Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boards > hem/onc 2 > Flashcards

hem/onc 2 Flashcards

1
Q

Risk factors for thyroid cancer

A
  • hx of radiation exposure
  • Family hx of thyroid cancer
  • subclinical hypothyroidism (elevated TSH)
  • iodine deficiency
  • *smoking and drinking have not been shown to increase risk for thyroid cancer and may actually be protective
  • multiple nodules is not associated with increased risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

US findings of thyroid nodules that increases risk for malignancy

A
  • size greater than 1 cm
  • hypo echoic echotexture
  • microcalcifications
  • increased vascularity
  • length greater than width
  • infiltrative margins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

physical exam features of malignant thyroid nodules

A
  • rapid growth, firm, fixed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clinical features of acute radiation pneumonitis + physical exam

A
  • antibiotic-nonresponsive + appears like pneumonia (fever + cough + pleuritic heat pain + leukocytosis)
  • exam = crackles and/or pleural rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

acute radiation pneumonitis radiographic features

A
  • straight line effect (affected lung tissue is usually confined to the radiation treatment area and may form a distinct boundary with adjacent normal parenchyma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

treatment of acute radiation pneumonitis

A

prednisone for 2 weeks with a gradual taper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cause of cancer-induced brachial plexopathy

A
  • typically from direct invasion of breast or apical lung cancer or radiation injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Presentation of cancer-induced brachial plexopathy

A
  • severe pain at symptom onset
  • weakness
    +/- Horner syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

complex regional pain syndrome presentation

A
  • throbbing pain + skin temperature changes + paresthesias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Physiologic cause of AKI in TLS

A

calcium-phosphate precipitation in renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Other sequela in TLS

A
  • arrhythmias
  • seizures
  • sudden cardiac death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Criteria for diagnosis of TLS

A

2 or more of any of the following:

  • uric acid 8 or higher
  • K of 6.0 or higher
  • phos of 4.5 or higher
  • calcium of 7 or lower
  • or 25% increase from baseline value
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

management of INR greater than 10 without bleeding

A

hold warfarin + administer 2.5-5 mg of oral vitamin K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

management of INR 4.5-10

A
  • hold warfarin + resume when INR is therapeutic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TRALI clinical features

A

within 6 hours of transfusion + acute onset dyspnea-hypoxemia + diffuse pulmonary infiltrates within 6 hours of a transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

TRALI pathophys

A
  • not just transfusion of a patient with underlying heart failure
  • it is likely due anti-leukocyte antibodies from donor’s plasma reacting with antigens on recipients leukocytes to intimate an inflammatory response within the pulmonary microvasculature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

TRALI clinical course

A

Patients typically improve rapidly and most are extubated within 2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of TRALI

A
  • supportive care

- no further plasma-containing blood products from the donor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Derm SE to know about with small molecule TKIs (imatinib, sorafenib, sunitinib)

A
  • hand-foot skin reaction (HFSR): focal, tender lesions and hands and feet that appear as blisters in areas of friction or trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of hand-foot skin reaction (HFSR) from small molecule TKIs

A
  • supportive care

- typically don’t need to discontinue treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Common association of Sweet’s syndrome

A

Heme malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Is it possible to have myeloma without an M-spike or gamma gap?

A

YES – non-secretory myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Next step of patient with CRAB symptoms with negative M spike and no gamma gap

A

urine immunofixation (need to rule out elevated protein in urine) to call it non-secretory and urine immunofixation further increases he sensitivity of identifying light or heavy chains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When DVT patients need to be admitted

A
  • Significant RF’s for complications
  • High bleeding risk
  • Abnormal kidney function
  • Hemodynamically unstable
  • Unreliable social environment for administration of anticoagulation
  • Large clot burden (iliofemoral DVT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When is it safe to ambulate following DVT?

A

As soon as anticoagulant reaches therapeutic level (early ambulation has been shown to reduce complications)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lab features of aplastic crisis

A
  • 0% reticulocyte count

- profound anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is hyper hemolytic crisis?

A
  • sudden worsening of anemia with reticulocytosis that can present after acute sickling events (eg painful crisis, acute chest syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

SE to know of with hydroxyurea

A
  • myelosuppression (leukopenia or neutropenia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

VTE treatment of choice in pregnant patients + duration

A
  • subcutaneous LMWH
  • continue at least 6 weeks postpartum
  • Xa inhibitors cross the placenta + there is inadequate information about their safety
  • Unfractionated heparin can also be used for bridging during pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Etiology in stem of lymphadenopathy not resolving fully with abx

A

lymphoid lineage neoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Initial step in evaluation of prolonged PT or PTT

A

mixing study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Urinary incontinence etiology + management following radical prostatectomy

A
  • damaged urinary sphincter

- pelvic floor exercises with biofeedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Patient subsets for which NOACs are not recommended

A

1) renal failure (CrClearance less than 30)
2) valvular heart disease
3) pregnant patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

First line treatment of VTE in patients with brain mets

A

LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

cancer types with brain mets that tend to bleed

A

melanoma, choriocarcinoma, thyroid carcinoma or RCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Waldenstrom clinical features

A
  • HSM + peripheral neuropathy + hyper viscosity syndrome (blurred vision, headache, vertigo)
  • engorged retinal veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Waldenstrom lab features

A
  • elevated ESR
  • Rouleaux formation
  • elevated gamma gap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Labs in vWF

A
  • typically prolonged PTT (but can be normal in some patients)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Screening tests for vWF

A
  • plasma vWF antigen
  • plasma vWF activity
  • FVIII activity
40
Q

what is a normal ferritin?

A

20-200

41
Q

Clinical features of carcinoid syndrome

A
  • episodic flushing
  • diarrhea
  • bronchospasm, dyspnea
  • cardiac lesions (tricuspid regurgitation)
  • cutaneous telangiectasis
42
Q

Other trigger for TTP

A
  • pregnancy (due to autoantibody formation or emergence of a previously undiagnosed hereditary case)
43
Q

ADAMTS13 level in TTP

A

decreased

44
Q

Features of anemia in TTP

A
  • hemolytic (increased LDH, low haptoglobin)

- MAHA

45
Q

General treatment of locally advanced rectal cancer + why

A

Neoadjuvant concurrent CRT (down-stage primary tumor + higher rates of sphincter preservation (which is important because it obviates the need for a permanent colostomy) + local control)

46
Q

Enteropathy-associated T cell lymphoma clinical setting + behavior

A
  • aggressive

- commonly seen in celiac patients with poor dietary compliance

47
Q

Diagnosis of paraneoplastic cerebellar degeneration

A

paraneoplastic antibodies (anti-Yo, anti-Hu) (but low sensitivity)

48
Q

initial step in fertility preservation prior to chemo

A

Referral to reproductive endocrinologist

49
Q

NOACs and CKD

A
  • Typically not used in GFR below 30 because of insufficient data in severe kidney disease
50
Q

weighing risk and benefits of anticoagulating patients with AF and elevated bleeding risk

A

Studies show that there’s typically a positive net clinical benefit of chronic anticoagulation in patients with AF

51
Q

Medical term for Pancoast tumor

A

Superior pulmonary sulcus tumor

52
Q

Pancoast tumor presentation

A
  • shoulder pain
  • Horner syndrome
  • paresthesias in 4th or 5th digits
    (TUmor arises in apical groove next to subclavian vessels thus presents with shoulder pain due to brachial plexus invasion)
53
Q

First step in workup of suspected pan coast tumor

A

CXR

54
Q

Horner syndrome clinical features

A
  • ipsilateral ptosis
  • miosis
  • enophthalmos
  • anhidrosis
55
Q

labs in vitamin K deficiency

A
  • prolonged PT + PTT (with PT being more significantly prolonged)
  • factor VII is initially low, and II, IX, and X may later become low
56
Q

malignant cancer seen almost exclusively in young patients with sickle cell trait

A
  • renal medullary carcinoma
57
Q

Other lab feature commonly seen in IDA

A

Thrombocytosis

58
Q

Patients who need bridging anticoagulation (generally speaking)

A
  • high risk thromboembolic conditions + **high bleeding risk procedures
    (low risk procedures like tooth extraction, cataract surgery, skin biopsy, you can just continue warfarin)
59
Q

Most common cause of thrombocytopenia in pregnancy

A

Gestational thrombocytopenia

60
Q

Management of gestational thrombocytopenia

A
  • benign, no workup
61
Q

Type 1 HIT mechanism

A
  • non-immune
  • heparin-induced platelet clumping
  • not clinically significant
62
Q

Type 1 HIT presentation

A
  • mild thrombocytopenia within first 48 hours of starting heparin exposure
  • platelet count usually greater than 100k
63
Q

Type 2 HIT mechanism

A
  • immune mediated

- antibodies directed against heparin-platelet factor 4 (PF4) complexes)

64
Q

Types of HIT

A
  • Type 1, Type 2, delayed-onset HIT
65
Q

Type 2 HIT presentation

A
  • mild or moderate thrombocytopenia with or without arterial, venous thrombus
  • 5-10 days after heparin initiation OR within 1 day if prior heparin exposure within last 30 days
  • platelet count greater than 20K
66
Q

Delayed-onset HIT mechanism

A
  • immune mediated due to high-titer antibodies against heparin-PF4 complexes in the absence of circulating heparin
67
Q

Delayed-onset HIT presentation

A
  • thrombocytopenia 5-19 days after heparin cessation
68
Q

cardio toxicity features of anthracyclins

A
  • dose dependent (related to cumulative dose)

- reversible

69
Q

Chemo associated with increased risk of secondary malignancy in Hodgkins

A

alkylating agents

70
Q

When secondary malignancies tend to occur after Hodgkin’s treatment

A

5-10 years

71
Q

Other pulmonary toxicity of bleomycin

A
  • organizing pneumonia
  • hypersensitivity pneumonitis
    (in addition to pulmonary fibrosis)
72
Q

Medication approved to decrease severity of cardiomyopathy associated with anthracyclines in patients who have received a cumulative dose of 300 and who will continue to receive anthracyclines + caveat

A
  • dexrazoxane (EDTA-like chelator)

- not recommended for use in patients who are initiating treatment because it lowers response to chemotherapy

73
Q

primary toxicities of cisplatin

A
  • nephrotoxic
  • ototoxic
  • peripheral neuropathy
74
Q

primary toxicities of cyclophosphamide

A
  • hemorrhagic cystitis
  • bladder cancer
  • gonadal toxicity
75
Q

primary toxicity of 5-FU

A
  • severe diarrhea
76
Q

primary toxicity of EGFR inhibitors

A
  • skin rash
77
Q

Interpretation of scoring of 4 T’s score

A

3 points or less = low probability

4 = intermediate probability

78
Q

Management of SCD patient with CVA (how to prevent recurrent stroke) + goal

A
  • Scheduled simple transfusions every month

- maintain Hb S levels of less than 30%

79
Q

Goal of exchange transfusion in acute SCD CVA management

A
  • rapidly reduce Hb S levels
80
Q

CLL presentation

A
  • lymphadenopathy (most commonly – cervical, axillary, supraclavicular) (50-90%)
  • splenomegaly (25-50%)
  • hepatomegaly
81
Q

Labs in CLL

A
  • neutropenia, anemia, thrombocytopenia, *leukocytosis
82
Q

Initial workup of CLL

A
  • peripheral smear
  • flow cytometry
  • Imaging not done routinely (not used for staging)
83
Q

Endometrial cancer presentation

A
  • abnormal uterine bleeding

- underlying chronic unopposed estrogen exposure (anovulation, obesity, PCOS)

84
Q

How to differentiate IDA from AICD based on bone marrow analysis and path

A
  • increased iron staining in the macrophages (due to iron trapping) but decreased staining in the erythrocyte precursors
  • IDA while show no iron staining in macrophages or red cell precursors
85
Q

pernicious anemia lab features

A
  • macrocytosis
  • normal or low retic count
  • normal-low WBC and platelet counts
86
Q

Definition of polycythemia

A
  • hematocrit greater than 48% in women and 49% in men
87
Q

PV clinical features

A
  • transient neurologic symptoms, including visual disturbance (signs of hyper viscosity syndrome)
  • aquagenic pruritus
  • erythromelalgia
  • arterial or venous thrombosis
88
Q

What is erythromelalgia

A

burning pain in the feet or hands associated with erythema, cyanosis, or pallor

89
Q

labs in PV

A
  • often significant thrombocytosis + leukocytosis (MPN)
90
Q

physical exam in PV

A
  • splenomegaly, facial plethora, skin excoriations
91
Q

treatment of PV

A

phlebotomy

IF increased VTE risk ==> hydrea

92
Q

Initial workup of suspected HUS

A
  • peripheral smear (looking for schistocytes)

- e coli serology (more sensitive than stool culture)

93
Q

Breast cancer surveillance in BRCA patients who don’t opt for prophylactic mastectomy

A
  • breast self exam beginning at age 18 + annual mammogram and breast MRI starting at age 25
94
Q

Features of lymphadenopathy concerning for malignancy

A
  • non tender
  • hard
  • greater than 2 cm
  • persistent for a month or more
  • enlarging
  • axillary or supraclavicular nodal involvement
  • generalized
95
Q

Management of pancreatic cancer patient presenting with biliary obstruction

A
  • endoscopic stent placement
96
Q

Initial workup of patient presenting with extrahepatic biliary obstruction + weight loss

A

CT abdomen (rule out pancreatic cancer first)

Boards (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions