Hematology

What distinguishes iron deficiency anemia from thalassemia?

Thalassemia presents with normal iron and ferritin levels.

What happens if iron is given to a patient with iron deficiency anemia?

The patient's condition improves.

What is a key laboratory finding in iron deficiency anemia?

Increased red cell distribution width (RDW).

What is a common blood smear finding in thalassemia?

Target cells are often observed.

What is the next best step if thalassemia is suspected?

Perform hemoglobin electrophoresis.

How does a-thalassemia differ from b-thalassemia in terms of mutations?

a-thalassemia can have 1-4 mutations; b-thalassemia has 2.

What is a consequence of repeated blood transfusions in thalassemia patients?

Iron overload, known as transfusional siderosis.

What is a typical presentation of b-thalassemia major?

Presents as a sick child with severe symptoms.

What does a normal hemoglobin electrophoresis indicate in a-thalassemia?

It suggests no abnormal hemoglobin synthesis.

What is a common symptom in children with severe thalassemia?

Hepatosplenomegaly due to extramedullary hematopoiesis.

What is anemia of chronic disease (AoCD)?

Caused by cytokines blocking iron release and hepcidin reducing gut absorption.

How does AoCD differ from iron deficiency anemia?

Ferritin levels are normal or slightly high in AoCD.

What is the primary treatment for AoCD due to renal failure?

EPO is used to address cytokine-mediated EPO deficiency.

What is multiple myeloma?

Cancer of plasma cells leading to increased serum immunoglobulins.

What are common symptoms of multiple myeloma?

Mid-back pain and hypercalcemia due to lytic bone lesions.

What does serum protein electrophoresis (SPEP) show in multiple myeloma?

Monoclonal spike of IgG kappa or lambda light chains.

What is Waldenstrom macroglobulinemia?

Cancer of plasmacytoid cells causing IgM M-protein spike.

How does Waldenstrom macroglobulinemia differ from multiple myeloma?

Does not cause hypercalcemia or lytic lesions.

What is polycythemia vera?

Caused by JAK2 mutation leading to increased hematopoietic stem cell proliferation.

What lab findings indicate polycythemia vera?

Elevated Hb, WBCs, and platelets; EPO is suppressed.

What is the difference between polycythemia vera and secondary polycythemia?

Secondary polycythemia has normal WBCs and platelets with increased EPO.

What does a high prothrombin time (PT) indicate?

Issues with the extrinsic clotting pathway.

What does a high activated partial thromboplastin time (PTT) indicate?

Problems with the intrinsic clotting pathway.

What is idiopathic thrombocytopenic purpura (ITP)?

Autoimmune condition causing low platelet count and increased bleeding time.

What triggers ITP?

Viral infections can precipitate antibody formation against platelets.

What is von Willebrand disease (vWD)?

Autosomal dominant disorder affecting platelet adhesion.

How does vWD affect bleeding time and PTT?

Increased bleeding time; PTT may be normal or elevated.

What is the treatment for vWD?

Desmopressin (DDAVP) to boost functional vWF levels.

What causes vitamin K deficiency?

Inadequate intake or absorption, often due to antibiotics.

What are the lab findings in vitamin K deficiency?

Increased PT and PTT; normal bleeding time.

What is disseminated intravascular coagulation (DIC)?

Consumption of clotting factors and platelets due to various triggers.

What are the lab findings in DIC?

Increased BT, PT, PTT, D-dimer; decreased fibrinogen and platelets.