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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
ITP with platelet >20,000
no treatment
26
heinz bodies
G6PD deficiency
27
inheritance of G6PD deficiency
XLR
28
mechanism of TTP
inhibition of ADAMTS13 which usually breaks down clots so microthrombi end up circulating
29
lab findings of DIC
``` elevated PT/PTT increased bleeding time decreased fibrinogen increased fibrin split products thrombocytopenia schistocytes ```
30
management of DIC
- 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
four indications for exchange transfusion in sickle cell disease
1. stroke 2. priapism 3. lung infection 4. retinal infarction
32
management of ITP
Plt < 20,000/µL-> corticosteroid | Plt<20K + bleeding- IVIG + steroids
33
lab abnormalities in factor IX defic
prolonged PT and PTT
34
heinz bodies/bite cells on smear
G6PD deficiency
35
inheritance of G6PD defic
XLR
36
how to minimize damage from TACO
give lasix between blood
37
new acute lung injury or ARDS within 6 hours of blood transfusion
TRALI
38
should platelets be given in TTP
no- will cause rapid deterioration
39
pentad of TTP
fever, anemia, thrombocytopenia, renal failure, neuro disorder
40
inheritance of von willebrand disease
AD
41
how do hematocrit levels change in hypothermic patients
2% increase in hematocrit for every 1 degree drop in temp
42
what factors are included in kcentra (4 factor PCC)
II, VII, IX, X, protein C/S
43
what factor is deficient in hemophilia C
factor XI
44
coags in hemophilia A
prolonged PTT
45
inheritance of hemophilia A
XLR
46
what are the vitamin K dependent clotting factors
II, VII, IX, X, and proteins C and S
47
MC hematologic abnormality seen in chronic alcoholism
macrocytosis
48
most common benign bone tumor
osteochondroma
49
MC malignant bone tumor in children
osteosarcoma
50
"onion skinning"periosteal reaction in kid bone XR
ewing's scarcoma
51
MC organism that causes osteo in sickle cell disease
salmonella, s. aureus
52
treatment of menorrhagia in von willebrand's disease
OCPs
53
Hemophilia b deficiency
Factor IX`
54
Inheritance of hemophilia b
X linked recessive
55
pulmonary edema from tumor lysis syndrome- treatment
plasmapharesis
56
Lowest neutrophil count after chemo
5 to 10 days after chemo
57
Inheritance of G6PD
X linked
58
Thrombocytopenia with multiple abortions
Antiphospholipid syndrome
59
Skin findings chronic, violaceous, raised plaques and nodules commonly found on the cheeks, nose, and around the eyes- pathognomic for what
Lupus pernio- sarcoidosis
60
Noncaseating granulomas
Sarcoidosis
61
How long should cpr continue after administration of lytics
20 minutes
62
describe findings in multiple myeloma
hypercalcemia renal insufficiency anemia lytic bone lesions/back pain
63
peripheral blood smear in MM
rouleax formation
64
malignant neoplasm of plasma cells
multiple myeloma
65
MC skeletal abnormality found in MM
osteoporosis
66
Measure of deviation in the volume of RBCs
RDW
67
Measure of hemoglobin content in an RBC
mean corpuscular hemoglobin
68
RDW in iron deficiency
Increased
69
RDW in thalassemia
Decreased
70
What red blood cell disorder has a characteristic increase in mean corpuscular hemoglobin concentration
Spherocytosis
71
Increase TIBC and decreased ferritin
Iron deficiency anemia
72
Mc hereditary cause of anemia
Fanconi anemia
73
medications that cause neutropenia
macrolides, antithyroid meds, procainamide
74
how does methylene blue work
reduces Fe3+ to Fe2+

Rosh Review (17 decks)

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