Hematologic and Oncologic Disorders

Practice flashcards covering hematologic and oncologic disorders, including anemias, leukemias, lymphomas, and coagulopathies.

Pica

An unusual craving for non-food items such as ice or clay, seen as a clinical sign when hematocrit falls below $\text{Hct} > 30$.

Oral Ferrous Sulfate

Iron supplementation prescribed at $300\text{-}325\,\text{mg}$ taken $1\text{-}2\,\text{hours}$ after meals; absorption is inhibited by antacids and enhanced when taken with vitamin C-containing juice.

Thalassemia

A genetically inherited disorder characterized by abnormal hemoglobin production that results in microcytic, hypochromic anemia, occurring primarily in Mediterranean, African, Middle Eastern, Indian, and Asian populations.

Thalassemia Minor

A heterozygous form of beta thalassemia where an individual carries one beta thalassemia gene and one normal beta-chain gene, presenting with mild anemia that may mimic iron-deficiency anemia.

Thalassemia Major (Cooley's Anemia)

A homozygous beta thalassemia disorder involving two abnormal genes and absent normal adult hemoglobin ($\text{Hb A}$), leading to severe anemia within the first few months of life, hepatosplenomegaly, jaundice, failure to thrive, and maxillary enlargement.

Pernicious Anemia

A macrocytic, normochromic anemia resulting from intrinsic factor deficiency and subsequent malabsorption of vitamin $B_{12}$, characterized by serum $B_{12} < 200\,\text{pg/ml}$ and neurological abnormalities such as paresthesia, vibratory sense loss, and positive Romberg and Babinski signs.

Anemia of Chronic Disease

The second most common form of anemia; a normocytic, normochromic anemia characterized by decreased erythrocyte life span associated with chronic infection, inflammation, renal failure, or malignancy, presenting with low serum iron, low TIBC, and elevated serum ferritin ($> 100\,\text{ng/ml}$).

Folic Acid Deficiency

A macrocytic, normochromic anemia caused by inadequate dietary intake or malabsorption of folate, marked by red blood cell folate $< 100\,\text{ng/ml}$ and differentiated from pernicious anemia by the complete absence of neurological signs.

Sickle Cell Anemia

A genetically transmitted chronic hemolytic anemia characterized by distorted sickle-shaped red blood cells that lead to vessel obstruction, cellular hypoxia, acidosis, tissue ischemia, and sudden severe pain in the back, abdomen, extremities, and joints.

Von Willebrand Disease

A genetic bleeding disorder caused by a mutation or deficiency in von Willebrand factor and clotting factor VIII, presenting with frequent, prolonged bleeding and easy bruising, managed with desmopressin or recombinant factor concentrates.

Acute Myelogenous Leukemia (AML)

A hematopoietic neoplasm accounting for $80\%$ of acute leukemias in adult patients, with remission rates ranging between $50\%$ and $85\%$ and a long-term survival rate of $40\%$.

Acute Lymphocytic Leukemia (ALL)

A leukemia characterized by pancytopenia with circulating blasts as its hallmark; exhibits a $90\%$ remission rate in pediatric patients but is more difficult to cure in adults.

Chronic Lymphocytic Leukemia (CLL)

The most common leukemia in adults, presenting in middle and older age with a hallmark of persistent lymphocytosis and a median survival of $10\,\text{years}$.

Chronic Myelogenous Leukemia (CML)

A myeloproliferative disorder seen most often in individuals aged $40$ and older, characterized by the Philadelphia chromosome in leukemic cells and a $5\text{-year}$ survival rate of approximately $65\%$.

Allopurinol

A pharmacologic agent initiated prior to or during chemotherapy to prevent and reduce tumor lysis syndrome in high-risk leukemia patients.

Lymphoma Staging

The anatomical staging system for lymphomas: Stage I (single node/group), Stage II ($> 1$ node group on one side of diaphragm), Stage III (nodal or splenic involvement on both sides of diaphragm), and Stage IV (disseminated involvement of liver or bone marrow).

Non-Hodgkin's Lymphoma

A lymphocytic malignancy of unknown or viral etiology that represents the most common neoplasm between ages $20\text{-}40\,\text{years}$, typically presenting with lymphadenopathy and an unpredictable pattern of spread.

Hodgkin's Disease

A lymphoid malignancy more common in males with an average presentation age of $32\,\text{years}$, typically beginning with cervical adenopathy and progressing predictably along contiguous lymph node groups.

Reed-Sternberg Cells

Distinctive malignant multinucleated giant cells identified on lymph node biopsy that confirm the diagnosis of Hodgkin's disease and differentiate it from non-Hodgkin's lymphoma.

Idiopathic Thrombocytopenic Purpura (ITP)

An acquired autoimmune disorder causing platelet destruction with or without suppressed thrombopoiesis, occurring three times more frequently in females ($3:1$) and managed when platelets fall below $< 20{,}000$ using corticosteroids or intravenous gamma globulin.

Thrombocytopenic Precautions

A set of preventive clinical measures to minimize bleeding risk in low platelet states, including avoiding constipation, holding shaving, avoiding dental flossing, and applying direct pressure to puncture sites for at least $5\,\text{minutes}$.

Direct Thrombin Inhibitors (Argatroban and Lepirudin)

Anticoagulant medications indicated for the clinical management of heparin-induced thrombocytopenia purpura (HIT).

Disseminated Intravascular Coagulation (DIC)

A life-threatening acquired disorder caused by widespread intravascular activation of thrombin and plasmin, triggering concurrent microvascular thrombosis and hemorrhagic factor consumption with a mortality rate of $50\%\text{-}85\%$.

Fibrin Degradation Products (FDPs)

Anticoagulant fragments produced by plasmin-mediated breakdown of fibrin clots; measured at $> 45\,\mu\text{g/ml}$ or at dilutions $> 1:100$ in acute DIC, where they directly impair hemostasis.

D-Dimer Test in DIC

A diagnostic laboratory assay reflecting concurrent thrombin and plasmin activation; positive at dilutions $> 1:8$, providing a $96\%$ predictive accuracy for disseminated intravascular coagulation when combined with elevated FDPs.

Cryoprecipitate

A concentrated blood product specifically administered during severe hemorrhage in disseminated intravascular coagulation to replenish depleted plasma fibrinogen levels.

Fresh Frozen Plasma (FFP)

A component therapy transfused during acute DIC hemorrhage to replace consumed clotting factors, including factors V and VIII, prothrombin, and fibrinogen.