vitamin K can be administered as an oral dose of 2.5 to 5 mg, depending on the bleeԁiոg risk of the patient. (Uptodate)
200
These cells are considered pathognomonic for Hodgkin lymphoma.
What are Reed-Sternberg cells ?
200
This condition is suggested by fever, dyspnea, hypotension, flank pain, and pink-colored urine appearing during or shortly after a transfusion.
What is an acute hemolytic transfusion reaction?
The transfusion must be stopped because the degree of hemolysis and prognosis is proportional to the volume transfused. Volume expansion and supportive care for associated complications are also necessary.
300
Low haptoglobin, high reticulocyte, LDH and bilirubin are commonly seen in this type of anemia.
What is Hemolytic Anemia?
300
The Starry Night is a famous painting by Vincent Van Gogh, whereas the Starry Sky is most famous for its classic association with this malignancy.
What is Burkitt lymphoma?
300
In addition to discontinuing warfarin, first line therapy in patients receiving warfarin with life-threatening hemorrhage.
What is 4-factor prothrombin complex and vitamin K?
- Give 4F PCC* 1500 to 2000 units¶ IV over 10 minutes. Check INR 15 minutes after completion of the infusion. If INR is not ≤1.5, give additional 4F PCC (refer to topic or drug reference for details).
- Give vitamin K 10 mg IV over 10 to 20 minutes.
300
First line treatment for a symptomatic patient with Hereditary hemochromatosis.
What is phlebotomy?
Symptomatic patients with evidence of end-organ injury and those with a more significantly elevated serum ferritin level (>1000 ng/mL [1000 μg/L]) should undergo aggressive therapeutic phlebotomy.
300
Guidelines recommend that erythropoietin-stimulating agents be withheld in patients with CKD not requiring dialysis who have a hemoglobin level greater than this threshold.
What is 10 g/dL (100 g/L)?
Higher hemoglobin targets are associated with adverse events, including worsening hypertension and volume overload
400
Much more common in Africans, this syndrome is a leading cause of death during periods of emergency. It should be treated with supportive measures, empiric antibiotics and may even require a transfusion.
What is Acute Chest Syndrome?
Acute Chest Syndrome is a clinical diagnosis based on the constellation of fever (>38.6 °C [101.5 °F]), tachypnea, hypoxia, cough, shortness of breath, and new pulmonary infiltrate.
Patients with ACS should receive empiric antibiotics (infection triggers are not uncommon) in addition to adequate hydration and supplemental oxygen as determined by pulse oximetry. Incentive spirometry should be encouraged and adequate analgesia provided. These patients also require erythrocyte transfusion, either with packed red blood cells (PRBCs) or as exchange transfusion.
400
While the most famous of all trisomies is known for its increased risk of cancer, it is most commonly associated with this type.
What is AML?
Children with Down's syndrome are at an increased risk of developing any type of acute leukaemia. In particular, they are 150 times more likely to develop acute myeloid leukaemia (AML) and are at a 33 times greater risk of developing acute lymphoblastic leukaemia (ALL).
400
Originally isolated from salmon sperm, this agent is used for the reversal of certain bleeds.
What is Protamine sulfate? Emergent reversal of unfractionated heparin
400
Sharing its name with a famous Ketchup maker, the microscopic sign is famous for being found in this X-linked disorder.
What is glucose-6-phosphate dehydrogenase deficiency?
G6PD deficiency affects the hexose-monophosphate shunt with failure to generate nicotinamide adenine dinucleotide phosphate (NADPH). NADPH is necessary to reduce oxidative stress in response to medications, infection, or other toxins. Without NADPH, hemoglobin is subject to oxidation, and denatured hemoglobin aggregates (Heinz bodies) form.
400
The peripheral blood smear of a 67-year-old woman evaluated for anemia and hypercalcemia is concerning for this condition.
What is multiple myeloma?
The presence of anemia, hypercalcemia, and rouleaux formation is highly suggestive of multiple myeloma. Increased serum proteins associated with multiple myeloma will cause rouleaux formation, or stacking of the erythrocytes.
500
In patients with hemolytic anemia and a positive direct antiglobulin test to anticomplement (C3) but not IgG, the diagnosis can be confirmed by this lab.
What is cold agglutinin titer?
Cold agglutinins are IgM antibodies that can cause erythrocyte agglutination and hemolytic anemia, with extravascular hemolysis driven by complement fixation. In cold agglutinin disease, the direct antiglobulin test result is positive for anticomplement (C3) and negative for anti-IgG. Cold agglutinin hemolytic anemia can arise as a primary process or secondary to an underlying condition such as infection, lymphoproliferative disorders, or autoimmune disease. Mycoplasma pneumoniae is a common infectious issue associated with development of cold agglutinins.
500
The hallmark of chronic myeloid leukemia is t(9;22). This class of medication is considered to be the first line treatment when diagnosed in the chronic phase.
What is a tyrosine kinase inhibitor?
A tyrosine kinase inhibitor such as imatinib is considered first-line treatment for patients with chronic myeloid leukemia diagnosed in the chronic phase (<20% blasts in the bone marrow). TKIs bind to the BCR-ABL oncoprotein and prevent downstream signaling. Other TKIs include nilotinib and dasatinib. Availability of TKIs has dramatically changed outcomes in CML, with the 8-year overall survival in CML exceeding 90%.
500
Thrombocytopenia, prolonged coagulation studies, low fibrinogen level, and elevated D-dimer level can be found in 2 pathologies, which can theoretically be differentiated by this lab.
What is Factor VIII?
Distinguishing between liver disease and DIC may be challenging, but measuring the factor VIII activity is a theoretical means of separating these disorders. Factor VIII is often normal or elevated in patients with liver disease because factor VIII is produced in hepatic and nonhepatic endothelial cells; however, factor VIII is consumed in DIC. A normal or elevated factor VIII level will support liver disease as the cause of this patient's coagulopathy.
500
A 49 year old man is admitted to the ICU with meningococcal sepsis, his peripheral blood smear is suggestive of this condition.
What is microangiopathic hemolytic anemia?
Microangiopathic hemolytic anemia is confirmed by erythrocyte fragments seen on the peripheral blood smear that appear as schistocytes (irregularly shaped and jagged fragments) (blue arrows) and helmet cells (scooped-out erythrocytes that resemble a helmet or bucket) (red arrow).
500
For general cancer patients with plans to start chemotherapy, a Khorana Risk score of 2 or higher is indication to offer this intervention.
What is VTE prophylaxis?
According to the 2020 American Society of Clinical Oncology guideline on VTE prevention and treatment in patients with cancer, routine pharmacologic thromboprophylaxis should not be offered to all outpatients with cancer. Increased thrombotic risk in patients with cancer is measured using the Khorana score. The guideline recommends that high-risk outpatients with cancer (Khorana score of 2 or higher before starting a new systemic chemotherapy regimen) may be offered thromboprophylaxis with apixaban, rivaroxaban, or low-molecular-weight heparin (LMWH) provided no significant risk factors for bleeding and no drug interactions are identified.