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USMLE STEP 2 CK RETAKE > Hematology/ Oncology > Flashcards

Hematology/ Oncology Flashcards

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USMLE® Step 1 flashcards
1
Q

Macrocytic Anemia MCV

A

> 100

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2
Q

Causes of nonmegaloblastic Anemia

A

Liver disease
EtOH
Drugs
Metabolic

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3
Q

Causes of Megaloblastic Anemia

A

B12 or Folate deficiency

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4
Q

Drugs that cause a nonmegaloblastic anemia

A

5FU
Ara-C
AZT, Zidovudine

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5
Q

Causes of Microcytic Anemia

A

Thalassemia
Iron Deficiency
Chronic Inflammation
IDA

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6
Q

Thalassemia Hx, Dx, Tx

A 
Anemia 
Dx: Iron studies normal 
Hgb Electropheresis 
find any other hemoglobin other than normal = beta thalassemia 
Tx: beta-transfusion 
for iron overload use defuroxamine
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7
Q

Normocytic anemia Dx

A

LDH elevated
Bilirubin Elevated
Haptoglobin Decreased
Means hemolysis

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8
Q

G6PD deficiency Hx, Dx

A

African American male taking Dapsone, TMP-SMX, Nitrofurantoin
Dx-Heinz bodies, Bite cells
Tx: Supportive
Avoid Stress

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9
Q

Sickle Cell Vasoocclusive Crises Dx and Tx

A 
Acute chest-MI
Brain CVA- Exchange transfusion 
Priapism 
Dx: Hgb electrophoresis 
Smear- Sickled Cells 
Long term treatment hydroxyurea 
Acute- IVF, pain meds, O2
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10
Q

AHI Coombs test

A

IgM-cold type caused by mycoplasma and mono
IgG warm Type-AI, CA,
use steroids, rituximab, splenectomy

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11
Q

AML M3 Variant Treatment

A

All Transretnoic Acid

presence of Auer Rods

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12
Q

CML bone marrow biopsy finding

A

Philadelphia Chromosome t(9,22) BCR-ABL

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13
Q

Non-tender lymphadenopathy indicates?

A

Cancer

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14
Q

Hodgkins with B symptoms presentation

A

Night Sweats
Fever
Weight loss
LN pain with ingestion of alcohol

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15
Q

Hodgkins Tx

A

ABVD or BEACOPP

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16
Q

Non-Hodgkins Tx

A

Rituximab or R-CHOP

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17
Q

Reed Sternberg cells found in what disease and what are the markers

A

CD 15 , CD 30

Hodgkins

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18
Q

Adriamycin, Doxirubicin AE

A

Cardiotoxicity

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19
Q

Vincristine/Vinblastine

A

Peripheral Neuropathy

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20
Q

Bleomycin AE

A

Pulm Fibrosis

21
Q

Cisplatin AE

A

Ototoxicity

Nephrotoxicity

22
Q

Cyclophosphamide AE

A

Hemorrhagic cystitis

23
Q

which is worse hodgkins or non-hodgkins

A

Non-hodgkins

24
Q

Plasma cell disorder presentation (Multiple Myeloma) CRAB

A

Hypercalcemia
Renal Failure
Anemia
Bone Pain

25
Q

Multiple Myeloma Dx

A

Spep=M spike
Upep=M-Spike
Skeletal changes
BMBx->10% Plasma

26
Q

Multiple Myeloma Tx

A

> 70, no donor=chemo

<70, donor-Stem cell transplant

27
Q

MGUS Hx, Dx, Tx

A

Asx
Dx- online Spep Positive
BMBx <10% Plasma cells
Tx: Monitor and observe

28
Q

Waldenstroms Hx, Dx, Tx

A 
Hyperviscosity with constitutional symptoms 
Dx: Spep positive 
Upep and skeletal negative 
BMBx- >10% plasma 
Tx: Rituximab
Plasampheresis
29
Q

TTP presentation

FATRN

A 
Fever 
Anemia (microangiopathic)
Thrombocytopenia 
Renal Failure 
Neuro Sxs
30
Q

TTP Dx

A

Decreased platelets
PT/PTT normal
Fibrinogen Normal
D-Dimer Normal

31
Q

TTP Tx

A

Exchange transfusion

32
Q

DIC Dx

A

Platelets decreased
PT/PTT increased
D-Dimer Increased
Fibrinogen Decreased

33
Q 
Elevated 
T. bili 
LDH
Decreased 
Haptoglobin
A

Hemolysis

perform Smear

34
Q

Folate Deficiency Presentation

A

Pt: Tea and Toast Diet
Dx: Folate level
MMA normal
Tx: Folic Acid

35
Q

B12 Deficiency Presentation

A 
Pt: Neuro Sxs
Strict vegan 
Dx: Decreased B12
increased MMA 
Schillings Test 
Tx: PO- nutritional deficiency 
IM B12- Impaired Absorption
36
Q

Schillings test

A

Give IM B12
then oral B12 if
Urine (+) B12-nutritional def
Urine (-) B12- Absorption

37
Q

Iron Deficiency Anemia Presentation

A 
Pt: Slow bleeds 
Old Male (+) Fecal Occult Blood Test 
Woman W/ Mennorrhagia 
Dx: Decreased Fe, Ferritin
Increased TIBC 
Tx: replace, 324mg Iron 
Stool Softeners
38
Q

Anemia of Chronic Disease Presentation

A 
Pt: Chronic Inflammatory Disease (SLE, RA)
Usually Asx 
Hgb >8 
Dx: 
Increased Ferritin 
Decreased TIBC, Fe 
Tx: Usually nothing 
maybe EPO
39
Q

Heriditary Spherocytosis Presentation

A 
(Spectrin, ankryin, Pallidin) 
Pt: Hemolysis
Smear shows Spherocytes 
Dx: Smear
Osmotic Fragility Test 
Tx: Splenectomy
40
Q

Paroxysmal Nocturnal Hemolglobinuria Presentation

A

Deficiency PIGA gene
Dx: Flow cytometry showing deficiency CD 55
Tx: Supportive
Ecluzimab

41
Q

AML presentation

A 
Pt: Acute 67 y.o.
Exposure- Benzine, Radiation 
CML: Blast crisis transformation 
Dx: Smear 
Bone marrow Bx->20% blasts 
\+ Myeloperoxidase 
non-M3 Variant-Chemo
42
Q

CML presentation

A

Pt: Asx with increase white count
Dx: Bone marrow Bx- Philadelphia Chromosome t(9.22) BCR-ABL
Tx: Imatinib
can transform into AML (Blast Crisis)

43
Q

ALL presentation

A 
Pt: Acute, Young Patient 
Dx: Smear
BMBx >20% blasts (Positive Tdt) 
Tx: Chemo 
ppx CNS with ARA-C
44
Q

CLL Presentation

A 
Pt: Chronic Older Patient 
Dx: Diff 
BMBx 
Tx: >65 +Asx= no treatment 
>65 + Sx = Chemo 
<65 +Donor = Stem Cell Transplant
45
Q

Von Willebrand Disease Presentation

A 
Decreased vWF and Factor 8
Pt: Platelet bleeding (superficial-Gums, vagina, petechiae)
Normal platelet count 
Dx: vWF
Tx: DDVAP 
Factor 8
46
Q

DIC Presentation

A

Very sick patient
Sepsis, ICU
Shock

47
Q

Heparin Induced Thrombocytopenia Tx

A

Stop heparin
Start Argatoban
Bridge to Warfarin

48
Q

HIT Presentation

A

Presents 7-14 days after starting

49
Q

Idiopathi Thrombocytopenic Purpura Presentation, Tx

A 
Usually a Female with AI 
Diagnosis of exclusion 
Tx: Steroids-Acute 
Critically Low- IVIg
Splenectomy-Refractory 
Rescue therapy-Rituximab

USMLE STEP 2 CK RETAKE (15 decks)

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