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USMLE Step Two > Hematology/Oncology Disorders > Flashcards

Hematology/Oncology Disorders Flashcards

1
Q

teenage African American male presents to the ER with right hip pain and a hematocrit of 25%

A

sickle cell anemia with osteonecrosis of the femoral head

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2
Q

next step in management of patient with febrile neutropenia due to chemotherapy

A

admission, neutropenic precautions, blood culture, urine culture, CXR, and broad spectrum IV antibiotics

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3
Q

most common cause of anemia in elderly patients

A

folate deficiency

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4
Q

blood smear of patient with anemia due to lead poisoning

A

microcytic, hypochromic, basophilic stippling, and sideroblastic anemia

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5
Q

cause of anemia in an alcoholic patient with an elevated MCV

A

folate deficiency

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6
Q

cause of anemia that develops after taking a sulfa drug

A

G6PD deficiency

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7
Q

medication used in long-term management of sickle cell anemia

A

hydroxyurea

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8
Q

compare serum iron, ferritin, and transferrin levels in iron deficiency anemia v. anemia of chronic disease

A

iron low in both
ferritin increased in chronic disease
transferrin increased in iron deficiency

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9
Q

what lab markers suggest anemia due to hemolysis

A

increased indirect bilirubin, reticulocyte count, LDH
MCV normal
H/H decreased
decreased haptoglobin

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10
Q

schistocytes

A

mechanical hemolysis, drug-induced hemolysis

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11
Q

RBC disorder associated with acanthocytes (spur cells)

A

abetalipoproteinemia

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12
Q

RBC disorder associated with bite cells

A

G6PD deficiency

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13
Q

RBC disorder associated with basophilic stippling of RBCs

A

lead poisoning, thalassemia, alcoholism

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14
Q

RBC disorder associated with peripheral neuropathy, sideroblastic RBCs

A

lead poisoning

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15
Q

RBC disorder associated with hypersegmented neutrophils

A

folate, B12 deficiecny

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16
Q

RBC disorder associated with heinz bodies

A

G6PD deficiency

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17
Q

which vaccines are particularly important in children with sickle cell disease

A

pneumococcal, HiB vaccines

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18
Q

other than vaccination, how is pneumococcal infection prevented in children

A

prophylactic penicillin until the age of 5

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19
Q

complication that occurs in 10% of patients with sideroblastic anemia

A

leukemia

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20
Q

differential diagnosis for serum eosinophilia

A

drugs (NSAIDs, penicillins/cephalosporins)
neoplasms
allergies, asthma, allergic bronchopulmonary aspergillosis
adrenal insufficiency
acute interstitial nephritis
collage vascular disease (PAD, dermatomyositis)
parasites, HIV, hyper-IgE, cocciodiomycosis, hypereosinophilic syndrome

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21
Q

drugs known for causing thrombocytopenia

A 
heparin, abciximab
carbamazepine, phenytoin, valproate
cimetidine
acyclovir, rifampin
sulfonamides (sulfasalazine, bactrim)
procainamide, quinidine
quinine, gold compounds
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22
Q

most common causes of DIC

A

sepsis, trauma, pancreatitis, neoplasm, obstetric complications, transfusions

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23
Q

inherited diseases of hypercoagulation

A

factor V leiden, antithrombin III def, protein C/S def, prothrombin gene mutation
hyperhomocysteinemia (MTHFR gene mutation)
rare: dysfibrinogenemia, plasminogen deficiency

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24
Q

treatment for mononucleosis

A

no antiviral medication
NSAIDs, tylenol, hydration
return to contact sport after 4 weeks, non-contact sport after 3 weeks

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25
Q

classic pentad for thrombotic thrombocytopenic purpura

A

hemolytic anemia, thrombocytopenia, acute renal failure

fever, neurological symptoms

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26
Q

most common mutation in white patients that predisposes to hypercoagulability

A

factor V leiden

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27
Q

mechanism of action of streptokinase

A

thrombolytic, cleaves fibrinogen

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28
Q

mechanism of action of aspirin

A

COX-inhibitor, blocks platelet aggregation

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29
Q

mechanism of action of clopidogrel

A

ADP inhibitor

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30
Q

mechanism of action of abciximab

A

gIIbIIIa inhibitor

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31
Q

mechanism of action of tirofiban

A

gIIbIIIa inhibitor

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32
Q

mechanism of action of ticlopidine

A

ADP inhibitor

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33
Q

mechanism of action of enoxaparin

A

binds factor Xa

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34
Q

mechanism of action of eptifibatide

A

gIIbIIIa inhibitor

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35
Q

lab test used to monitor warfarin, heparin, LMWH

A

warfarin: PT, INR
heparin: PTT
LMWH: anti-factor Xa

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36
Q

treatment for von Willebrand disease

A

DDAVP, vWF or factor VIII infusion for surgery, OCP for menorrhagia

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37
Q

platelet count, bleeding time, PT, PTT in HUS/TTP

A

platelet count decreased
bleeding time increased
PT normal
PTT normal

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38
Q

platelet count, bleeding time, PT, PTT in hemophilia A/B

A

platelet count normal
bleeding time normal
PT normal
PTT increased

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39
Q

platelet count, bleeding time, PT, PTT in von Willebrand’s disease

A

platelet count normal
bleeding time increased
PT normal
PTT increased

40
Q

platelet count, bleeding time, PT, PTT in DIC

A

platelet count decreased
bleeding time increased
PT increased
PTT increased

41
Q

platelet count, bleeding time, PT, PTT in warfarin use

A

platelet count normal
bleeding time normal
PT increased
PTT increased

42
Q

platelet count, bleeding time, PT, PTT in end stage liver disease

A

platelet count decreased or normal
bleeding time increased or normal
PT increased
PTT increased

43
Q

platelet count, bleeding time, PT, PTT in aspirin use

A

platelet count normal
bleeding time increased
PT normal
PTT normal

44
Q

what are the SIRS criteria

A

temperature < 35 OR > 38
WBC < 4,000 OR > 12,000 or > 10% bandemia
RR > 20
HR > 90

45
Q

most important medication in treatment of anaphylaxis

A

subcutaneous/IM epinephrine

46
Q

most common neoplasm in children

47
Q

most common leukemia in adults

48
Q

philadelphia chromosome is almost always seen

49
Q

smudge cells on peripheral smear

50
Q

peripheral blasts are PAS+ and TdT+

51
Q

peripheral blasts are PAS-, myeloperoxidase+, and have Auer rods

52
Q

pancytopenia in a down syndrome patient

53
Q

medication associated with remission in 95% of patients with CML

54
Q

21 year-old male presents with recent weight loss, pruritis, night sweats, hepatosplenomegaly, and a nontender cervical lymphadenopathy

A

hodgkin’s lymphoma

55
Q

blood cell pathology associated with EBV in Africa

A

burkitt’s lymphoma

56
Q

reed-sternberg cells, cervical lymphadenopathy, and night sweats

A

hodgkin’s lymphoma

57
Q

bence-jones proteins, osteolytic lesions, high calcium

A

multiple myeloma

58
Q

translocation 14;18

A

follicular lymphoma

59
Q

most common lymphoma in the US

A

diffuse large B-cell

60
Q

translocation 8;14

A

burkitt’s lymphoma

61
Q

translocation 9;22

A

CML philadelphia chromosome

62
Q

most common form of hodgkin’s lymphoma

A

nodular sclerosis

63
Q

starry-sky pattern due to phagocytosis of apoptotic tumor cells

A

burkitt’s lymphoma

64
Q

high hematocrit/hemoglobin, pruritis, burnign pain in hands or feet

A

polycythemia vera

65
Q

blood smear with hair-like projections, splenomegaly

A

hairy cell leukemia

66
Q

antiretroviral that causes lactic acidosis

67
Q

antiretroviral that causes GI intolerance

A

protease inhibitors

68
Q

antiretroviral that causes pancreatitis

A

didanosine, stavudine, zalcitabine, ritonavir

69
Q

antiretroviral that causes peripheral neuropathy

A

didanosine, stavudine, zalcitabine

70
Q

antiretroviral that causes megaloblastic anemia

A

zidovudine

71
Q

antiretroviral that causes rash

72
Q

antiretroviral that causes hyperglycemia, diabetes mellitus, and lipid abnormalities

A

protease inhibitors

73
Q

antiretroviral that causes bone marrow suprression

A

zidovudine

74
Q

antiretroviral that is given to pregnant women with HIV

A

HAART therapy +/- ziduvodine during labor

75
Q

antiretroviral regimen for occupational HIV exposures

A

HAART: 2 NRTIS + NNRTI/protease inhibitor

zidovudine + lamivudine

76
Q

antibiotic prophylaxis for HIV patients

A

< 200: TMP-SMX/dapsone for PCP

< 100: erythryomycin/clarithromycin for MAC

77
Q

treatment for CLL

78
Q

no alpha-globin production, fetal death occurs

A

hydrops fetalis

4 abnormal alpha genes

79
Q

minimal alpha-globin production, chronic hemolytic anemia, pallor, splenomegaly, microcytic RBCs on blood smear, decreased lifespan

A

hemoglobin H disease

3 abnormal alpha genes

80
Q

reduced alpha-globin production, mild anemia, microcytic RBCs and target cells

A

alpha-thalassemia minor

2 abnormal alpha genes

81
Q

generally asymptomatic hematologic disorder, children are at increased risk for alpha-thalassemia

A

alpha-thalassemia minima

1 abnormal alpha gene

82
Q

no beta-globin production, asymptomatic until decline of fetal hemoglobin, growth retardation, increase in hemoglobin A2 and F, patients die in childhood without transfusions

A

beta-thalassemia major

2 abnormal beta genes

83
Q

reduced beta-globin production, mild anemia, transfusions may be needed during periods of stress

A

beta-thalassemia minor

1 abnormal beta gene

84
Q

treatment for anti-phospholipid syndrome

A

heparin, warfarin

hydroxychloroquine

85
Q

prophylaxis when CD4 < 200

A

TMP-SMX for toxoplasmosis and PCP

86
Q

treatment for porphyria cutanea tarda

A

phlebotomy and chloroquine

87
Q

treatment for coxsackie virus herpangina

A

reassurance and symptomatic treatment

88
Q

causes of distributive shock

A

sepsis, anaphylaxis, burns, adrenal insufficiency, drug reactions, and CNS injury

89
Q

ovalo-macrocytes, leukopenia, thrombocytopenia, neutrophils with decreased segmentation

A

myelodysplastic syndrome

90
Q

treatment for polycythemia vera

A

serial phlebotomy, antihistamines (for pruritis), aspirin (prevent strokes), hydroxyurea (bone marrow suppression)

interferon-alpha is a refractory treatment

91
Q

HIV medication that causes weird, colorful dreams

A

efavirens (NNRTI)

92
Q

congenital marrow failure with poor growth, morphologic abnormalities, and macrocytic anemia

A

fanconi’s anemia

93
Q

genetic cause of fanconi’s anemia

A

chromosomal breaks

94
Q

decreased red blood cells, craniofacial abnormalities, limb deformities, elevated adenosine deaminase

A

diamond-blackfan anemia

95
Q

treatment for minor cat bites

A

amoxicillin/clavulanate (for pasturella))

USMLE Step Two (17 decks)

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