*spooky laugh* (MAHAHAHA)
HalloTWEEN
100
Name five laboratory tests that should be included in the initial evaluation of suspected hemolytic anemia.
LDH, haptoglobin, indirect bilirubin, reticuloyte count, and peripheral blood smear.
Hemolytic anemia typically presents with elevated LDH, decreased haptoglobin, elevated indirect bilirubin, reticulocytosis, and peripheral smear abnormalities (e.g., schistocytes in MAHA).
A direct antiglobulin test (DAT/Coombs) is also important to distinguish immune from nonimmune hemolysis.
100
n parts of the northeastern United States, October 30th is known by this name, traditionally associated with pranks such as egging houses, toilet-papering trees, and ringing doorbells before running away.
What is Mischief Night?
200
This scoring system can be used to help risk-stratify patients for whom TTP is on the differential diagnosis.
What is the PLASMIC Score?
200
This candy features two crunchy biscuit sticks covered in caramel and chocolate, traditionally packaged together in a gold wrapper.
What is Twix?
300
List one complication of a gastric sleve procedure and two complications of a Roux-en-Y gastric bypass.
Sleeve gastrectomy: Gastroesophageal reflux disease (GERD), staple-line leak, or gastric sleeve stenosis.
Roux-en-Y gastric bypass: Internal hernia, dumping syndrome, marginal ulceration, small bowel obstruction, or nutritional deficiencies (iron, vitamin B12, calcium, thiamine).
300
This Disney Channel original movie follows a young girl who discovers that her grandmother is a witch and lives in a magical town filled with supernatural creatures.
What is Halloweentown?
400
This class of medications should be considered for a patient with MAHA, for which infectious workup is bland and ADAMSTS13 level is >10%.
What are complement inhibitors?
Examples include eculizumab and ravulizumab, monoconal antibodies targeting complement protein C5.
These are used to treat complement-mediated thrombotic microangiopathy (atypical HUS).
MAHA with thrombocytopenia, ADAMTS13 activity ≥10%, and negative Shiga toxin testing should raise suspicion for complement-mediated TMA, although other causes of TMA must also be excluded.
400
This 2013 horror film, often associated with Halloween movie marathons, centers on a family that is terrorized by a supernatural entity after moving into a farmhouse in Rhode Island.
What is The Conjuring?
500
A 38-year-old patient presents with recurrent abdominal pain, fatigue, and progressive anemia. Laboratory studies reveal elevated LDH, undetectable haptoglobin, and a negative direct antiglobulin test. Imaging demonstrates hepatic vein thrombosis. Bone marrow biopsy reveals hypocellularity without evidence of malignancy. This acquired hematologic disorder best explains the constellation of findings.
What is paroxysmal nocturnal hemoglobinuria (PNH)?
Teaching pearl: PNH should be suspected in patients with Coombs-negative intravascular hemolysis, unusual-site thrombosis (particularly Budd-Chiari syndrome), and bone marrow failure. It results from an acquired PIGA mutation in hematopoietic stem cells and can coexist with aplastic anemia.
500
This Wonka candy, popular in the 2000s and early 2010s, consisted of chewy, fruit-flavored pieces shaped like miniature bottle caps with a hard outer shell.
What are Chewy Gobstoppers?