what condition cause hypoxic erythrocytosisSaO2<92% (PaO2<65%) can cause secondary polycythemia
(classified as absolute polycythemia= ☆increase in true RBC mass (51Cr-tagged red blood cell infusion)) hematologyrespiratoryUWorld Jun 14, 2020, 4:25 AM HirotoShishido
urinalysis for multiple myelomaFor urinalysis, use 24-hr urine protein electrophoresis (UPEP) to detect ☆light chain, as routine urine dipstick detects only albumin. hematologyUWorld Jun 12, 2020, 6:50 AM HirotoShishido
what molecular findings suggest malignancy in the patient with lymphoma☆monoclonal T-cell receptor(TCR) gene rearrangements
The clonality of a T-cell population
can be assesed by molecular methods such as PCR. If a single allele for the V region of the TCR predominates in a lymphocytlc population, monoclonal proliferation is suspected. hematologyimmunologyUWorld Jun 6, 2020, 10:42 PM HirotoShishido
how to test cold agglutinins
treatmentTesting for cold agglutinins can be done at the bedside by drawing blood into an edetate disodium-containing tube and placing it in a ☆cup of ice. Removing the tube after several seconds will reveal clumping/agglutination(turbidity) that resolves as the tube warms.
primary central nervous system lymphoma(PCNSL)non Hodgkin lymphoma of ☆B-cell origin that occurs as a late complication of HIV infection
needs to be distinguished from toxoplasmosis via CSF analysis→ positive EBV polymerase chain reaction analysis
+ in toxoplasmosis, ★multiple ring-enhancing lesions are usually present
age related changes in bone marrowhigher quantity of fat and a ☆reduced overall mass
→ older patients with acute traumatic blood loss have a much lower reticulocyte count and much longer time to recovery to pretrauma hemoglobin level compared to younger patients
heparin-induced trombocytopenia and thrombosis(HITT)
onset, mechanism of aggregation+thrombocytopenia5-10days following exposure to heparin products
the generation of IgG antibodies to ☆heparin and platelet factor 4(PF4) → Fc component of the IgG than binds to additional platelets→ widespread platelet activation
bortezomibfirst line for multiple myeloma for both an induction therapy and chemotherapy alone
(HSCT eligible : induction therapy followed by autologous HSCT
HSCT ineligible: chemotherapy alone)
Proteasome inhibitor→accumulation of toxic intracellular proteins, and an excess of proapoptotic proteins
Both of these effects induce ☆apoptosis of the malignant plasma cells. hematologyUWorld Apr 22, 2020, 4:59 AM HirotoShishido
change in PTH for the patients with multiple myelomaosteolytic cytokines→
liberate calcium from bone→
hypercalcemia→
inhibits the release of PTH from parathyroid cells→
①increase urinary calcium excretion(☆hypercalciuria)
②reduce renal 1-alfa-hydroxylase→☆low 1,25 dihydroxyvitamine D endocrinologyhematologyUWorld Apr 18, 2020, 6:48 AM HirotoShishido
blood smear of aplastic crisisInfection of erythroid progenitor cells prevents red blood cell maturation, leading to formation of
☆abnormal giant pronormoblasts (several times larger than surrounding red
blood cells) with glassy, intranuclear viral inclusions. hematologyUWorld Apr 18, 2020, 6:27 AM HirotoShishido
when does therapeutic efficacy of warfarin take placeTherapeutic efficacy is delayed until ☆preexisting clotting factors in the plasma are consumed.
Although INR tends to slowly increase in the first few days of administration due to the short half-life of factor VII (4-6 hours), full therapeutic effect does not typically occur for 3 days due to the long half-life of factor II. hematologypharmacologyUWorld Apr 15, 2020, 11:54 PM HirotoShishido
in sickle cell trait, ☆HbA is higher than HbS throughout the lifetime
β-thalassemia major become symptomatic only ☆after 6 months, when fetal hemoglobin declines (HbF is rather protective in the infant)
newborns wrth sickle cell disease is also asymptomatic hematologyUWorld Apr 15, 2020, 3:56 AM HirotoShishido
hip and pelvic pain on exertion on the patient with sickle cell disease☆avascular necrosis
the second most common non-Hodgkin lymphoma
clinical coursefollicular lymphoma t(14;18)
(the most common→ DLBCL)
☆waxing and waning clinical course
in middle aged patients with painless(indolent) lymph node enlargement or abdominal discomfort from an abdominal mass hematologyUWorld Apr 13, 2020, 5:23 AM HirotoShishido
what are the subtrates for δ-aminolevulinic acid(ALA) synthaseglysine+succinyl CoA hematologyNBME Apr 4, 2020, 4:52 PM HirotoShishido