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Rosh Review > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

elevated direct bilirubin is suggestive of

A

liver process that slows secretion of bilirubin into bile or bile into the intestine

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2
Q

elevated indirect bilirubin is suggestive of

A

increased hemolysis, decreased conjugation (gilbert)

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3
Q

treatment of von willebrand disease

A

desmopressin (DDAVP)

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4
Q

normal coags, prolonged bleeding from mucosal surfaces

A

von willebrand disease

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5
Q

MC inherited bleeding disorder

A

von willebrand disease

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6
Q

describe hyperacute transplant rejection

A

minutes to hours, irreversible, due to preformed abs

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7
Q

what mediates an acute transplant rejection

A

humoral/t-cell mediated

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8
Q

red cells in TTP

A

schistocytes

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9
Q

fibrinogen in DIC

A

decreased

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10
Q

treatment for TTP

A

supportive, plasma exchange, steroids

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11
Q

pathogenesis of DIC

A

thrombin excess

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12
Q

pathogenesis of TTP

A

endothelial defect

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13
Q

when is vancomycin added in neutropenic fever

A

suspected skin/soft tissue infect, pneumonia, catheter releated infection, hemodynamic instability

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14
Q

MC of infectious neutropenic fever

A

bacteria

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15
Q

fever in neutropenic fever

A

fever >100.9 once, fever >100.4 sustained for >1 hr

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16
Q

when is pt at greatest risk for neutropenic fever

A

7-14 days after chemo

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17
Q

leading cause of cancer death

A

infection

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18
Q

JAK2 mutation

A

polycythemia vera

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19
Q

mechanism of an acute hemolytic reaction

A

rapid hemolysis of donor red cells from host antibodies

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20
Q

management of acute hemolytic reaction

A

fluids, stop transfusion, diuretics to maintain UOP 1-2ml/kg/hr

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21
Q

immunocompromise, rash, pancytopenia, increased LFTs after blood transfusion

A

GVHD

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22
Q

management of supratherapeutic INR <10

A

omit next 1-2 doses and recheck INR

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23
Q

treatment of ITP with platelet <10,000

A

steroids and IVIG

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24
Q

treatment of ITP with platelet 10,000- 20,000 and avitce bleeding

A

steroids and IVIG

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25
Q

ITP with platelet >20,000

A

no treatment

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26
Q

heinz bodies

A

G6PD deficiency

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27
Q

inheritance of G6PD deficiency

A

XLR

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28
Q

mechanism of TTP

A

inhibition of ADAMTS13 which usually breaks down clots so microthrombi end up circulating

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29
Q

lab findings of DIC

A 
elevated PT/PTT
increased bleeding time
decreased fibrinogen 
increased fibrin split products 
thrombocytopenia
schistocytes
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30
Q

management of DIC

A
  • repleting the consumed clotting factors and platelets with fresh frozen plasma (for elevated PT or aPTT > 1.5 or fibrinogen < 100 mg/dL)
  • transfusing platelets (if < 50,000/mm3 and active bleeding)
  • Packed red blood cells should be given as needed to maintain adequate hemodynamics and tissue perfusion. -increased coagulation-> Heparin/LMWH
  • TXA (trauma)
31
Q

four indications for exchange transfusion in sickle cell disease

A
  1. stroke
  2. priapism
  3. lung infection
  4. retinal infarction
32
Q

management of ITP

A

Plt < 20,000/µL-> corticosteroid

Plt<20K + bleeding- IVIG + steroids

33
Q

lab abnormalities in factor IX defic

A

prolonged PT and PTT

34
Q

heinz bodies/bite cells on smear

A

G6PD deficiency

35
Q

inheritance of G6PD defic

A

XLR

36
Q

how to minimize damage from TACO

A

give lasix between blood

37
Q

new acute lung injury or ARDS within 6 hours of blood transfusion

A

TRALI

38
Q

should platelets be given in TTP

A

no- will cause rapid deterioration

39
Q

pentad of TTP

A

fever, anemia, thrombocytopenia, renal failure, neuro disorder

40
Q

inheritance of von willebrand disease

A

AD

41
Q

how do hematocrit levels change in hypothermic patients

A

2% increase in hematocrit for every 1 degree drop in temp

42
Q

what factors are included in kcentra (4 factor PCC)

A

II, VII, IX, X, protein C/S

43
Q

what factor is deficient in hemophilia C

A

factor XI

44
Q

coags in hemophilia A

A

prolonged PTT

45
Q

inheritance of hemophilia A

A

XLR

46
Q

what are the vitamin K dependent clotting factors

A

II, VII, IX, X, and proteins C and S

47
Q

MC hematologic abnormality seen in chronic alcoholism

A

macrocytosis

48
Q

most common benign bone tumor

A

osteochondroma

49
Q

MC malignant bone tumor in children

A

osteosarcoma

50
Q

“onion skinning”periosteal reaction in kid bone XR

A

ewing’s scarcoma

51
Q

MC organism that causes osteo in sickle cell disease

A

salmonella, s. aureus

52
Q

treatment of menorrhagia in von willebrand’s disease

A

OCPs

53
Q

Hemophilia b deficiency

A

Factor IX`

54
Q

Inheritance of hemophilia b

A

X linked recessive

55
Q

pulmonary edema from tumor lysis syndrome- treatment

A

plasmapharesis

56
Q

Lowest neutrophil count after chemo

A

5 to 10 days after chemo

57
Q

Inheritance of G6PD

A

X linked

58
Q

Thrombocytopenia with multiple abortions

A

Antiphospholipid syndrome

59
Q

Skin findings chronic, violaceous, raised plaques and nodules commonly found on the cheeks, nose, and around the eyes- pathognomic for what

A

Lupus pernio- sarcoidosis

60
Q

Noncaseating granulomas

A

Sarcoidosis

61
Q

How long should cpr continue after administration of lytics

A

20 minutes

62
Q

describe findings in multiple myeloma

A

hypercalcemia
renal insufficiency
anemia
lytic bone lesions/back pain

63
Q

peripheral blood smear in MM

A

rouleax formation

64
Q

malignant neoplasm of plasma cells

A

multiple myeloma

65
Q

MC skeletal abnormality found in MM

A

osteoporosis

66
Q

Measure of deviation in the volume of RBCs

A

RDW

67
Q

Measure of hemoglobin content in an RBC

A

mean corpuscular hemoglobin

68
Q

RDW in iron deficiency

A

Increased

69
Q

RDW in thalassemia

A

Decreased

70
Q

What red blood cell disorder has a characteristic increase in mean corpuscular hemoglobin concentration

A

Spherocytosis

71
Q

Increase TIBC and decreased ferritin

A

Iron deficiency anemia

72
Q

Mc hereditary cause of anemia

A

Fanconi anemia

73
Q

medications that cause neutropenia

A

macrolides, antithyroid meds, procainamide

74
Q

how does methylene blue work

A

reduces Fe3+ to Fe2+

Rosh Review (17 decks)

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