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MRCP > Haem/ Onc > Flashcards

Haem/ Onc Flashcards

1
Q

Eastern Cooperative Oncology Group (ECOG) score - functional status for determination for oncological therapies

A

0 Fully active
1 Restricted physical activity, able to work
2 Able all self care unable to do work
3 Limited self care; in bed/ chair >50% day
4 Completely disabled
5 Dead

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2
Q

t(14;18)

A

follicular lymphoma

increased BCL-2 transcription

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3
Q

t(11;14)

A

Mantle cell lymphoma

deregulation of the cyclin D1 (BCL-1) gene

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4
Q

t(8;14)

A

seen in Burkitt’s lymphoma

MYC oncogene is translocated to an immunoglobulin gene

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5
Q

t(15;17)

A

seen in acute promyelocytic leukaemia (M3)

fusion of PML and RAR-alpha genes

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6
Q

t(9;22) - Philadelphia chromosome

A

CML

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7
Q

SIckel cell disaese - Sequestrian crisis

A

splenomegaly
hypotension
increased reticulocyte count

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8
Q

Sickle cell disease: Vasculo-oclusive/ Thrombotic crisis

A

extremely severe, deep bone pain

organ infarcts

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9
Q

Aplastic crises

A

caused by infection with parvovirus

sudden fall in haemoglobin

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10
Q

CA 125
CA 19-9
CA 15-3

A

CA 125 Ovarian cancer
CA 19-9 Pancreatic cancer
CA 15-3 Breast cancer

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11
Q 
PSA
AFP 
CEA
S-100
Bombesin
A 
S-100 - Melanoma, schwannomas
Bombesin - Small cell lung carcinoma, gastric cancer, neuroblastoma
PSA - Prostatic carcinoma
AFP - Hepatocellular carcinoma, teratoma
CEA - Colorectal cancer
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12
Q

Factor V Leiden mutation results in…

A

activated protein C resistance

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13
Q 
Associated Carcinogens to cancers
Aflatoxin (produced by Aspergillus) 
Aniline dyes 
Asbestos 
Nitrosamines 
Vinyl chloride
A

Aflatoxin (produced by Aspergillus) - hepatocellular
Aniline dyes - Bladder (transitional cell ca)
Asbestos - Mesothelioma + bronchial
Nitrosamines - Oesophageal and gastric cancer
Vinyl chloride - Hepatic angiosarcoma

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14
Q

Thrombotic thrombocytopenic purpura (TTP) features (5)

A

Thrombotic thrombocytopenic purpura (TTP) is classically characterised as a pentad of: thrombocytopenia, microvascular haemolysis, fluctuating neurological signs, renal impairment and fever.

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15
Q

Thrombotic thrombocytopenia Mx

A

Plasma exchange

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16
Q

t(15;17)

A

Acute Myeloid Leukaemia

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17
Q

Thrombotic Thrombocytopenic Purpura pathophys

A

deficiency of ADAMTS13

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18
Q

Methaemaglobinaemia pathophys

A

Methaemoglobinaemia = oxidation of Fe2+ in haemoglobin to Fe3+

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19
Q

Desmopressin (DDAVP) MOA in von Willebrand disease

A

induces release of von Willebrand’s factor from endothelial cells

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20
Q

Paroxysmal Nocturnal Haemaglobinuria diagnostic test

A

Flow cytometry for CD59 and CD55

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21
Q

Herediatry angioedema Mx

A

acute - IV C1-inhibitor concentrate/ fresh frozen plasma

prophylaxis: anabolic steroid Danazol

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22
Q

Chronic lymphocytic leukemia investigation (2)

A

Immunophenotyping - key diagnostic tool

Blood film - smudge cells

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23
Q

Hereditary spherocytosis investigation

A

EMA binding test

24
Q

Hereditary spherocytosis features (3)

A

Normocytic anaemia
Gall stones
Family history
Splenomegaly

25
Q

Diseminated intravascular coagulation blood picture (5)

A

↓ platelets

↓ fibrinogen

↑ PT & APTT

↑ fibrinogen degradation products

schistocytesdue to microangiopathic haemolytic anaemia

26
Q

Thrombophillia most common cause

A

Factor V Leiden (protein C resistance)

27
Q

Chronic myeloid leukemia Mx

A

Imatinib - tyrosine kinase inhibitor

28
Q

Essential Thrombocytopenia
Features (3)
Mutation (1)
Mx

A

Platelets >600, thrombosis and haemorrhage possible,
burning sensation in hands

JAK2 mutation

Mx - Hydroxyurea (hydroxycarbamide)/ IFN alpha

29
Q 
Burkitt's Lymphoma 
Gene translocation
viral association
microscopy findings
Mx - chemotherapy - complication
A

c-myc gne translocation, t(8;14)
EBV
starry sky appearance
Tumour lysis syndrome

30
Q 
Blood film:
Myelofibrosis
Iron Def Anaemia
Hyposplenism
microangiopathic haemolytic anaemia
Hereditary spherocytosis/ Autoimmune Haemolytic anaemia
A 
"Tear Drop" Poikilocytes
"Pencil" Poikilocytes
Howell-jolly
Schistocytes
Spherocytes
31
Q

Cyclophosphamide
MOA
side effect (3)

A

MOA - cross-linking in DNA

Haemorrhagic cystitis, myelosuppression, Transitional cell Ca

32
Q

Bleomycin
MOA
SE

A

Degrades preformed DNA

Lung fibrosis

33
Q

Anthracyclines (doxyrubicin)
MOA
SE

A

inhibits DNA + RNA synthesis, Stabilise DNA-topoisomerase II complex
Cardiomyopathy

34
Q

Methotrexate
MOA
SE (2)

A

Inhibit dihydrofolate reductase

Myelosuppression, Lung/ liver fibrosis

35
Q

Fluorouracil
MOA
SE

A

Thymidylate synthase inhibitor

Myelosuppression, mucositis, dermatitis

36
Q

Cytarabine
MOA
SE

A

pyrimidine antagonist, inhibit DNA polymerase

Myelosuppression, ataxia

37
Q

Vincristine
MOA
SE

A

inhibit microtubule formation

peripheral neuropathy

38
Q

Docetaxel
MOA
SE

A

prevent microtubule depolymerisation

Neutropenia

39
Q

Irinotecan
MOA
SE

A

inhibit topoisomerase I

myelosuppression

40
Q

cisplatin
MOA
SE (3)

A

cross-link DNA

Ototoxicity, peripheral neuopathy, hypomagnesaemia

41
Q

Hydroxyurea
MOA
SE

A

Inhibit ribonucleotide reductase

myelosuppression

42
Q

tumour lysis syndrome Mx

A

Rasburicase + IV fluid

43
Q

Polycythaemia rubra vera assosications (2)

A

myelofibrosis

AML

44
Q

Acute intermittent porphyria
Features (3)
Ix
Mx

A

Abdominal, Neuro, psych symptoms
Raise urinary porphobilinogen
IV Haematin/ IV Glucose

45
Q

Chronic lymphocytic leukaemia is due to…

A

Monoclonal proliferation of B cell lymphocytes

46
Q

Haemophillia A deficiency in…

Haemophillia B deficiency in…

A

A - VIII

B - IX

47
Q

Rasburicase MOA

A

Rasburicase - a recombinant version of urate oxidase, an enzyme that metabolizes uric acid to allantoin

48
Q

Chronic Lymphocytic Leukaemia
Features
Ix

A

Often none - incidental lymphocytosis

Ix - immunophenotyping/ flow cytometry

49
Q

Myeloma

Features (3)

A

Hypercalcaemia, renal failure, high total protein

50
Q

Methaemaglobinuria causes

A

congenital - NADH methaemaglobin reductase def

Aquired - Co-Trimoxazole, dapsone, nitrates, sulphas, chloroquine

51
Q

Essential Thrombocystosis - Platelets >600

Mx

A

Hydroxyurea/ hydroxycarbimide

52
Q

Waldenstrom Macroglobulinaemia

Features (3)

A

Older
Hyperviscocity - strokes, headaches, blurred vision
hepatosplenomegaly
IgM

53
Q

Vitamin B12 is absorbed where…?

A

Actively in terminal ileum

54
Q

Methaemaglobinaemia
Fx (1)
Mx (1)

A

Normal pO2 with decreased oxygen saturations

Methylene Blue

55
Q

Felty syndrome features (3)

A

neutropenia
splenomegaly
rheumatoid arthritis

56
Q

Multiple Myeloma
Features (4)
Ix (1)

A

CRAB - hyperCalcaemia, Renal disfunction, Anaemia, bone pain

serum electrophoresis

57
Q

Contrast-enhanced CT coronary angiogram is the first line investigation for…

A

stable chest pain of suspected coronary artery disease aetiology

MRCP (14 decks)

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