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Step 1 > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

Dark urine in the morning that improves throughout the day, + sucrose test

A

PNH

  • precipitated by iron, vaccines, infections
  • Inc COMPLEMENT destruction d/t impaired GPI anchor
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2
Q

Osmotic fragility test +

A

Hereditary spherocytosis

  • spectrin, ankyrin gene
  • aplastic crisis
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3
Q

Cigar-shaped RBCs

A

Hereditary elliptiocytosis

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4
Q

+ coombs, normocytic anemia

A

Auto-immune hemolytic anemia

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5
Q

Back pain with hemoglobinuria a few days later, Heinz bodies, Bite cells

A

G6PD deficiency

- sulfas, anti-malarials, fava beans

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6
Q

Burr cells/echinocytes/acanthocytes

A

Pyruvate kinase deficiency

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7
Q

Babesia DOCs

A

Quinine

Clindamycin

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8
Q

Metabolite of cyclophosphamide responsible for hemmorrhagic cystitis

A

Acrolein

- mercaptoethansulfate (mensa) binds this

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9
Q

Drug used in 9:22 translocation leukemia

A

Imatinib used in CML

- Inhibits TK activity from BCR-ABL fusion

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10
Q

Inc TIBC

Dec, ferritin, Serum Fe, % sat, free protoporphyrin

A

Iron deficiency anemia

- Duodenctomy, Breast fed, Ulcers, Pregnancy, Polyps, Hookworm

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11
Q

Inc Ferritin, protoporphyrin

Dec TIBC, Serum Fe, % sat

A

Anemia of chronic disease

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12
Q

Iron-laden mitochondria
Inc Ferritin, Serum Iron % Sat
Dec TIBC

A

Sideroblastic anemia

  • aminolevulinic acid synthase deficiency (ALAS)
  • alcohol, lead, B6 deficiency
  • Tx = pyridoxine (B6)
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13
Q

Pale line on gingiva, basophilic stippling of RBCs, abdominal colic, siderblastic anemia

A

Lead poisoning

  • Inhibits ferrochelatase & ALA dehydratase
  • Tx = Dimercaprol + EDTA
  • Kids = Succimer
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14
Q

Alpha-Thal

A

1-2 deletions = no Sx

3 deletions = HbH (B4)

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15
Q

B-Thal Minor (B/B+)

A

Usually ASx

HbA2 >3.5%

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16
Q

B-Thal Major (B0/B0)

A

ABSENT B chain –> (a2, y2)

  • Ineffective erythoporesis
  • Erythroid hyperplasia –> crew cut, chipmunk facies
  • Extramedullar hematopoesis –> nucleated RBCs
  • Aplastic crisis
  • No HbA, inc HbA2, HbF
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17
Q

Anemia w/ >3% corrected Retic count, inc LDH, inc unconjugated bilirubin & jaundice, no hemoglobinuria, bile stones, splenomegaly

A

Extravascular hemolysis

  • Spherocytosis
  • Sickle Cell
  • Pyruvate kinase
  • HbC
  • G6PD
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18
Q

Anemia w/ >3% corrected Retic count, inc LDH, dec haptoglobin, hemoglobinuria

A

Intravascular hemolysis

  • PNH
  • G6PD
  • Immune hemolytic
  • Microangiopathic
  • Malaria
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19
Q

Howell-Jolly bodies

A

Hereditary spherocytosis after splenectomy

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20
Q

HbC defect

A

Glut –> Lysine

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21
Q

Sickle Cell defect

A

Glut –> Valine

  • Low O2, or dehydration –> inc sickling
  • Extramedullary hematopoesis
  • AUTOSPLENECTOMY
  • dactylitis in kids
  • HU –> inc HbF
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22
Q

SLE CLL, methyldopa, warm IgG anemia, Coombs +

A

Warm agglutinin auto-immune hemolytic anemia

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23
Q

Triggered by cold, mycoplasma, Mono, CLL, IgM, Coombs +

A

Cold agglutinin auto-immune hemolytic anemia

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24
Q

Helmet cells on blood smear (schistocytes)

A

Microangiopathic

- DIC, TTP-HUS, SLE, HTN, prosthetic valves

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25
Q

Dec TIBC

A

Hemochromatosis

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26
Q

Urine that turns tea color when exposed to light

A

PCT

- Uroporphyrinogen decarboxylase

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27
Q

Painful abdomen, Red-wine colored urine, polyneuropathy, psych disturbances

A

Acute intermittent porphyria

- Defect in porphobilinogen deminase

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28
Q

Dec GP1b

A

Bernard-Soulier

- can’t bind vXF

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29
Q

Dec GPIIb/IIIa

A

Glansmann’s

- Defect in platelet-platelet

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30
Q

Anti-GPIIb/IIIa Abs

A

Idiopathic thrombocytopenic purpura

- platelet-AB complex consumed by MO

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31
Q

ADAMTS 13 deficiency

A 
Thrombocytopenic purpura (TTP)
- LARGE vWF multimers --> thrombosis
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32
Q

Most common inherited bleeding disorder

A

vWF disease

- Tx = DDAVP

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33
Q

Most common inherited hypercoagulability

A

Factor V Leiden

- Can’t be degraded by protein C

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34
Q

Reed-sternberg cells (bilobed nuclei w/ prominent nucleoli surrounded by clear cytoplasm)

A

Hodgkin lymphoma

  • CD15, 30+
  • CD20 -
  • Tx = brentuximab (CD30 Ab)
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35
Q

Young female, bands of sclerosis, lacunar cells, enlarging LN

A

Nodular sclerosing HL

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36
Q

Best prognosis HL

A

Lymphocyte rich

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37
Q

Worst prognosis HL

A

Lymphocyte depleted

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38
Q

(8;14) c-myc, starry sky

A

Burkitt’s

  • CD20+
  • EBV
  • africa = Jaw
  • sporadic = abdomen
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39
Q

Most common adult NHL

A

Diffuse

40
Q

(11;14) cyclin D, CD23-

A

Mantle cell

- Cyclin promotes G1–>S

41
Q

(14;18) bcl-2, CD10+, CD5-

A

Follicular

  • prevents apoptosis
  • Tx = Rituximab CD20 Ab
42
Q

CD20+, assoc w/ auto-immune diseases/chronic inflammatory - Hasimoto’s, Sjogren, H. pylori

A

Marginal zone

- MALTOMA - H. pylori

43
Q

Most common primary malignancy of bone

A

Multiple myeloma

44
Q

High IL-6, bone pain w/ hyperCa, M-spike of IgG on SPEP, Rouleaux formation, clock-face chromatin

A

Multiple myeloma

  • Bence-Jones proteins –> renal failure
  • Light chain amyloidosis
  • M-spike = IgG or IgA
  • Lytic bone lesions
45
Q

Bence-Jones Proteins

A

Multiple myeloma

46
Q

M-spike w/ IgM, retinal hemorrhage, papilledema, bleeding from nose and gums, no lytic bone lesions or renal impairment, HA

A

Waldenstroms
- Tx = plasmaphoresis

MGUS = Asx + <10% plasma cells on BM Bx

47
Q 
10 y/o w/ infections, fatigue, bone pain, petechiae, bleeding
Down >5
CNS, testicular, LA
Tdt +
(9;22) 
Lymphoblasts
A

ALL

  • B-type most common
  • CALLA Ag
48
Q 
65 y/o
Down <5
Auer rods
MPO & Sudan black stains
Myeloblasts
(15;17)
A

AML

  • M3 = ATRA, Auer rods –> DIC, 15;17
  • M5 = no MPO, GUMS
  • M7 = Down <5
49
Q

Auer rods

A

AML

50
Q

(9;22)

A

CML & ALL

51
Q

(11;22)

A

Ewing sarcoma

52
Q

(15;17)

A

M3 type of AML (all trans retinoid acid)

53
Q

T-ALL

A 
Tdt
CD2, 8
NO CD10
Thymic mass
Teens (remember all the Ts)
54
Q

CD5, CD20, CD23+
Smudge cells
>60 y/o

A

CLL

55
Q

Stains with tartrate resistant acid phosphatase, splenomegaly, dry bone aspirate, fried egg appearance

A

Hairy cell leukemia

  • All the TRAPs
  • Tx = 2-CDA
56
Q

Cerebriform nuclei, CD4 and CD3 cell aggregate in epidermis (Pautrier microabscesses)

A

Mycosis fungiodes

57
Q

30-60
(9;22) bcr-abl
(-) Leukocyte alkaline phosphatase

A

CML

  • Tx = imatinib (TK inhibitor for bcl-abl)
  • 2/3 –> AML
  • 1/3 –> ALL
58
Q

Myeloproliferative disorders assoc w/ JAK mutations

A

Polycythemia
Thrombocytosis
Myelofibrosis - tear-drop cell

59
Q

Heparin

A

Activates AT-III

Ok for preggers

60
Q

Enoxaparin

A

LMW

  • more predictable, low HIT
  • selective Xa inhibitor
61
Q

Direct thrombin inhibitors

A

Lepirudin

Bivalrudin

62
Q

Fondaparinux

A

Binds only AT-III

DVT prophylaxis*

63
Q

Clopidogrel, ticlopidine

A

Block ADP receptors –> inhibit platelet aggregation

Ticlopidine –> neutropenia

64
Q

Cilostazol, dipyridamole

A

PDE III- inhibitor –> inc cAMP –> inhibits platelet aggregation

Used for claudication, prevention of stroke

65
Q

Abciximab

A

GPIIb/IIIa inhibitor

66
Q

Inhibits M-phase

A

Vinca alkyoids & paclitaxol

67
Q

Bind tubulin preventing spindle formation

A

Colchicine, Vincristine, Vinblastine

- Block polymerization in M-phase

68
Q

Bind microtubules preventing DEploymerization

A

Paclitaxel

69
Q

Inhibits topoisomerase

A

Etoposide

70
Q

Alkylating agents

A

Cisplatin

71
Q

DNA intercalators

A

Dactinomycin

Doxorubicin

72
Q

Inhibits thymidylate synthase

A

MTX

5-FU

73
Q

Dec purine synthesis

A

6-MP

  • Inc toxicity w/ allopurinol
  • 6-TG ok w/ allopurinol
74
Q

MTX antidote for myelosuppression

A

Leucovorin (folinic acid)

75
Q

Used for kids tumors

A

ACTinomycin D - intercalates

76
Q

DNA intercalator assoc w/ cardiotoxicity

A

Dox and danrubicin

77
Q

Used in brain tumors

A

Nitroureas - carmustin, lomustine, semustine

Croses BBB

78
Q

Inhibits cycophilin to inhibit T-cell activiation

A

Cyclosporine

79
Q

Inhibits immunophilin FKBP

A

Tacrolimus

80
Q

Inhibits FKBP-12, m-TOR, T-cell response

A

Sacrolimus

81
Q

Inhibits CD52 in lymphoma

A

Alemtuzumab

82
Q

Inhibits VEGF in Colorectal cancer

A

Bevacizumab

83
Q

Inhibits CD33 in AML

A

Gemtuximab

84
Q

Inhibits EGFR in colorectal cancer

A

Cetuximab

85
Q

Drugs cause peripheral neuropathy, BM suppression

A

Vincristine

VinBlastine = BM

86
Q

Drugs cause nephro and ototoxicity

A

Cisplatin, carboplatin

87
Q

Drug specific for S-phase inhibit RnR

A

HU

88
Q

Monclonal Ab to HER-2/neu

A

Traztuzumab

89
Q

Dapsone

A

Inhibits dihydropteroate synthase
Used for Malaria, Toxo, M. leprae
can –> hemolysis in G6PD

90
Q

Hyperproliferation of megakaryocytes, thrombocytosis,

A

Essential thrombocytosis

  • JAK2 mutation
  • Tx = aspirin
91
Q

VTs and skin necrosis w/ warfarin use

A

Protein C deficiency

92
Q

Inc Hct, WBCs, platelets

Vertigo, HA, tinnitus, thrombosis, gout, digital ischemia, CVA/MI/DVT/PEs, PRURITIS AFTER SHOWER, Erythromelagia

A
  • Polycythemia vera*
  • JAK2 mutation
  • Erythromelagia = red burning extremities relived by cold and aspirin
93
Q

Splenomegaly, mild anemia, dry bone marrow aspirate, tear-drop cell

A

Myelofibrosis

  • JAK2 mutation
  • Fibrosis of BM
94
Q

Pt being treated for CML has developed pulmonary fibrosis and hematuria is most likely on what drug?

A

Busulfan

- Alkylating agent –> N7 of guanosine

95
Q

Functions to bind factor VIII and prevent degradation by protein C, deficiency presents with excessive epistaxis, menorrhagia

A

vWF disease

- Tx = DDAVP –> retains water –> hypoNa, K

96
Q

Anaphylaxis after blood transfusion

A

IgA deficiency

97
Q

7 y/o w/ short stature, cafe au lati, short thumb, pancytopenia

A

Fanconi anemia

- DNA repair genes

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