Hemat Onco Flashcards
Döhle bodies (light blue, peripheral inclusions) due to left shift are seen in
Neutrophils
Platelets contain dense granules such as
Calcium, ADP, Serotonin, Histamine
Platelets contain alpha granules such as
vWF, fibrinogen, fibronectin, platelet factor 4
Macrophages naming varies by specific tissue type eg-
Osteoclasts in the bone, histiocytes in connective tissue
Lipid A from bacterial LPS binds CD14 on macrophages to initiate
Septic shock
Basophils mediate allergic reaction and contain granules like
Heparin (anticoagulant) and histamine (vasodilator)
Leukotrienes are synthesised and released on demand
Mast cells contain basophilic granules and mediate -
Local tissue allergic reactions
Mast cells are activated by tissue trauma, C3a and C5a, surface IgE cross linking by antigen (IgE receptor aggregation) and cause
Degranulation and release of histamine, heparin, tryptase and eosinophil chemotactic factors
Cromolyn sodium prevents
Mast cell degranulation (used in asthma prophylaxis)
Vancomycin, opioids, radiocontrast dye can elicit
IgE-independent mast cell degranulation
CD56, CD16 (FcR)
NK cells
CD4+ helper T cells are the primary target of
HIV
Neutrophil lysosomes (Azurophilic granules) contain
Proteinases, acid phosphatases, myeloperoxidase, B glucuronidase
Neutrophil chemotactic agents
C5a, IL 8, LTB4, 5 HETE, Kallikrein, platelet activating factor, bacterial proteins
Aspirin irreversibly inhibits COX, thereby inhibiting
TXA2 synthesis
What drugs inhibit ADP-induced expression of GpIIb/IIIa by blocking P2Y12 receptor
Clopidogrel, Prasugrel and Ticagrelor
Abciximab, Eptifibatide, Tirofiban
Inhibit GpIIb/IIIa directly
Risocetin activates
vWF to bind GpIb
Failure of aggregation with Risocetin assay occurs in
von Willebrand disease and Bernard-Soulier syndrome
Desmopressin promotes the release of
vWF and factor VIII from endothelial cells
Drug induced hemolytic anemia caused by
Penicillins, Cephalosporins, NSAIDS
Drug induced hemolytic anemia caused by
Penicillins, Cephalosporins, NSAIDS
Acute intermittent porphyria
Affected enzyme: Porphobilinogen deaminase
Accumulated substrate: Porphobilinogen, ALA
Treatment: Hemin and glucose
Porphyria cutanea tarda
Affected enzyme: Uroporphyrinogen decarboxylase
Accumulated substrate: Uroporphyrin (tea coloured urine)
Treatment: Sun avoidance, Hydroxychloroquine
Lead poisoning
Affected enzyme: Ferrochelatase and ALA dehydratase
Accumulated substrate: Protoporphyrin, ALA
von Willebrand disease
Menorrhagia and epistaxis
Antithrombin III inhibits factors -
IIa and Xa
Burkitt lymphoma
t(8,14) translocation of c-myc and heavy chain Ig
Starry sky appearance, tingible body macrophages
Diffuse large B cell lymphoma
Most common type
Mutations in BCL 2 and BCL 6
Follicular lymphoma
t(14;18) - translocation of heavy chain Ig (14) and BCL 2 (18)
Painless waxing and waning lymphadenopathy
Mantle cell lymphoma
t(11;14) translocation of cyclin D1 (11) and heavy chain Ig (14)
Very aggressive
Marginal zone lymphoma
t (11;18)
Chronic inflammation, Sjögren’s syndrome, chronic gastritis (MALT lymphoma)
Primary central nervous system lymphoma
EBV related associated with AIDS
Ring enhancing lesion on MRI
Argatroban can be used in HIT, when heparin is bad for the patient
Directly inhibits factor IIa (thrombin)
Apixaban, Edoxaban, rivaroxaban directly inhibits factor Xa
Used in stroke prophylaxis for atrial fibrillation
Bleeding is reversed with andexanet alfa
Cilostazol blocks phosphodiesterase, decreases cAMP hydrolysis and increases cAMP in platelets
Intermittent claudication
Tranexamic acid
Antifibrinolytic (prevents clot breakdown)
Vincristine, Vinblastine
M phase specific (Mitosis)
Binds B tubulin and inhibits it’s polymerization into microtubules - Prevents mitotic spindle formation
Adverse effects - Neurotoxicity (crisps the nerve)
Myelosuppression (blasts the marrrow)
Paclitaxel
M phase specific
Hyperstabilizes polymerised microtubules - Prevents mitotic spindle breakdown
Adverse effect: Neuropathy
Cisplatin (makes kidneys got ciSPLATin)
G1 specific (Duplicates cellular content)
Cross links DNA
Adverse effects: Nephrotoxicity, Ototoxicity
Busulfan
G1 specific
Cross links DNA
Adverse effect: Pulmonary fibrosis
Busulfan
G1 specific
Cross links DNA
Adverse effect: Pulmonary fibrosis
Cyclophosphamide
Cross links DNA
Requires liver bio activation
Adverse effects: Hemorrhagic cystitis - Tx : Mesna
SIADH
Carmustine
G1 specific
Cross links DNA
Crosses BBB
Used in glioblastoma multiforme
Adverse effects: CNS toxicity
Azathioprine, 6 MP
S phase specific (DNA synthesis)
Inhibits de novo purine synthesis
Activated by HGPRT
Metabolised by Xanthine oxidase
Allopurinol/ Febuxostat inhibit Xanthine oxidase
Methotrexate
S phase specific (DNA synthesis)
Inhibits ribonucleotide reductase
Adverse effect: Myelosupression
Tx - Leucovorin rescue
Cladribine
S phase specific (DNA synthesis)
Purine analogue
Used in hairy cell leukaemia
5 FU
S phase specific (DNA synthesis)
Pyramidine analogue inhibits thymidylate synthase
Adverse effect: Hand-Foot syndrome
