Heme/Onc Flashcards
Which medications precipitate the oxidative injury to RBCs that occurs in glucose 6 phosphate dehydrogenase deficiency hemolytic anemia?
Dapsone, antimalarials, nitrofurantoin, bactrim, fava beans
40 year old woman with multiple past sexual partners presents with 2 months of sore throat with persistent, enlarged, firm neck mass and ulcerated tonsillar lesion and ipsilateral cervical adenopathy most likely has what?
HPV-positive Head and neck squamous cell carcinoma
Elderly man with several months of lower back pain bothering him during sleep, focal lumbar tenderness, low/normal calcium, elevated alk phos, and focal sclerotic lesions indicative of osteoblastic bone disease most likely has?
Metastatic prostate cancer - particularly causes osteoblastic disease with focal sclerotic lesions
What are Howell-Jolly bodies and what condition are they seen in?
They are nuclear remnants of RBCs seen as single circular blue inclusions on peripheral smear and they are seen in asplenia or functional hyposplenism (sickle cell) as the spleen usually would remove them.
Heinz bodies (G6PD deficiency)
G6PD deficiency: Oxidized hemoglobin becomes insoluble heinz bodies that are seen as Peripheral blue inclusions on crystal violet staining; peripheral smear shows bite cells
Basophilic stippling (precipitation of ribosomal ribonucleic acid) is seen in:
Lead poisoning
Paraneoplastic syndromes:
Myasthenia gravis
Lambert Eaton
Dermatomyositis/polymyositis
MG= POSTsynaptic acetylcholine receptors LE= PREsynaptic voltage-gated Ca2+ channels D/P= muscle fiber injury
What process is affected by Wiscott Aldrich Syndrome (microthrombocytopenia, eczema, recurrent infections)?
cytoskeleton regulation
T cell lymphocytes lack CD40 Ligand
Hyper IgM syndrome
Ataxia telangiectasia
DNA repair defect
Chronic lymphocytic leukemia presentation (older people ~70)
severe lymphocytosis and smudge cells***
- can be asymptomatic
- mild thrombocytopenia, anemia, hepatosplenomegaly
Tx: rituximab - monoclonal antigen against CD20 on B-lymphocytes
Chronic myelogenous leukemia presentation
Imtinib inhibits BCR-ABL tyrosine kinase gene
- marked leukocytosis of neutrophil lineage
Myelodysplastic syndrome presentation
Ovalomacrocytosis with hypo-segmented neutrophils
- macrocytic anemia, thrombocytopenia, leukopenia
Bone marrow biopsy for diagnosis
Acute Myeloid Leukemia
**Auer rods; neutrophil predominant; younger
Acute lymphoblastic leukemia
**lymphoblasts instead of mature lymphocytes
