Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE > heme > Flashcards

heme Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

lead poisoning (MOA… leads to… )

A
  • inhibition of both aminolevulinic acid dehydratase (leads to increased precursor) and ferrochelatase (final step in heme synthesis)
  • lead-induced porphyria leads to microcytic (hemoglobin poor) anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most common primary cardiac tumor (name and histology, possible complication)

A
  • atrial myxoma
  • amorphous extracellular matrix
  • associated with multiple syncopal episodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CD4 marker

A

-helper T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CD19 marker

A

-B lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CD28 marker

A

-helper T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CD3 marker

A

-helper T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CD16 marker

A

-natural killer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CD14 marker

A

-macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

G6PD (MOA and inciting drugs)

A
  • glucose-6-phosphatate dehydrogenase important enzyme in hexose monophosphate shunt
  • reduces NADP+ to NADPH, which in turn reduces GSSG to glutathione–> glutathione protects RBC’s against oxidative stress
  • deficiency results in hemolytic anemia
  • common in AA and mediterranean descent
  • primaquine, chloroquine, sulfa, Isoniozid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

paroxysmal nocturnal hemoglobinuria (genetic defect, MOA)

A
  • defect in PIG-A gene which produces GPI anchors
  • GPI anchors are necessary to attach complement inhibiting proteins, without which, complement chronically lyses RBCs
  • occurs throughout the day, most concentrated urine in AM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

blood smear of macrocytic anemia

A
  • hypersegmented neutrophils

- can distinguish folate from B12 by neuro symptoms (only in B12) and increased MMA (only in B12)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SCID (enzyme deficiency… MOA… tx)

A
  • adenosine deaminase deficiency
  • inability to breakdown purines, buildup of deoxyadenosine triphosphate, which prevents synthesis of other nucleotides
  • toxic to rapidly growing cells such as immune cells
  • tx: bone marrow transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CML (genetics… MOA.. tx)

A
  • t(9;22), philly chromosome, creates BCR-ABL fusion protein, constitutively active tyrosine kinase
  • tx: TKI, imatinib (gleevec)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dacryocytes (tear drop cells on smear)

A

-indication of extramedullary hematopoeisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

von Willebrands (what is it, what does it do, lab values, inheritance)

A
  • 2 jobs: protect factor 8 and adhesion of platelets to collagen via glycoproteins
  • increased bleeding time and partial thrombosplatin time
  • NL prothrombin time and NL platelets
  • autosomal dominant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

protein C

A

-inactivation of factors V and VIII, deficiency leads to prothrombotic state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

DIC (common causes… 2 fold mechanism… lab values… diagnostic test…)

A
  • sepsis or trauma, but most commonly obstetric complications
  • activation of BOTH coagulation cascade and fibrinolytic system, leading to…
  • increased bleeding time, PT and PTT
  • fibrin split products (D-dimer)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Burkitt’s Lymphoma (genetics, path, common symptom)

A
  • t(8;14) resulting in overexpression of c-myc
  • starry sky, field of lymphocytes interrupted by occasional macrophages
  • mass in jaw, and assoc. with EBV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Folate deficiency (physiologic role of folate… what deficiency looks like, who gets it, time course)

A
  • tetrahydrafolate is important in one carbon transfers, crucial for purine synthesis
  • deficiency leads to megaloblastic microcytic anemia without neurological symptoms
  • folate stores deplete quickly (time course of months rather than years in B12)
  • *NL MMA**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

taut vs relaxed hemoglobin

A
  • taut, tight, low oxygen, release oxygen, low affinity

- relaxed, lots of oxygen, pick it up and hold onto it, high affinity

21
Q

SLL/CLL vs diffuse large B-cell lymphoma (Path smear and pathogenicity)

A
  • small, still mostly circular lymphocytes on smear
  • Richter’s is a transformation from SLL/CLL to diffuse large cell (about 10% of SLL/CLL) and a smear shows a distinct line of transformation
  • 4-5x larger cells and more disorganized morphology
22
Q

most common cause of hypercoaguable state (and 1 uncommon cause and 3 rare cases)

A
  • factor V leiden
  • prothrombin gene mutation
  • protein s deficiency
  • protein c deficiency
  • antithrombin III deficiency
23
Q

CLL (path smear)

A
  • clonal expansion of b-lymphocytes arrested in development somewhere between pre-b cell and mature b cell
  • results in smudge cells as b cells are not fully mature and break apart during preparation
24
Q

HIT

A
  • heparin induced thrombocytopenia
  • antibodies form against heparin/platelet complex, activates platelets, they all quickly get used up forming lots of clots
  • more likely in people who have been heparinized before
25
Q

1 unit of raises hematocrit by….

A

-3%

26
Q

thrombotic thrombocytopenic purpura (TTP)

A
  • deficient vonWillebrand factor, leads to continual activation of platelets, destroys RBCs, leads to renal insufficiency
  • this damage can lead to renal insufficiency and elevated creatinine
  • NL PT and PTT, clotting factors are OK
27
Q

vitamin K in clotting cascade

A
  • vitamin K assits in carboxylating several clotting factors

- warfarin interferes with this action

28
Q

acute onset cardiac friction rub is an indication of….

A

-uremia, get them some dialysis pronto

29
Q

contraindicated for warfarin

A

-pregnant women

30
Q

hemophagocytic lymphohistiocytosis (HLH)

A
  • constitutional symptoms

- bone marrow aspirate reveals RBC’s engulfed in macrophages

31
Q

multiple myeloma (CRAB)

A
  • hypoCalcemia
  • Renal insufficiency
  • Anemia
  • Bone lesions
32
Q

hairy cell leukemia (negative symptoms, smear, diagnostic test)

A
  • neg for night sweats and fever
  • 4x more common in men, fatigue, fullness, weight loss
  • “hairy cell” on smear
  • TRAP (tartrate resistant acid phosphatase) positive… trap the hairy animal
33
Q

fanconi’s anemia (what is it, why does it happen, what does it cause)

A
  • most common congenital aplastic anemia and important cause of myeloid leukemia in kids
  • defect in DNA repair
  • bifid thumbs, renal dysgenesis, hypogonadism, microcephaly, high fetal hemoglobin
34
Q

carboxylation of glutamic acid residues

A

-role of vitamin K in coag cascade

35
Q

hemorrhagic disease of the newborn (what causes it, what prevents it)

A
  • usually 2-7 days after birth, due to deficiency of vitamin K
  • lacking intestinal flora that makes vitamin K
  • every newborn in HOSPITAL gets vit K intramuscularly after birth
36
Q

schilling test

A

-radiolabled B12–> in NL individuals, absorbed and excreted in urine, so we look for radiolabled B12 in urine, if not there, its not being absorbed (due to lack of intrinsic factor (produced by parietal cells) )

37
Q

TTP-HUS (thrombotic thrombocytopenic purpura and hemolytic uremic syndrome)

A
  • a subtype of MAHA (microangiopathic hemolitic anemia) often idiopathic, sometimes caused by certain drugs bacterial toxins (shiga toxin from E. coli)
  • trifecta of hemolytic anemia, thrombocytopenia and platelet aggregation
  • tx is generally supportive, keeping an eye on fluids, maybe dialysis
38
Q

hemophilia A and B (which cofactors are affected, genetics)

A
  • hemophilia A: factor 8
  • hemophilia B: factor 9
  • both are X-linked recessive
39
Q

PT and PTT measure which cofactors…

A
  • PT: 7… also 10, 5, prothrombin and fibrinogen

- PTT: 8, 9, 11, 12… also 10, 5, prothrombin and fibrinogen

40
Q

hereditary spherocytosis (presentation (triad of symptoms), defect, and tx)

A
  • anemia, splenomegaly, jaundice
  • defect in RBC anchoring proteins: ankyrin, spectrin, band 3
  • tx: splenectomy to cure anemia, sphereocytes persist
41
Q

genetic abnormality in sickle cell disease (HbS)

A

-substitution of valine for glutamic acid at 6th position

42
Q

henoch-schonlein (presentation, and serious complication)

A
  • young boys, palpable purpuric lesions on buttocks and legs, joint pain, fever, malaise
  • acute renal failure w/hematuria and proteinuria
43
Q

post splenectomy, pts are at risk for… (4 pathogens with common trait..bonus, what will you see on smear?)

A
  • encapsulated organisms: neisseria meningitides, strep pneumo, h. influenza, klebsiella pneumo
  • given prophylactic vaccinations
  • howell-jolly bodies, irregular RBCs, and target cells
44
Q

bronze diabetes…

A
  • jaundice and diabetes

- hemochromatosis… leads to end organ damage

45
Q

lymphocyte rich hodgkins lymphoma (smear, epidemiology, prognosis)

A
  • few RS cells (binucleate with inclusion-like nucleoli
  • usually young males
  • decent prognosis
46
Q

mixed cellularity hodgkins (smear, epidemiology, prognosis)

A
  • many RS cells, many lymphocytes (mixed ratio)
  • generally presents in older pts
  • poor prognosis
47
Q

plummer-vinson disease (triad)

A
  • esophageal-cervical web
  • iron deficiency anemia (microcytic hypochromic)
  • glossitis
  • MOA: dysphagia due to web and glossitis prevent proper intake, results in iron deficiency anemia
48
Q

scurvy… (vitamin deficiency, symptoms and pathophys)

A
  • deficient in vit C
  • important in hydroxylating valine and leucine allowing for crosslinks which add structural integrity to collagen
  • bleeding gums, poor wound healing etc
49
Q

sickle cell trait… (common SE)

A
  • much less severe than sickle cell disease, can see some more serious complications at altitude
  • episodic hematuria and polyuria as renal tubules are damaged over time and body is unable to concentrate urine

USMLE (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions