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Dr. Mel - Hemato/Oncology > First Aid > Flashcards

First Aid Flashcards

1
Q

3 diseases causing splenomegaly

A

Hairy cell leukemia
CML
Myelofibrosis

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2
Q

Reduced platelet function or quantity results in

A

Petechiae

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3
Q

Excess protease activity or deficient antiprotease activity

A

Centriacinar and panacinar emphysema

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4
Q

Elevated neutrophil count in 2 conditions

A

Bacterial infection

After a corticosteroid therapy (falsely elevated)

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5
Q

Hypersegmented neutrophils in 2 conditions

A

Vitamin B12 deficiency

Folate deficiency

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6
Q

5 causes of eosinophilia

A 
Neoplasia
Asthma
Allergic processes
Chronic adrenal insuffisiency
Parasites (invasive)
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7
Q

Basophil granules contain 3 products

A

Heparin (anticoagulant)
Histamine (vasodilator)
Leukotrienes (synthesized on demand)

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8
Q

2 disorders of mast cells

A

Urticaria pigmentosa

Systemic mastocytosis

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9
Q

Langhans cell and Langerhans cell

A

Langhans: multinucleared giant cell - from monocyte - granulomatous inflammation
Langerhans: dendritic cell in skin - from myeloid line

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10
Q

Treatment of ABO hemolytic disease of the newborn

A

Phototherapy or Exchange transfusion

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11
Q

5 thrombolytics

A 
Reteplase
Alteplase
Tenecteplase
Streptokinase
Tissue Plasminogen Activator (tPA)
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12
Q

Platelet plug: 1 pro-aggregation and 2 anti-aggregation factors

A

TXA2 (by platelets)

PGI2 and NO (by endothelial cells)

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13
Q

GpIb, GpIIb/IIIa, vWF deficiencies

A

GpIb: Bernard-Soulier syndrome
GpIIb/IIIa: Glanzmann thrombasthenia
vWF: von Willebrand disease

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14
Q

Difference between thalassemias and porphyrias

A

Thalassemias: abnomal globin synthesis
Porphyrias: abnormal heme synthesis

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15
Q

6 symptoms of lead poisoning

A 
Lead lines on gingivae and metaphyses
Encephalopathy
Erythrocyte basophilic stippling
Abdominal colic
Sideroblastic anemia
Drops (wrist and foot)
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16
Q

Treatment of Lead poisoning: 2 for adults and 1 for kids

A

Dimercaprol and EDTA

Succimer (chelation)

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17
Q

Treatment of sideroblastic anemia

A

Pyridoxine (vit B6)

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18
Q

5 causes of Cobalamin (vit B12) deficiency

A 
Insufficient intake (veganism)
Malabsorption (Crohn ds)
Pernicious anemia
Diphyllobotrium latum
Gastrectomy
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19
Q

2 differences between vitamin B9 and B12 deficiencies

A

B9: normal methylmalonic acid - NO neuro symptoms
B12: elevated methylmalonic acid - Neuro symptoms

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20
Q

Treatment of orotic aciduria

A

Uridine monophosphate

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21
Q

8 findings in intravascular hemolysis

A 
Low haptoglobin
High LDH
Schistocytes
High reticulocytes
Hemoglobinuria
Hemosiderinuria
Urobilinogen in urine
High unconjugated bilirubin
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22
Q

4 findings in extravascular hemolysis

A

Spherocytes
High LDH
High unconjugated bilirubin
Urobilinogen in urine

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23
Q

Anemia of chronic disease associated with 4 conditions

A

Rheumatoid arthritis
SLE
Neoplastic disorders
Chronic kidney disease

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24
Q

Aplastic anemia (by failure or destruction of myeloid stem cells) in 4 conditions

A

Radiation or drugs
Viral agents (ParvoB19, EBV, HIV, hepatitis)
Fanconi anemia
Idiopathic

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25
5 treatments for Aplastic anemia
``` Withdrawal of offending agent Immunosuppressive regimens Bone marrow allograft RBC/platelet transfusion Bone marrow stimulation ```
26
3 findings + treatment of Hereditary spherocytosis
Splenomegaly Aplastic crisis (ParvoB19) Osmotic fragility test + Splenectomy
27
4 findings in G6PD deficiency
Back pain Hemoglobinuria Heinz bodies Degmacytes (bite cells)
28
Triad + 1 finding + treatment of Paroxysmal nocturnal hemoglobinuria
Negative Coombs + pancytopenia + venous thrombosis CD55/59 deficiency Eculizumab
29
4 triggers that precipitate sickling
Low O2 High altitude Acidosis Dehydration
30
6 complications of Sickle cell anemia
Aplastic crisis (ParvoB19) Autosplenectomy (Howell-Jolly bodies) / Functional asplenia Splenic infarct / sequestration crisis Infection by encapsulated organisms (Salmonella osteomyelitis) Painful crises (vaso-occlusive) Renal papillary necrosis + Microhematuria
31
Diagnosis + Treatment of Sicke cell anemia
Hemoglobin electrophoresis Hydroxuyrea (elevates HbF) Hydration
32
Warm and Cold AIHAs associated with 3 conditions each
SLE - CLL - certain drugs CLL - Mycoplasma pneumonia - Infectious mononucleosis
33
Microangiopathic anemia seen in 4 conditions
DIC TTP/HUS SLE Malignant hypertension
34
Macroangiopathic anemia seen in 2 conditions
Prosthetic heart valve | Aortic stenosis
35
5 causes of Neutropenia
``` Sepsis / postinfection Drugs Aplastic anemia SLE Radiation ```
36
8 causes of Lymphopenia
``` HIV DiGeorge syndrome SCID SLE Corticosteroids Radiation Sepsis Postoperative ```
37
2 causes of Eosinopenia
Cushing syndrome | Corticosteroids
38
Effect of Corticosteroids on WBCs
Neutrophilia (impaired migration out of Vx) Eosinopenia (sequestered in lymph nodes) Lymphopenia (apoptosis)
39
2 conditions with Left shift (high neutrophil precursors)
``` In acute response to infection/inflammation (w/ neutrophilia) Leukoerythroblastic reaction (w/ immature RBCs) when severe anemia or marrow response ```
40
5 presentations in Lead poisoning
Microcytic anemia GI disease Chronic tubulointerstitial nephritis / Acute tubular necrosis Mental deterioration (children) Headache, memory loss, demyelination (adults)
41
5 P's of Acute intermittent porphyria
``` Painful abdomen Port wine-colored urine Polyneuropathy Psychological disturbances Precipitated by drugs (CYP450 inducers), alcohol, starvation ```
42
Treatment + MOA of Acute intermittent porphyria
Glucose + Heme (inhibit ALA synthase)
43
Treatment of Iron poisoning
IV deferoxamine or Oral deferasirox | Dialysis
44
Treatment of Hemophilia A, B and C
A: Desmopressin + Factor VIII concentrate B: Factor IX concentrate C: Factor XI concentrate
45
Difference between coagulopathies and platelet defects
Coagulopathies: deep tissue bleeding | Platelet defects: mucocutaneous bleeding
46
Treatment of HUS and TTP
HUS: plasmapheresis TTP: plasmapheresis, steroids
47
Presentations of HUS
Thrombocytopenia Microangiopathic hemolytic anemia Acute renal failure
48
Pentad of TTP
``` Neurologic symptoms Renal symptoms Fever Thrombocytopenia Microangiopathic hemolytic anemia ```
49
2 findings + 3 treatments of Immune thrombocytopenia
Anti-GpIIb/IIIa antibodies High megakaryocytes on marrow biopsy Steroids IVIG Splenectomy (if refractory)
50
Treatment + MOA of von Willebrand disease
Desmopressin (releases vWF stored in endothelium)
51
7 causes of DIC
``` Sepsis (Gram -) Trauma Obstetric complications Acute pancreatitis Malignancy Nephrotic syndrome Transfusion ```
52
6 lab findings in DIC
``` Schistocytes High PT, PTT, BT High fibrin degradation products (D-dimers) Low platelet count Low fibrinogen Low factors V and VIII ```
53
2 causes of Antithrombin deficiency
Inherited (diminishes the increase of PTT after Heparin) | Acquired (renal failure/nephrotic syndrome)
54
4 Hereditary Thrombosis syndromes (Hypercoagulability)
Antithrombin deficiency Factor V Leiden Protein C or S deficiency Prothrombin gene mutation
55
3 complications of Factor V Leiden
DVT Cerebral vein thromboses Recurrent pregnancy loss
56
1 finding in Protein C or S deficiency
High risk of thrombotic skin necrosis with hemorrhage after Warfarin
57
3 indications of Fresh frozen plasma
DIC Cirrhosis Immediate Warfarin reversal
58
5 constituents of Cryoprecipitate
``` Fibrinogene F VIII F XIII vWF Fibronectin ```
59
5 risks of blood transfusion
``` Infection (low) Transfusion reactions Iron overload Hypocalcemia (citrate) Hyperkalemia (RBC lysis in old blood) ```
60
7 characteristics of Hodgkin lymphoma
``` Localized, single node group Contiguous spread Good prognosis (predicted by stage) Reed-Sternberg cells Bimodal distribution Ass w/ EBV B symptoms ```
61
6 characteristics of Non-Hodgkin lymphoma
``` Multiple lymph nodes + extranodal Noncontiguous spread Majority B cells Children + adults Ass w/ HIV and Autoimmune ds Sometimes B symptoms ```
62
5 B cells and 2 T cells Non-Hodgkin lymphoma
``` Burkitt lymphoma Diffuse large B-cell lymphoma Follicular lymphoma Mantle cell lymphoma Primary central nervous system lymphoma ``` Adult T-cell lymphoma Mycosis fungoides / Sézary syndrome
63
6 characteristics of Burkitt lymphoma
``` Adolescents / yound adults t(8:14) "Starry sky" (lymphocytes + macrophages) Ass w/ EBV Jaw lesion (endemic) Pelvis or abdomen (sporadic) ```
64
4 characteristics of Follicular lymphoma
Adults t(14:18) Bcl-2 inhibits apoptosis Painless "waxing+waning" lymphadenopathy
65
4 characteristics of Mantle cell lymphoma
Adult males t(11:14) Very aggressive Late-stage presentation
66
4 characteristics of Primary CNS lymphoma
Adults Ass w/ HIV-AIDS Variable presentation (confusion, memory loss, seizures) Lesion on MRI (# dg: toxoplasmosis)
67
5 characteristics of Adult T-cell lymphoma
``` Adults Caused by HTLV (ass w/ IV drug) Cutaneous lesions Lytic bone lesions Hypercalcemia ```
68
4 characteristics of Mycosis fungoides / Sézary syndrome
Adults Skin patches-plaques (cutaneous T-cell lymphoma = Mycosis fungoides) Atypical CD4+ cells Progression to T-cell Leukemia (= Sézary sd)
69
5 findings of Multiple myeloma
High susceptibility to infection Primary amyloidosis M spike on serum protein electrophoresis (IgG>IgA) Ig light chains in urine (Bence Jones protein) Rouleaux (RBCs)
70
5 signs/symptoms of Multiple myeloma
``` Hypercalcemia Renal involvement Anemia (normocytic normochromic) Bone lytic lesions Back pain ```
71
4 characteristics of MGUS
Monoclonal expansion of plasma cells Asymptomatic No CRAB Lead to MM in 1-2%/year
72
3 characteristics of Waldenström macroglobulinemia
M spike (IgM) Hyperviscosity syndrome No CRAB
73
4 characteristics of Myelodysplastic syndromes
Ineffective hematopoiesis Defects in maturation of all nonlymphoid lineages De novo mutation or environmental exposure Risk of transfo to AML
74
7 characteristics of ALL
``` Children ++ / Worse in adults Ass w/ Down syndrome t(12:21) better pg May spread to CNS/testes Responsive to ttt Very high lymphoblasts (blood+marrow) TdT+ (preB + preT) and CD10+ (preB) ```
75
6 characteristics of CLL/SLL
``` >60 yo B-cell (CD20+ and CD5+) Asymptomatic Smudge cells (blood) Autoimmune hemolytic anemia Richter transformation (into aggressive lymphoma esp. DLBCL) ```
76
5 characteristics + treatment of HCL
``` Adult males Mature B-cell tumor Filamentous projections on LM Marrow fibrosis Massive splenomegaly ``` Cladribine Pentostatin
77
7 characteristics of AML
``` Adults (~65 yo) Auer rods Myeloperoxidase positive (esp in M3AML=APL) Very high myeloblasts (blood) 4 risk factors t(15:17) is APL subtype DIC (common presentation) ```
78
6 characteristics + treatment of CML
``` 45-85 yo (~64 yo) Philadelphia chromosome t(9:22), BCR-ABL Dysregulated production of granulocytes Splenomegaly May transform to AML or ALL Very low LAP ``` bcr-abl tyrosine kinase inhibitors (Imatinib)
79
Difference between CML and leukemoid reaction
CML: malignant neutrophils so very low LAP | Leukemoid reaction: benign neutrophilia so high LAP
80
4 characteristics + 4 symptoms of Langerhans cell histiocytosis
Proliferative disorders of dendritic cells (child) S-100 CD1a Biberck granules (on EM) Lytic bone lesions Skin rash (erythematous + scaling) Recurrent otitis media Mass in mastoid bone
81
5 findings of Leukemoid reaction
Benign leukocytosis (>50000) Underlying condition (severe inf/hge, acute hemolysis, solid tumor) BM: normal or hypercellular w/ mature neutro precursors Blood: Döhle bodies High LAP
82
4 myeloproliferative disorders + their association
Polycythemia vera Essential thrombocytopenia Myelofibrosis CML Ass w/ V617F JAK2 mutation
83
4 characteristics + treatment of Polycythemia vera
High hematocrit Intense itching after hot shower Erythromelalgia (severe burning pain + red-blue) Low EPO Aspirin
84
4 characteristics of Essential thrombocythemia
Massive proliferation of megakaryocytes + platelets (large or abnormal) Bleeding Thrombosis Erythromelalgia
85
4 characteristics of Myelofibrosis
High fibroblast activity Obliteration of BM with fibrosis Massive splenomegaly Dacrocytes (Teardrop RBCs)
86
4 types of polycythemia
Relative Appropriate absolute Inappropriate absolute Polycythemia vera
87
3 findings in Heparin-induced thrombocytopenia (HIT)
IgG against heparin-PF4 (activating platelets) Thrombosis Thrombocytopenia
88
4 indications for Heparin
PE DVT ACS MI
89
2 indications for Direct thrombin inhibitors
Venous thromboembolism | Atrial fibrillation
90
1 indication for Warfarin
Chronic anticoagulation (Venous thromboembolism prophylaxis Prevention of stroke in AFib)
91
3 indications for Direct factor X inhibitors
Ttt + prophylaxis for DVT Ttt + prophylaxis for PE Prophylaxis for stroke when AFib
92
3 indications for Thrombolytics
Early MI Early ischemic stroke Severe PE
93
3 indications for ADP receptor inhibitors
ACS Coronary stenting Thrombotic stroke (lowers recurrence)
94
4 indications for Phosphodiesterase III inhibitors
Intermittent claudication Coronary vasodilation Prevention of stroke/TIA Angina prophylaxis
95
2 indications for GpIIb/IIIa inhibitors
Unstable angina | Percutaneous angioplasty
96
7 antimetabolite drugs
``` Azathioprine 6-mercaptopurine Cladribine Cytarabine 5-fluorouracil Methotrexate Hydroxyurea ```
97
3 characteristics of Azathioprine + 6-MP
Purine analog Activated by HGPRT Metabolized by xanthine oxidase (high toxicity with Allopurinol or Febuxostat)
98
6 indications for Azathioprine + 6-MP
``` Preventing organ rejection Rheumatoid arthritis IBD SLE Wean off steroids in chronic ds Treat steroid-refractory chronic ds ```
99
1 characteristic + 1 indication for Cladribine
Purine analog Hairy cell leukemia
100
1 characteristic + 2 indications for Cytarabine
Pyrimidine analog Leukemias (AML) Lymphomas
101
4 characteristics of 5-FU
Pyrimidine analog Inhibits thymidilate synthase Effects enhanced w/ addition of Leucovorin Worsened myelosuppression w/ addition of Leucovorin
102
3 indications for 5-FU
Colon cancer Pancreatic cancer Basal cell carcinoma (topical)
103
3 characteristics of Methotrexate
Folic acid analog Inhibits dihydrofolate reductase Reversible myelosuppression w/ Leucovorin
104
10 indications for Methotrexate
``` Leukemias (ALL) Lymphomas Choriocarcinoma Sarcomas Ectopic pregnancy Medical abortion (w/ Misoprostol) Rheumatoid arthritis Psoriasis IBD Vasculitis ```
105
4 antitumor antibiotics
Bleomycin Dactinomycin Doxorubicin Daunorubicin
106
1 characteristic + 2 indications for Bleomycin
Induces free radical formation Testicular cancerk Hodgkin lymphoma
107
1 characteristic + 3 indications for Dactinomycin
Intercalates in DNA Wilms tumor Ewing sarcoma Rhabdomyosarcoma
108
3 characteristics + 3 indications for Doxorubicin + Daunorubicin
Generate free radicals Intercalate in DNA Add Dexrazoxane to prevent cardiotoxicity Solid tumors Leukemias Lymphomas
109
4 alkylating agents + MAO
Busulfan Cyclophosphamide Ifosfamide Nitrosoureas Cross-link DNA
110
2 indications of Busulfan
CML | Ablate BM before BM transplantation
111
3 indications + 1 adverse effect (+ prevention) for Cyclophosphamide + Ifosfamide
Solid tumors Leukemia Lymphomas Hemorrhagic cystitis Prevented w/ hydration + Mesna or N-acetylcysteine
112
1 characteristic + 1 indication + 1 adverse effect for Nitrosoureas
Cross blood-brain barrier Brain tumors CNS toxicity (convulsions, dizziness, ataxia)
113
4 microtubule inhibitors
Paclitaxel Other taxols Vincristine Vinblastine
114
1 MOA + 2 indications for Paclitaxel + other taxols
Hyperstabilize polymerized microtubules in M phase Ovarian carcinoma Breast carcinoma
115
MAO + 4 indications of Vincristine + Vinblastine
Bind beta-tubulin Inhibit its polymerization Solid tumors Leukemias Hodking lymphoma (Vinblastine) Non-Hodgkin lymphoma (Vincristine)
116
4 indications for Cisplatin + Carboplatin
Testicular carcinoma Bladder carcinoma Ovary carcinoma Lung carcinoma
117
4 topoisomerase inhibitors
Etoposide (topoisomerase II) Teniposide (topoisomerase II) Irinotecan (topoisomerase I) Topotecan (topoisomerase I)
118
3 indications of Etoposide + Teniposide
Solid tumors (esp. testicular + small cell lung) Leukemias Lymphomas
119
1 indication of Irinotecan + 2 for Topotecan
Colon cancer Ovarian cancer Small cell lung cancer
120
3 indications for Hydroxyurea
Melanoma CML Sickle cell disease
121
3 indications for Prednisone + Prednisolone
CLL Non-Hodgkin lymphoma (combination ttt) Immunosuppression (in autoimmune ds)
122
11 adverse effects of Prednisone + Prednisolone
``` Cushing-like symptoms Acne Central obesity Osteoporosis Weight gain Muscle breakdown Cataracts Hypertension Peptic ulcers Hyperglycemia Psychosis ```
123
MAO + 1 indication + 3 adverse effects of Bevacizumab
Anti-VEGF monoclonal Ab / inhibits angiogenesis Solid tumors (colorectal, renal cell carcinoma) Hemorrhage Blood clots Impaired wound healing
124
MAO + 1 indication + 1 adverse effect of Erlotinib
EGFR tyrosine kinase inhibitor Non-small cell lung carcinoma Rash
125
MAO + 2 indications + 3 adverse effects of Cetuximab
Anti-EGFR monoclonal Ab Stage IV colorectal cancer Head + neck cancer Rash High LFTs Diarrhea
126
MAO + 2 indications + 1 adverse effect of Imatinib
Tyrosine kinase inhibitor of BCR-ABL and c-kit CML GI stromal tumors Fluid retention
127
MAO + 4 indications + 1 adverse effect of Rituximab
Anti-CD20 monoclonal Ab Non-Hodgkin lymphoma CLL ITP Rheumatoid arthritis High risk of progressive multifocal leukoencephalopathy
128
2 SERMs + MOA
Tamoxifen Raloxifene Receptor antagonists in breast Receptor agonists in bone
129
2 indications + 2 adverse effects of Tamoxifen
Breast cancer treatment Breast cancer prevention High risk of endometrial cancer High risk of thromboembolic events
130
2 indications + 1 adverse effect of Raloxifene
Breast cancer prevention Osteoporosis prevention High risk of thromboembolic events
131
MOA + 2 indications + 1 adverse effect of Trastuzumab (Herceptin)
Anti-HER-2 monoclonal Ab HER-2 positive breast cancer Gastric cancer Cardiotoxicity
132
MOA + indication of Vemurafenib
Inhibitor of BRAF oncogene positive melanoma (V600E) Metastatic melanoma

Dr. Mel - Hemato/Oncology (3 decks)

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