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HEMATO-ONCOLOGY Flashcards

0
Q

What are the vWF and Fibrinogen receptors?

A

GpIb

GpIIb/IIIa

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1
Q

Which cytokine activate macrophages?

A

Gamma-interferon

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2
Q

What is the first step to septic shock activation by macrophages?

A

Lipid A From bacteria LPS binds CD14

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3
Q

Causes of eosinophilia (5) NAACP

A

Neoplasia
Asthma
Allergic processes
Chronic adrenal insufficiency
Parasites (invasive)

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4
Q

What substances are in basophils (3)

A

Heparin
Histamine
Leukotrienes

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5
Q

What type of Igs can be bind by Mast cells and what substances can release (3)?

A

Fc portion of Ig E

Causing degranulation of
Histamine
Heparin
Eosinophilic Hemotactic factor

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6
Q

What type of cell proliferate most in Multiple Myeloma?

A

Plasma cells

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7
Q

What agents activate intrinsic and extrinsic coagulation pathways?

A

Intrinsic : collagen, basement membrane,activated platelets

Extrinsic : thromboplastin (tissue factor)

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8
Q

What are Xa factor inhibitors?

A

LMWH☑️
Heparin
Apixaban, rivaroxaban
Fondaparinux

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9
Q

What are IIa factor (thrombin) inhibitors (3)

A

Heparin☑️
LMWH (deltaparin-enoxaparin)
Argatroban,bivalirudin,dabigatran

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10
Q

What enzyme is inhibited by warfarin?

A

Vitamin K epoxied reductase

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11
Q

Which factors are inhibit by protein C and S

A

V factor

VIII factor

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12
Q

What factors are inhibited by antythrombin ( enhanced by heparin)(6)?

A 
II
VII
IX
X
XII
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13
Q

What’s factor V Leiden mutation ?

A

Factor V resistant to inhibition by protein C

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14
Q

When you see target cells(4)?

A

HbC disease
Asplenia
Liver disease
Thalassemia

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15
Q

When you see Heinz bodies?

A

G6PD deficiency

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16
Q

When you see Howell-jolly bodies?

A

Hyposplenia

Asplenia

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17
Q

What are normocytic anemias extravascular hemolysis (5)?

A 
Hereditary espherocitosis
G6PDH deficiency 
Piruvate kinase deficiency
Paroxysmal nocturnal hemoglobinuria
Sickle cell anemia
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18
Q

What are microcytic anemias(5)?

A 
Iron deficiency (late) 
ACDa 
Thalassemias
Lead poisoning 
Sideroblastic anemia
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19
Q

What’s Plummer-Vinson syndrome triad?

A

iron deficiency anemia
esophageal webs
atrophic glossitis

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20
Q

What’s Hb Barts and Hb H?

A

4 allele deletion: No α-globin. Excess γ-globin forms γ4 (Hb Barts). Incompatible with life (causes hydrops fetalis).
3 allele deletion: HbH disease. Very little

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21
Q

X-Ray finding of beta thalassemia major

A

Crew cut

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22
Q

Tile of hemoglobin , skeletal deformities and infeciosus risk in beta thalassemia mejor?

A

Hb F ( alfa2 gamma2)
Chipmunk facies
Parvovirus B19

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23
Q

Managment of lead poisoning (3)

A

Dimercaprol
EDTA

Succimer (kids)

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24
Q

Which enzymes are impaired in lead poisoning(2).

A

ferrochelatase

ALA dehydratase

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25
Q

Enzyme defect in hemosiderosis

A

δ-ALA synthase

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26
Q

Causes of sideroblastic anemia (5)

A 
alcohol is most common
lead
vitamin B6 deficiency (TREATMENT)
copper deficiency 
isoniazid
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27
Q

Big differences between folate and B12 deficiency(3)

A

FOLATE
⬆️homocysteine
↔️Methylmalonic acid
❎Neurological symptoms

B12
️⬆️homocysteine
⬆️Methylmalonic acid
✅Neurological symptoms

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28
Q

How chronic diseases cause anemia?

A

Liver secretes hepcidin

Which inhibit intestinal iron absorption

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29
Q

Cause of paroxysmal nocturnal hemoglobinuria

A

impaired synthesis of GPI anchor for decay-accelerating factor that protects RBC membrane from complement

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30
Q

Symptoms and treatment for paroxysmal nocturnal hemoglobinuria

A

Triad: Coombs ⊝ hemolytic anemia, pancytopenia, and venous thrombosis.
Labs: CD55/59 ⊝ RBCs on flow cytometry.

Treatment: eculizumab (terminal complement inhibitor).

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31
Q

Treatment for sickle cell anemia

A

Hydroxyurea ⬆️HbF

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32
Q

Actions of corticosteroids in lymphocytes and eosinophils

A

lymphocytes APOPTOSIS

eosinophils SEQUESTERING IN LYMPHNODES

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33
Q

Symptoms of acute intermittent porphyria (5Ps)

A

Painful abdomen
ƒ Port wine–colored urine
ƒ Polyneuropathy
ƒ Psychological disturbances
ƒ Precipitated by drugs (e.g., cytochrome
P-450 inducers), alcohol, starvation

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34
Q

Enzyme impaired in Acute intermittent porphyria

A

Porphobilinogen deaminase

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35
Q

Enzyme impaired in Porphyria cutanea tarda

A

Uroporphyrinogen decarboxylase

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36
Q

Bernard-Soulier syndrome

Cause And how differentiate it from other

A

⬇️ GpIb

No agglutination on ristocetin

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37
Q

Glanzmann thrombasthenia

Cause And how differentiate it from other

A

 ⬇️GpIIb/IIIa Ž

no platelet clumping. Agglutination with ristocetin

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38
Q

Immune thrombocytopenia

Cause and Dx



A

Anti-GpIIb/IIIa antibodies Ž

⬆️ megacaryocytes in bone marrow

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39
Q

Cause and diagnosis of Thrombotic thrombocytopenic purpura

A

Inhibition or deficiency of ADAMTS 13 (vWF metalloprotease) Ž 
Labs: schistocytes,  LDH.

Symptoms: pentad of
1. neurologic
2.renal symptoms
3. fever
4. thrombocytopenia,
5. microangiopathic hemolytic anemia.

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40
Q

Diagnosis and treatment of Von Willerbrand disease

A

Dx ristocetin cofactor assay
( agglutination is diagnostic).

Treatment: desmopressin, which releases vWF stored in endothelium.

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41
Q

Which factors are affected ind antythrombin deficiency?

A

IIa

Xa

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42
Q

Which disease cause thrombotic skin necrosis with hemorrhage after warfarin administration?

A

Protein C or S deficiency

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43
Q

Which contains cryoprecipitate?(5)

A

fibrinogen
factor VIII
factor XIII
vWF
fibronectin

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44
Q

Difference between leukemoid reaction and CML

A

leukemoid reaction ⬆️ leukocyte alkaline phosphatase (LAP)

CML ⬇️leukocyte alkaline phosphatase (LAP)

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45
Q

Principal characteristics of Hodgkin lymphoma (4)

A

Localized, single group of nodes;
Reed-Sternberg cells.
young adulthood and> 55 years;
associated with EBV.

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46
Q

Principal characteristics of no Hodgkin lymphoma (4)

A

extranodal involvement common
Majority involve B cells
20–40 years old.
associated with HIV and autoimmune diseases.

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47
Q

Cell markers of reed-sternberg cells (3)

A

CD15+
CD30+
B-cell origin

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48
Q

Causes and findings in Burkina lymphoma (1-3)

A

t(8;14)—translocation of c-myc (8) and heavy-chain Ig (14)

“Starry sky” appearance
Associated with EBV.
Jaw lesion

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49
Q

Age of patients and Genetics of mantle cell lymphoma

A

Older males

t(11;14)—translocation of cyclin D1 (11) and heavy-chain Ig (14)

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50
Q

Multiple myeloma findings (5)

A

Monoclonal plasma cell (“fried egg” appearance)
Punched-out lytic bone lesions on x-ray A
ƒM spike on serum protein electrophoresis (IgG IgA)
ƒIg light chains in urine (Bence Jones
protein)
ƒ Rouleaux formation B

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51
Q

What’s Pseudo–Pelger-Huet anomaly—

A

neutrophils with bilobed nuclei. Typically seen after chemotherapy.

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52
Q

Markers to ALL

A

TdT+ (marker of pre-T and pre-B cells)

CD10+ (pre-B cells only).

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53
Q

Markers to SLL and CLL

And characteristic cell

A

CD20+, CD5+ B-cell neoplasm

Smudge cell

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54
Q

Diagnosis and treatment of Hairy cell leukemia

A 
Stains TRAP (tartrate-resistant acid phosphatase ⊕)
flow cytometry.
Treatment: cladribine, pentostatin.
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55
Q

Acute myelogenus leukemia findings (2)

A

Auer rods

peroxidase ⊕ cytoplasmic inclusions

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56
Q

Markers and typical cells in langerhans cell histiocytosis

A

S-100 and CD1-a

Bribeck granules “tennis rackets”
Lytic bone lesions

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57
Q

Which mutation is implied in chronic myeloproliferative disorders?

A

JAK 2

In Polycythemia vera
Essential thrombocytosis
Myelofibrosis

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58
Q

Findings in CML

A 
⬇️ RBCs
⬆️ WBCs
⬆️ Platelets
✅ Philadelphia chromosome
❎JAK mutation
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59
Q

What’s heparin-induced thrombocytopenia?

A

IgG antibodies against heparin- bound platelet factor 4 (PF4). platelets Ž thrombosis and thrombocytopenia.

ALTERNATIVE Bivalirudin!!!!

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60
Q

What are Direct factor Xa inhibitors?

A

Apixaban

Rivaroxaban

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61
Q

Mechanism of action of clopidogrel ,ticagrelor (reversible)

A

Inhibit platelet aggregation by irreversibly blocking ADP receptors. Prevent expression of glycoproteins IIb/IIIa on platelet surface.

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62
Q

Mechanism of action of Cilostazol and dipyridamole?

A

Phosphodiesterase III inhibitor;  cAMP in platelets, resulting in inhibition of platelet aggregation; vasodilators.

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63
Q

Which anti metabolites have ⬆️ toxicity whit de use of allopurinol or febuxotat?

A

Azathioprine

6-MP

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64
Q

Which drug is an folic acid which inhibit competitively dihydrofolate reductase?

A

Methotrexate

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65
Q

What pharmac can rescue the myelosuppression caused by methotrexate ?

A

Leucovorin

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66
Q

Pharma used to prevent cardio toxicity by doxorubicin daunorubicin

A

Dexrazoxane

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67
Q

Which Pharma prevents myelosuppression caused by cyclophosphamide ?

A

Mesna

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68
Q

Which anti cancer drugs do not cause bone marrow suppression(3)?

A

Bleomycin. Pulmonary fibrosis
Cisplatin. Nephrotoxicity
Vincristine Neurotoxicity

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69
Q

How can avoid cisplatin and carboplatin nephrotocixyty?

A

Amifostine

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70
Q

Mechanism of action of Hydroxyurea ?

A

Inhibit ribonucleotide reductase

Cause SEVERE MYELOSUPRESSION

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71
Q

Mechanism of action of bevacizumab

A

Monoclonal antibody against VEGF

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72
Q

Mechanism of action of erlotinib

A

EGFR tyrosine kinase inhibitor

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73
Q

Mechanism of action of imatinib

A

Tyrosine kinase inhibitor of BCR-ABL and c-KIT

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74
Q

Mechanism of action of rituximab

A

Monoclonal antibody against CD20

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75
Q

Mechanism of action of TAMOXIFEN RALOXIFENE

A

Tamoxifen estrogen receptors ❎ breast ✅endometrium✅bone

Reloxifene estrogen receceptors ❎breast ❎endometrium ✅bone

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76
Q

Mechanism of action of trastuzumab ?

A

Monoclonal antibody against HER-2 human epidermal grow factor 2
Is a tyrosine kinase exceptor which promotes apoptosis

77
Q

Mechanism of action of vemurafenib

A

Inhibitor of BRAF oncogene melanoma

78
Q

What are sequences of changes in iron deficiency anemia?(6)

A 
⬇️ferritin  hemosiderin bone marrow 
⬇️serum ferritin
⬆️TIBC, transferrin
⬇️serum iron
⬇️blood hemoglobin
Microcytic,  hypo chromic
79
Q

What are contraindications of fibrinolytic use (5)

A

Hemorrhagic stroke 180/110

Suspect of dissecting aneurism

80
Q

What’s the most common repercussion arrhythmia?

A

Accelerated idioventricular rhythm

81
Q

How aTPT is in hemophilia type A and B

A

Increased

82
Q

Functions of vWF(2)?

A

Platelet adhesion

Carrier protein for factor VIII

83
Q

Functions of prostacilcina (2)

A

Anti platelet aggregator

Vasodilator

84
Q

Which events occurs in cellular the 5 cellular phases ?

A 
G0 resting
G1. RNA protein lipids carbohydrates synthesis 
S DNA replication
G2 ATP synthesis
M mitosis
85
Q

Function of retinoblastoma protein

A

Hypophosphorilated ACTIVE cell cannot go G1⏩S

Hyperphosphorilated INACTIVE cell can go G1⏩S

86
Q

Neoplasias linked whit dermatomyositis (4)

A

Ovarian
Lung
Colorrectal
Non-Hodgkin lymphoma

87
Q

Clinical sings of whipple disease (3)

A

Arthritis
Diarrhea
Fever

88
Q

Why ⬆️ACTH produces hyper pigmentation?

A

BECAUSE HAS A SIGNIFICANT SEQUENCE HOMOLOGY WITH ALFA-MSH!!!!!!!! PERROS HPSSSS

89
Q

What type of hormones are secreted by lung small cell carcinoma?(2)

A

ACTH

Vasopressin

90
Q

What type of hormones are secreted by squamous cell carcinoma lung (1)?

A

PTHrP

91
Q

How high doses of folate can precipitate seizures?

A

Folate is an antagonist of phenytoin

92
Q

Vasopressin is used to treat what hematologist disease (2)?

A

vWD

Hemophilia type A

93
Q

Mechanism of action of aminocaproic acid?

A

Inhibition of breakdown of fibrin in blood clots

94
Q

How HBV. DNA virus can produce cancer?

A

HBx an oncogen viral protein

Inactivate P53

95
Q

What’s the protein product of c-myc implied in Burkitt lypmphoma?

A

Transcription factor nuclear phosphoprotein

96
Q

What’s BCL2 protein implied in follicular lymphoma?

A

Apoptosis inhibitor

97
Q

What are BRCA1 BRCA2 enzymes implicated in many tumor diseases?

A

DNA repair Enzymes

98
Q

What is cyclin D1 product mutation in mantle cell lymphoma?

A

Promote G1 to S phase

99
Q

What’s the product of fusion gene in CML (Philadelphia chromosome>

A

Increase tyrosine kinase
Promote mitosis
Inhibit apoptosis

100
Q

Effect of use of rivaroxaban an in times of coagulation

A

⬆️aPTT
⬆️PT
↔️ TT

101
Q

Effect of use of NON fractionated heparin an in times of coagulation

A

⬆️ aPTT
⬆️ TT
↔️ PT

102
Q

Effect of use of davigatran an in times of coagulation

A

⬆️ aPTT
⬆️ PT
⬆️ TT

103
Q

What is the net effect of heparin-induced thrombocytopenia?

A

PARADOXICAL THROMBOSIS

104
Q

Treatment of heparin induced thrombocytopenia?(3)

A

Hirudin
Lepirudin
Argabatran

DIRECT THROMBIN INHIBITORS

105
Q

How increase hemoglobins after iron replacement in iron deficiency anemia?

A

2gr/Dl per week the first three weeks

106
Q

Hat is the problem in factor V Leiden mutation?

A

Factor V is resistant to the action anticoagulant of protein C
Creating an procoagulant state.

107
Q

Which time of coagulation is increase in anti phospholipid antibody?

A

⬆️aPTT

108
Q

What’s the action of folinic acid (leucovorin) to overcome leukopenia by methotrexate?

A

Folinic acid compete by DHF reductase against MTX

109
Q

What’s the action of sulfonamide?

A

Inhibit the conversion of PABA to folic acid

ONLY IN PROKARYOTES

110
Q

What’s chromosomes are implicated in acute promyelocytic leukemia?( a typo of Acute myelogenus leukemia)

A

t15-17

111
Q

Etiology of black Vs brown biliary stones

A

Black stones chronic hemolysis or ileal disease

Brown stones biliary tract infection

112
Q

What’s the worst picture for hemorrhage by low Vit k factors dependent (4) ?

A

Newborn
Refusal to Vit K prophylaxis
Exclusive Breastfeeding
Cystic fibrosis

113
Q

Treatment for multiple myeloma

A

Proteasome inhibitors

Bortexomib
Boronic-acid contain dipeptide

114
Q

Clinical findings of Multiple Myeloma (5)

A 
Bone pain
Fatigue
Anemia
Kidney disease 
Hypercalcemia
115
Q

Which proteins of extra celular spa con interact with integrines ?

A

Collagen
Fibronectin
Laminin

116
Q

Most important clinical findings in polycythemia Vera (3)

A

Aquagenic pruritus
Facial plethora
Splenomegaly

117
Q

What type of red cells are typical in abetalipoproteinemia?

A

Acanthocytes

118
Q

Mechanism of action of infliximab and uses (3)

A

Antibody to TNF-alpha

Rheumatoid arthritis
Ankylosing spondylitis
Crohn disease

119
Q

Function of BCL 2 gene

A

It is an oncogene which inhibit cell death cascade

120
Q

Genes implicated in follicular lymphoma

A

t14-18 bcl-2 oncogene

121
Q

Mechanism of action of drug resistance of tumors like cells

A

P- glycoproteins an ATP dependent efflux protein

122
Q

Cytokeratin is a cell marker for…

A

Epithelial cells!!!!!!

123
Q

What type of cancer is linked whit EBV?

A

Nasopharyngeal carcinoma

124
Q

What’s pure red cell aplasia?

A

IgG antibodies and T citotoxic cells
Produced in thymoma and lymphoma
Parvovirus B19

125
Q

What is the effect of hepcidin?

A

⬇️iron absorption in the gut by causing degradation of ferroportin (transmembrane protein responsible for take the iron from the enterocyte to blood circulation)

126
Q

What protein takes the iron from gut lumen to the enterocyte?

A

Divalent metal transporter-1

DMT-1

127
Q

Mechanism of action of raltegravir ?

A

Integrase inhibitor!!!

128
Q

Mechanism of action of enfuvirtide?

A

Fusion inhibitor

129
Q

Ending word for protease inhibitor?

A

NAVIR!!!!!

130
Q

What kind of antibodies are generated in immune thrombocytopenic purpura?

A

GP IIb/IIIa IgG

131
Q

Common causes of aplastic anemia?(4)

A

Parvovirus
Epstein-Barr
⬆️Chemotherapy
Radiation

132
Q

What drug can overcome the toxicity of methotrexate?

A

LEUCOVORIN!! (Folinic acid)

133
Q

What association is used to enhance the effect of 5-fluorouracil?

A

LEUCOVORIN!!! (Folinic acid)

134
Q

What kind of translocation has follicular lymphoma and what gene is overexpresed?

A

t14;18

BCL2

135
Q

Direct and indirect Factor Xa inhibitors

A

DIRECT Rivaroxaban, Apixaban

INDIRECT Fondaparinox

136
Q

Mechanism of action of Heparin non fractionated and enoxaparin?

A

Heparin bind to ANTITOMBIN III: f Xa - Thrombin

Enoxaparin bind to ANTITROMBIN III - f Xa

137
Q

What kind of Basophilic cells (blue) are pathognomonic of MULTIPLE MYELOMA in the bone marrow aspirated?

A

WAGON WHEEL !!! 🎡

138
Q

Why sickle cell anemia cause macrocytic anemia?

A

Deficiency of folic acid Vit B9

Because increased erythrocyte turnover

139
Q

Which factors cause angiogenesis (2)

A

Vascular endothelial growth factor (VEGF)

Fibroblast growth factor (FGF)

140
Q

Cause and clinical features of thrombotic thrombocytopenic purpura?

A

⬇️ADAMTS13 activity leads to vWF ⬆️⬆️microThrombi

Hemolitic anemia
Thrombocytopenia

Sometimes
Renal failure
Neuro manifestations
Fever

141
Q

What ⬇️ haptoglobin means ?

A

Intravascular hemolysis

142
Q

What RBCs surface markers are absent in paroxysmal nocturnal hemoglobinuria?

A

CD55
CD59

Because there is an mutation at phosphatidylinositol glycan mutation

⬆️complement- mediated hemolysis
PANCYTOPENIA!!!!

143
Q

Clinical features of Hemolytic uremic syndrome?(4)

A

Bloody diarrhea
Hemolytic anemia schistocytes
Thrombocytopenia
Acute kidney injury

144
Q

Function of Vit B9 folic acid in DNA synthesis

A

Single carbon donor for purine and pyrimidine synthesis

145
Q

What kind of anemia is produced in chronic alcoholism whit chronic pancreatitis?

A

MEGALOBLASTIC ANEMIA!!!!

146
Q

What is pathognomonic Histologic and clinical finding in follicular lymphoma?

A

Lymphoma cells whit clefted nuclei t14;18 ⬆️bcl-2

Fluctuating lymphadenopathy

147
Q

What farmac can prevent the cytotoxicity of acrolein derivative of cyclophosphamide ?

A

MESNA!!!

148
Q

Which farmac can prevent the toxicity of doxorubicin?

A

Dexrazoxane!!!

149
Q

Histologic finding in glioblastoma multiforme

A

Central necrosis and vascular proliferation.

150
Q

Two clinical pathognomonic findings in aplastic anemia?

A

PANCYTOPENIA

NO SPLENOMEGALY!!!!

151
Q

Tumors in Lí-Fraumeni syndrome ⬇️TP53 (5)

A 
Sarcoma
Breast cancer
Brain tumor
Adrenocrotical carcinoma
Leukemia
152
Q

What exams are alternated in von Willebrand disease?(2)

A

⬆️ bleeding time (platelet disfunction)

⬆️ PTT( degradation of VIII factor)

153
Q

What is the final path in the coagulation cascade

A 
Xa -(Va)
⬇️
Prothrombin --- thombrin IIa
         ⬇️
Fibrinogen- fibrin        Ia
154
Q

Treatment for hemophilias?

A

THROMBIN!!!!!

155
Q

Auer rods are seen in…

A

ACUTE MYELOGENUC LEUKEMIA !!!!!
AML!!!!!!

t 15;17
Promyelocytic leukemia ➕Retinoic receptor alpha gene

156
Q

How are the coagulation times in chronic renal failure?

A

⬆️ bleeding time uremic toxins qualitative platelet disorder
TP, TPT NORMAL

157
Q

What gene is Overexpressed in Burkit lymphoma and what infectious agent is related?

A

c-MYC t(8;14)

EBV in HIV patients

158
Q

How treat warfarin overdoses? (3)

A

Fresh Frozen Plasma
Prothrombin Complex Concentrates (II,VII,IX,X)
Vitamin K

159
Q

Which feature differentiate immune thrombocytopenic anemia from hemolytic uremic syndrome?

A

Would not produce anemia or renal disease

160
Q

Which cells is infected an which cells proliferated anomaly after Epstein bar virus infection?

A

Infect B cells

Activation of T cells proliferate anomaly

161
Q

Where are seen pautrier micro abscesses?

A

Mucous is fungoides

Sezary sindrome

162
Q

How MCHC is in spherocytosis?

A

⬆️MCHC

163
Q

Complications of espherocitosis ?

A

Pigment gallstones

Aplastic crises from parvovirus B19 infection

164
Q

How is haptoglobin in hemolytic anemia?

A

⬇️haptoglobin

165
Q

Abnormal cells related whit sideroblastic anemia?

A

Pappenheimer

166
Q

Principal findings in hairy cell leukemia ?

A 
Middle age men
Bone marrow fibrosis 
Pancytopenia
Massive Splenomegaly 
Tartrate-resistant acid phosphatase  test
167
Q

What are the pathognomonic findings in ferropenic anemia? (2)

A

Disphagia (esophageal webs)

Koilonuchia (spoon nails)

168
Q

How is the CBCs in paroxysmal hemolytic anemia?

A

Hemolytic anemia
⬇️ leucocytes
⬇️ platelets

169
Q

Findings in leukemoid reaction (3)

A

Left shift
Dohle bodies( MATURE neutrophils whit Basophilic oval inclusions)
⬆️↔️Leukocyte alkaline phosphatase

170
Q

Drugs and infections which produce Aplastic anemia?(3,2)

A

Chloramphenicol
Carbamazepine
Sulfonamides

Parvovirus B19
Epstein-Barr virus

171
Q

Clinical manifestations of carcinoid syndrome?(4) ⬆️5-HIAA urine

A

SKIN flushing telangectasias cyanosis
GI watery diarrhea cramping
PULMONARY Bronchospasm dyspnea
CARDIAC valvular fibrosis plaques (right>left)

172
Q

What’s Trousseau syndrome?

A

Migratory thrombophlebitis by visceral cancer (pancreas,colon, lung)
Adenocarcinomas produce thromboplastin-like substance

HYPERCOAGULABILITY STATE

173
Q

Presence of immune complex vasculitis associated with IgA and C3 deposition is typical in….

A

Henoch-Schonlein purpura

174
Q

Cause of liver fatter change and Hepatocyte necrosis?

A

FREE RADICAL INJURY!!!!
⬇️
Mithocondrial disfunction

175
Q

Meaning of presence of Myeloblast, Myelocyte and band In Peripheral blood?

A

Myeloblast. MALIGNANCY
Myelocyte LEUKEMOID REACTION , PREGNANCY
Band NORMAL INFECTION

176
Q

Important features of AML acute myelogenus leukemia ( the most common acute leukemia upon adults)? (3)

A

Around 65 years old
WBCs. 15000-20000
Blasts >20%

177
Q

Which factors reflects PT?

A

Tissue factor
Fibrinogen
II , V, VII, X

178
Q

What measure trombine time TT?

A

Rate of conversion of fibrinogen to fibrin

If prolonged means liver disease

179
Q

Explain how high doses of Vit A can cure acute Promyelocytic leukemia an AML?

A

t(15;17)
🚫Retinoic acid receptor alpha (differentiation of myeloid precursors)

Treatment with all-trains-retinoic acid VIT A!!!! In high quantities
Overcomes this situation

180
Q

How works LMWH (enoxaparin) and Heparin?

A

Heparin binds: ANTITROMBIN III+ THROMBIN
ANTITHROMBIN III+ Factor Xa

LMWH binds : ANTITHROMBIN III+ Factor Xa

181
Q

Rare tumor associated with arsenic and polyvinyl chloride , CD31+?

A

Liver angiosarcoma

CD31+ = PECAM1

182
Q

Mechanism of action of Etanercept?

A

TNF-alpha inhibitor !!!!

183
Q

What “mab” means in farmac?

A

Mab. Monoclonal antibody

184
Q

What “nib” means in farmac?

A

nib kinase inhibitor

185
Q

Explain the genetic feature of follicular lymphoma, CML, Burkitt lymphoma , breast cancer, Lí-fraumeni syndrome?

A

follicular lymphoma Bcl2- Overexpression t14-18
CML Bcr-abl hybrid formation t9-22
Burkitt lymphoma C-myc Overexpression t8-14 t8-22 t8-2
breast cancer Erb-B2 Overexpression
Lí-fraumeni syndrome p53 inactivation

186
Q

What is the treatment for warfarin-induced skin necrosis?

A

fresh frozen plasma

to replenich protein C

187
Q

How patients whit ALL develops dysphagia,stridor and disnea?

A

30% are T-cells ALL and develope
mediastinal mass compressing the esophagus and trachea.

but the majority 70% are B-cell ALL
whitout mediastinal mass.

188
Q

How is clasiffied Acute Myelogenous Leukemia? and what is Acute Promyelocytic Leukemia (APML)?

A

M0-M1-M2-M3 (APML)-M4-M5-M6-M7-M8

APML t(15;17)
abnormal retinoic acid receptor
Auer Rods

PANCYTOPENIA
Disseminated intravascular coagulation

189
Q

function of EGFR , implied in colo rectal cancer?

A

EGFR transmembrane receptor

binds KRAS which in turn cause Cell proliferation

190
Q

What ere the neuroendocrine cells markers?(3)

A

Neuron-specific enolase
Chromogranine
Synaptophysin

Step 1 (1) (16 decks)

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