Hemato-Oncology Flashcards
What metal poisoning can Porphyria cause ?
Lead through inhibition of ALA in heme synthesis
Basophillic stripping (aggregates of ribosomes or fragments of ribosomal RNA precipitated throughout the cytoplasm of circulating erythrocyte)
(Basophilic stippling occurs because of imperfect RNA resolution and abnormal ribosomal structure)
Causes include :
1.lead poisoning
2.Hemolysis
3.Thalassemia
Lead poison
Basophillia stripping
Blue Burton line on Gum
Demyelination of motor axon
Memory deficit
Arthralgia Myalgia
GI symptoms
How to know duration of lead poison ?
FEP -check intoxication of past 120 days
Serum lead - exposure within 3 weeks
Plummer Vinson syndrome
Atropic glossitis
Esophageal web
Microcytic anemia
CRAB mnemonic
Multiple Myeloma
Elevated Calcium , Renal Failure , Anemia, Bone lesion
MGUS
Monoclonal Gammopathy of undetermined Significance
M protein ( Immunoglobulin ) < 3 g/dl
Asymptomatic
30% May progress to MM
ABVD regime
HL
Adriamycin/Docorubicin
Bleomycin
Vinblastine
Decarbazine
Androgen Excess (Hirtuism+acne+irregular period ) + Adnexal mass +Ovarian Ca ?
Sertoli leydig ovarian tumor
(Sex cord stromal tumor) -Benign
Sertoli cell / Leydig cell of ovary function ?
S- convert Testosterone to estrogen (Spermatogenesis)
L-secrete testosterone
vWF disease
Factor VIII carrier
Platelet adhesion
Deep Bleeding (Joint )
(Platelet disorder )
Adult , Bloody diarrhea
5 cardinal signs
1.Renal Insufficiency ,
2.Anemia
3.Fever ,
4.CNS problems,
5.Thrbocytopenia
TTP/HUS
E.coli toxin»_space; endo cells damage >thrombosis+plt activation
Rx of TTP/HUS
Plasma Exchange
Immunosuppressant
Painless , round,firm,non-illuminating testicular mass ,elevated LDH
Testicular tumor (Seminoma)
Translluminate testicular mass + Cystic fluid collection
Hydrocele,Vericocele
Painful testicular mass+ elevated WBC
Epidydimitis /Orchitis
Most common germ cell tumor of women
Dysgerminoma (ovarian Tumor)
IncreaseD ALP ,LDH
Causes of increased b-HCG
normal pregnancy
Gestational trophoblastic disease ( Choriocarcinoma , Hydatiform mole ,ectopic pregnancy )
Child
Increased MCHC
normocystic anemia(Intravascular Hemolysis )
Small ,Round RBC
H. Spherocytosis
Osmotic fragility Test
Direct Coomb - Neg
Most common lung cancer
NSCLC
1. Adenocarcinoma ( Acinar)
2.squamous cell carcinoma (hilum )
Which lung ca are not related to smoking risk?
Large cell lung cancer
Bronchoalveolar Ca
Risk factors of SCLC
Smoking
Asbestos
Aromatic carbon
Ionizing radiation
What condition (syndrome ) is associated with SCLC ?
Lambert Eaton MG (Paraneoplastic Syndrome )
Ca channel antibodies at pre-syneptic NMJ
Lambert Eaton MG features
Ptosis
Diplopia
Muscle weakness
Cause of Pain Crisis in Anemic patient with Jaundice ?
Sickle Cell Anemia ( parvovirus-19)
Pain crisis is due to Sickle disease and b-thalassemia
What causes Sickle cell anemia ?
Assault to RBC due to hypoxia / dehydration»_space; Vascular congestion»_space;sickle»_space; thrombosis»_space;DIC
Missense mutation of b-Hgb
Child (3yr)
Chalky ,White retinal mass in the central eye
Esotropia
Vision , movement ,reflex intact
Retinoblastoma ( Rb TSG)
-Cong Cataract
-abnormal vitreous /retina
Inflammation
Retinoblastoma secondary malignancies ??
Soft tissue sarcoma
Osteosarcoma
Malignant melanoma
Mets via : SAS, Blood ,lymph
Rx of Retinoblastoma ?
Removal of Optic Nerve to prevent brain metastasis
Increased Hgb
Hct 62%(high)
Plt high
Blur vision , rib pain
Primary polycythemia Vera ( EPO normal or decreased )
EPO level in secondary PCV ?
Increased due to renal stimuli
( Eg : Renal tumor , hypoxia, high altitude , EPO receptor mutation )
Polycythemia can cause what carcinoma?
Renal Cell Ca
HCC
How can VSD or PDA causes Polycythemia Vera ?
LยปR shunt first ,later pulmonary Vascular resistance allow RยปL shunt»_space; deoxygenated blood»_space; Cyanosis»_space; EPO stimulation»_space; RBC increased
3 types of Myeloproliferative disorders
Increased RBC ( PCV)
Increased WBC ( AML)
Increased Plt ( 1 essential thrombocytosis )
Painless jaundice + Abd pain + RUQ mass
Pancreatic cancer
Whipple procedure
Resection of
Antrum + part of duodenum +head of pancreas + GB
Most common brain tumor in child
Medullablastoma
Cerebellar tumor
Hydrocephalus ( large ,shiny scalp , visible veins,downward gaze ,increase ICP)
Most common brain tumor in adult
Glioblastoma ( Butterfly gliomas)
Cerebral Hemisphere + Corpus callosum
Oligodendroma
Slow growing > transient symptoms
Frontal lobes
Glial cells ( made up myelin of axon )
Parasthesia + weakness
Recent infection
Elevated calcium /Cr
Back pain
M protein
Multiple Myeloma