Deck 1 Flashcards
Precipitating factors of G6PD?
Infections, drugs (dapsone, antimalarials, sulfa antibiotics), DKA, favism
What med is used for CMV? Side effects?
Gancyclovir. Neutropenia, anemia, thrombocytopenia, impaired renal function
What effect does Cp450 have on warfarin?
CYP450 enhancers (rifampin, phenobarbital, phenytoin) decrease efficacy of warfarin. Inhibitors (cimetidine, amioridone, TMP-SMX) increase efficacy
What reverses MTX toxicity?
Leucovorin (folinic acid)
What agents prevent chemo induced vomiting?
serotonin antag. (ondansetron), DA antagonists (metoclopramide, prochlorperazine), NK1 antagonists
What is fast and slow way to reverse warfarin toxicity?
Fast = fresh frozen plasma. Slow = vitamin K
Heinz bodies and bite cells
G6PD
Reversal of heparin toxicity?
protamine sulfate (Not FFP)
Newborn with clotting problem?
Think vitamin K deficiency- not transferred over and don’t have gut bacteria yet. Problem of clotting factor carboxylation
Polycythemia vera mutation and characteristics?
V > F of JAK2 gene rendering hematopoeitic cells more sensitive to growth factors = Thrombotic events, pruritus, peptic ulcer, gouty arthritis, ruddy face and splenomegaly.
What disorders have a JAK2 mutation leading to constituitive activity of JAK-STAT pathway?
Chronic myeloproliferative disorders - PV, essential thrombocytosis, primary myelofibrosis
inheritence of G6PD?
X linked recessives
Bony pain at night- what causes it?
Spinal metastasis; Commonly prostate, but also breast, kidney, thyroid, lung (PB/KTL or “lead kettle”)
Condition of absent B cells but intact T cells?
Brutons (x-linked agammaglobulinemia)
Kaposis sarcoma is characterized how and associated with what?
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
Bloody diarrhea and schistocytes?
Hemolytic uremic syndrome
HIV signs….
Candida infection, diarrhea, weightloss, lymphadenopathy, thrush. Can increase risk of EBV associated lymphomas
What condition if sarcoma, leukemia, adrenal, breast, brain….
Li fraumeni - TP53 (SLABB)
What hereditary neoplasm conditions are autosomal dominant?
Lynch, FAP, VHL, Li Fraumeni, MEN
What condition if colorectal, endometrial, ovarian?
Lynch
What condition/ gene if… colorectal, desmoids & osteomas, brain?
FAP - APC gene
What condition/ gene if… hemangioblastomas, clear cell renal carcinoma, pheo?
von Hippel Lindau -VHL gene
What condition/ gene if… sarcomas, breast cancer, brain, adrenocortical, leukemia?
Li Fraumeni - TP53
What condition/ gene if… PTH, pituitary, pancreatic?
MEN1
What condition/ gene if… PTH, medullary thyroid, pheo
MEN2 - RET
Which is an autosomal dominant gain of function mutation (provo-oncogene)?
MEN2 - RET
What direction does DNA synth occur?
5’ - 3’. (goes 3-5 on template strand)
What does proteosome inhibition by bortezomib cause in multiple myeloma?
Induces apoptosis
What enzyme is restricted to the nucleolus?
RNA Pol 1; Nucleolus is also site of ribosomal subunit maturation and assembly
Local vs. metastatic carcinoid?
Don’t see flushing, diarrhea, bronchospasm if local because 5HIAA and prostaglandins get metabolized by liver; Have to metastasize to liver to see symptoms
Whats the difference between LMWheparin and normal heparin?
Both bind antithrombin leading to a conformational change to inhibit Xa and thrombin; Heparin does both. LMWH = only Xa
Difference between ELISA and Western blot
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
Northern blot?
mRNA
Signs of dermatomyositis?
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
Why can someone receiving whole blood experience parasthesias?
The solutions in the blood have a citrate anticoagulant that can bind to calcium and cause hypocalcemia –> parasthesias
What is the haldane effect with RBC’s?
In alveolar capillaries pO2 increases the binding to O2 and causes release of H and CO2
How do nitrates cause poisoning of hemoglobin?
Induce conversion to oxidized ferric (3+) form leading to formation of methemoglobin -> Now unable to bind oxygen
How does desmopressin help with bleeding disorders?
Increases circulating factor VIII and vWF
Difference between Th1 and Th2 ? What does Th1 do?
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
Difference between Th1 and Th2 ? What does Th2 do?
Th2: Humoral. Activates B cells/ class switching. Secretes IL-4, IL-5, IL-10, IL-13
