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PANCE prep JQ > Hematology/Oncology > Flashcards

Hematology/Oncology Flashcards

1
Q

Most common cause of anemia

A

Iron deficiency

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2
Q

Name 3 types of microcytic hypochromic anemias

A

Iron deficiency

Thalassemia

Sideroblastic

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3
Q

X linked recessive disorder with bite cells and Heinz bodies found in peripheral smear

A

G6PD deficiency

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4
Q

What abn labs do you expect with hereditary spherocytosis?

A

RBC lack central pallor and have increased osmotic fragility

Anemia

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5
Q

Electrophoresis reveals HbS

A

Sickle cell dz

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6
Q

Pancytopenia and bone marrow biopsy shows absence of precursors if hematopoesis

A

Aplastic anemia

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7
Q

To determine protest probability for DVT or PE use this

A

Well’s criteria

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8
Q

CXR findings for PE

A

Hampton’s hump and westemark sign

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9
Q

If pt is hemodynamically stable what test do you use to confirm PE?

A

CTPA or VQ scan

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10
Q

If pt is NOT hemodynamically stable what test do you use to confirm PE?

A

Echocardiogram to look for R ventricular collapse

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11
Q

Auer rods

A

Acute myeloid leukemia(AML)

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12
Q

Associated with abn BCR-ABL1 gene/Philadelphia chromosome

A

Chronic myeloid leukemia(CML)

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13
Q

Lymphoma seen in young adults associated with EBV and presenting with severe pain after alcohol

A

Hodgkin’s lymphoma

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14
Q

Fatigue, bone pain, and neurological changes in a 66yr old African American should make you think of this

A

Multiple myeloma

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15
Q

Pathology of anemia of chronic dz/anemia of inflammation

A

Hepcidin induced alteration in iron metabolism

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16
Q

This type of thalassemia is more common in people of Mediterranean descent

A

Thalassemia B

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17
Q

This type of Thalassemia is more common in people of African and Asian descent

A

Thalassemia A

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18
Q

What 4 things might you see on peripheral smear in Sickle cell dz?

A

Sickle cells

Nucleated RCBs

Target cells

Howell-Jolly bodies

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19
Q

Most common acute leukemia in adults

A

Acute myeloid leukemia (AML)

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20
Q

Rare EKG findings for PE

A

S1Q3T3

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21
Q

Reed-Sternberg cells (multinucleated popcorn cells)

A

Hodgkins Lymphoma

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22
Q

X rays show generalized osteoporosis with lytic lesions

A

Multiple myeloma

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23
Q

Iron studies for iron deficiency anemia

A

Low ferritin and iron

High TIBC and tranferrin

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24
Q

What does peripheral smear look like with iron deficiency?

A

Anisocytosis and poikilocytosis

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25
Q

MCV for microcytic anemia

A

<80

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26
Q

MCV for macrocytic anemia

A

> 100

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27
Q

Immature RCB are called and indicate what in anemia?

A

Retuculocytes

Indicate anemia is due to blood loss or increased RBC destruction (not a synthesis or bone marrow issue)

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28
Q

Cooley’s anemia

A

AKA beta thalassemia major

Born with no problem but developed severe anemia over the first year of life as fetal Hgb is no longer available

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29
Q

Basophillic stippling

A

Associated with Beta thalassemia, lead poisonous and sideroblastic anemia

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30
Q

Type of anemia associated with chronic alcoholism

A

Sideroblastic

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31
Q

Heinz bodies

A

Associated with alpha thalassemia and G6 PD

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32
Q

Megaloblastic anemia with glossitis and vague GI symptoms that developed over months

A

Folate deficiency

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33
Q

Megaloblastic anemia with glossitis, jaundice, splenomegaly and neurological findings that developed over years

A

B12 deficiency

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34
Q

This medication will decrease incidence of painful sickle cell crises

A

Hydroxyurea

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35
Q

Chronic lymphoid neoplasm caused by progressive accumulation of functionality incompetent B lymphocytes

A

Chronic lymphocytic leukemia(CLL)

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36
Q

Most common inherited clotting disorder

A

Von willebrand dz

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37
Q

Deficiency in factor VII

A

Hemophilia A

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38
Q

Deficiency in factor IX

A

Hemophillia B

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39
Q

Christmas disease

A

Hemophilia B

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40
Q

Reduction in synthesis of globin chains

A

Thalassemia

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41
Q

Second most common cause of anemia

A

Chronic disease/inflammation

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42
Q

What do you expect to see in peripheral smear of sideroblastic anemia?

A

Siderocytes and pappenheimer bodies

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43
Q

Megaloblastic anemia with elevated homocysteine and normal methylmalonic acid levels

A

Folate deficiency

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44
Q

Megaloblastic anemia with elevated homocysteine and elevated methylmalonic acid levels

A

B12 deficiency

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45
Q

Positive shillings test

A

B12 deficiency

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46
Q

Spontaneous hemarthrosis should make you think

A

Hemophillia

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47
Q

Rare deficiency in clotting factor XI seen more in Ashkenazi Jews

A

Hemophilia C

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48
Q

Pernicious anemia pathology

A

Autoimmune response to intrinsic factor that prevents absorption of dietary B12

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49
Q

Iron studies in anemia of chronic dz

A

Fe and TIBC low

Ferritin elevated

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50
Q

Episodic hemolytic anemia associated with sulfa drugs, favs beans, and infections

A

G6PD

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51
Q

Rouleaux formation

A

RBC stack together like coins on peripheral smear

Suggestive of multiple myeloma

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52
Q

Coarse blue granules in RBCs

A

Basophillic stippling

Sideroblastic anemia, heavy metal poisioning, thalassemia

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53
Q

B12 deficiency etiologies

A

Pernicious anemia

Strict vegans

Malabsorption:ETOH, celiacs, crohns

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54
Q

Potential side effect of b12 therapy

A

Hypokalemia

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55
Q

Clinical presentation of Fe deficiency anemia

A

Pagophagia(ice craving), pics, angular checkouts, koilonychia

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56
Q

Plummer-Vinson syndrome

A

Dysphasia, esophageal webs, strophic glossitis and Fe deficiency anemia

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57
Q

What increases Fe absorption?

A

vit C

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58
Q

Iron chelation agents that can be used in thalassemia tx

A

IV Deferoxamine or PO Deferasirox

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59
Q

MC population to be affected by G6PD deficiency

A

African American males

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60
Q

Tx for sickle cell crisis

A

IV hydration, O2, and narcotic for pain control

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61
Q

Measures efficacy of intrinsic coagulation cascade

A

PTT

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62
Q

Measures efficacy of extrinsic coagulation cascade

A

PT

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63
Q

Abs to ADAMTS13 leads to large vWF —> Sm vessel thrombosis and hemolytic anemia

A

Thrombotic thrombocytopenic purpura (TTP)

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64
Q

TTP treatment of choice

A

Plasmapheresis

*sometimes corticosteroids are used

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65
Q

Desmopressin has these 2 effects on the clotting cascade

A

Increases factor VIII and vWF

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66
Q

MC hereditary bleeding disorder

A

Von Willebrand Disease

67
Q

Thrombocytopenia labs

A

PT and PTT unaffected

Bleeding time prolonged

Platelet count low

68
Q

Hemophillia labs

A

PT, bleeding time, platelet count are unaffected

PTT prolonged

69
Q

Von willibrand disease labs

A

PT and platelet count unaffected

Bleeding time and PTT prolonged

70
Q

Warfarin/vit K deficiency labs

A

PT prolonged

PTT, bleeding time, and platelet count unaffected

71
Q

Clinical manifestation of multiple myeloma

A

BREAK

Bone pain
Recurrent infections
Elevated calcium 
Anemia
Kidney failure
72
Q

Tx for multiple myeloma

A

Autologous stem cell transplant

73
Q

MC cause of inherited hypercoagulability

A

Factor V Leiden mutation

74
Q

Warfarin induced skin necrosis is associated with this inherited hypercoagulability disorder

A

Protein C deficiency

75
Q

Tx of choice for Hodgkin lymphoma

A

Dacarbazine, bleomycin, vinblastine, and doxrubicin (ABVD)

76
Q

Anisocytosis

A

Variation in RBC size

RDW >15%

77
Q

To diagnose anemia Hgb level must be:

A

<14 in men

<12 in women

78
Q

Average lifespan of a RBC

A

120d

79
Q

Poikilocytosis

A

Variation in RBC shape

80
Q

Polychromasia

A

Blue reticulocytes

Lots of blue means lots of new

81
Q

Cold agglutinins

A

IgM

82
Q

Warm agglutinins

A

IgG

83
Q

What can precipitate a sickle cell crisis?

A

Dehydration, hypoxia,high altitude, or intense exercise

84
Q

PTT rest is used to assess

A

Intrinsic and common coagulation pathways

Monitor heparin

85
Q

PT test is used to asses

A

Extrinsic and common coagulation pathways

Monitor warfarin

86
Q

Factor 8 deficiency

A

Hemophillia A

87
Q

Factor 9 deficiency

A

Hemophillia B

88
Q

INR goals

A

1.5-2 prophylaxis

2-3 VTE, afib, or aortic valve

2.5-3.5 mitral valve replacement

89
Q

AKI in children after a O157:H7 E. coli infection

A

HUS

90
Q

Ab against ADAMTS-13

A

TTP

91
Q

Describe IgM

A

Large, first responder Ab

Lives up to 10d

92
Q

When sound you screen babies for iron deficiency anemia?

A

12m

93
Q

G6PD deficiency is associated with which ethnicities?

A

African, Mediterranean, and Asian

94
Q

MC bleeding disorder in peds

A

ITP

95
Q

MC inherited bleeding disorder

A

vWF deficiency

96
Q

This disorder is associated with warfarin induced skin necrosis

A

Protein C deficiency

97
Q

Cofactor for protein C

A

Protein S

98
Q

Activates protein C

A

Factor V Leiden

99
Q

MC small vessel vasculitis

A

HSP

100
Q

Palpable purpura should make you think of this

A

HSP

101
Q

MC soiling tumor in childhood

A

Brain tumor

102
Q

MC abdominal tumor in peds

A

Neuroblastoma

  • crosses midline
103
Q

2nd MC abd tumor in peds

A

Nephroblastoma(Wilms tumor)

*rarely crosses midline

104
Q

MC primary bone tumor in peds

A

Osteosarcoma

105
Q

2nd MC bone tumor in peds

A

Ewing’s sarcoma

106
Q

Rhabdomyosarcomas are MC located

A

On head and neck

107
Q

MC type of skin Ca

A

BCC

108
Q

Describe BCC

A

Modular

Pearly

Telangiectasias

*MC in head and neck

109
Q

Describe SCC

A

Friable

Pruritic

Warty

110
Q

AKs May develop into this type of skin Ca

A

SCC

111
Q

MC type of malignant melanoma

A

Superficial spreading

112
Q

Progressive dysphasia should make you concerned for this

A

Esophageal cancer

113
Q

This type of esophageal cancer is associated with smoking, ETOH consumption, and is more common in African Americans

A

SCC

114
Q

This type of esophageal cancer is associated with GERD and is more common in Caucasian males

A

Adenocarcinoma

115
Q

> 90% of stomach cancers are

A

Adenocarcinomas

116
Q

Enlarged left supraclavicular LN associated with GI Ca

A

Virchow’s node

117
Q

Enlarged periumbilical LN associated with GI Ca

A

Sister Many Joseph’s node

118
Q

Enlarged left axillary LN associated with GI Ca

A

Irish node

119
Q

Blood marker used to monitor colon cancer recurrence

A

CEA

120
Q

When do colonoscopies start for pt with FAP?

A

10yo

121
Q

When do colonoscopies start for pts with Lynch syndrome/HNPCC?

A

20yo

122
Q

How do you diagnose Lynch syndrome/HNPCC?

A

Amsterdam Criteria

3 family members
2 generations
1 under 50

123
Q

What is the MC site for lung cancer to metastasize to?

A

Liver

124
Q

Most metastatic brain cancer originated from the…

A

Lungs

125
Q

Identify the lung cancer type: originated in central airways, Hilar mass, very aggressive

A

Small cell carcinoma/oat cell

126
Q

Identify the lung cancer type: Most common type, distal/peripheral mass

A

Adenocarcinoma

127
Q

Identify the lung cancer type: central/main bronchus origin, cavitary masses, hemoptysis

A

SCC

128
Q

Identify the lung cancer type: very aggressive, can be central or peripheral

A

Large cell carcinoma

129
Q

What paraneoplastic syndrome(s) is small/oat cell lung cancer associated with?

A

SIADH
SVC syndrome
ATCH/cushings
Eaton-Lambert

130
Q

What paraneoplastic syndrome(s) is Adenocarcinoma lung cancer associated with?

A

Usually none

131
Q

What paraneoplastic syndrome(s) is squamous cell lung cancer associated with?

A

PTH secretion->bone destruction

Pancost syndrome (Horner’s + unilateral weakness)

132
Q

What paraneoplastic syndrome(s) is Large cell lung cancer associated with?

A

HCG secretion-> gynecomastia

133
Q

MC type of breast cancer

A

Infiltrating ductal carcinoma

134
Q

Compare: ductal carcinoma in situ with lobular carcinoma in situ

A

Ductal carcinoma in situ May become invasive so should be treated as malignancy

Lobular carcinoma in situ does NOT become invasive so it does not warrant treatment but women should have increased surveillance since they are at greater risk for invasive carcinoma

135
Q

How does ductal carcinoma in situ appear on mammogram?

A

Cluster pleomorphic calcifications

136
Q

This type of breast cancer is often bilateral and estrogen receptor positive.

A

Infiltrating lobular carcinoma

137
Q

How do you treat vulvar intraepithelial neoplasia (VIN)?

A

If usual type associated with HPV in younger women: CO2 laser vaporization

If differentiated type not associated with HPV in older women: excision

138
Q

MC symptom of vulvar cancer

A

Pruritis

139
Q

Age distribution of vulvar cancer

A

Bimodal 20-40 and 60-70

140
Q

Elderly women who develop vulvar cancer often have hx of these conditions(3)

A

Lichen sclerosis

Lichen simplex chronicus

Squamous cell hyperplasia

141
Q

MC type of vaginal cancer

A

SCC

142
Q

Vaginal cancer is MC caused by

A

Mets from endometrium, cervix, or ovaries

143
Q

Concerning features of adenexal masses (3)

A

Thick >2mm septations

Modular or papillary solid component

Increased blood flow

144
Q

4 subtypes of epithelial ovarian cancer

A

Serous (MC 80%)

Endometriod

Clear cell

Mucinous

145
Q

Epithelial ovarian cancer is associated with this blood marker

A

Ca-125

146
Q

5 subtypes of ovarian germ cell tumors

A 
Dysgerminoma (MC)
Endodermis sinus
Immature teratoma 
Embryonal carcinoma
Choriocarcinoma
147
Q

Who gets germ cell ovarian tumors?

A

Young women in 20-30s

148
Q

Germ cell ovarian tumors are associated with this blood marker

A

afp

149
Q

2 subtypes of sex-cord stromal ovarian tumors

A

Granulosa (MC)

Sertoli

150
Q

What hormone changes occur with sex-cord stromal ovarian tumors?

A

Granulosa: hyperestrogenism

Sertoli:hyperandrogenism

151
Q

What do you do if PAP comes back back ASCUS or LSIL (most CIN I)?

A

Repeat PAP in 12m

152
Q

What do you do if your PAP comes back HSIL-CIN I?

A

PAP in 6m

153
Q

What do you do if your PAP comes back HSIL or ASCH (usually CIN2 or >)?

A

LEEP

154
Q

MC type GYN cancer

A

Endometrial

155
Q

2nd MC type of GYN cancer

A

Ovarian

156
Q

Increased tranferrin
Increased TIBC
Decreased Ferritin

A

Iron deficiency anemia

*decreased serum Fe present in iron deficiency anemia and anemia of chronic dz

157
Q

Decreased tranferrin
Decreased TIBC
Increased ferritin

A

Anemia of chronic dz

*decreased serum Fe present in iron deficiency anemia and anemia of chronic dz

158
Q

G6PD episodic hemolysis is associated with(3)

A

Sulfa drugs

Favs beans

Infection

*states of increased oxidative stress

159
Q

Rouleaux formation

A

RBCs stacked together

Suggest multiple myeloma

160
Q

Where is B12 absorbed?

A

Terminal ileum (CD)

161
Q

Pagophagia

A

Ice craving

162
Q

Polycythemia Vera

A

Overproduction of all 3 myeloid cell line

163
Q

Bronze diabetes

A

Hereditary hemochromatosis

164
Q

Howell-Jolly bodies should make you think of

A

B12 or folate deficient anemia, sickle cell anemia and celiac disease

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