Deck 1

Question 1

Precipitating factors of G6PD?

Answer 1

Infections, drugs (dapsone, antimalarials, sulfa antibiotics), DKA, favism

Question 2

What med is used for CMV? Side effects?

Answer 2

Gancyclovir. Neutropenia, anemia, thrombocytopenia, impaired renal function

Question 3

What effect does Cp450 have on warfarin?

Answer 3

CYP450 enhancers (rifampin, phenobarbital, phenytoin) decrease efficacy of warfarin. Inhibitors (cimetidine, amioridone, TMP-SMX) increase efficacy

Question 4

What reverses MTX toxicity?

Answer 4

Leucovorin (folinic acid)

Question 5

What agents prevent chemo induced vomiting?

Answer 5

serotonin antag. (ondansetron), DA antagonists (metoclopramide, prochlorperazine), NK1 antagonists

Question 6

What is fast and slow way to reverse warfarin toxicity?

Answer 6

Fast = fresh frozen plasma. Slow = vitamin K

Question 7

Heinz bodies and bite cells

Answer 7

G6PD

Question 8

Reversal of heparin toxicity?

Answer 8

protamine sulfate (Not FFP)

Question 9

Newborn with clotting problem?

Answer 9

Think vitamin K deficiency- not transferred over and don’t have gut bacteria yet. Problem of clotting factor carboxylation

Question 10

Polycythemia vera mutation and characteristics?

Answer 10

V > F of JAK2 gene rendering hematopoeitic cells more sensitive to growth factors = Thrombotic events, pruritus, peptic ulcer, gouty arthritis, ruddy face and splenomegaly.

Question 11

What disorders have a JAK2 mutation leading to constituitive activity of JAK-STAT pathway?

Answer 11

Chronic myeloproliferative disorders - PV, essential thrombocytosis, primary myelofibrosis

Question 12

inheritence of G6PD?

Answer 12

X linked recessives

Question 13

Bony pain at night- what causes it?

Answer 13

Spinal metastasis; Commonly prostate, but also breast, kidney, thyroid, lung (PB/KTL or “lead kettle”)

Question 14

Condition of absent B cells but intact T cells?

Answer 14

Brutons (x-linked agammaglobulinemia)

Question 15

Kaposis sarcoma is characterized how and associated with what?

Answer 15

Bluish or brown dermal plaques on hands and feet, lesion of mucosa of face and genitals, lesions in GI and lungs. Histo: spindle and epithelial proliferation, RBC extravasation; HIV and HH8

Question 16

Bloody diarrhea and schistocytes?

Answer 16

Hemolytic uremic syndrome

Question 17

HIV signs….

Answer 17

Candida infection, diarrhea, weightloss, lymphadenopathy, thrush. Can increase risk of EBV associated lymphomas

Question 18

What condition if sarcoma, leukemia, adrenal, breast, brain….

Answer 18

Li fraumeni - TP53 (SLABB)

Question 19

What hereditary neoplasm conditions are autosomal dominant?

Answer 19

Lynch, FAP, VHL, Li Fraumeni, MEN

Question 20

What condition if colorectal, endometrial, ovarian?

Answer 20

Lynch

Question 21

What condition/ gene if… colorectal, desmoids & osteomas, brain?

Answer 21

FAP - APC gene

Question 22

What condition/ gene if… hemangioblastomas, clear cell renal carcinoma, pheo?

Answer 22

von Hippel Lindau -VHL gene

Question 23

What condition/ gene if… sarcomas, breast cancer, brain, adrenocortical, leukemia?

Answer 23

Li Fraumeni - TP53

Question 24

What condition/ gene if… PTH, pituitary, pancreatic?

Answer 24

MEN1

Question 25

What condition/ gene if… PTH, medullary thyroid, pheo

Answer 25

MEN2 - RET

Question 26

Which is an autosomal dominant gain of function mutation (provo-oncogene)?

Answer 26

MEN2 - RET

Question 27

What direction does DNA synth occur?

Answer 27

5’ - 3’. (goes 3-5 on template strand)

Question 28

What does proteosome inhibition by bortezomib cause in multiple myeloma?

Answer 28

Induces apoptosis

Question 29

What enzyme is restricted to the nucleolus?

Answer 29

RNA Pol 1; Nucleolus is also site of ribosomal subunit maturation and assembly

Question 30

Local vs. metastatic carcinoid?

Answer 30

Don’t see flushing, diarrhea, bronchospasm if local because 5HIAA and prostaglandins get metabolized by liver; Have to metastasize to liver to see symptoms

Question 31

Whats the difference between LMWheparin and normal heparin?

Answer 31

Both bind antithrombin leading to a conformational change to inhibit Xa and thrombin; Heparin does both. LMWH = only Xa

Question 32

Difference between ELISA and Western blot

Answer 32

Both proteins that are put on membrane with antibodies for probe of protein, but ELISA tests serum directly and western blot does gel electrophoresis first

Question 33

Northern blot?

Answer 33

mRNA

Question 34

Signs of dermatomyositis?

Answer 34

Autoimmune inflammatory dz that affects muscles and skin (proximal muscle weakness, heliotrope rash, Gottrons papules, perimysial infiltrates on histo) and can be paraneoplastic syndrome with ovarian, lung, colorectal and non-hodgkins lymphoma cancer

Question 35

Why can someone receiving whole blood experience parasthesias?

Answer 35

The solutions in the blood have a citrate anticoagulant that can bind to calcium and cause hypocalcemia –> parasthesias

Question 36

What is the haldane effect with RBC’s?

Answer 36

In alveolar capillaries pO2 increases the binding to O2 and causes release of H and CO2

Question 37

How do nitrates cause poisoning of hemoglobin?

Answer 37

Induce conversion to oxidized ferric (3+) form leading to formation of methemoglobin -> Now unable to bind oxygen

Question 38

How does desmopressin help with bleeding disorders?

Answer 38

Increases circulating factor VIII and vWF

Question 39

Difference between Th1 and Th2 ? What does Th1 do?

Answer 39

Th1: Cell mediated immunity = activates Mx and cytotoxic T cells. Mx produces IL-12 to differentiate to Th1. Th1 then secretes IFN-gamma, IL-2, lymphotoxin B; Causes cytotoxicity and delayed hypersensitivity

Question 40

Difference between Th1 and Th2 ? What does Th2 do?

Answer 40

Th2: Humoral. Activates B cells/ class switching. Secretes IL-4, IL-5, IL-10, IL-13