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DIT STEP 2 > HEM&ONC > Flashcards

HEM&ONC Flashcards

1
Q

Shift oxy-hemoglobin curve to left

A

Metabolic alkalosis Decreased body temp Increased Hgb F

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2
Q

Shift oxy0hemoglobin curve to the right

A

Metabolic acidosis Increased body temp High altitude Exercise

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3
Q

5 causes of microcytic anemia

A

Iron deficiency Lead poisoning Anemia of chronic disease Sideroblastic anemia Thalassemias

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4
Q

3 causes of normocytic anemia

A

Hemolytic anemia Anemia of chronic disease Hypovolemia

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5
Q

Normal MCV Increased retake count Increased indirect bill Increased LDH Decreased serum haptoglobin

A

Hemolytic anemia

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6
Q

Pathology of G6PD deficiency

A

Deficiency of G6PD (enzyme required to repair oxidative damage to RBCs) Ingestio nof an oxidant causes excessive hemoylsis

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7
Q

Heinz bodies

A

Small densities of Hgb in RBC seen in GG6PD deficiency

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8
Q

Oxidants that exacerbate G6PD deficiency

A

Fava beans High dose ASA Sulfa Dapsone Quinine/quinidine Primaquine Nitrofurantoin

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9
Q

Serum iron and ferritin in sideroblastic anemia

A

Increased

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10
Q

Which thalassemia shows basophilic stippling

A

Beta

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11
Q

Gingival lead lines, peripheral neuropathy, decreased MCV

A

Lead poisoning anemia (acquired sideroblastic anemia)

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12
Q

Treamtnet for lead poisoning

A

EDTA or Dimercaptosuccinic acid

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13
Q

Drugs that can cause aplastic anemia

A

Chloramphenicol, sulfonamides, phenytoin, chemotherapeutics

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14
Q

H/P of aplastic anemia

A

Persistent infections Poor clotting Easy brusiing

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15
Q

Defective heme synthesis

A

Sideroblastic anemia

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16
Q

Causes of sideroblastic anemia (3) - acquired

A

Alcohol Isoniazid Lead poisoning

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17
Q

Tx of hereditary sideroblastic anemia

A

Vitamin B6. Significant iron overload requires therapeutic phlebotomy or chelation with deferoxamine.

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18
Q

Complication in 10% of sideroblastic anemia patients

A

Acute leukemia

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19
Q

SORE tongue points to what kind of anemia

A

folate deficiency

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20
Q

How many abnormal genes do pts with alpha thalassemia minor have

A

Two

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21
Q

What kind of Hb increases in pts with B-thalassemia minor

A

HbA2

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22
Q

What kind of Hb is increased in pts with B-thalassemia major

A

HbA2 and F

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23
Q

Complications of thalassemias

A

Chronic iron overload from repeat transfusions causes damage to heart and liver.

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24
Q

Diff between sickle cell anemia and beta thalassemia

A

SCD causes production of DEFECTIVE beta chains. In B-thalassemia, decreased production of NORMAL beta chains.

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25
"fish mouth vertebrae"
sickle cell disease
26
Encapsulated organisms
S pneumo H influenzae N. meningitidis Klebsiella
27
What type of hypersensitivity is drug-induced hemolytic anemia
Type II
28
Increased PT/INR indicates decreased function of which factors
Factors II, VII, IX, X
29
Increased PTT indicates decreased function of which factors
IIa, IXa, Xa, XIa, XIIa
30
Monitoring required in LMWH
None :)
31
Only factors not synthesized by the liver
VWF and VIII therefore they remain normal in liver failure
32
vWD labs
Increased PTT Increased bleeding time decreased ristocetin cofactor assay
33
Name 3 GPIIb/IIIa inhibitors
Abciximab Tirofiban Eptifibatide
34
Name 2 drugs you can use for HIT patients
lepirudin Argatroban Direct thrombin inhibitors
35
MOA of dipyridamole
Inhibit activity of adenosine deaminase and phosphodiesterase to inhibit platelet aggregation
36
4 things increased in DIC
increased PT Increased PTT Increased fibrin split products Increased D-dimer
37
Plasmodium infection. Ntote enlarged size, intracellular ring and eosinophilic Schuffners granules
38
Prophylactic regimen for HIV in needle stick injury
Lamivudine + zidovudine for 4 weeks.
39
At what CD4 count is Kaposi sarcoma seen
\<500
40
Tx of toxoplasmosis
Pyrimethamine Sulfadiazene Clindamycin Chronic tx may be needed.
41
3 infections seen at CD4\<50
MAC CMV Cryptococcal meningitis
42
Complication of polycythemia vera
Leukemia
43
Most common form of Hodgkin lymphoma
Nodular sclerosing
44
"Starry sky pattern"
Burkitt lymphoma
45
t14:18
Follicular lymphoma
46
t8;14
Burkitt lymphoma
47
Staining with myeloperoxidase
AML
48
Smudge cells
CLL
49
Philadelphia chromosome (t9;22 BCR-ABL)
CML. Also associated with 15% of adult ALL cases.
50
massive splenomegaly and NO lymphadenopathy is what leukemia?
Hairy cell
51
Features of Fanconi anemia
Short stature ABnormal skin pigmentation Horsehoe kidney Thumb abnormalities Its bone marrow failure + pancytopenia + increased risk of leukemia
52
Congenital pure RBC anemia
Diamond-Blackfan
53
Elevated megakaryocytes
ITP
54
Giant platelets, abnormal ristocetin assay, thrombocytopenia
Bernard-Soulier
55
Labs in hereditary spherocytosis
Anemia with reticulocytosis and increased MCHC Higher incidence of PSEUDO HYPERKALEMIA as RBCs lyse after blood draw and intracellular potassium leaks.
56
Tx of hereditary spherocytosis
Folic acid, 1 mg daily. RBC transfusion if extreme anemia. Splenectomy in moderate to severe disease.
57
What lab markers suggest anemia due to hemolysis
Low H & H Normal MCV High reticulocyte count Indirect bilirubinemia High LDH LOW haptoglobin.
58
Name 4 things that cause schistocytes
DIC HUS TTP Hemolytic anemia
59
What disease do you see acanthocytes in?
Abetalipoproteinemia
60
3 times you'd see basophilic stippling of RBCs
Lead poisoning Thalassemia Alcohol use
61
Heinz bodies
G6PD
62
Ddx for serum eosinophilia
D NAAACP Drugs (NSAIDs, pcn/cephs) Neoplasms Allergies, Arthma (Churg Strauss), Allergic bronchopulonary aspergillosis AIN Collagen vasc disease (PAN, dermatomyosities) Parasites (Such as strongyloides, ascaris lofflers eosinophilic pneumonitis)
63
What drugs are known for causing thrombocytopenia
Heparin, abciximab Carbamazepine, phenytoin, valproate Cimetidine Acyclovir, rifampin Sulfonamides Procainamide Quinine, gold compounds
64
You gave a von willebrand pt DDAVP but theyre still bleeding. Now what.
Cryo or Factor VIII concentrates.
65
MOA of clopidogrel
ADP blocker
66
MOA of eptifibatide
GPIIb/IIIa
67
MOA of ticlopidine
ADP blocker
68
MOA of tirofiban
GPIIb/IIIa
69
Labs in HUS or TTP
Decreased platelets Increased bleeding time Nml PT, nml PTT
70
Labs in Hemophilia A or B
Isolated elevation in PTT
71
Labs in Von Willebrand
Normal platelets Increased bleeding time Normal PT Increased PTT (Due to factor VIII)
72
Labs in end stage liver disease
Platelet count: decreased or normal Bleeding time : increased or normal PT: Increased PTT: increased
73
Labs in ASA use
Increased bleeding time ONLY!
74
Erythromelalgia -- what is it and what dz is it classically seen in
Burning pain in hands/feet with erythema, pallor or cyanosis that is relieved by ASA. Seen in polycythemia vera
75
Treatment of polycythemia vera
PHlebotomy to keep hct below 45% in men, 42% in women
76
What can you add to therapy for a polycythemia vera patient if at high risk for thrombosis
Hydroxyurea. Can also take ASA daily to help prevent thrombosis
77
What can you add to therapy if a patient has refractory pruritis or refractory erythrocytosis in polycythemia vera
IFN alpha
78
What medication is associated with remission in 95% of patients with CML
Imatinib
79
Peripheral blasts are PAS + and TdT+
ALL
80
21 y/p/ with recent weight loss, pruritis and night sweats. PE reveals hepatosplenomegaly and nontender cervical lymphadenopathy. What do you immediately suspect
Hodgkins
81
Which anti retroviral causes lactic acidosis
NRTI
82
4 anti retrovirals that cause pancreatitis
Didanosine!!! Zalcitabine Stavudine Ritonavir
83
Which anti retroviral causes megaloblastic anemia and bone marrow suppression
zidovudine
84
Regimen for HIV exposure ppx
AZT plus lamivudine
85
At CD4 \<200, add what meds prophylactically? for waht organisms?
TMP-SMX or dapsone for PCP and toxoplasmosis
86
At CD4 \<100, add what meds prophylactically and for what organism
Erythro or clarithromycin for MAC

DIT STEP 2 (17 decks)

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