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2024 - élo - usmle rx qbank > hematology > Flashcards

hematology Flashcards

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USMLE® Step 1 flashcards
1
Q

woman from middle east …. grayish skin, hepatomegaly, massive splenomegaly, and edema
anemia and leukocytes less than 4000

A

sandfly
leishmanias
KALA AZAR

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2
Q

ixodes tick transfers

A

babesiosis , lyme, erichiliosis

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3
Q

anopheles mosquito

A

malaria

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4
Q

aedes mosquito

A

flavivirus—- yellow fever and dengue

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5
Q

Defective actin cytoskeleton formation

A

wiskot aldrich .. WASp … XLR
disorder of B and T cells
eczema pyogenic infections thrombocytopenia

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6
Q

Impaired migration and adhesion to the vascular endothelium

A

LFA-1 integrin (CD18) on the surface of leukocytes, which impairs their ability to bind intracellular adhesion molecules (ICAMs) on the vascular endothelium.

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7
Q

Microtubule dysfunction with failure of phagosome-lysosome fusion

A

partial albinism with hypopigmentation of the skin, eyes, and hair.
chediak higashi … LYST

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8
Q

soldier myalgia diarrhea stomach pain…
liver enlarged and spleen enlarged
eosinophilia

A

katayama fever
unsanitary drinking water
schistosoma mansoni
txt - praziquantil

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9
Q

trichinella symptoms and what causes it

A

Trichinella infection would cause muscle inflammation and periorbital edema.
undercooked meat

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10
Q

dissolve clot mechanism and drug

A

alteplase reteplase ….

plasminogen to plasmin

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11
Q

pancytopenia , nosebleeds, deformed thumbs, other skeletal abnormalities

A

fanconi anemia
txt with bone marrow transplant
age of diagnosis - around 8n yrs

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12
Q

congenital pure red cell aplasia …. cleft lip … shield chest… webbed neck,,, short stature

A

diamond blackfan syndrome\txt with setroids

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13
Q

decreased surface expression of glycoprotein Ib

A

bernard soulliere …. increased BT

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14
Q

plateltes dont have glycoprotein IIb IIIa receptor

A

glanzman

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15
Q

what is a hapten give example

A

a moleculre that cannot induce an immune response on its own but when it binds to a protein it can activate helper T cell
penicillin induced hypersins reaction … type II .. pt presents with fatigue splenomegaly pallor

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16
Q

sickle cell anemia shifts oxxygen curve to

A

the RIGHT

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17
Q

auer rods are +ve for?

A

myeloperoxidase

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18
Q

prognosis of AML what can happen

A

auer rods can disseminate … activate coag cascade throughout the body… causing platelet-fibrin microthrombi …. can damge passing RB
hemolytic anemia and DIC

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19
Q

increased INR means?

A

blood taking longer to clot … so if pt taking warfarin check for CP450 inhibitors
SICKFACES.COM

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20
Q

is hogkin lymphoma a neoplasm of stem cells ?

A

no
thats why pt can use autologous grafts ( taken from other parts of body)
least likely to be rejected

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21
Q

a short-acting anesthetic that potentiates chloride through GABA-A receptors

A

propofol

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22
Q

This explains the rapid onset and short duration of action

A

high lipid solubility

redistribution

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23
Q

58 man …..small tense vesicles, bullae and erosions over the dorsal aspect of both forearms and hands.
tea coloured urine

A

PCT

defect in enzyme…. uroporphyrinogen decarboxylase in cytoplasm

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24
Q

effective way to reduce the incidence of catheter-related bloodstream infections and has minimal adverse effects; it is recommended for all patients in the ICU.

A

daily chlorhexidine bathing

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25
Q

increased HbF ,,, decreased HbA2,,,,,, NO hbA1

A

b thalassemia major

due to complete absence of A1

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26
Q

define Hb A1

A

means 2 alpha 2 beta

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27
Q

pt has a history of DVT … comes in the clinic and is started on intravenous anticoag …. develops severe thrombocytopenia and increased PTT bleeding time
also large brusies can be noted

A

this is heparin induced thrombocytopenia
antibodies to platelet factor 4 develop and bind heparin… they activate platelets and cause thrombosis

TXT with direct thrombin inhibitos ARGATROBAN or bivalirudin

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28
Q

abdominal pain, nausea, hematemesis, hypotension, and tachypnea are signs of

A

acute iron overload

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29
Q

a child has really high WBC count
sea of blast cells seen on smear
fatigue night sweats fever seen
what is the diagnosis and what else could be seen in blood test

A

ALL

blast crises …. leads to neutropenia

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30
Q

marginal zone

A

B cells in spleen

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31
Q

which viruses have humoral response ONLY

A

RIP
killed vaccines
rabies influenza (intramus) polio salk and hepA

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32
Q

ristocetin test

A

The ristocetin factor activates vWF to bind the platelet receptor gylcoprotein Ib (GpIb). When ristocetin is added to normal blood, it causes agglutination. Failure of aggregation with ristocetin assay occurs in von Willebrand disease and Bernard-Soulier syndrome.

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33
Q

pregnant woman….. complains of shivering and chills …. develops ecchymoses on legs …. low BP
inadequate bleeding control

A

amniotic fluid embolism
DIC
thrombocytopenia ,… increased BT PT PTT

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34
Q

acanthocytes

A

are also known as spur cells and are found in liver disease and abetalipoproteinemia

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35
Q

inhibition of porphobilinogen deaminase

A

acute intermittent porphyria

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36
Q

treated for meningitis in russia

signs of aplastic anemia

A

chloramphenicol

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37
Q

preferred anticoagulants in the setting of AF.

A

Direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban) or dabigatran (a direct thrombin inhibitor)

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38
Q

osteomyelitis in sickle cell patient

A

salmonella … capsule is virulence

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39
Q

ITP what can be seen in peripheral blood smear

A

large platelets

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40
Q

RBCs with cytoplasmic basophilic remnants

A

howell joley bodies … in aasplenic pts

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41
Q

medulla of the lymph node house the cords n sinuses

A

contain b cells and plasma cells

sinuses contain reticular cells n macrophages

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42
Q

taut hb

A

deoxy form …. peripheral capillaries

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43
Q

MGUS diagnosis

A

no CRAB symptoms

m protein <3g/dl

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44
Q

classical complement pathway can be triggered by igM or igG after binding to a specific part on the ig …. where is this

A

CH2 Fc portion of heavy chain

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45
Q

VH and VL, on the Fab fragment, that together are known as

A

antigen bindng domain

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46
Q

pregnant woman … DVT what meds to use

A

enoxaparin over LMWH

after 37 weeks of gestation LMWH can be used

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47
Q

5 Ps for AIP

A 
porphobilinogen deaminase 
painful abd
port wine urine
psychological 
polyneuropathy 
precipitated by drugs (alcohol starvation)
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48
Q

Aminolevulinate synthase deficiency

A

XL sideroblstic anemia

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49
Q

which type of graft rejection presents with erythematous macules and papules all over body

A

GVHD

5 weeks

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50
Q

mechanism of MTX

A

DHF to THF

inhibits dehydrofolate reductase

51
Q

signs and symptoms of spontaneous bleeding, purpura, elevated levels of PT and PTT, and decreased fibrinogen are signs of …..
which leukemia is this assoc with?

A

DIC

AML t 15 17

52
Q

mother has a mechanical heart valve,
gives birth to a child nasal and midface hypoplasia; shortened limbs and digits; calcifications of the vertebral, humeral, and femoral epiphyses
what meds was she taking?

A

warfarin
long term anticoag due to valve
warfarin can cross the placenta

53
Q

chronic lymphocytic leukemia (CLL) is a low-grade malignancy of

A

b cells

CD 23 5 20

54
Q

CLL can progress to

A

autoimmune hemolytic anemia

55
Q

blast crisis in which type of leukemia

A

CML —- ALL OR AML blast crises

56
Q

richter transformation

A

CLL —– DLBCL which is an aggressive lymphoma

57
Q

intrinsic apoptosis pathway

A

BCL2 BCLx are antiapoptotic molecules that prevent release of cytochrome c
BAX and BAK are proapoptotic that can trigger release of the cytochrome c

58
Q

extrinsic apoptosis pathway

A

binding of FasL to Fas and TNF-α to its receptor or the release of perforin and granzyme B in immune cells activate caspases.

59
Q

most common antibiotic to cause aplastic anemia

A

chloramphenicol … binds 50s

60
Q 
low serum iron
low TIBC
high ferritin 
\+dsDNA and high creatine
diagnose and treat
A

anemia of chronic disease
due to SLE nephropathy
give EPO

61
Q

how is the majority of CO2 transported

A

plasma as hCO3-

62
Q

Spike and dome” on electron microscopy is associated with

A

membranous glomerulonephritis

subepithelial deposits

63
Q

risk factors for an ischemic stroke

A

. Risk factors include hypertension, high cholesterol, cigarette smoking, advanced age, and diabetes mellitus

64
Q

txt for ischemic stroke

A

ADP inhibitors

clopidogrel ticagrelor

65
Q

how to calculate corrected reticulocyte count for a pt with EPO def

A

reticulocyte count x pt hct/normal hct

66
Q

highly mitotic, basophilic lymphocytes, surrounding clear zones of macrophages
biopsy from abdoiminal mass

A

Burkitt 814 cmyc

starry sky

67
Q

T cell acute lymphoblastic leukemia

A

T-ALL, Thymic mass, Teenagers, Testosterone (more likely in males).

68
Q

light blue, scanty, and nongranular cytoplasm

A

lymphoblasts

69
Q

anemia in SLE

A

Anemia in patients with SLE is most commonly caused by anemia of chronic disease or autoimmune hemolytic anemia. Autoimmune hemolytic anemia is caused by a type II hypersensitivity reaction and presents with an increased reticulocyte count, spherocytes on peripheral blood smear, and a positive direct antiglobulin (Coombs) test.

70
Q

PGI2 function

A

Prostaglandin I2 (PGI2) inhibits platelet aggregation, causes relaxation of smooth muscle, reduces systemic and pulmonary vascular resistance by direct vasodilation, and causes natriuresis in the kidneys.

71
Q

baby 8 months old has anemia

drinks breast milk and produces normal wet diapers

A

iron def

after 6 months iron must be given with diet — as in formula milk or solid food

72
Q

describe schilling test in context of pernicious anemia

A

stage 1 –oral b12 … if in urine means absp is OK if not in urine go to stage 2

stage2 —radiolabeled b12 and IF given … now if b12 in urine diagnosis is pernicious anemia because the issue was with IF … if still no b12 in urine then problem with malabsp

73
Q

commonly used in the treatment of myeloproliferative disorders such as polycythemia vera and essential thrombocythemia, as well as sickle cell disease.

A

hydroxyurea

74
Q

partially double-stranded DNA virus that is found to have RNA-dependent DNA polymerase.

A

hep B

75
Q

has an RNA-dependent DNA polymerase (reverse transcriptase). however, is an RNA virus

A

HIV

76
Q

with a severe normocytic anemia, ptosis, and double vision.

A

MG
thymoma
low erythroblasts as it caauses pure RBC aplasia

77
Q

why is sulfamethoxazole CI in pregnancy

A

Sulfamethoxazole is contraindicated in pregnancy because it binds to albumin and can displace unconjugated bilirubin, leading to cerebral toxicity in the fetus.
damages basal ganglia

78
Q

is used for anticoagulation in patients with heparin-induced thrombocytopenia

A

argatroban

direct thrombin inhibitor

79
Q

patient presents with weight loss, signs of anemia, generalized lymphadenopathy, and hepatosplenomegaly

A

non-Hodgkin lymphoma often involves multiple lymph nodes, while extranodal involvement is also common.

80
Q

(mutation in IL-2R gamma chain)

A

scid

81
Q

ymphocyte apoptosis due to increased intracellular dATP)

A

scid … adenosine deaminase def

82
Q

bleeding from different parts of her body, throbbing and burning in her hands and feet, and an enlarged spleen
platelet count high only

A

Essential thrombocythemia

83
Q

co admin of cyclosporine and erythromycin will have wha effect

A

macrolides are CP450 inhibitrs

so increase levels of cyclosprn

84
Q

how does GCSF work

A

binds to the SURFACE RECEPTOR in bone marrow cells

85
Q

CD16

A

CD16 is found on natural killer cells

86
Q

overproduction of antiapoptotic protein happens in wch type on non hodgkin lymphoma

A

follicular
t 14 18
BCL2

87
Q

an overactive transcription factor.

A

ewing sarcoma

11 22

88
Q

pt has seizure … given a med and comes back with macrocytic anemia … wat meds is he taking

A

phenytoin

folate def

89
Q

warm reactive autoimmune hemolytic anemia with spherocytes treatment

A

corticosteroids

90
Q

b7 marker

A

on APC that interact with CD28 on t cells

91
Q

CD28

A

t cells

92
Q

CD40

A

macrophages

93
Q

CD56

A

NK cells

94
Q

CD34

A

human stem cells

95
Q

inhibits IMP dehydrogenase

A

mycophenolate

96
Q

mechanism of griseofulvin

A

disrupts microtubule

97
Q

acute anticoagulation use

A

heparin

98
Q

to prevent MI use

A

aspirin

99
Q

chadvasc score of 2 or more .. afib pt …

A

warfarin

apixaban rivaroxaban dabigatran

100
Q

steven johnson syndrome caused by

A

s allopurinol, acetaminophen, ibuprofen, penicillin, and anticonvulsants.

101
Q

sunburn like rash is a hallmark feature for

A

TSST

102
Q

staph toxic shock syndrime

A

Gastrointestinal (nausea/vomiting)
Muscular (myalgia with elevated creatine phosphokinase level)
Renal (elevated serum blood urea nitrogen and/or creatinine levels, or pyuria)
Hepatic (elevated aspartate aminotransferase, alanine aminotransferase, and/or bilirubin)
Hematologic (platelet count <100,000/mm3, leukocytosis)
Central nervous system (altered mentation/consciousness without focal findings).

103
Q

folate fujnction in the body

A

transfer carbon

104
Q

transplant patient presents with vessel occlusion, ischemia ,fibrinoid necrosis which type of reaction is this

A

hyperacute

105
Q

Recipient antigen-presenting cells presenting donor peptides after transplant

A

chronic rejection

106
Q

acute graft rejection

A

recepient cytotoxic t cells

only against SOLID transplants not bone marrow

107
Q

Daclizumab

A

Dacluzimab is an interleukin-2 receptor antagonist

108
Q

reatment of acute myelogenous leukemia (AML).

A

Daunorubicin (intercalate between strands of DNA) and cytarabine (pyramidine analogue)

109
Q

CLL treatment

A

Fludarabine and rituximab

110
Q

doxorubicin SE and prophylaxis

A

dexrazoxane iron chelating

dialated cardiomyopathy

111
Q

plummer vinson

A

esophageal webs
iron def anemia
atrophic glossitis

112
Q

Broken and destroyed lymphocytes

A

smudgec ells

CLL

113
Q

Mutations in the phosphatidylinositol glycosyltransferase gene

A

PIGA gene

PNH

114
Q

A prolonged partial thromboplastin time (PTT) that is corrected by fresh-frozen plasma

A

in hemophilia for example

115
Q

female reports many miscarriages
joint pain
weight loss
+ve RPR but negative treponemal test

A

antiphospholipid syndrome
+ve B2glycoprotein
and crdiolipin (igM igG)

116
Q

when to use FFP

A

extrinsic pathway problems … like overdose with wrfarin

117
Q

cryoprecipitate

A

this has factor 1 (fibrinogen) that is converted to fibrin …. use this in DIC

118
Q

HLA3

A

hemochromatosis

119
Q

HLAB8

A

addison
Myasthenia
Graves

120
Q

HLADR5

A

hashimoto

pernicious

121
Q

Splenic macrophages consuming RBCs with IgG bound to the surface is seen

A

in warm autoimmune hemolytic anemia, which would present with anemia with splenomegaly and jaundice. There would be marrow hyperplasia with a corrected reticulocyte count > 3%.

122
Q

CD 14 is a marker on

A

macriphages

123
Q

aspirin mechanism

A

irresversibly inhibit COX 1 COX 2

124
Q

pegylated interferon (IFN) for hep b

A

he most worrisome complications include bone marrow suppression, resulting in cytopenias (eg, neutropenia) and life-threatening infections, neuropsychiatric symptoms, worsening of autoimmune disorders, and ischemic disorders.

2024 - élo - usmle rx qbank (29 decks)

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