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UWORLD Notecards > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

name the important neutrophil chemotactic agents

A 
C5a
IL-8
LTB4
kvllikrein
platelet-activating factor
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2
Q

lipid A from bacterial LPS binds what on macrophages to induce septic shock

A

CD 14

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3
Q

what causes eosinophilia

A 
Neoplasm
Asthma
Allergic RXN
Chronic adrenal insufficniey
parasites
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4
Q

what lymphocyte mediate cell immunity

A

T cells

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5
Q

what lymphocyte mediates humoral immune response

A

b cells

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6
Q

cell wth clock face chromatin distribution and eccentric nucleus with well developed golgi

A

plasma cell

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7
Q

what makes oxidized vitamin k into reduced vitamin k so it can activate the coagulation factors

A

epoxide reductase

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8
Q

antithrombin inhibits wha factors

A 
2
7
9
10
11
12
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9
Q

inhibit ADP induced expression of GpIIb/IIIa

A

Ticlopidine
clopidogrel
Prasugrel

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10
Q

inhibit GpIIb/IIIa directly

A

Abciximab, Eptifibatide, Tirofiban

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11
Q

what activates vWF to bind to GpIb

A

Ristocetin

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12
Q

spur cells are seen in

A

Abetalipoproteinemia and Liver disease

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13
Q

what test tests for autoimmune hemolytic anemia because the body produces AB to RBC

A

direct coombs test

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14
Q

a test that detects antibodies to RBC unbound in the patients serum. used in pregnant women and before blood transfusions

A

indirect coombs test

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15
Q

cis deletion of alpha globulin in alpha thalassemia means what

A

deletions are on the same chromosome

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16
Q

cis deletion of A thalamseima is seen in

A

Asians

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17
Q

trans deletion of A thalassemia is seen in

A

Black people

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18
Q

b thalesemia is present in what people

A

mediteraniean

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19
Q

what is protective against major beta thalassemia

A

HbF until 6 months

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20
Q

b thalassemia major patients have an increased chance of what problem

A

parvovirus B19 induced aplastic crisis

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21
Q

what is the chelation for lead poison used in children

A

Succimer

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22
Q

sideroblastic anemia has a defect in what

A

ALA synthase gene

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23
Q

treatment for sideroblastic anemia

A

ALA synthase or pyridoxine

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24
Q

historical test used to diagnose B12 def.

A

Schilling test ( tells if the problem is malabsorption or dietary insufficiency)

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25
Q

defect in UMP synthase that causes failure to thrive in children and megaloblastic anemia. No hyperammonemia is present

A

Orotic Aciduria

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26
Q

important physical symptom of Diamond Blackfan syndrome

A

triphalangeal thumb

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27
Q

haptoglobin are increased in what kind of hemolysis

A

extravascular hemolysis

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28
Q

haptoglobin are decreases in what kind of hemolysis

A

intravascular hemolysis ( paroxysmal nocturnal hemoglobunbria)

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29
Q

hemolytic anemia of the newborn because of decreased levels of ATP is seen because of

A

Pyruvate kinase deficiency

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30
Q

what is the terminal complement inhibitor that treats Paroxysmal Nocturnal Hemoglobinuria

A

Eculizumab

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31
Q

Cold IGM complement induced autoimmune hemolytic anemia can be caused by

A

Mycoplasma Pneumonia
Mono
Cll

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32
Q

acute intermittent porphyria is caused by a deficiency in what

A

porphobilinogen deaminase

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33
Q

porphyria cutanea tarde is a deficiency in what

A

uroprphyrinogen decarboxylase

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34
Q

what usually cause HUS in children

A

SHiga toxin producing E. Coli (O157:H7)

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35
Q

skin necrosis and hemorrhage after administration of warfarin is seen when

A

there is protein C and S deficiency

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36
Q

what should be given if you want to replace coagulation factors fibrinogen and factor 8

A

cryopercipitate

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37
Q

8:14t

A

burritos

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38
Q

14:18 t

A

follicular lymphoma

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39
Q

11:14 t

A

mantle cell lymphoma

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40
Q

starry sky appearance of lymphocytes associated with EBV and a jaw lesion in the african type

A

Burritos lymphoma

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41
Q

most common type of non hodgkin lymphoma in adults

A

diffuse large b cell lymphoma

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42
Q

waxing, winning lymphadenopathy lymphoma

A

follicular lymphoma

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43
Q

verry aggressive with patients mainly presenting in the alter stages lymphoma

A

mantel cell lymphoma

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44
Q

AIDS defining illness that needs to be differentiated from toxoplasma

A

primary central nervous system lymphoma

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45
Q

associated with IV drug abuse which presents with cutneoys lesions and lytic bone lesions and hypercalcemia

A

adult t cell lymphioma

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46
Q

skin patches are seen with atypical CD4 cells with cerebriform nuclei which may progress to Sezary Syndrome

A

Mycosis Fungicides

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47
Q

hyper viscosity syndrome associated with an Mspike and Raynaud phenomenon

A

Waldenstrom Macroglobulinemia

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48
Q

bone lytic lesions, anemia, renal involvement and hypercalcemia

A

multiple myeloma

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49
Q

monoclonal plasma cell expansions that is asymptomatic that could lead to multiple myeloma

A

MGUS

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50
Q

neutrophils with bilobed nuclei usually seen after chemo

A

Pseudo-Pelter Huet Anomaly

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51
Q

what is the ALL with a better prognosis

A

12:21

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52
Q

t cell All can present how

A

like a mediastinal mass like in SVC syndrome

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53
Q

when SLL/CLL progresses into aggressive diffuse large be cell lymphoma

A

Richter Transformation

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54
Q

marrow fibrosis that causes dry tap on aspiration and spleenomegaly

A

hairy cell leukemia

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55
Q

hairy cell leukemia stains with what

A

TRAP

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56
Q

tx for hair cell leukemia

A

pentostatin

cladribine

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57
Q

AML that responds t retinoid acid

A

15:17

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58
Q

philadelphia chromsome 9:22 BCR-ABL represent

A

CML

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59
Q

what is Imatinib

A

BCR-ABL tyrosine kinase inhibitor that treats CML

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60
Q

lytic bone lesions in kids with skin rash and recurrent otits media . a mass involving the mastoid bone

A

Langerhans cell histocytosis

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61
Q

what is characteristic on the EM of langerhans cell histocytosis

A

tennis rackets, Birbeck granules

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62
Q

when is there a decrease in EPO seen in a polycythemia

A

vera

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63
Q

innaprpriate absolute polycythemia its seen when

A

there is ectopic EPO secretion (renal cell carcinoma)

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64
Q

when is there appropriate absolute polycythemia

A

high altitude

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65
Q

when is there relative polycythemia

A

dehydration and burns

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66
Q

name the two LMW heparin

A

Enoxaparin

Dalteparin

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67
Q

What kind of virus is parvovirus b 19

A

Non envelopes single stranded DNA

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68
Q

What kind of virus is EBV

A

Envelopes double stranded Dna

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69
Q

What kind off virus is hep c

A

Envelopes single stranded positive sense rna

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70
Q

What kind of virus is hep e

A

Non envelopes single stranded positive sense RNA

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71
Q

What kind of virus is HIV

A

Enveloped single stranded positive sense RNA

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72
Q

What kind of virus is parvovirus b 19

A

Non envelopes single stranded DNA

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73
Q

What kind of virus is EBV

A

Envelopes double stranded Dna

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74
Q

What kind off virus is hep c

A

Envelopes single stranded positive sense rna

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75
Q

What kind of virus is hep e

A

Non envelopes single stranded positive sense RNA

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76
Q

What kind of virus is HIV

A

Enveloped single stranded positive sense RNA

77
Q

In mono there is hyperplasia of what part of the lymph node

A

Paracortex (t cell)

78
Q

Peri arterial lymphatic sheath is the part that is distended when

A

There is a T cell infection like mono ( this is the area of T cells)

79
Q

What does mono spot test detect

A

IgM Heterophile antibodies

80
Q

name the six protooncogenes

A 
RAS
ABL 
HER2
EGFR
MYC
BRAF
81
Q

Name six tumor suppressor genes

A 
WT1
VHL
RB
Tp53
APC
BRCA
82
Q

protooncogene associated with hairy cell leukemia

A

BRAF

83
Q

what do the BRCA genes do

A

they repair breaks in DNA

84
Q

zinc containing enzymes that are used in wound healing and remodeling to break down collagen, laminin, and fibronectin

A

Metalloprotineases

85
Q

CD 55 is used for what? and is missing in what

A

it is used to inactivate complement and it is missing in Paroxysmal Nocturnal Hemoblobinguria

86
Q

hemolytic anemia, low haptons, pancytopenia and thrombosis of things like the mesenteric vein are associated with what disease

A

Paroxysmal Nocturnal Hemoglobinuria

87
Q

explain hemosiderosis seen in PNH

A

there is a continuous destruction of RBC which leads to free iron being deposited in the kidney

88
Q

cast nephropathy is seen in what disease

A

multiple myeloma

89
Q

what diseases cause osteolytic bone metastasis

A 
Multiple myeloma
non small cell lung cancer
non hodgkin lymphoma
renal cell carcinoma 
melanoma
90
Q

what diseases cause osteoblastic bone metastasis

A

prostate cancer
small cell lung cancer
hodgkin lymphoma

91
Q

cancer associated with high parathyroid hormone related peptide (PTH rP) and hypercalcemia as well as osteolytic bone metastasis

A

non small cell lung cancer

92
Q

diffuse medium sized lymphocytes and high proliferation index represented by the high Ki-67 fraction approaching 100% is seen in what disease

A

Burritk’s Lymphoma

93
Q

how can giving packed RBC to a patient who lost a lot of blood cause hypocalcemia

A

packed blood contains citrate which can chelate calcium and cause hypocalcemia (parathesias)
* usually seen after a massive transfusion

94
Q

what infections induces heterophil antibodies that react with antigens from animal RBCs (sheep-PaulBunnell test or horse - Monospot test)

A

EBV infections

95
Q

what are two malignancies that EBV is associated with

A

BurrKits lymphoma

Nasopharyngeal Carcinoma

96
Q

the absence of factor 8 and 9 won’t allow for the activation of factor 10 and subsequently won’t allow for the activation of prothrombin to thrombin so clots won’t be formed. What can you give to someone with hemophilia who won’t quit bleeding

A

thrombin

97
Q

what turns fibrinogen into fibrin, main part of a clot

A

thrombin

98
Q

waxing and waning lymphadenopathy are common in what cancer

A

follicular lymphoma

99
Q

what cells clonal expand because of EBV infected B cells

A

Cytotoxic T cells CD 8+

100
Q

CD14 is a marker for what

A

macrophages, this is where LPS binds to activate them

101
Q

decreased ferritin, increased transferrin and low MCV are seen in

A

IRON deficiency anemia

102
Q

RECAM-1 is used for

A

transmigration

103
Q

ICAM-1 is used for

A

tight adhesion

104
Q

Leukocyte Adhesion Deficiency type 1 is what

A

when there is an absence of CD 18 so that interns Mac-1 and LFA1 aren’t synthesized so there is no tight adhesion, crawling or trasnmigration

105
Q

symptoms of LAD 1

A

skin infections with no puss, delayed detachment of umbilical cord and poor wound healing

106
Q

small rings called trophozoites found on RBC is common in what disease

A

malaria p. falciparum

107
Q

main treatment for malaria

A

chloroquine

108
Q

treatment for malaria in chloroquine resistant areas

A

mefloquine

109
Q

ivermectin treats>

A

Onchocerciasis “River Blindness”

110
Q

Nifurtimox treats

A

Chagas Disease

111
Q

Pentamide is used for what

A

prophylaxis of Pneumocystis Jirovecii in HIV patients

- african sleeping sickness and leishmaniasis

112
Q

what is needed to kill P vivid and P oval liver hypnozoites

A

Primaquine

113
Q

most cases of HUS are preceded by what

A

diarrhea from Shiga toxin producing bacteria (Shigella and Ecoli 0157:H7)

114
Q

systemic autoimmune disease characterized by proximal muscle weakness resembling polio but with the additional inflammatory features that involved to skin

A

Dermatomyositis

115
Q

Gottronsq Papules and Heliotrope rash are seen in what disease

A

Dermatomyositis

116
Q

non enveloped single stranded DNA virus that can cause arthralgia in the hands, knees, wrist and feet without a rash

A

Parvovirus

117
Q

Why is haptoglobin decreased in hemolytic anemia due to prosthetic valves

A

Because haptoglobin binds to free hemoglobin and with the increased destruction of red blood cells, there is more free hemoglobin binding to the haptoglobin making the number of haptoglobin decease

118
Q

Repeated splenic infections seen in sickle cell disease makes what happen to the spleen

A

Fibrosis and atrophy

119
Q

Splenic sequestration can cause what to happen to the spleen

A

Splenic congestion

120
Q

Patients with sickle cell disease are lily to develop what because of high RBC turnover

A

Folic acid deficiency

121
Q

Parvovirus in a pregnant woman can cause what in the fetus

A

interruption of erythropoiesis causing profound anemia which causes CHF. This CHF causes pleural effusion, lung hypoplasia and ascites

122
Q

what kind of viruses are VZV, CMV and HSv

A

enveloped dsDNA

123
Q

what kind od virus is rubella

A

enveloped ss RNA

124
Q

What can VZV in a pregnant woman do to a fetus

A

cause limb hypoplasia

125
Q

indirect bilirubin is the same as

A

unconjugated billirubin

126
Q

what is the most specific red cell index for spherocytosis

A

increased mean corpuscular hemoglobin concentration

127
Q

what is caused by a defective binding of the red cell cytoskeleton to the plasma membrane due to mutations involving ankyrin, band 3 and spectrum proteins

A

hereditary spherocytosis

128
Q

pappenheimer bodies in RBCS are associates with what

A

sideroblastic anemia

129
Q

increased osmotic fragility on acidified glycerol lysis test ( hemoglobin is released when the patients RBC are incubated with glycerol) is seen in

A

hereditary sphereocytosis

130
Q

pigmented gallstones are a complication of what

A

hemolytic anemia like in hereditary spherocytosis

131
Q

two factors that drive angiogensesis

A

VEGF

FGF

132
Q

what can interferon-y do

A

INDIRECTLY PROMOTE neovascularization by activating macrophages (these release VEGF)

133
Q

benzene is found in what

A

gasoline and tobacco smoke

134
Q

what disease affects erythrocyte precursors and causes red cell aplasia ( anapestic crisis) in patients who already have a preexisting blood disease like nickel cell, or hereditary spherocytosis

A

Parvovirus B19

135
Q

neuroblastoma has an over expression of what marker

A

n-myc

136
Q

what is the function of the c-myc gene

A

transcription activation which controls cell proliferation, differentiation and apoptosis

137
Q

cyclin D1 promotes what

A

g1–> s phase

138
Q

what gives the toughness and rigidity to keratin protein

A

the disulfide bonds between the cysteine molecules

139
Q

what gives keratin its small structure and ability to coil tightly and form many hydrogen bonds

A

alanine and glycine molecules

140
Q

what are the two markers used for neuroendocrine tumors

A

Chromogranin A and neuron specific enolase

141
Q

what is the intermediate filament seen in mesenchymal tissue

A

vimentin

142
Q

what pathology is associated with an inversion of the short arm of chromosome 2 that creates a fusion gene between EML4 ( echinoderm microtubule associated protein like 4) and ALK ( analytic lymphoma kinase) that causes active tyrosine kinase that causes malignancy

A

non small cell lung cancer

143
Q

treatment for the EML4-ALK fusion protein that causes malignancy in non small cell lung cancer

A

Crizotinib (tyrosine kinase inhibitor)

144
Q

EML4-ALK non small cell lung cancer pathophysiology is the most similar to what cancer

A

CML ( it is also a fusion protein)

145
Q

hemolytic anemia that presents after the administration of TMP-SMX is usually due to what disease

A

G6PD deficiency

146
Q

increased vulnerability od RBC to oxidative stress manifesting as hemolytic anemia that is induced by

  • infection
  • drugs ( bacterium, dapsone, antimalarials, nitrofurantoin)
  • fava beans
A

G6PDD

147
Q

x linked disorders mainly seen in men in which presides of oxidative stress cause extra/intravascualr hemolysis. Haptoglobin are low and urine is dark read. Fave bean, and sulfa drugs canc cause this

A

G6PD D

148
Q

what should be checked before administering dapsone so that you do not cause hemolytic anemia in your patient

A

G6PD levels

149
Q

how does peripheral tolerance occur

A

by T cell anergy ( inactivation of t cells that react to self)

150
Q

central tolerance happens where

A

in the fetal thymus during negative selction

151
Q

where does isotoype switching of b cell occurs ( when they switch from IgM to something else by making antibodies)

A

in the germinal centers in the lymph nodes

152
Q

interaction of the CD40 receptor on B cells and the CD40 ligand on activated T cells cause what

A

isotope switching

153
Q

where are heterophiles antibodies found

A

in patients with EBV mono

154
Q

when are ringed sideroblast found

A

in myelodysplastic syndrome

155
Q

the hEr2 oncogene encodes for what

A

185-kD transmembrane glycoprotein that has intracellular tyrosine kinase activity

156
Q

toll like receptors release what

A

cytokines

157
Q

what is clathrin

A

an intracellular cytosolic protein the mediated endocytosis

158
Q

autoimmune destruction of platelets by anti platelet antibodies likely IgG agains GpIIb/IIIa

A

Immune thrombocytopenia purpura

159
Q

main clue for immune thrombocytopenia purport

A

isolated thrombocytopenia

160
Q

small lymphoid cells with increased nuclei to cytoplasmic ration and cleaved nuclei are seen in what cancer

A

follicular lymphoma

161
Q

what is the disease that presents as a benign leukocytosis that happens in response to an underlying condition like infection, hemorrhage, malignancy or acute hemolyisi.

A

Leukemiod reaction

162
Q

Dhole bodies are basophilic granules inside of neutrophils seen in

A

leukemiod reaction

163
Q

where dose positive selection happen

A

in the cortex of the thymus

164
Q

where does negative selection occur

A

in the medulla of the thymus

165
Q

interaction of the developing t cell with thyme medullary epithelial and dendritic cells in seen in

A

negative selection

166
Q

eczematous nipple lesion is associated with what kind of disease

A

pagets

167
Q

what causes black gall stone

A

chronic hemolysis

168
Q

what causes brown gall stones because of the release of microbial B-glucuronidases

A

biliary tract infection

169
Q

what are two things that the splenic red pulp is important for

A
  1. destroying aged RBCs

2. Clearing out circulating bacteria

170
Q

what are the three main encapsulated bacteria that can present as a problem for individuals with no spleen

A

Strep Pneumo
H. Influenza
N. Meningitides

171
Q

what causes macrophages and t cells to be activated in viral infected cells

A

interferon a and b

172
Q

pro carcinogens are metabolized by what

A

P450 monooxygenase

173
Q

what makes bilirubin into soluble bilirubin

A

glucuronide transferase

174
Q

PT prolongation seen in liver dysfunction is due to what

A

Factor 7 running out from the extrinsic pathway (shortest half life)

175
Q

pure red cell aplasia is associated with what?

A

thymic tumor (thymoma)

176
Q

MAIN MECHANISMS OF IONIZING RADIATION

A

double strand breaks in the DNA

free radical formation

177
Q

hypophosphorylated RB is what

A

active

178
Q

hyperphosphorylated RB is what

A

inactive

179
Q

explain the pathophysiology of Thrombotic Thrombocytopenia Purpura

A

there is a decrease in ADAM13 activity which causes a larger vWF multiuser that causes microvascular platelet rich thrombi

180
Q

name the clinic features of Thrombotic Thrombocytopneic Purpura

A

hemolytic anemia
low haptoglobin
thrombocytopenia
schistocytes

181
Q

how to manage TTP

A

plasma exchange

182
Q

what is the normal role of ADAM13

A

it cleaves vWF into smaller pieces so that clotting won’t occur

183
Q

IgA immune complex deposition and palpable purpura renal disease and arthritis

A

Hence Schonlein Puprpura

184
Q

frequent nose bleeds and HEAVY menstrual periods is a good sign of what disease

A

vWF deficiency

185
Q

deep tissue blessing into muscle and joints, g.i. bleeding is usually a sign of what disease

A

Factor 8 deficiency

186
Q

clot instability and recurrent bleeding after surgery is a sign of what disease

A

Factor 13 deficiency

187
Q

vWF is a protective carrier for what

A

factor 8

188
Q

vWF binds to what

A

collagen

189
Q

prolonged PTT and bleeding time is seen in what problem

A

vWF deficiency

UWORLD Notecards (32 decks)

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