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Exam > Haem > Flashcards

Haem Flashcards

1
Q

Thelper

A

CD 3, CD 4, CD 28

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2
Q

Cytotoxic T

A

CD 3, CD8, CD 28

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3
Q

T reg

A

CD 3, CD 4, CD 25,

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4
Q

B cell

A

CD 19, CD 20, CD 40, B7 (for CD 28)

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5
Q

macrophage

A

CD 14, CD 40, B7 (for CD 28)

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6
Q

NK cell

A

CD 16, CD 56

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7
Q

CD 23

A

CLL (negative in Berkett)

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8
Q

CD 105

A

Hairy Cell

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9
Q

CD13, 33, 34, 117 and MPO

A

AML

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10
Q

t 9;22

A

CML- philadelphia

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11
Q

t 15;17

A

APML- PLM/RAR alpha fusion

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12
Q

t 8;14

A

Burkitt- MYC oncogene

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13
Q

t 11;14

A

Mantal cell- BCL 1

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14
Q

t 14;18

A

follicular- BCL 2

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15
Q

CD 15, CD 30

A

Hodgkins, Reed-stenberg

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16
Q

Hodgkin poor prognosis

A

age > 45, stage IV, Hb < 105, lymph < 0.6, male, albumin<40, WCC >15

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17
Q

Hodgkin treatment

A

ABVD- doxorubicin, bleomycin, vinblastine, dacarbazine

BEACOPP- sub dacarbazine to procarbazine, cyclophos, pred
** secondary cancer, pulmonary, cardiac, infertility

Brentuximab- anti CD 30 conjugate with MMAE tubulin toxin–> peripheral neuropathy

PD-1 - pembro

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18
Q

CD 10/19/20, BCL2, BCL 6

A

Follicular. B cells
Grade 1-3B
BCL2 overexpression
nodular growth pattern on histology
treat when advance stage symptomatic

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19
Q

Follicular treatment

A

RCHOP, RCVP (cyclo/vincris/pred)

OBintuzumab + Bendamustine- anti CD 20- better then ritux

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20
Q

Mantle cell

A

CD 19, CD 20, CD 5, negative CD 23
B symptoms, splenomegaly
Ritux + chemo + ASCT

New - ibrutinib for relapsed ( inhibitor of Bruton’s tyrosine kinase)

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21
Q

Waldenstrom

A

plasma cells
lymphoplasmacitic lymphoma
high Ig M
CD19, CD20, CD22, CD25, CD27, CD38, CD79a, FMC

MYD 88 or CXCR 4 mutation

peripheral neuropathy, lymph, splien, B symptoms, hyperviscos, cryoglobulinaemia

PLEX, anti CD 20
alkylating agents (chlorambucil, cyclophosphamide,melphalan), purine analogues (cladribine, fludarabine)

Ibrutinib

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22
Q

POEMS

A

polyneuropathy, organomegaly, endocrinopathy (adrenal, thyroid, pit), monoclonal plasma cell, skin changes

+ bone lesion, castleman

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23
Q

MGUS

A

non-IgM
monoclonal protein <30g, BM plasma cell <10%, no End organ dam

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24
Q

plasmacytoma

A

biopsy proven bone/soft tissue plasma cell

BM <10%
no end organ dam

radiation
transform risk 10-15%

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25
Q

MM

A

IgG 50%, IgA 20%
rouleaux
B 2 microglobulin

CRAB- anaemia most common
hyperviscous
AL amyloid

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26
Q

high risk MM

A

del 17p, t14;16, t 16;20, 1q,

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27
Q

MM staging

A

revised ISS
high b2 microglobuin, genetics
LDH high
unfit

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28
Q

bortezomib

A

proteasome inhibitor
MM 1st line

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29
Q

lenalidomide

A

immunomodulator Inhibition of TNF-a and IL-6 / VEFG
MM 1st line , maintainance
deletion 5q in MDS
myelosuppression, renal clear. increase clots

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30
Q

daratutumab

A

anti‐CD38
MM relapsed

interfere with transfusion testing !!

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31
Q

Elotuzumab

A

anti‐SLAMF7
MM relapsed

32
Q

pomalidomide

A

immunoomodulator
MM relapsed

33
Q

CART

A

chimeric antigen receptor T cell
target BCMA, FcRH5 in MM

Tisagenleclucel- DLBCL, B-ALL

Axicabtagene- LBCL

infections, B cell aplasia, cytopenia

34
Q

Hairy cell

A

CD 19/20, CD11c, CD25 & CD103
Tartrate-Resistant Acid Phosphatase on histology

splenomegaly and pancytopenia
BRAF inhibitor: Vemurafenib

35
Q

DLBCL

A

CD 19, 20, 22, 79a
Ki-67= proliferation marker
B symptom, nodes

International prognosis
- age, ECOG, stage, extranodes, LD

35
Q

DLBCL

A

CD 19, 20, 22, 79a
Ki-67= proliferation marker
B symptom, nodes

International prognosis
- age, ECOG, stage, extranodes, LD

RCHOP

36
Q

Burkett

A

CD 19,20, 22, 79a, CD 10, BCL 6
MYC chrosome 8
t8;14
EBV, AIDs
“starry sky: histicocytes
jaw/facial bone, lymph node, TLS

CNS prophylaxis

37
Q

HLH

A

raised ferritin, triglyceride
soluble CD 25 (solluble IL2 receptor alpha)
elevated CXCL9

Dex, etop, cyclo
IVIG, anakinra, ritux

38
Q

cytokine release syndrome

A

IL6 sytolkine storm, oedema, organ dysfunction, fever shock, hypoxic

give tocilizumab IL6 and steroids

39
Q

ICAN

A

Immune effector cell associated neurotoxicity syndrome
IL-1B into BBB

headache, ehcephalopathy, delirium

steroids, seizure prophylaxis

40
Q

romiplostin

A

ITP- activate thrombopoeitin receptor

41
Q

PNH

A

PIGA gene- loss CD 55, CD 59, lack glycoprotein glycosyl-phosphatidylinositol

complement mediated haemolysis
Budd chiari
aplastic anaemia

eculizumab- C5 inhbibitor
anticoagulation
stem cell transplant

42
Q

acute thrombosis affect tests

A

protein C, protein S, antithrombin, and lupus anticoagulants can have falsely low

43
Q

eculizumab

A

a monoclonal antibody directed against terminal protein C5 for PNH

44
Q

HbF

A

2 alpha 2 gamma

45
Q

HbA2

A

2 alpha 2 delta= beta thallacemia

46
Q

venetoclax

A

BCL2 inhibitor
for unfit AML

47
Q

AML unfavourable

A

t 6;9, t 11;23, T 9;22, inv 3, del 5q, del 7, del 17, FLT 3, mutated RUNX1, ASXL1, TP 53

48
Q

FLT 3 is

A

TK receptor stimulat cell proliferation

49
Q

AML induction

A

cytarabine, idarubicin
- cardiomyopathy, mucositis, cerebellar

50
Q

AML consolidation

A

cytrabine, idarubicin, etoposide,

51
Q

midostaurin

A

FLT 3 muitation positive AML
multitarget protein kinase inhibitor

cytopenia, LFT, rash, HTN

52
Q

Ruxolitinib

A

JAK1&2 inhibitor
myelofibrosis
VSV

53
Q

hydroxyurea

A

(ribonucleotide reductase) RR inhibitor
reduces intracellular deoxynucleotide triphosphat

54
Q

What Haemoglinoopathy is protective in sickle cell anaemia -

A

HbF

55
Q

G6PD

A

deficiency of NADPH , X linked

56
Q

poikilocyte

A

pencel cell, FE deficiency

57
Q

tear-drop

A

myelofibrosis

58
Q

Schistocytes

A

FBC fragment- DIC

59
Q

MDS prognostic

A

IPSS-R
cytogenetic
blast%
Hb
plt

60
Q

Azacitidine

A

DNA hypomethylating agent (exact mechanism not clear)
50% respond high risk MDS

61
Q

mastocytosis mutation

A

C-KIT— D816V, specific for systemic mastocytosis

62
Q

Obinutuzumab + chlorambucil

A

CLL
anti CD 20 with enhanced antibody depeodnent cytotoxicity

63
Q

idealisib

A

PI3 kinase inhibitior–
CLL
increase PJP, MCV

64
Q

CLL < 65 treatment

A

fludarabine, cyclophos, ritux

65
Q

ibrutinib

A

BTK inhibitor
CLL
AF, HTN, platelet dysfunction

66
Q

Romiplostim

A

thrombopoietin recepotr agonist
bind to the TPO receptor (c-MpL) and stimulate megakaryocyte differentiation and proliferation

a recombinant, Fc-peptide fusion protein (peptibody) given subcutaneously,

67
Q

eltrombopag

A

thrombopoietin recepotr agonist
bind to the TPO receptor (c-MpL) and stimulate megakaryocyte differentiation and proliferation

orally available drug that binds to the transmembrane region of c-MpL

ITP
aplastic anaemia

68
Q

Unfractionated heparin

A

inhibits thrombin, factors Xa, IXa, XIa and XIIa

69
Q

LMWH

A

increases the action of antithrombin III–> inhibit factor Xa

70
Q

antibodies form against complexes of platelet factor 4 (PF4)

A

HIT
check heparin PF4 assay, heparin antibodies

71
Q

fondaparinux

A

anti Xa
contraindicate eGFR <30
half-life 17 hr

72
Q

bivalirudin

A

direct thrombin inhibitor
can use in liver, kidney (dose adjust)
continuous infusion

73
Q

argatroban

A

direct thrombin inhibitor
continuous intravenous infusion, can use CKD. avoid in liver

74
Q

Haemophilia A

A

Factor 8
X link- 30% spontaneous mutation

Emicizumab- mimiv factor 8- bind factor 9/10
desmopressin- increases plasma concentrations of coagulation factor VIII and von Willebrand factor

75
Q

typical hus

A

shiga toxin E coli, HIV, pneumococcal

Exam (6 decks)

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