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USMLE Step 1-2015 > Hem Onc > Flashcards

Hem Onc Flashcards

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USMLE® Step 1 flashcards
1
Q

Fibrinogen receptor

A

Gp IIb/IIIa

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2
Q

vWF receptor

A

Gp Ib

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3
Q

What are in platelets dense granules and alpha granules

A

Dense granules-ADP, Ca2+

Alpha granules-vWF, fibrinogen

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4
Q

Protein C inhibits what 2 cofactors?

A

Va, VIIIa

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5
Q

When would you see a target cell?

A

Hbc disease, Asplenia, Liver disease, Thalassemia

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6
Q

When are howell-jolly bodies seen?

A

patients with functional hyposplenia or asplenia

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7
Q

What encompasses association with thalassemia intermedia?

A

Kozak sequence is gccRccAUGG, where R normally takes place of adenine or guaning 3 bases uptream of mRNA molecule methionine AUG. Adenine or guanine 3 bases upstream is a key initiation process Mutation with G–>C in B globin gene assoc. with thalassemia intermedia (decrease protein synthesis, but not as severe as b thal major)

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8
Q

What would you see in a megaloblastic macrocytic anemia cs non megaloblastic macrocytic anemia?

A

Difference would be presence of hypersegmented neutrophils

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9
Q

How do u calculate corrected reticulocyte count?

A

RC *Hct/45

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10
Q

HbC point mutation

A

Glutamic acid with lysine

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11
Q

4 diseases with increased risk of parvovirus b19 induced aplastic crisis

A

Aplastic anemia, hereditary spherocytosis, b-thal, sickle cell

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12
Q

Most structural abnormalities follow a ______ pattern while most enzyme abnormalities follow an ________ pattern

A

Auto dominant

Auto recessive

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13
Q

What effect does cortidcosteroids have on neutrophils, eosinophils, and lymphocytes?

A

Causes neutrophilia becasue decrease activation of neutrophil adhesion molecules, impairing migration out of the vasculature to site of inflammation. In contrast, corticosteroids sequester eosinophils in lymph notes and cause apoptosis of lymphocytes (lymphopenia). This would also be seen in Cushings

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14
Q

What is most sensitive cell in the body to radiation?

A

Lymphocytes causing lymphopenia

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15
Q

Inheritance of acute intermittent porphyria

A

auto dominant

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16
Q

Bevacizumab MOA and toxicity

A

Monoclonal antibody to VEGF. inihibits angiogenesis

Hemorrhage, clots, impaired wound healing

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17
Q

Erlotinib

A

EGFR tyrosine kinase inhibitor
used for non-small cell carcinoma
rash

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18
Q

Imatinib

A

Tyrosine kinase inhibitor of Bcr-ABL (philadelphia chromosome) and c-kit (common GI stromal tumors). inhibits cellular proliferation of bcr/abl w/o inducing apoptosis
Toxicity: fluid retention

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19
Q

Rituximab

A

monoclonal antibody against CD20 found on most b cell neoplasms
increase risk of progressive multifocal leukoencephalopathy

20
Q

trastuzumab (herceptin)

A

monoclonal antibody to her-2 (c-erbB2), a tyrosine kinase receptor. Helps kill cancer cells that overexpress HER-2 through inhibition of her 2 initiated cellular signaling and antibody dependent toxicity
used for her2 positive breast and gastric cancer
cardiotoxicty

21
Q

vemurafenib

A

small molecule inhibitor of BRAF oncogene + melanoma (v600 e mutation subtype)

metastatic melanoma

22
Q

Leukemoid reaction vs. Leukemia

A

Leukemoid rxn increase WBC with left shift and increase in leukocyte alkaline phosphatase
Leukemia- increase WBC count with left shift, but decrease LAP

23
Q

Reason for lymphadenopathy in follicles, paracortex, medulla

A

Follicles-B-cell origin due to HIV infection or rheumatoid arthritis
Paracortex hyperplasia-T-cell origin seen with viral infections
Medulla-hyperplasia of sinus histiocytes seen in lymph nodes that are draining a tissue with cancer

24
Q

Burkitt lymphioma
Translocation?
Gene involved?

A

t (8;14)

c-myc (8) w/ heavy chain Ig (14)

25
Q

Follicular lymphoma
Translocation?
Gene involved?

A

t (14,18)

Heavy-chain Ig (14) and bcl-2 (18)

26
Q

Mantle cell lymphoma
Translocation?
Gene involved?

A 
t (11;14)
cyclin d1 (11) and heavy chain Ig (14)
27
Q

Adult t cell lymphoma associated with what virus

A

Human t lymphotropic virus

28
Q

T (8;14)

A

Burkitt lymphoma

29
Q

t (9;22)

A

CML (BCR-ABL hybrid) philadelphia chromosome

30
Q

t (11;14)

A

Mantcle cell lymphoma (cyclin D1 activation)

31
Q

t (14;18)

A

Follicular lymphoma (BCL-2 activation)

32
Q

t (15;17)

A

M3 type of AML

33
Q

Tdt+

A

Lymphoblast

34
Q

Precursor B cell type ALL expresses what?

A

CD19 CD 10+ Tdt+

35
Q

Precursor T cell type ALL expresses what?

A

CD 2-CD8 Tdt+

36
Q

Tdt+ is absent in what?

A

Myeloid blasts and mature lymphocytes

37
Q

What is the name of the M3 subtype of AML?

A

Acute promyelocytic leukemia

38
Q

CD5 + lymphoma

A

Mantle cell lymphoma

39
Q

CLL expresses what?

A

CD 5+ CD 20 + co expression as a B cell neoplasma

40
Q

What can small lymphocytic lymphoma progress to?

A

Large B-cell lymphoma (Richter transformation)

41
Q

Hairy cell leukemia treatment and explain mechanism?

A

Cladribine (adenosine deaminase inhibitor causes adenosine to accumulate to toxic levels in neoplastic B cells)

42
Q

Splenomegaly is different in chronic leukemia than hairy cell leukemia how?

A

Chronic leukemia you will see splenomegaly due to expansion of white pulp. In hairy cell, its due to expansion of red pulp

43
Q

CML characterized by increased?

A

Neutrophils, metamyelocytes, and basophils (within granulocytes basophilia is characteristic)

44
Q

What cell line are langerhans cells derived from?

A

myeloid

45
Q

Mutation involved in myeloproliferative disorders

A

Everything JAK 2 besides CML (BCR-ABL)

46
Q

Mutation specific of myeloproliferative disorders

A

All have V617 mutation with tyrosine kinase activity and cytokine independent activation of STAT transcription factors. Valine replaces phenylalanine making hematopoietic cells more sensitive to growth factors. THIS MUTATION IS NOT PRESENT IN CML

47
Q

JAK2 inhibitor approved for treating primary myelofibrosis

A

Ruxolitinib

USMLE Step 1-2015 (18 decks)

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