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COMLEX 3 > Hem/Onc > Flashcards

Hem/Onc Flashcards

1
Q

macrocytic anemia –> methylmalonic acid is high –> what is etiology of anemia?

A

B12 def

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2
Q

macrocytic anemia –> methylmalonic acid is normal –> what is etiology of anemia?

A

folate def

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3
Q

children –> what type of leukemia?

A

ALL

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4
Q

20-40yo –> what type of leukemia?

A

AML

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5
Q

40-60yo –> what type of leukemia?

A

CML

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6
Q

> 65yo –> what type of leukemia?

A

CLL

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7
Q

AML –> RF (2)?

A
  • exposure: benzene, radiation

- CML –> blast crisis

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8
Q

AML –> how dx?

A

BM bx:

  • > 20% blasts
  • myeloperoxidase+
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9
Q

AML –> M3 variant –> tx?

A

vitA

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10
Q

AML –> not M3 variant –> tx?

A

ctx

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11
Q

AML –> M3 variant –> histology?

A

auer rods

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12
Q

ALL –> how dx?

A

BM bx:

  • > 20% blasts
  • cALL-a+
  • Tdt+
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13
Q

ALL –> tx?

A

ctx + CNS ppx (ARA-C +/- rad)

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14
Q

CML –> how dx?

A

BM bx –> Philadelphia chromosome/t(9.22)/BCR-ABL

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15
Q

CML –> tx?

A

imatinib

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16
Q

CLL –> >65yo + asx –> tx?

A

none

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17
Q

CLL –> >65yo + sx –> tx?

A

ctx

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18
Q

CLL –> young + donor available –> tx?

A

stem cell transplant

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19
Q

Hodgkin’s disease –> MC presentation?

A

painless LAD

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20
Q

MEN1 –> syndrome components?

A

PPP:

  • Pituitary tumor
  • hyperPTH
  • Pancreas tumor (ie gastrinoma)
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21
Q

von Willebrand disease –> what test to dx? what does it do?

A

ristocetin cofactor assay –> measure capacity of vWF to agglutinate platelets

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22
Q

vWF –> tx for acute bleeding episodes? how does it help?

A

DDAVP –> increase release of stored vWF and factor 8 from platelets

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23
Q

presentation: thyroglossal duct cyst vs branchial cleft cyst

A

thyroglossal duct cyst:

  • midline mass
  • mv w tongue protrusion

branchial cleft cyst

  • lateral to midline
  • overlie sternocleidomastoid muscle
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24
Q

cystic hygroma vs thyroglossal duct cyst/ branchial cleft cyst

A

cystic hygroma: usu diagnosed by 2yo

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25
Q

what is pernicious anemia

A

gastritis –> loss of gastric parietal cells –> intrinisc factor deficiency –> megaloblastic anemia

26
Q

hodgkin’s lymphoma –> MC subtype

A

nodular sclerosing

27
Q

hodgkin’s lymphoma –> how dx?

A

excisional LN bx

28
Q

prostate CA –> metastasizes to?

A

bone

29
Q

30F –> severe menorrhagia –> Hb 6 –> 3unit RBC –> 2hr into transfusion –> hypotension, wheezing, diaphoresis, rash

what condition?

A

anaphylaxis

30
Q

anaphylactic rxn from blood transfusion –> indicates what condition?

A

IgA def

31
Q

tumor marker AFP –> assoc w what malig?

A
  • HCC
  • germ cell ovarian
  • testicular
32
Q

differentiate Hodgkin’s vs non-Hodgkin’s lymphoma

A

Hodgkin’s:

  • Reed-Sternberg cells
  • better prognosis

non-Hodgkin’s:

  • no Reed-Sternberg cells
  • worse prognosis
33
Q

nontender LAD –> next step

A

excisional bx

34
Q

nontender LAD –> excisional bx shows lymphoma –> next step?

A

stage:
1) CXR
2) CT chest/abd/pelvis or PETCT
3) BM bx

35
Q

Hodgkin’s lymphoma –> risk of what complication

A

chemotherapy/radiation –> progress to non-Hodgkin’s

36
Q

lymphoma staging –> what is stage 2?

A

multiple nodes –> same side of diaphragm

37
Q

lymphoma staging –> what is stage 3?

A

multiple nodes –> both side of diaphragm

38
Q

thrombotic thrombocytopenic purpura –> pathophys

A

ADAMTS-13 def –> hyaline clot in vessels –> shred RBCs & platelets –> clots –> obstruct flow to distal tissue

39
Q

thrombotic thrombocytopenic purpura –> presentation

A

FATRN:

  • fever
  • anemia (microangiopathic hemolytic)
  • thrombocytopenia
  • renal fail
  • neuro ssx
40
Q

TTP –> blood smear finding

A

microangiopathic hemolytic anemia –> schisotocytes

41
Q

TTP –> tx

A

exchange transfusion

42
Q 
CBC: decreased platelet
smear: schistocytes
PT/PTT: normal
Fibrinogen: normal 
D-dimer: normal

what dx?

A

TTP

43
Q 
CBC: decreased platelet
smear: schistocytes
PT/PTT: high
Fibrinogen: low
D-dimer: high

what dx?

A

DIC

44
Q

HIT –> tx

A
  • stop heparin

- start argatroban/lepirudin –> bridge to warfarin

45
Q

immune thrombocytopenic purpura –> pathophys

A

autoimmune –> Ab to platelet

46
Q

immune thrombocytopenic purpura –> tx

A
  • steroid

- IVIG

47
Q

immune thrombocytopenic purpura –> refractory –> tx

A

splenectomy

48
Q

wVF dz –> lab findings:

platelets?
PT?
PTT?

A

platelets: normal
PT: normal
PTT: normal-prolonged (due to dysfunction factor 8)

49
Q

R supraclavicular adenopathy –> assoc w what malignancies (3)?

A
  • mediastinus
  • lung
  • esophagus
50
Q

L supraclavicular adenopathy –> assoc w what malignancies (3)?

A
  • stomach
  • GB
  • pancreas
51
Q

differentiate: neurofibromatosis type 1 vs type 2

A

type 1:

  • cafe au lait spots
  • lisch nodules
  • Crowe sign: axillary freckles

type 2:

  • bilateral acoustic neuroma (schwannoma of CN VIII)
  • few cafe au lait spots
52
Q

von Hippel Lindau synd –> assoc w what malignancies?

A
  • RCC
  • pheochromocytoma
  • hemangioblastoma
53
Q

Burkitt lymphoma –> tx

A

rituximab

54
Q

tumor marker CA 19-9 –> what malig?

A

pancreatic

55
Q

tumor marker calcitonin –> what malig?

A

medullary thyroid CA

56
Q

tumor marker CEA –> what malig?

A

epithelial cancers (bowel, lung, thyroid, pancreatic, cervical, bladder, etc)

57
Q

tumor marker thyroglobulin –> what malig?

A

thyroid

58
Q

CLL –> complication

A

Richter transformation –> conversion to diffuse large B cell lymphoma

59
Q

cancer death –> top 3

A

1) lung
2) breast/prostate
3) colorectal

60
Q

cancer prevalence –> top 3

A

1) breast/prostate
2) lung
3) colorectal

61
Q

MEN 2A

A

PPM:

  • PTH
  • pheo
  • medullary thyroid CA
62
Q

MEN2B

A

PMM:

  • pheo
  • medullary thyroid CA
  • mucocutaneous neuromas/Marfanoid

COMLEX 3 (17 decks)

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