Heme- FA Flashcards
1
Q
Warfarin blocks what enzyme?
A
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2
Q
Basophilia- what malignancy?
A
CML
3
Q
Life span of platelet? what about RBC?
A
platelet
RBC
4
Q
How eosinophils are associated with parasites?
A
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5
Q
7 causes of DIC? (what is mnemonic?)
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6
Q
What three classes of anticoagulant drug do not require monitoring?
A
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- direct inhibitors don’t require monitoring (LMWH is also specific to Xa)
7
Q
Conditions for
- warm autoimmune hemolytic anemia (3)
- cold autoimmune hemolytic anemia (2)
A
- warm
1.
2.
3. - cold
1.
2.
8
Q
Asian vs. African- what kind of deletion in thalassemia?
A
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- Asian is the worst (fuck)
9
Q
Two fates of HMWK (High Molecular Weight Kininogen)?
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10
Q
Exact mechanism of action of 5FU?
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11
Q
What accumulated substrate causes port-wine color of urine in acute intermittent porphyria? where does this compound come from?
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12
Q
What can be given to reverse tPA toxicity as a thrombolysis inhibitor?
A
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13
Q
compare pattern of lymph nodes in Hodgkin vs. Non-Hodgkin
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14
Q
Four etiologies for aplastic anemia?
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15
Q
What process is defective in Fanconi anemia?
A
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16
Q
Define
- anisocytosis
- poikilocyrosis
A
- anisocytosis
- poikilocytosis
17
Q
Two hematologic disorders where splenctomy is indicated?
A
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18
Q
What is RBC, WBC, Platelets level look like in CML?
A
- RBC
- WBC
- Platelets
19
Q
Level of RBC in myelofibrosis?
A
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- level of WBCs and platelets are variable
20
Q
Three actions of plasmin
A
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21
Q
What is the mutation in factor V laiden? what does this mutation do?
A
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22
Q
Langerhans cell histiocytosis
- three phenotypes
- markers
A
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23
Q
What is reticulocyte?
A
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- indicates erythroid proliferation
24
Q
Failure of aggregation of Ristocetin indicates what?
What two diseases?
A
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25
What is in FFP (fresh frozen plasma)?
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26
What is in cryoprecipitate (5)?
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27
Three indications for FFP?
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28
What mutation on what gene is common in chronic myeloproliferative disorders?
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29
How does anemia of chronic disease progress in terms of normocytic/microcytic/macrocytic anemia
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30
How to treat HUS/TTP? why?
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31
How does RBC membrane get changed in pyruvate kinase deficiency? what is mechanism? inheritance pattern of PK deficiency?
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32
positive for TdT and CD10. Where two sites you also wanna check?
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33
Heme does negative feedback to what enzyme in heme synthesis?
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34
Which two hematologic disorders can be treated with IVIG
- ITP (Immune thrombocytopenic purpura)
- Immune hemolytic anemia
* Immune mediated RBC or platelet destructions can be treated with IVIG. Whole idea is that Ig is sacrificed against destruction, preventing RBC or platelet from immune mediated destruction
35
Fatigue, cafe-au-lait sign, odd looking hands: diagnosis?
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36
What is triad of PNH (paroxysmal nocturnal hemoglobinuria)?
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37
Why venous thrombosis is happening in PNH?
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38
What is Diamond-Black fan anemia? three phenotypes?
intrinsic defect in erythroid progenitor cells, macrocytic anemia
- triphalangeal thumbs
- short stature
- craniofacial abnormalities
vs. Fanconi anemia, where short stature is also seen, but radial/thumb deviation and no craniofacial abnormalities
39
What alklyating agent is not recommend to patient with liver failure? why?
cyclophosphamide, which needs to be bioactivated in liver
40
Antidote to reverse nephrotoxicity by cisplatin?
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41
Name 4 hypercoagulalbe hematologic disease
- anti-thrombin deficiency
- factor V laiden (most common)
- protein C/S deficiency
- prothrombin gene mutation (G20120A, 3' UTR leading to high expression of prothrombin)
42
What is in dense granules of platelet? (2)
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43
What is in alpha granules of platelet? (3)
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44
What is the common cause of acquired antithrombin deficiency?
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45
Multiple myeloma vs. Waldenstrom macroglobulinemia: compare what peaks of immunoglobulin will be seen
MM: IgG and IgA
Wladenstrom macroglobulinemia: IgM
* this kinda makes sense: MM is disorder of plasma cells, which produced antibodies (that underwent class switching).IgG and IgA can only be produced after class switching.
46
Cosmetic side effect of bleomycin?
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* sketchy:
47
Cosmetic side effect of doxorubucin?
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* sketchy:
48
Effect of tPA in platelet count?
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* plasmin cleaves fibrin mesh and inhibits platelet aggregation, but it does not alter level of platelet itself.
49
How to differentiate leukocytosis in CML vs. leukomoid reaction?
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50
How to treat PNH (paroxysmal nocturnal hemoglobinuria)?
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51
What is common cause of ITP (immune thrombocytopenia)?
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52
What is target of antibody in ITP?
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53
How does lead poisoning cause basophilic stippling?
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54
four reactions in coagulation cascade that requires Ca2+ and phospholipid as cofactor?
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55
Factor 13a does what? what else does it need for reaction?
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56
A patient comes in with fever, hallucinations, and altered mental status. Labs show anemia, proteinuria, and thrombocytopenia. Diagnosis?
TTP
* classic pentiad
1. CNS defect
2. renal defect
3. thrombocytopenia (platelet used up for microthrombi)
4. anemia
5. fever
* hallucination: CNS defect
57
non-megaloblastic anemia
- what is it
- causes (2)
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58
Essential Thrombocytopenia
- RBC level
- WBC level
- platelet level
- RBC
- WBC
- platelet
59
Adult T cell lymphoma
- epidemiology
- social history
- what infection
- clinical findings (3)
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60
"coombs negative hemolysis" is buzzword for what disease?
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61
Crew-cut on skull x-ray: what two hematologic disorders should I think?
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*crew-cut indicates extramedullary hematopoeisis
62
Explain the mechanism of heparin induced thrombocytopenia
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63
List three hematologic disorders that can have aplastic crisis by parvovirus B19 infection
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64
How to treat polycythemia vera?
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65
What is common presentation of AML?
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66
What type of hemolysis is seen in sickle cell?
BOTH extra and intravascular hemolysis
67
What is clinical presentation of essential thrombocytopenia?
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68
two findings in blood smear of megaloblastic anemia
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69
In what condition is elliptocyte seen in blood smear?
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70
Describe four locations and timing of fetal erythropoeisis
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71
Cetuximab
- MOA
- use of cetuximab is limited to certain type of colorectal cancer. what type is this? why?
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72
One side effect of Rituximab?
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73
Antidote for heparin?
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74
Two phenotypes of Waldenstrom macroglobulinemia
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75
Renal cell carcinoma resulting in polycythemia
- plasma volume
- O2 saturation
- RBC mass
- EPO
- plasma volume: NL
- O2 saturation: NL
- RBC mass: increased
- EPO: increased
cancer cells producing tons of EPO, secondary inappropriate polycythemia
76
By what mechanism is septic shock initiated?
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77
Why heparin is given during initial treatment of warfarin?
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78
What stain is useful for reticulocyte on blood smear? what is it staining for?
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79
What is seen on blood smear in DIC?
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80
4 viral infections that cause aplastic anemia
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81
Which ABO blood type is used as a universal donor of plasma
AB
* PLASMA- AB type don't have any antibodies
82
Hemoglobin electrophoresis finding in Diamond-Blackfan anemia?
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83
What is definition of myelodysplastic syndrome? what is serious complication of this disease?
blast less than 20% (more than 20% is considered as AML)
- It can develop to AML
84
What is required cofactor for activation of protein C?
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85
Disadvantage of fondaparinux/ LMWH compared to traditional heparin?
longer half-life, not easily reversible.
* heparin has relatively short half-life and can be reversed by protamine sulfate
86
Bleeding into joint (hemarthroses), what hematologic disease should I think first?
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87
What antibiotic can cause aplastic anemia
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88
G6PD deficiency: inheritance pattern?
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89
# Define each and explain under what disease this happens
- Hb Barts
- HbH
- increased HbF
- increased HbA2
- Hb Barts: gamma 4, 4 alpha gene deletions
- HbH: beta 4, 3 alpha gene deletions
- increased HbF: beta thalessemia major
- increased HbA2: beta thalessemia minor (>3.5%)
90
Which drug may lead to excessive bleeding (and excessive increased in INR) when given with warfarin? by what mechanism?
TMP-SMX
This binds to albumin and replaces warfarin bound to albumin, releasing free warfarin. Thus more warfarin activity
* sketchy: photographer girl is bleeding excessivley
91
Is target cell seen in alpha thalassemia?
YES.
generally target cell is seen with all beta globulin problems (sickle cell, HbC) as well as liver disease and asplenia.
I originally thought that only beta thalassemia can show target cell, but no. ALL THALASEMIAS INCLUDING ALPHA can also show target cells.
92
CLL (CD5 and CD 20 positive) can progress to what another type of lymphoma?
diffuse large B cell lymphoma
93
How CLL may result in anemia?
It can result in autoimmune hemolytic anemia, cold IgM
*think in this way: CLL is naive B cell leukemia (CD 5 and CD 20), so it may somehow produce cold IgM antibody?
94
Asplenia: findings (2) on blood smear?
- Howell-Jolly bodies
| - target cell
