Hematology and Oncology

Question 1

Cilostazol and dipyridamole

Answer 1

PDE III inhibitors that increase cAMP in platelets and inhibit aggregation. Used in claudication, coronary vasodilation, prevention of stroke/tia (WITH ASPIRIN).

Question 2

AIP

Answer 2

Defect in porphobilinogen deaminase. Causes stomach pain, port wine urine, polyneuropathy. Exacerbated by drugs and alcohol. Treat with glucose and heme to stop ALAS

Question 3

Porphyria cutanea tardea

Answer 3

Defect in urobilinogen decarboxylase. Causes blistering photosensitivity and tea colored urine

Most common porphyria

Question 4

First step of heme breakdown?

Answer 4

Heme to biliverdin by heme oxidase (gives bruises color)

Question 5

Mutation that causes PV?

Answer 5

JAK 2 mutation. JAK 2 is intracellular receptor that increases sensitivity to growth factors.

Question 6

How to lyse clot from MI?

Answer 6

Use TPA

Question 7

Hepcidin

Answer 7

Stops ferroportin in gut lumin and macrophages – produced by liver. Decrease in HFE decreases hepcidin

Question 8

Things that activate and inhibit alasynthase

Answer 8

Increased by cyp inducers (alcohol, smoking, barbiturates)

Stopped by glucose and heme

Question 9

Signs of spinal metastases?

Answer 9

Deep bone pain that is constant and worse at night. Not responsive to position changes or analgesics

Question 10

Decrease in HFE

Answer 10

Body thinks iron is low and causes increased iron

Question 11

Cladribine

Answer 11

Adenosine deaminase resistant adenosine analog used to treat hairy cell leukemia

Question 12

Raltegrevir

Answer 12

Integrase inhibitor. No viral DNA integration, so mRNA can’t be synthesized.

Question 13

JAK 2

Answer 13

Cytoplasmic tyrosine kinase

Question 14

Sickle cell carrier protected from malaria?

Answer 14

Yup

Question 15

Who is likely to have a macrocytic megaloblastic anemia due to low folate?

Answer 15

Sickle patients and other hemolytic anemias.

Question 16

Treatment for TIA?

Answer 16

Aspirin

Question 17

How does alcoholism affect bleeding?

Answer 17

Increases PT because liver damage decreases synthesis of coag factors, including factor 7 which has shortest half life

Question 18

Characteristics of GBM

Answer 18

Necrosis surrounded by granulation tissue. Can cross midline. In middle aged patients. Pseudopalisading necrosis. Poorly demarcated

Question 19

Highest incidence cancers

Mortality?

Answer 19

Breast/prostate, lung, colon

Lung, breast/prostate, colon

Question 20

Candida appearance after incubation at 37 degrees?

Answer 20

Yeast with germ tubes

Question 21

What changes in the HB O2 graph cause sickling

Answer 21

Shift to the right.

Question 22

What stimulates EPO

Answer 22

Low tissue O2

Question 23

Pol mutations

Answer 23

Due to prolonged use of HAART, which causes resistance

Question 24

Which aa is gamma carboxylated by vit k

Answer 24

Glutamate

Question 25

P-glycoprotein

Answer 25

MDR pump in cancer cells that causes resistance

Question 26

Rb

Answer 26

Hypophosphorylated (active) still binds E2F. Phosphorylated by CDK4+6? Releases E2F and G1-S.

Question 27

SE of ganciclovir+zidovudine?

Answer 27

Neutropenia

Question 28

Drugs that cause agranulocytosis?

Answer 28

Clozapine, carbamazepine, colchicine, propilthyiouracil, methimazole, dapsone

Question 29

Citrate

Answer 29

Calcium chelator, big infusions can cause hypocalcemia (parasthesias, etc..)

Question 30

Heparin safe during preg?

Answer 30

yup

Question 31

Most common childhood tumor

Answer 31

Pilocytic astrocytoma – cyst with solid component. Has rosenthal fibers. Low grade

Then medulloblastoma which is malignant and totally solid.

Question 32

Heparin vs enoxaparin

Answer 32

Heparin blocks thrombin, enoxaparin and AT3 are better at blocking X

Question 33

CCL4

Answer 33

Converted to CCL3 to cause fatty change and hepatocyte necrosis via free radical injury.

Question 34

Li Fraumeni Syndrome

Answer 34

P53 mutation that causes breast, brain, adrenal, sarcomas, and leukemias

Question 35

BRCA1

Answer 35

Mutation causes breast and ovarian

Question 36

Which cancer has waxing and waning LAD?

Answer 36

Follicular lymphoma

Question 37

Reticulocytes show ____ on Wright-Giemsa stain?

Answer 37

rRNA

Question 38

Bleeding in kidney failure?

Answer 38

Due to uremia which increases bleeding time due to a qualitative platelet disfunction. Improves with dialysis.