Hematology/Oncology Flashcards
1
Q
Most common cause of anemia
A
Iron deficiency
2
Q
Name 3 types of microcytic hypochromic anemias
A
Iron deficiency
Thalassemia
Sideroblastic
3
Q
X linked recessive disorder with bite cells and Heinz bodies found in peripheral smear
A
G6PD deficiency
4
Q
What abn labs do you expect with hereditary spherocytosis?
A
RBC lack central pallor and have increased osmotic fragility
Anemia
5
Q
Electrophoresis reveals HbS
A
Sickle cell dz
6
Q
Pancytopenia and bone marrow biopsy shows absence of precursors if hematopoesis
A
Aplastic anemia
7
Q
To determine protest probability for DVT or PE use this
A
Well’s criteria
8
Q
CXR findings for PE
A
Hampton’s hump and westemark sign
9
Q
If pt is hemodynamically stable what test do you use to confirm PE?
A
CTPA or VQ scan
10
Q
If pt is NOT hemodynamically stable what test do you use to confirm PE?
A
Echocardiogram to look for R ventricular collapse
11
Q
Auer rods
A
Acute myeloid leukemia(AML)
12
Q
Associated with abn BCR-ABL1 gene/Philadelphia chromosome
A
Chronic myeloid leukemia(CML)
13
Q
Lymphoma seen in young adults associated with EBV and presenting with severe pain after alcohol
A
Hodgkin’s lymphoma
14
Q
Fatigue, bone pain, and neurological changes in a 66yr old African American should make you think of this
A
Multiple myeloma
15
Q
Pathology of anemia of chronic dz/anemia of inflammation
A
Hepcidin induced alteration in iron metabolism
16
Q
This type of thalassemia is more common in people of Mediterranean descent
A
Thalassemia B
17
Q
This type of Thalassemia is more common in people of African and Asian descent
A
Thalassemia A
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
19
Q
Most common acute leukemia in adults
A
Acute myeloid leukemia (AML)
20
Q
Rare EKG findings for PE
A
S1Q3T3
21
Q
Reed-Sternberg cells (multinucleated popcorn cells)
A
Hodgkins Lymphoma
22
Q
X rays show generalized osteoporosis with lytic lesions
A
Multiple myeloma
23
Q
Iron studies for iron deficiency anemia
A
Low ferritin and iron
High TIBC and tranferrin
24
Q
What does peripheral smear look like with iron deficiency?
A
Anisocytosis and poikilocytosis
25
MCV for microcytic anemia
<80
26
MCV for macrocytic anemia
>100
27
Immature RCB are called and indicate what in anemia?
Retuculocytes
Indicate anemia is due to blood loss or increased RBC destruction (not a synthesis or bone marrow issue)
28
Cooley’s anemia
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
29
Basophillic stippling
Associated with Beta thalassemia, lead poisonous and sideroblastic anemia
30
Type of anemia associated with chronic alcoholism
Sideroblastic
31
Heinz bodies
Associated with alpha thalassemia and G6 PD
32
Megaloblastic anemia with glossitis and vague GI symptoms that developed over months
Folate deficiency
33
Megaloblastic anemia with glossitis, jaundice, splenomegaly and neurological findings that developed over years
B12 deficiency
34
This medication will decrease incidence of painful sickle cell crises
Hydroxyurea
35
Chronic lymphoid neoplasm caused by progressive accumulation of functionality incompetent B lymphocytes
Chronic lymphocytic leukemia(CLL)
36
Most common inherited clotting disorder
Von willebrand dz
37
Deficiency in factor VII
Hemophilia A
38
Deficiency in factor IX
Hemophillia B
39
Christmas disease
Hemophilia B
40
Reduction in synthesis of globin chains
Thalassemia
41
Second most common cause of anemia
Chronic disease/inflammation
42
What do you expect to see in peripheral smear of sideroblastic anemia?
Siderocytes and pappenheimer bodies
43
Megaloblastic anemia with elevated homocysteine and normal methylmalonic acid levels
Folate deficiency
44
Megaloblastic anemia with elevated homocysteine and elevated methylmalonic acid levels
B12 deficiency
45
Positive shillings test
B12 deficiency
46
Spontaneous hemarthrosis should make you think
Hemophillia
47
Rare deficiency in clotting factor XI seen more in Ashkenazi Jews
Hemophilia C
48
Pernicious anemia pathology
Autoimmune response to intrinsic factor that prevents absorption of dietary B12
49
Iron studies in anemia of chronic dz
Fe and TIBC low
Ferritin elevated
50
Episodic hemolytic anemia associated with sulfa drugs, favs beans, and infections
G6PD
51
Rouleaux formation
RBC stack together like coins on peripheral smear
Suggestive of multiple myeloma
52
Coarse blue granules in RBCs
Basophillic stippling
Sideroblastic anemia, heavy metal poisioning, thalassemia
53
B12 deficiency etiologies
Pernicious anemia
Strict vegans
Malabsorption:ETOH, celiacs, crohns
54
Potential side effect of b12 therapy
Hypokalemia
55
Clinical presentation of Fe deficiency anemia
Pagophagia(ice craving), pics, angular checkouts, koilonychia
56
Plummer-Vinson syndrome
Dysphasia, esophageal webs, strophic glossitis and Fe deficiency anemia
57
What increases Fe absorption?
vit C
58
Iron chelation agents that can be used in thalassemia tx
IV Deferoxamine or PO Deferasirox
59
MC population to be affected by G6PD deficiency
African American males
60
Tx for sickle cell crisis
IV hydration, O2, and narcotic for pain control
61
Measures efficacy of intrinsic coagulation cascade
PTT
62
Measures efficacy of extrinsic coagulation cascade
PT
63
Abs to ADAMTS13 leads to large vWF —> Sm vessel thrombosis and hemolytic anemia
Thrombotic thrombocytopenic purpura (TTP)
64
TTP treatment of choice
Plasmapheresis
*sometimes corticosteroids are used
65
Desmopressin has these 2 effects on the clotting cascade
Increases factor VIII and vWF
66
MC hereditary bleeding disorder
Von Willebrand Disease
67
Thrombocytopenia labs
PT and PTT unaffected
Bleeding time prolonged
Platelet count low
68
Hemophillia labs
PT, bleeding time, platelet count are unaffected
PTT prolonged
69
Von willibrand disease labs
PT and platelet count unaffected
Bleeding time and PTT prolonged
70
Warfarin/vit K deficiency labs
PT prolonged
PTT, bleeding time, and platelet count unaffected
71
Clinical manifestation of multiple myeloma
BREAK
```
Bone pain
Recurrent infections
Elevated calcium
Anemia
Kidney failure
```
72
Tx for multiple myeloma
Autologous stem cell transplant
73
MC cause of inherited hypercoagulability
Factor V Leiden mutation
74
Warfarin induced skin necrosis is associated with this inherited hypercoagulability disorder
Protein C deficiency
75
Tx of choice for Hodgkin lymphoma
Dacarbazine, bleomycin, vinblastine, and doxrubicin (ABVD)
76
Anisocytosis
Variation in RBC size
RDW >15%
77
To diagnose anemia Hgb level must be:
<14 in men
<12 in women
78
Average lifespan of a RBC
120d
79
Poikilocytosis
Variation in RBC shape
80
Polychromasia
Blue reticulocytes
Lots of blue means lots of new
81
Cold agglutinins
IgM
82
Warm agglutinins
IgG
83
What can precipitate a sickle cell crisis?
Dehydration, hypoxia,high altitude, or intense exercise
84
PTT rest is used to assess
Intrinsic and common coagulation pathways
Monitor heparin
85
PT test is used to asses
Extrinsic and common coagulation pathways
Monitor warfarin
86
Factor 8 deficiency
Hemophillia A
87
Factor 9 deficiency
Hemophillia B
88
INR goals
1.5-2 prophylaxis
2-3 VTE, afib, or aortic valve
2.5-3.5 mitral valve replacement
89
AKI in children after a O157:H7 E. coli infection
HUS
90
Ab against ADAMTS-13
TTP
91
Describe IgM
Large, first responder Ab
Lives up to 10d
92
When sound you screen babies for iron deficiency anemia?
12m
93
G6PD deficiency is associated with which ethnicities?
African, Mediterranean, and Asian
94
MC bleeding disorder in peds
ITP
95
MC inherited bleeding disorder
vWF deficiency
96
This disorder is associated with warfarin induced skin necrosis
Protein C deficiency
97
Cofactor for protein C
Protein S
98
Activates protein C
Factor V Leiden
99
MC small vessel vasculitis
HSP
100
Palpable purpura should make you think of this
HSP
101
MC soiling tumor in childhood
Brain tumor
102
MC abdominal tumor in peds
Neuroblastoma
* crosses midline
103
2nd MC abd tumor in peds
Nephroblastoma(Wilms tumor)
*rarely crosses midline
104
MC primary bone tumor in peds
Osteosarcoma
105
2nd MC bone tumor in peds
Ewing’s sarcoma
106
Rhabdomyosarcomas are MC located
On head and neck
107
MC type of skin Ca
BCC
108
Describe BCC
Modular
Pearly
Telangiectasias
*MC in head and neck
109
Describe SCC
Friable
Pruritic
Warty
110
AKs May develop into this type of skin Ca
SCC
111
MC type of malignant melanoma
Superficial spreading
112
Progressive dysphasia should make you concerned for this
Esophageal cancer
113
This type of esophageal cancer is associated with smoking, ETOH consumption, and is more common in African Americans
SCC
114
This type of esophageal cancer is associated with GERD and is more common in Caucasian males
Adenocarcinoma
115
>90% of stomach cancers are
Adenocarcinomas
116
Enlarged left supraclavicular LN associated with GI Ca
Virchow’s node
117
Enlarged periumbilical LN associated with GI Ca
Sister Many Joseph’s node
118
Enlarged left axillary LN associated with GI Ca
Irish node
119
Blood marker used to monitor colon cancer recurrence
CEA
120
When do colonoscopies start for pt with FAP?
10yo
121
When do colonoscopies start for pts with Lynch syndrome/HNPCC?
20yo
122
How do you diagnose Lynch syndrome/HNPCC?
Amsterdam Criteria
3 family members
2 generations
1 under 50
123
What is the MC site for lung cancer to metastasize to?
Liver
124
Most metastatic brain cancer originated from the...
Lungs
125
Identify the lung cancer type: originated in central airways, Hilar mass, very aggressive
Small cell carcinoma/oat cell
126
Identify the lung cancer type: Most common type, distal/peripheral mass
Adenocarcinoma
127
Identify the lung cancer type: central/main bronchus origin, cavitary masses, hemoptysis
SCC
128
Identify the lung cancer type: very aggressive, can be central or peripheral
Large cell carcinoma
129
What paraneoplastic syndrome(s) is small/oat cell lung cancer associated with?
SIADH
SVC syndrome
ATCH/cushings
Eaton-Lambert
130
What paraneoplastic syndrome(s) is Adenocarcinoma lung cancer associated with?
Usually none
131
What paraneoplastic syndrome(s) is squamous cell lung cancer associated with?
PTH secretion->bone destruction
Pancost syndrome (Horner’s + unilateral weakness)
132
What paraneoplastic syndrome(s) is Large cell lung cancer associated with?
HCG secretion-> gynecomastia
133
MC type of breast cancer
Infiltrating ductal carcinoma
134
Compare: ductal carcinoma in situ with lobular carcinoma in situ
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
How does ductal carcinoma in situ appear on mammogram?
Cluster pleomorphic calcifications
136
This type of breast cancer is often bilateral and estrogen receptor positive.
Infiltrating lobular carcinoma
137
How do you treat vulvar intraepithelial neoplasia (VIN)?
If usual type associated with HPV in younger women: CO2 laser vaporization
If differentiated type not associated with HPV in older women: excision
138
MC symptom of vulvar cancer
Pruritis
139
Age distribution of vulvar cancer
Bimodal 20-40 and 60-70
140
Elderly women who develop vulvar cancer often have hx of these conditions(3)
Lichen sclerosis
Lichen simplex chronicus
Squamous cell hyperplasia
141
MC type of vaginal cancer
SCC
142
Vaginal cancer is MC caused by
Mets from endometrium, cervix, or ovaries
143
Concerning features of adenexal masses (3)
Thick >2mm septations
Modular or papillary solid component
Increased blood flow
144
4 subtypes of epithelial ovarian cancer
Serous (MC 80%)
Endometriod
Clear cell
Mucinous
145
Epithelial ovarian cancer is associated with this blood marker
Ca-125
146
5 subtypes of ovarian germ cell tumors
```
Dysgerminoma (MC)
Endodermis sinus
Immature teratoma
Embryonal carcinoma
Choriocarcinoma
```
147
Who gets germ cell ovarian tumors?
Young women in 20-30s
148
Germ cell ovarian tumors are associated with this blood marker
afp
149
2 subtypes of sex-cord stromal ovarian tumors
Granulosa (MC)
Sertoli
150
What hormone changes occur with sex-cord stromal ovarian tumors?
Granulosa: hyperestrogenism
Sertoli:hyperandrogenism
151
What do you do if PAP comes back back ASCUS or LSIL (most CIN I)?
Repeat PAP in 12m
152
What do you do if your PAP comes back HSIL-CIN I?
PAP in 6m
153
What do you do if your PAP comes back HSIL or ASCH (usually CIN2 or >)?
LEEP
154
MC type GYN cancer
Endometrial
155
2nd MC type of GYN cancer
Ovarian
156
Increased tranferrin
Increased TIBC
Decreased Ferritin
Iron deficiency anemia
*decreased serum Fe present in iron deficiency anemia and anemia of chronic dz
157
Decreased tranferrin
Decreased TIBC
Increased ferritin
Anemia of chronic dz
*decreased serum Fe present in iron deficiency anemia and anemia of chronic dz
158
G6PD episodic hemolysis is associated with(3)
Sulfa drugs
Favs beans
Infection
*states of increased oxidative stress
159
Rouleaux formation
RBCs stacked together
Suggest multiple myeloma
160
Where is B12 absorbed?
Terminal ileum (CD)
161
Pagophagia
Ice craving
162
Polycythemia Vera
Overproduction of all 3 myeloid cell line
163
Bronze diabetes
Hereditary hemochromatosis
164
Howell-Jolly bodies should make you think of
B12 or folate deficient anemia, sickle cell anemia and celiac disease
