ABIM Hematology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Restrictive transfusion threshold

For most stable hospitalized adults, a hemoglobin trigger of 7 to 8 g/dL is noninferior to a liberal trigger and reduces exposure to donor blood and transfusion reactions.

Platelet threshold for lumbar puncture

Platelet transfusion is generally recommended to raise the count to at least 50,000/microL before lumbar puncture or major surgery to reduce bleeding risk.

Irradiated blood products indication

Irradiation prevents transfusion-associated graft-versus-host disease and is indicated for Hodgkin lymphoma, aplastic anemia, and intrauterine or neonatal transfusion, among other cellular immunodeficiencies.

Traumatic tap correction

When cerebrospinal fluid is blood-contaminated, subtract one white blood cell per 700 red blood cells from the counted white cells to estimate the true cell count.

Ferritin in iron deficiency

A serum ferritin below 30 ng/mL is diagnostic of iron deficiency; values of 30 to 100 ng/mL require transferrin saturation to distinguish deficiency from inflammation.

Anemia of chronic disease pattern

Low serum iron, low total iron-binding capacity, normal or elevated ferritin, and reduced transferrin saturation characterize anemia of inflammation, which is typically normocytic.

CML molecular hallmark

Chronic myeloid leukemia is defined by the t(9;22) translocation producing BCR-ABL1; tyrosine kinase inhibitors are first-line therapy and response is tracked by quantitative transcript levels.

APL genetic defining lesion

Acute promyelocytic leukemia carries t(15;17) forming PML-RARA; treatment uses all-trans retinoic acid plus arsenic trioxide with aggressive platelet and fibrinogen support.

Myeloma-defining events

Plasma cell myeloma can be diagnosed without CRAB features when clonal plasma cells exceed 60 percent, free light chain ratio exceeds 100, or more than one MRI lesion is present.

Heparin-induced thrombocytopenia management

Stop all heparin immediately and start a non-heparin anticoagulant such as argatroban, bivalirudin, or fondaparinux; platelet transfusions are generally avoided because of thrombosis risk.

TTP diagnostic confirmation

Thrombotic thrombocytopenic purpura is confirmed by ADAMTS13 activity below 10 percent; plasma exchange should begin urgently on clinical suspicion without waiting for the result.

Acute chest syndrome therapy

Sickle cell acute chest syndrome is treated with oxygen, antibiotics, bronchodilators, incentive spirometry, and transfusion to a hemoglobin near 10 g/dL, avoiding hyperviscosity.

Transfusion reaction root cause

Clerical error causing wrong-blood administration is the most common cause of acute hemolytic transfusion reactions, so bedside identity verification is the key preventive control.

Anticoagulation reversal time metric

Interval from intracranial hemorrhage recognition to reversal agent administration is a trackable quality measure reflecting protocol reliability and pharmacy readiness.

Single-unit transfusion metric

The proportion of red cell orders that are single-unit with reassessment is a standard audit measure of blood stewardship and is reported to the hospital transfusion committee.

Trial enrollment as quality measure

The fraction of eligible patients screened and enrolled in clinical trials benchmarks access to novel therapy and care delivery performance in malignant hematology.

Chemotherapy consent elements

Consent must cover treatment intent, expected benefit, common and serious toxicities, alternatives including no therapy, and effects on fertility before cytotoxic agents are given.

Serious news conversation steps

Prepare the setting, assess baseline understanding, deliver information in plain language, respond empathetically to emotion, and summarize agreed next steps.

Goals-of-care documentation

Documented discussion of patient values and prognosis is associated with less unwanted aggressive end-of-life care and earlier hospice referral in advanced hematologic malignancy.

Interpreter use standard

Professional interpretation is required for patients with limited English proficiency; minor children and untrained family members should not serve as medical interpreters.

Hematology handoff essentials

Handoffs must state anticoagulation status, recent transfusions, neutropenia and isolation precautions, pending crossmatches, and time-critical therapy windows.

Sunshine Act reporting

Federal law requires public reporting of transfers of value from industry to physicians, including consulting fees, speaking honoraria, meals, and gifts.

Genetic confidentiality limits

Disclosing a heritable hematologic diagnosis to at-risk relatives generally requires patient permission, balancing family benefit against the duty of confidentiality.

Research equipoise principle

Human subjects research requires institutional review board approval and informed consent, with genuine uncertainty about comparative benefit and minimization of risk.

Record alteration prohibition

Retroactively editing the medical record to reflect orders or care that did not occur is fraudulent and grounds for disciplinary action.

Anticoagulation stewardship program

Such programs standardize indication, agent choice, monitoring, and reversal protocols, reducing bleeding events and drug cost across an institution.

Hospital transfusion committee role

This committee oversees blood utilization, reaction reporting, and blood bank policy, and commonly promotes restrictive transfusion protocols to improve safety and reduce cost.

Infusion center capacity planning

Chair time, pharmacy turnaround, and immediate hypersensitivity response capability must be planned to avoid delays in chemotherapy administration and to manage reactions safely.

Prior authorization delay metric

Tracking time from oral targeted agent prescription to approval identifies specialty pharmacy bottlenecks that delay initiation of tyrosine kinase inhibitors and similar drugs.

Sickle cell medical home model

A dedicated hematologist, written individualized pain plan, and coordinated emergency department protocol reduce crisis visits and improve continuity for adults with sickle cell disease.

FACT accreditation scope

The Foundation for the Accreditation of Cellular Therapy accredits transplant and apheresis programs, verifying quality standards for stem cell collection, processing, and administration.

Value-based hematology measures

Payment models increasingly link reimbursement to emergency department use, readmissions, and adherence to oral anticoagulants or tyrosine kinase inhibitors.