Hem/Onc

Question 1

Features of acute hemolytic transfusion reaction. What causes it? How do you diagnose?

Answer 1

• fever, chills, flank pain, hemoglobinuria, infusion site discomfort, DIC
• caused by ABO incompatibility
• Diagnosed by + direct Coombs, pink plasma (plasma free Hb >25), hemoglobinuria, an repeat type and cross-match.

Question 2

Which agents potentiate the effects of warfarin?

Answer 2

Acetaminophen (>2g/day), Amiodarone, and Antibiotics may increase the risk of bleeding.

Question 3

Hodgkin Lymphoma

Answer 3

Curable cancer of the young
Huge risk of developing secondary malignancy later in life (lung, breast, bone, thyroid, GI)
Pts who got chemo or RT can get non-Hodgkin lymphoma or leukemias

Question 4

Which cancers commonly metastasize to the liver? How do you differentiate liver mets from primary liver tumors?

Answer 4

GI tract, lung, and breast cancers commonly metastasize to the liver.
Liver mets usually have multiple lesions; primary liver cancers are usually a solitary mass.

Question 5

late complication of chest wall irradiation?

Answer 5

Constrictive pericarditis, leading to right heart failure

• peripheral edema
• ascites
• hepatic congestion with hepatomegaly (can progress to cardiac cirrhosis)
• elevated JVP with hepatojugular reflux and Kussmaul’s sign (JVP is unchanged on respiration)
• pericardial knock (mid-diastolic sound).

Question 6

Which tumors are assoc. w/ MEN I?

Answer 6

parathyroid, pituitary, and pancreatic tumors

Question 7

Which tumors are assoc. w/ MEN IIA?

Answer 7

medullary thyroid carcinoma
pheo
parathyroid hyperplasia

Question 8

Which tumors are assoc. w/ MEN IIB?

Answer 8

medullary thyroid carcinoma
pheo
mucosal & intestinal neuromas
marfanoid habitus

Question 9

mediastinal mass with elevated beta-HCG and alpha-fetoprotein?

Answer 9

non-seminomatous germ cell tumor