Brainscape's Knowledge GenomeTM

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


See full index

UWORLD QuestionQuestions > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

Anemia, reticulocytosis and increased indirect bilirubin indicates?

A

hemolytic anemia

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

peripheral blood smear of dysmorphic red blood cells without central pallor describes what?

A

spherocytes

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

In hemolysis what happens to:
retiulcytes?
LDH?
Haptoglobin

A

Reticulocytosis
incr. LDH
decreased haptoglobin

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

name two tests for Heridiatry spherocytosis& whats deficient ?

A

Increased MCHC=> membrane loss & RBC dehyration
Osmotic fragility testing

Spectrin

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

What is used to reverse methotrexate toxicity?

A

Folinic acid (leucovorin)

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

And what two situations is allopurinol used? How does it work?

A

Noncompetitive inhibitors of xanthene oxidase used in the treatment of :

gout
Tumor lysis syndrome (also use Rasburicase)

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

When and how does filgrastim work?

A

G-CSF analog stimulate proliferation/differentiation of granulocytes in patients with NEUTROPENIA

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

When is Mezna used? Which drugs is a given with concurrently?

What does a bind?

A

Hemorrhagic cystitis
Cyclophosphamide, ifosfamide

Acrolein

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

What do you use to treat anthracycline induced cardiotoxicity?

A

Dexrazoxane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where does isotype switching occur? Which receptor is necessary?

A

Germinal centers of lymph nodes requires interaction OCD 40 receptor on B cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where does the VDJ recombination occur?

A

During B cell maturation within the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Name what these diagnostic test correlate to:
Panpanicolaou smear
Cryoglobulins
Hemadsorption in cell culture
Heterophile antibodies
A

Human papilloma virus
Hepatitis C virus
Influenza/parainfluenza
EBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which cells exert master control over other cells involved in iron metabolism?

A

Hepatic parenchymal cells due to intercellular binding protein FERRITIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Purpose of lactoferrin where it is secreted?

A

Renal tubular cells

Finds two free iron in the urine and recovers from metabolic use

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

What carries out the non-oxidative reactions of the HMP shunt?

Oxidative?

A

Transketolase
Transaldolase

G6Phosphate dehydrogenase =RLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which chemo drug would cause burning on urination and urgency?

A

Cyclophosphamide ifosfamide

Induced hemorrhagic cystitis

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

Which chemo drug would be associated with CHF symptoms?

A

Doxorubicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dry cough, exertional dyspnea, pulmonary toxicity is a side effect of which chemotherapy drug?

A

Bleomycin = >progressive pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Alkylating agents of chemotherapeutic agents are associated which which type of symptoms?

A

Tarry stools

Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which chemotherapy drug would cause abdominal pain and jaundice what type of drug is this?

A

Mercaptopurine

S-phase specific purine Analog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What diseases associated with factor X I deficiency ? When is bleeding seen?

A

Hemophilia see

bleeding only occurs in surgical procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What metabolizes pro carcinogens?

A

Cytochrome P450 MONOOXYGENASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

YOUR MOM

A

is LOVELY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Homocysteine to cystathione
Cofactors
Enzyme

A

Serine, vitamin B6

Cystathionine synthetase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cystathionine to cysteine

A

Vitamin B6

Cystathionase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Homocystine to methionine
Cofactors
Enzyme
What byproducts are produced?

A

Methylcobalamin, 5-methyl tetrahydrofolate

Methionine synthase

THF4, cobalamin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

folic acid to THF ?

What inhibits this? (2)

A

folic acid–>

DHFReductase |— methotrexate

DHF–>

DHFReductase |— methotrexate

THF

THF—>DHF by thymidylate synthetase ( |— 5-FU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does leucovorin rescue work?

A

follinic acid (leucovorin) is not require the action I’m dihydrofolate reductase to be converted to THF and it’s unaffected by methotrexate poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Germ tubes/true hyphae are diagnostic of which fungi? (aka positive germ tube test)

Three potential manifestations?

A

Canada albicans

Oral thrush
Vulvovaginal candidiasis-White discharge
Cutaneous candidiasis-maceration/fissuring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Attributable risk percentage =?

A

ARP = (risk and exposed -risk and unexposed)/ risk and exposed

USE:
ARP = (RR -1)/RR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

HbS mutation location?

How does this affect hemoglobin molecules?

A

valine in place of glutamic acid @ 6th amino acid position in beta subunits

Promotes hydrophobic interactions among hemoglobin molecules = > polymerization of HbS molecules and red blood cell distortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Wiskott Aldridge syndrome triad?

A

Eczema, thrombocytopenia, B & T lymphocytes deficiency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

AML is associated with which cytogenic abnormality?

A

t(15:17)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why does Erythroblastosis fetalis, or hemolytic disease of the newborn not occur in parens with maternal blood type A or B?

why would it occur in type O mothers

A

Anti-A & Anti-B antibodies are IgM and cannot cross the placenta.

type O antibodies are IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which mitochondrial enzyme activates caspases?

A

Cytochrome C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What type of lymphocytes respond to an active EBV infxn?

A

Activated CD8 cytotoxic positive T lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What diseases are associated with multiple myeloma? at age ~70yrs

A

Anemia

Hypercalcemia

Bone resorption (secretion of IL-1-osteoclastic actv. factor) and IL-6 ==> PUNCHED OUT LYTIC LESION

Increased susceptibility to infection (M protein, Bence-Jones protein, Rolleaux formation, Increased ESR

AL amyloid(MM & Monoclonal Plasma cell dyscrasia)

Renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Drug of choice and HeparinInducedThrombocytopenia?

A

Direct thrombin inhibitors:
Hiruden
Lepiruden
Argatroban

*** do not require ATIII

39
Q

Which drug shares the same pathogenesis of Glanzmann’s thrombastenia? and how?

A

Abciximab

GPIIb/IIIa blocked/deficient in drug/disease respectively

40
Q

What is used to prevent the renal sometimes Timberledge the syndrome?

A

allopurinol

Rasbicurase

41
Q

side effect of dapsone?

A

Methemoglobinemia

42
Q

What worsens G6PD deficiency? (bite cells) 4+descriptions

A

Infections
Drugs-dapsone, TMP-SMX, antimalarials
Diabetic ketoacidosis
Fava beans

43
Q

What recesses of clozapine work on?

What life-threatening side effect is associated with this drug?

A

D4

Agranulocytosis

44
Q

Which drug can cause aplastic anemia/pancytopenia?

A

Chloramphenicol

45
Q

The presence of an oligoclonal IgG band in multiple sclerosis indicates this disease is?

A

Autoimmune disorder

46
Q

4 features of anaplastic tumors? (anaplastic=COMPLETE LACK OF CELL DIFFERENTIATION)

A

1 cells coalesce due to loss of cell polarity
2 cellular and nuclear pleomorphism
3 disproportionately large nuclei, giant multinucleated tumor cells
4 mitotic figures

47
Q

What activates and what blocks Delta aminolevulinate synthase?

A

Activate: alcohol, barbiturates, hypoxia
Inhibit: heme, glucose

48
Q

What converts fibrinogen to fibrin

A

Thrombin

49
Q

What converts prothrombin to thrombin?

What cofactors are required for this?

A

factor Xa

Calcium, factor V, platelets phospholipid

50
Q

Lead blocks what from being made by inhibiting which enzyme?

ferrochelatase blocks what from being made?

A

Porphobilinogen
ALA Synthetase

HEME

51
Q

When would you see schistocytes schistocytes schistocytes?

A

HUS
TTP
DIC
Prosthetic valve

52
Q

Main differentiating symptoms of TTP vs HUS

A

TTP: adult, neurologic involvement
HUS:children, renal involvement

53
Q

When does Henonch Schloein Purpura usually occur?
Symptoms/Manifestations?
Tx

A

children age 3-10

Leukocytoclastic vasculitis due to depositions of IGA complexes

Abdominal pain, lower extremity purpura, arthralgias, renal involvement

54
Q

How might desmopressin affect bleeding disorders?

Which bleeding disorder is a used to treat?

A

Releases von Willebrand factor and factor VIII from endothelial cells

Mild to moderate hemophilia A

55
Q

CD14

A

Monocyte macrophage cell lineage

56
Q

High oxygen affinity hemoglobins leads to which type of shifts? what happens to P50 w/ this?

What happens to renal system, red blood cells?

A

Left shift, Decreased P50

Renal hypoxia, increased EPO synthesis = > erythrocytosis

57
Q

4 associated left findings with intravascular hemolytic anemia

A

DECREASED serum haptoglobin levels

INCREASED LDH hemoglobin bilirubin

58
Q

Type/MOA:
Enoxaparin
Fondaparinux
Unfractionated Heparin

A

E-LMWH that more specifically binds Antitrhombin (more than it does thrombin) to inactivate Factor Va

F- pentasaccharide factor Va inhibitor

UH- binds both antithrombin and thrombin (inactivating it) and is most antithrombotic

59
Q

what occurs 4-12 days post Subarachnoid hemorrhage?

how do you prevent this?

A

Vasospasm

CCBs=nimodipine

60
Q

all mycoplasma species are resistant to which types of drugs?

WHAT CANNOT TREATS THESE INFXNS? 4

A

drugs that affect peptidoglycan wall because they are intracellular- penicillins, cephalosporins, carbapenems, vancomycin

Erythromycin/Tetracyclines

61
Q

what laboratory finding is seen in uremic platelet dysfunction?

A

increased BT only

62
Q

When does HBS aggregate?

A

Deoxygenated state

63
Q

4 common features of sarcoidosis?

A

Erythema nodosum, arthralgias, granulomas, elevated serum ACE levels

64
Q

What is diagnostic of PNH?

A

CD 55, CD 59 deficiencies; these deficiencies disallow the inactivation of compliment

65
Q

distinguish btw relative & absolute erythrocytosis?

A

relative-normal RBC mass

absolute-Incr. RBC mass

66
Q

Increased Hematocrit= ?

A

Erythrocytosis
> 52% males
> 48% females

67
Q

Subunits of HbF?

when does switch to HbA occur? subunits in this

A

2 alpha
2 gamma

@6mo of life
2 alpha
2beta

68
Q

AL amyloid associated with which 2 diseaes and what is seen under polarized light?

A

Apple green birifrengence with congo red stain

Multiple Myelolma
Monoclonal plasma cell dyscrasias (clockface purple cells)

69
Q

Haptoglobin MOA?

Why would these levels decrease in Intravascular hemolysis?

A

binds to free Hb and promotes uptake by the RES.

Decr. when significant quantities of Hb are released into circulation (seems wrong but this is right - in UWORLD)

70
Q

What drugs increases fetal Hb?

A

Hydroxyurea

71
Q

What bug uses this method of Infection?

pharynx–> lymphatics–> meninges

A

H.Influenzae

72
Q

What bug uses this method of infection?

Middle ear–>contiguous tissue–> meninges

A

S.pnuemonia

73
Q

what bug uses this method of infection?

Primary Lung focus–> blood–> meninges

A

Mycobacterium tuberculosis
&
S. Pneumonia

74
Q

what bug uses this method of infection?

Pharynx–>Blood–>Choroid Plexus–> Meninges

A

Neisseria Meningitidis

75
Q

what 3 things are associated with red cell aplasia?

A

thyoma

lymphocytic leukemias

ParvovirusB19

76
Q

What has a similar presentation to CML?

how do you differentiate between the 2?

A

Leukemoid reaction => elevated white cell count

neutrophil alkaline phosphatase level
LEUKORXN= Elevated
CML=Decreased

77
Q

Nitrites

A

Causes Methemeaglobinemia and Treats Cyanide poisoning.

78
Q

which _______ can cause Serotonin syndrome?

analgesic
antiemetic
antibiotic

A

tramadol
ondasteron
Linezolid

79
Q

aplastic anemia (3 symptoms)

A

pancytopenia
low reticulocyte count
absent splenomegaly

dry bone marrow aspirate; fat cells & fibrous stroma

80
Q

The lower the MAC the ______ the potency?

A

higher

81
Q

Vitamin B12 Deficiency vs Folate Deficiency

A

BOTH Megaloblastic anemia

B12 is associated with neurologic deficiency.

82
Q

Abdominal pain, hepatomegaly, Pancreatic calcifications suggest what?

what is this usually due to?

A

Chronic Pancreatitis due to ethanol abuse

83
Q

Rifampin MOA?

A

blocks action of bacterial DNA dependent RNA polymerase inhibiting transcription

84
Q

Where do pancoast syndrome tumors usually occur?

what characterizes this disorder?

A

in the superior sulcus of the lung apex

ipsilateral horners syndrom
rib destruction, atrophy of hand muscles
pain in C8-T1 T2 nerve roots

85
Q

what would you use to treat lyme disease?

A

doxycycline or

penicillin-type antibiotics

86
Q

what inhibits the synthesis of mycolic acids?

A

isoniazid

87
Q

What type of cancer is associated with Epstein-Barr virus?

A

Primary CNS lymphoma

88
Q

what enzyme does heparin activate

A

AntiThrombin III

89
Q

DIC due to: (3 common)
Path
Lab findings

A

sepsis, burn injury, acute pancreatitis

fragmented RBCs, Thrombocytopenia

Lab Test prolonged PT & PTT
decreased fibrinogen, Factor V, Factor VIII

90
Q

difference btw Brachiocephalic and SVC drainage?

A

SVC drains bilateral Brachiocephalic veins

Brachiocephalic drains UNILATERAL jugular & cephalic veins (Same symptoms as SVC syndrome but to ONE SIDE)

91
Q

Metastatic Carcinoid tumor test

4 common symptoms? When are these symptoms present when are they absent?

A

5-hydroxyIndoleacetic acid

Vasomotor instability: cutaneous flushing, dizzy
GI probs: secretory diarrhea & abd. pain
Bronchoconstricion
Right sided valvular Heart disease

Absent when confined to INTESTINE

present outside intestine/ WHEN metastasized to LIVER

92
Q

Features of Polycythemia Vera (PRIMARY)

A

DECR. EPO
incr. RBC MASS
Incr. Plasma Volume levels

ALL CELL LINEAGES INCREASED

JAK2 V617F mutation
Incr. Sensitivity to Growth factors

93
Q

Secondary Polycythemia vera

2 causes
Findings

A

Hypoxia
EPO-producing tumor

***ONLY RBC Lineage is increased
Incr. RBC Mass
Incr. EPO
NORMAL plasma vol.

UWORLD QuestionQuestions (12 decks)

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