Heme/Onc Flashcards
The individual subunits of hemaglobin are structurally similar to
Myoglobin
Individually they no longer show sigmoid binding
How do you treat cyanide poisoining
Nitrates
They create Methemoglobin like state
cyanide likes to bind ferric in methemoglobin and this saves the mitochondria from CN damag
What is Methemoglobin
Contains Ferric rather than ferrous iron
What do we usually bridge a pt with when starting warfrin
Heprin
Helps prevent necrosis
What drug blocks gp2b3a
Abciximab
What diease is messed up gp2b3a
Glanzmann thrombocytopenia
What accumulates in acute porphyria attack
aminolevulinate
porphobilinogen
O type blood mom
AB type baby
Is the baby in trouble?
Maybe, because Type O moms make IgG vs other blood (ab) and IgG will cross the placenta
AB moms only make IgM
HbF contains ____ instead of B globin
gama globin
The JAK2 mutation of polycythemia vera leads to what
makes hemopoetic stem cells more sensative to growth factors
What cancers are caused by Li Fraumeni
Sarcoma Breast Cancer Brain Tumor Adrenal Tumor Leukemia
p53 mutation
What cancers come with VHL
Hemangioblastoma
Clear cell renal carcinoma
Pheochromocytoma
What are the s/s of bladder cancer
Painless bloody urine
CA arises from transitional epithlium
Lets say you mistook B12 def, and said it was folate deficiency and therefor gave folate. What will happen
Treating b12 def with folate will make neurosymtoms worse
Translocation for Follicular Lymphoma
t (14:18)
Overexpression of BCL2
Inhibits apoptosis, promotes surviaval
2 key growth factors for tumor angiogenesis
VEGF
Fibroblast growth factor
What does anaplastic mean
the tumor cell has no resemblence to the tissue of origin
thrombotic thrombocytopenic purpura is?
Antibody vs ADAMS13
VWF doesnt degrade
Microthrombi form
RBCs shear into shchistocytes
Where do the intrinsic and extrinsic apoptosis pathways converge
Caspases
What is a reticulocyte
an immature RBC
Compare AML and CML
AML is most common acute leukemia for over 65
Increased WBC with lots of blasts
CML has elevated WBC, increase in precursor forms (ie myelacytes), and a decrease in Leukocyte Alkaline Phosphatase
T cells “live” in this part of the lymph node
Paracortex
Where do B cells “live” in the lymph node
Lymph Node cortex
Dermatomyositis may occure alone or as _______ (plus what s/s)
Dermatomyositis may be a paraneoplastic syndrome
s/s: proximal muscle weakness, inflamitroy skin findings
Which clotting factors does the liver make
2, 7, 9, 10
*these become activated by Vitamin K
What is wrong if is you have a bleeder with liver disease, you give Vitamin K, and nothing improves
if Prothrombin time does not correct with vit k, Factor 7 is likely deficient (has the shortest half life)
What is wrong in Polycythemia Vera
JAK2 Mutation- a non receptor cytoplasmic TK
What disease have a JAK2 mutation
Thrombocytopenia
Primary Mylofibrosis
PCV
How do you reverse Methotrextae poisoining
Folinic Acid (leukorvian) Does not require the DHFR that methotrexate inhibits - it is already reduced
How is G6PD inheritied?
X linked
Causes hemolytic anemia under oxidative stress
What is the most common brain cancer in children
Pilocytic Astrocytoma (astrocyte- cystic and soild) > Meduloblastoma (solid and malignant) > Ependymoma (ventricle lining)
This drug is a good “antagonist” to supress pretty much any excess hormone
Octerotide- Somatostain anaolog- encourages somatostaisis
What part of the bone has decresed density in osteomalacia
Osteoid
Abnormal formation of lamellar bone
Paget Disease of bone
What direction does DNA replication occure
5’–> 3’
What are the symptoms of Multiple Myeloma
Bone pain Fatigue Anemia Kidney Disease Hypercalcemia
What does mutiple Myeloma make a lot of
Large amounts of light chains (like IgG) that like to deposit in tissue
What is the most common primary brain tumor of adults
Glioblastoma Multiforme
Very malig, poor prognosis
Lots of necrosis and hemmorhage
What are the clasical lab findings of mutiple mylemoa
Roulaeux Formation
Bence Jones protein in urine
What does the RB protein do
Tumor Supresor
Keeps G1–> S checkpoint = Activated RB stops the progression
Phosphorylated RB allows Cell through the checkpoint
This disease is a triad of eczema, thrombocytopenia, and combo B/T cell deficiency
Wiscot Aldrich
* Encapsulated infections happen frequently
What are the s/s of lead poisoining
BASOPHILIC STIPPLING
AB PAIN
weakness
constipation
Pancytopenia with acellular bone marrow with tons of fat is likely what?
Aplastic Anemia
Usually Aquired- T cell vs progenitors
Who gets warfrin indused skin necrosis
People who have an underlying Protein C or Protein S deficincy
What chemo causes hemorrhagic cyctitis and how do you prevent that outcome
Cyclophosfomide= chemo Mensa= Binds toxic metabolites
What does ATRA treat
Atra= Vit A = Acute Promyelocytic Leukemia, a type of AML
What random drug increases factor 7 and VWF
Desmopressin
