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Step II CS > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

Plt activation, prothrombosis, thrombocytopenia 5-10 d after anticoag

A

HIT (abs to hep-plt factor 4)

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2
Q

Paraprotein gap (ptn-alb >3-4), increased risk for infection because decreased functional abs, maybe leukopenia.

A

multiple myeloma

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3
Q

Nuclear remnants within RBCs, blue inclusions, s/p splenectomy

A

Howell-Jolly bodies

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4
Q

DDx for anterior mediastinal mass

A 
Terrible Ts
Thymoma,
Teratoma (and other germ cell tumors)
Terrible lymphomas 
Thyroid
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5
Q

MMA and homocystine with b12 and folate

A

b12: MMA and homocystine both increased
folate: ml MMA, elevated homochysteine

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6
Q

MCV in hemolytic anemia

A

NL

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7
Q

Thalassemia MCV

A

typically very very low. Nl iron studies

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8
Q

Risks for polycythemic infants infants

A

respiratory distress, poor feeding and nn probs (not hyperglycemia)

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9
Q

hyposthenuria

A

inability to concentrate urine. sickle cell trait

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10
Q

Salvage therapy

A

Therapy when standard therapy fails

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11
Q

Infections in sickle cell asplenia

A

s pneumo most common

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12
Q

Anabolic steroid use effect on hct

A

increase hct

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13
Q

Sx dvts

A

from iliofemoral vv (calf vv often asx)

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14
Q

Thrombocytopenia in Wiskott Aldrich

A

from impaired production

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15
Q

HIV is a RF for TTP

A

schistocytes, hemolytic anemia. nl mcv. increased retic

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16
Q

Hairy cell leukemia

A

TRAP +, tx with cladrabine

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17
Q

Smudge cells

A

Seen with CLL. From fragile cells and smear preparation. Low PLT is a poor prognostic sign.

18
Q

Sunburst pattern on XRAY/codmans triangle. PE - large, tender mass

A

Osteosarcoma

19
Q

Onion skin on XRAY (osteolytic lesion with a periosteal reaction that produces layers of reactive bone). Concurrent flu-like symptoms

A

Ewings Sarcoma - 22:11

20
Q

How to treat decreased appetite in cancer patients

A

Progesterone analogues. Cannabanoids dont have eough research behind them. Or steroids, but prog analogues have fewer side effects

21
Q

Middle Mediastinal Mass?

A

Bronchogenic cyst

22
Q

Posterior Mediastinal Mass?

A

Neurogenic tumors - meningocele, enteric cyst, lymphoma, diaphragmatic hernia, esophageal tumors, aortic aneurysm

23
Q

Elderly patient, painless LAD, smudge cells. Thrombocytopenia and hemolytic anemia also maybe present

A

CLL - tx with CD20 MAB

24
Q

Most common causes of malignant pleural effusion?

A

Breast and Lung CA. MM isnt common

25
Q

MSK pain in sickle cell - caused by?

A

Vaso-occlusion. Can manifest as spinal and nn pain

26
Q

Renal damage in MM cause by ?

A

Renal tubular damage more common than glom pathology

27
Q

A Thalassemia - located on what chromosome ? What is minor look like?

A

11 - minor can be cis or trans. Only one deletion (a,a,a,-) shows no clinical dz.

28
Q

Elevated PTT, petechiea, bruising in hospital/post op setting?

A

think HIT - remove offending agent

29
Q

Anemia s/p gastrectomy. What type of anemia?

A

Think B12def - megaloblastic. IF isn’t produced as much

30
Q

Breast cancer, most important prognostic factor?

A

TNM. More important than ER+/PR+

31
Q

EBV infection can cause what hematologic abnormality?

A

Autoimmune hemolytic anemia. usually 2-3 weeks after onset of sxs

32
Q

Spherocytes on peripheral smear. Low haptoglobin, high ldh, anemia. Coombs positive. dx?

A

AIHA. Can be warm (igG) or cold (IgM) mediated. Hereditary spherocytosis has a negative coombs.

33
Q

ALWAYS check cbc/diff for eosinophils. It really narrows potential dx.

A

SErz. Makes it a lot easier. DNAAACP

34
Q

HIT is thrombogenic and you need to monitor closely for aa or vv clots

A

truth

35
Q

Hematuria in a patient who recently took medication?

A

Think G6PD def

36
Q

Stroke in sickle cell patients. Treatment?

A

Do exchange transfusion to decrease percentage of sickled cells. Fibrinolytic therapy won’t work because it’s not a true embolus.

37
Q

VERY high WBC with lots of granulocyte forms. Also has low leukocyte alk phos.

A

CML. PHL chromosome

38
Q

fever, chills, malaise 1-6 h after blood products

A

TRALI. Tx is to irradiate cells (wash cells with IgA def)

39
Q

Young patient with cervical LAD <2.0 cm, mobile. Otherwise no sx. What do you do?

A

Observe. no need to bx in this patient. Only bx if >2.0 cm or sx

40
Q

Tx for sarcoid

A

steroids

41
Q

Treatment for TTP/HUS?

A

emergent plasmapheresis

42
Q

eczematous rash over nipple. does not respond to topical treatment. bx shows large cells surrounded by clear halos

A

PAget’s disease of breast/adenoCa

Step II CS (17 decks)

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