Difference between revisions of "HemOnc"
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| + | =Multiple Myeloma= | ||
| + | *H&P: Often presents with CRAB symptoms (Calcium, Renal failure, Anemia, or Bone lesions) or frequent infections. Can be complicated by unstable bradycardia, osteoporosis, ATN (via IG light chain, an endogenous nephrotoxin), nephrotic syndrome secondary to renal (AL) amyloidosis, type II RTA | ||
| + | *Dx: Bone marrow biopsy showing >10% clonal plasma cells + end organ damage (CRAB) OR >60% clonal plasma cells without end organ damage. M-spike on SPEP (also shows up in smoldering myeloma). Bone scan shows punched out lesions. Impaired platelet function. β2 microglobulin is a prognostic marker. | ||
| + | *Tx: Autologous Stem Cell Transplant or chemotherapy | ||
| + | |||
=Missed Concepts= | =Missed Concepts= | ||
*For supratherapeutic INR in a patient on Warfarin, if INR <4.5, can hold Warfarin for 1-2 days then recheck and resume, if INR 4.5-10, give 1-2.5 mg PO vitamin K. | *For supratherapeutic INR in a patient on Warfarin, if INR <4.5, can hold Warfarin for 1-2 days then recheck and resume, if INR 4.5-10, give 1-2.5 mg PO vitamin K. | ||
*The biggest drawback of IVC filters is that they '''double the risk of DVT''' | *The biggest drawback of IVC filters is that they '''double the risk of DVT''' | ||
*Factor V Leiden accounts for about 50% of hereditary thrombophilia. | *Factor V Leiden accounts for about 50% of hereditary thrombophilia. | ||
Revision as of 05:56, 14 January 2023
Multiple Myeloma
- H&P: Often presents with CRAB symptoms (Calcium, Renal failure, Anemia, or Bone lesions) or frequent infections. Can be complicated by unstable bradycardia, osteoporosis, ATN (via IG light chain, an endogenous nephrotoxin), nephrotic syndrome secondary to renal (AL) amyloidosis, type II RTA
- Dx: Bone marrow biopsy showing >10% clonal plasma cells + end organ damage (CRAB) OR >60% clonal plasma cells without end organ damage. M-spike on SPEP (also shows up in smoldering myeloma). Bone scan shows punched out lesions. Impaired platelet function. β2 microglobulin is a prognostic marker.
- Tx: Autologous Stem Cell Transplant or chemotherapy
Missed Concepts
- For supratherapeutic INR in a patient on Warfarin, if INR <4.5, can hold Warfarin for 1-2 days then recheck and resume, if INR 4.5-10, give 1-2.5 mg PO vitamin K.
- The biggest drawback of IVC filters is that they double the risk of DVT
- Factor V Leiden accounts for about 50% of hereditary thrombophilia.