Heme/Onc/Lymph U WORLD Questions Flashcards by Lauren Walgren

new HA, intracranial mass, biopsy, age 60s, with areas of necrosis surrounded by columns of tumor cells, capillaries at the periphery =

this is the _____ primary brain neoplasm in adults

pathology feature

origin cell

glioblastoma multiforme

most common

pseudopalisading necrosis

astrocyte

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given several units of packed red blood cells, develop tingling and hypocalcemia due to ______chelation by ______ that is added to stored blood

calcium

citrate

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exposure status determined then followed during study =

exposure status determined after study =

prospective cohort

retrospective cohort

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dermatomyositis occurs during _____ and is characterized by proximal muscle weakness, heliotrope rash in periorbital and cheek region, and ____, which are erythematous plaques over the joints.

muscle biopsy will show

strong associated with lung, colorectal, and _____ cancers

malignancy

Gottron Papules

perimysial infiltrates

ovarian

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sickle cell anemia is autosomal _______ inheritance and can be confirmed by __________ electrophoresis. the abnormal hemoglobin is designated _____

recessive

hemoglobin

HbS

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radiation therapy induces DNA damage through ______ and formation of free radicals

DNA double strand breaks

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factors II, VII, IX, and X are _______ dependent coagulation factors synthesized in the _______. Factor _____ has the shortest half life. Failure of ________, which assess the extrinsic and common pathway of coagulation, to correct with vitamin K supplementation indicates ________ deficiency

Vitamin K

LIver

VII

Prothrombin time

VII

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______blotting is used to ID proteins. ________ blotting is used to ID RNA sequences. ______ blotting IDs specific DNA sequences in an unknown sample

Western

Northern

Southern

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dizziness, HA, pruritus after showering, ruddy complexion, splenomegaly =

increased platelets, RBC mass, and decreased EPO is due to increased bone marrow sensitiity to ____ which results in polycythemia _____, typically with mutation _____

normal platelet count, increased RBC mass, and increased EPO is usually due to an inappropriate _____ producing _____

incrased EPO and RBC mass in the presence of decreased SaO2 is a _______ response

polycythemia

Growth factors

vera

JAK2/V617F

EPO

Tumor

physiologic

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anemia, reticulocytosis, and increased indirect bilirubin indicates _______anemia. RBCs w/o central pallor are called_____, and can be acquired or hereditary. Hereditary _______ can be due to mutations involving ____, band 3, or ______, while acquired ______ is due to autoimmune disorder. Both of these will show an elevation in _________

hemolytic

spherocytes

spherocytosis

ankyrin, spectrin

spherocytosis

Mean corpuscular hemoglobin concentration MCHC

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HIV pol genes are responsible for _______ to antiretroviral therapy. Env gene mutations enable _____ from host neutralizing antibodies

acquired resistance

escape

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newborn w/ jaundice, hepatomegaly, edema, low hemoglobin, + direct Coombs, extramedullary hematopoeisis =

due to _______ antibodies developed during a prior _____ pregnancy which cause severe autoimmune hemolytic anemia and hydrops fetalis

erythroblastosis fetalis (Rh sensitization)

maternal anti RhD IgG

RhD+

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chemokine receptor ______ acts as a coreceptor that enables the HIV virus to ____ cells. HIV virus uses ___ as a primary receptor, and both _____ and ____ are bound to HIV viral outer envelope protein gp120

CCR5

enter

CD4

CD4 and CCR5

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fever, bleeding gums, sore throat, several myeloblasts with abundant _______ cytoplasm and a large number of coarse rod shaped intracytoplasmic granules called ____ rods that stain for ________ indicate _______ type M3

basophilic

Auer

peroxidase

AML

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all NSAID impair platelet aggregation except ____ which is a _____ selective inhibitor and has no side effects of bleeding and GI ulceration

Celecoxib

COX2

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mature erythrocytes lose their ability to synthesize heme when they ______ their ________

lose

mitochondria

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folate deficiency inhibits the synthesis of ______, which leads to defective ______ synthesis and megaloblastic anemia. THis can be overcome w/ _______ supplementation

deoxythymidine monophosphate (dTMP)

DNA

Thymidine

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tRNA that is mischarged with the incorrect amino acid will _________________ amino acid into the polypeptide chain

incorporate the wrong

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Neutrophils roll via the loose binding of ______ or _______ to L -selectin on neutrophils or ________ on endothelial cells

Neutrophils firmly attach to the endothelium (tight adhesion and crawling) via binding of ________ to _______ on enodthelial cells

Neutrophils migrate out of vasculature (transmigration) via attachment to _______

Sialyl Lewis X

PSGL1

E/P selectin

LFA-1

ICAM-1

PECAM-1

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chemotherapy induced emesis can be treated w/ _______ and _______ that act as 5HT3 receptor antagonists

Ondansetron

Granisetron

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mTOR pathway = binding of growth factor, autophosphorylation of _____ residues, activation of _______, activation of ______, then activation of _____ which translocates to the nucleus

tyrosine

PIP3

AKT

mTOR

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bone pain, fatigue, kidney disease, hypercalcemia, anemia is typical of ________ which is due to neoplastic B lymphocytes that mature into plasma cells and synthesize large amounts of ________. These plasma cells are susceptible to the effects of proteasome inhibitors such as ________, a boronic acid containing dipeptide

Multiple myeloma

Ig or Ig fragments

bortezomib

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a left shift on O2-Hbg dissociation curve can be caused by _________ (3) and indicates

a right shift can be caused by _____(3) and indicates

inc in pH, dec 2,3BPG, dec temp

O2 less available to tissues

dec in pH, inc 2,3BPG, inc temp

O2 more available to tissues

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Meningococcal meningitis that progresses to DIC results in _______ on peripheral blood smear, which are fragmented erythrocytes

schistocytes

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_______ can reverse the toxicity of methotrexate in non cancerous cells of the GI mucosa and bone marrow. This drug is also called ________

Leucovorin Folinic acid

6-MP is degraded by _____, which can be inhibited by ____. Both 6-MP and 6-thioguanine are prodrugs that require activation by _______

XO allopurinol HGPRT

hemolytic anemia due to medication induced oxidative stress is indicative of _______. Antimalarial drugs usually precede the hemolysis. Peripheral blood smear shows RBCs w/ ______, dark intracellular inclusions that stain w/ supravital stain. This disorder follows ______ recessive inheritance

G6PD deficiency Heinz bodies X linked

diffuse large B cell lymphoma is the most common type of NHL and is typically treated w/ ________, which act during the ______ phase of the cell cycle and can cause _______

vincristine, vinblastine M peripheral neuropathy (stocking and glove)

dysplasia is ____ change in epithelial cells, which CIS is _______, and invasive carcinoma shows

reversible irreversible invasion of basement membrane

fatigue, weak, conjuvtival pallor, decrease hemoglobin = bruising = high lipid content of bone marrow = all of which suggestive of ______, which will present w/ increased production of ________

anemia thrombocytopenia hematopoetic cell aplasia aplastic anemia EPO

+TdT, CD10, CD19 = +CD2-8, TdT, CD1a =

precursor B-ALL precursor T-ALL

anemia, megaloblastic anemia, neuro deficits = can be due to a ___diet

B12 deficient strict vegan

female, fatigue, hypochromic, microcytic anemia = bluish color on RBCs after treatment due to =

iron deficient anemia reticulocytosis (increased ribosomal RNA)

CD8 T cell mediated apoptosis results in rapid cell death due to activation of ______

caspases

SLE can present in women w/ arthralgias and decreased erythrocytes, leukocytes, and platelets. This is called ______

pancytopenia

HIV infection can cause reactivation of latent _____ and result in ________ lymphomas, including ______ lymphoma

EBV EBV induced Burkitt

aspirin is an NSAID that ________ inhibits _______ via acetylation

irreversibly COX 1 and 2

sickle cell can present with jaundice, lower back pain, extremity pain, and anemia. this results in ____ of the spleen due to repeated ________ infarcts

fibrosis and atrophy splenic

sickle cell patients have increased __________ requirements due to high RBC turnover. THis can result in ________ anemia as well

folic acid megaloblastic

industrial worker or child with weakness, cramping abdominal pain due to ________ peripheral blood smear will show physical exam will show

lead poisoning coarse basophilic stippling blue lead lines on teeth and gingiva

carbon monoxide poisoning will ______ carboxyhemoglobin, but will have no effect on _______

increase partial pressure oxygen methemoglobin

PCR requires knowledge of the nucleotide sequence of the regions ______ the target exon

flanking

three most common cancer incidence in women are _______ respectively three most common cancer death in women, respectively

Breast, Lung, colon Lung, breast, colon

kid w/ hemolytic anemia, jaundice, splenomegaly, spherocytes (lack central zone of pallor) =

hereditary spherocytosis

sickle cell anemia experiencing aplastic crisis is due to infection of erythroid progenitor cells with _____, which is a nonenveloped ________ virus

parvovirus B19 ssDNA

t(14;18) is associated w/ ______ overexpression and _____ lymphoma

BCL2 follicular

anti RhD Ig administered usually at _____weeks

erythematous itch breast rash w/ skin texture of orange peel = caused by cancerous cells ________ drainage

peu d orange, inflammatory breast cancer obstructing lymphatic

HbF is composed of 2 ____ units and 2 ____ units Adult hemoglobin is composed of 2 ____ and 2 _____

alpha gamma alpha beta

cutaneous lymph from the umbilicus down, including the anus below the dentate line, drain to the ________ lymph nodes exceptions are (2)

superficial inguinal glans penis posterior calf

t(15;17) is associated w/ ____ and is a translocation involving _______ and the PML gene often presents with fatigue, easy bruising, and _____

APML RARA gum bleeding

methemoglobinemia causes a dusky discoloration of the skin similar to _____ when patients are exposed to high levels of _______ in labs. The partial pressure of oxygen in these patients is

cyanosis nitrates unchanged

sickle cell patients are functionally _______, which increases risk for infection by __________ and ________, which are encapsulated. The most common cause of osteomyelitis in sickle cell patients is ______

asplenic Strep pneumo H influenza Salmonella

weakness, fatigue, loss of expression of gene coding for protein on basolateral surface of hepatocytes and enterocytes that interacts w/ transferrin receptor Disorder = protein = leads to = inc risk of developing =

primary hemochromatosis HFE protein, decreased hepcidin synthesis and DMT1 overexpression Iron overload liver cirrhosis and hepatocellular carcinoma

newborn with intracranial hemorrhage, "natural" newborn period, born on time w/o complications? diagnosis if Vitamin K prophylaxis had been given ?

Vitamin K deficiency = impaired clotting factor carboxylation abusive head trauma = subdural hemorrhage and ICB

monoclonal antibodies that block ______ and ______ help prevent T cell inhibition and promote T cell mediated destruction of tumor cells used in?

PD-1 and CTLA-4 advanced melanoma

patient presents with abdominal pain, low hemoglobin, platelets, inc bilirubin, inc lactate dehydrogenase, low haptoglobin, mesenteric vein thrombosis, absence of CD55 on RBC = gene = renal =

paroxysmal nocturnal hemoglobinuria (complement mediated hemolytic anemai) PIGA hemosiderosis due to iron deposition

hepatocellular carcinoma can be caused by Hepatitis B which is _____ virus, or Hepatitis C which is a ______ virus

DNA RNA

renal cortical cells sense _____ and release ____

hypoxia EPO

Rituximab is a monoclonal AB directed against the _____ antigen and used in aggressive lymphomas

CD20

the C1 complement molecule binds to the ____ region of the ______ Ig chain in the region near the hinge point Ig___ is a better activator of complement

Fc Heavy M

a reduced ability to relase oxygen within the peripheral tissues results in renal hypoxia and compensatory

erythrocytosis

family history of osteosarcomas, breast cancer, brain tumors, adrenal tumors, leukemias = gene

Li Fraumeni TP53, AD, TumorSuppressor

young, multiday history of nausea, constipation, severe, poorly localized abdominal pain, anxiety, difficulty concentrating, poor sleep, tingling of limbs, several similar episodes in past = exacerbated by: treated w/ due to downregulation of urine

acute, intermittent porphyria alcohol, drugs, or calorie restriction IV heme preparation Aminolevulinate synthase port wine colored, PBG, ALA +

the binding of oxygen to hemoglobin drives the release of ____ and ___ from hemoglobin, called the Haldane effect. High concentrations of CO2 and H+ in peripheral tissues facilitates ______ from hemoglobin, called the Bohr effect

H+ and CO2 oxygen unloading

spleen acts as a blood filter capable of removig circulating encapsulated pathogens such as (3)

Strep Pneumo H Influ N. Meningitidis

rate limiting enzyme in pentose phosphate pathway deficient = interconversion of ribose 5 - phosphate and fructose 6 phosphate is mediated by

G6PD no NADPH = hemolytic anemia transketolase

baby african american boy with painful swelling in hands and feet = due to lab value

dactylitis Sickle cell low haptoglobin

pneumonia + sepsis can result in ______ which is benign leukocytosis (>50,000). Peripheral blood smear will show _____ bodies, which are light blue (______) peripheral granules in neutrophils

leukemoid reaction Dohle basophilic

chemotherapy that leads to rapid lysis of neoplastic cells can result in = patients can be given ______ which protects normal organs by converting ______ into more soluble metabolites

tumor lysis syndrome rasburicase or allopurinol uric acid

the human mutli drug resistant gene ______ encodes for a _______ that is a transmembrane ATP dependent efflux pump and is responsible for preventing the action of various _________ agents

MDR1 glycoprotein chemo

heparin increases the effect of the naturally occurring anticoagulant ______ by binding it and is used for prophylaxis against _____ in nonambulatory post operative patients. This drug, in LMW form is called ____

antithrombin III DVT enoxaparin

patients bleed, coagulation cascade active, PT and PTT prolonged, low fibrinogen and increased FDP = not bleeding, only platelets activated, normal PT and PTT, normal fibrinogen increased partial thromboplastin time, everything else normal =

DIC (gram neg. rod infection) TTP- HUS (fever, neuro, acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia) vWF disease

high peak gamma globulin region on serum protein electrophoresis w/ M protein = presents w/

multiple myeloma anemia, lytic bone lesions, renal insufficiency, hypercalcemia, amyloid deposition

HbS aggregates in a _____ state, low ____, and high ______ state

deoxygenated pH 2.3 BPG

Mediterranean, mild anemia, microcytic, increased hemoglobin A2, hypochromia, poikilocytes (spherocytes + target cells), asymptomatic = caused by mutations in

beta thalassemia minor defective transcription, processing, and translation of betaglobin mRNA

young man, recurrent jaundice, pallor, icterus, mild splenomegaly no hepatomegaly or LAD, inc lactate dehydrogenase, low Hg, RBCs release hemoglobin in hypotonic solution w/ glycerol (osmotic fragility) = treatment? complications??

hereditary spherocytosis splenectomy pigmented gallstones, aplastic crises from parvovirus B19

CD4 virus CD21 virus Erythrocyte P antigen

HIV gp120 EBV gp 350 Parvovirus B19

glutamic acid to valine substition at position 6 in beta globin gene = missense mutation

sickle cell GAG to GTG in DNA strand

warfarin inhibits ______ which can lead to skin and fat necrosis seen in the first few days of warfarin therapy

protein C and S

high dose opioid treatments in metastatic cancer commonly require _______ and _____ in order to maintain bowel regularity

adequate fluid intake and daily laxatives

proliferation signals activate _____ which results in hyperphosphorylation of the _____ protein, inactivating it. When this protein is inactive, cells are allowed to transition from G1 to S, thus increasing activity of dihydrofolate reducatse and DNA polymerase

CDK4 Rb

new onset neurologic symptoms, hemolytic anemia w/ schistocytes, thrombocytopenia, acute kidney injury = deficiency of ____ leads to large uncleaved cWF multimers treat with

thrombotic thrombocytopenic purpura ADAMTS13 plasma exchange therapy

metalloproteinases are zinc containing enzymes that _____ the _______ of the basement membrane, allowing tumor cell invasion

degrade ECM

extramedullary hematopoiesis in a child causes a range of skeletal problems such as _______ and is due to ______ such as B thalassemia major

maxillary overgrowth (chipmunk facies) chronic hemolytic anemia

large, binucleated cells w/ an owls eye appearance are called _____ cells and are diagnostic of _____

Reed Steinberg Hodgkin lymphoma

excessive bruising since childhood with abnormal platelet aggregometry and a defect in platelet glycoprotein surface receptor = normally binds = inheritence treated w/

Glanzmann thrombasthenia fibrinogen AR defect in GP IIB/IIIa abciximab

isotype switching occurs in the ______ of lymph nodes and requires interaction of the _______ receptor on B cells with the ______ ligand on activated T cells

germinal centers CD40 CD40

hepcidin is synthesized by ________ and acts as the central regulator of _______ homeostasis

hepatic parenchymal cells iron

when the body mounts a response against _________, a bug that shares antigens with human erythrocytes, it also lyses RBCs, leading to anemia. These antibodies are called cold agglutinins. Once the _______ has faded, the anemia resolves

mycoplasma pneumoniae immune response

fatigue, fever, return from central Africa, multiple small rings in RBCs on Giemsa staining = multiple small rings called treatment of choice required for P. vivax and P ovale?

Plasmodium falciparum malaria trophozoites chloroquines: mefloquine for resistant bugs primaquine due to dormant liver forms

sudden onset abdominal pain, ascites, anemia, reticulocytosis, thrombocytopenia, CD55 and 59, DVT or HVT = gene = CD55 and 59 role

paroxysmal nocturnal hemoglobinuria PIGA complement inhibitors: disease due to complement activation

eczema, recurrent infections, thrombocytopenia with petechiae, purpura, epistaxis in a child, B and T lymphocyte deficiency = inheritance = susceptible to = treatment is =

Wiskott-Aldrich X linked encapsulated organisms HLA matched bone marrow transplant

mutation at RCC before AUG - methionine start codon leads to a block at

initiation of translation

Beta thalassemia results in ________ _________ anemia due to decrease beta globin chain synthesis. unpaired _____ chain precipitate within red cells and cause membrane ______, leading to extravascular hemolysis and ineffective erythropoiesis

microcytic anemia alpha damage

DVT, given a drug that increases PT and aPTT but does not effect thrombin time, what drugs (2)? Mechanism? drugs that prolong thrombin time?

apixaban, rivaroxaban direct factor Xa inhibitors unfractionated heparin, direct thrombin inhibitors (dabigatran)

______ is the mitochondrial enzyme that activates caspases and indirectly brings about cell death through intrinsic pathway apoptosis

cytochrome C

young african american boy, exertional dyspnea, acute chest syndrome, bone pain = mutation

sickle cell anemia point mutation : valine substituted for glutamic acid

chemotherapy, followed by progressive hematuria and suprapubic tenderness due to _______ causative agent is nitrogen mustards such as metabolized by the kidneys into prevented by

hemorrhagic cystitis cyclophosphamide, ifosfamide acrolein mesna and sulfhydrl compound

black pigmented stones with low cholesterol content arise from conditions that increase _________ in bile such as _______ in sickle cell, thalassemia, and hereditary spherocytosis

unconjugated bilirubin chronic hemolysis

the most common trigger for DIC in pregnancy is the release of _______ from an injured ________ into the maternal circulation. Presents with bleeding from incision sites, IV sites, and mucosal surfaces due to rapid consumption of clotting factors and platelets

Tissue Factor Placenta

the change in color of bruise from dark blue to greenish in color is caused by activity of what enzyme?

heme oxygenased: heme to biliverdin (green)

persistent, fluctuating LAD who may have had an unrelated pharyngitis treated with antibiotics on initial presentation most likely has translocation

follicular lymphoma t(14;18)

angiogenesis of a hepatic hemangioma is primarily driven by ______ and ______

VEGF and FGF2

pyruvate kinase deficiency causes ______ anemia, and splenic ______ results from increased work of the splenic parenchyma to remove the deformed RBCs from cirulation

hemolytic red pulp hyperplasia

night sweats, weight loss, cough, apical pulmonary granulomas = cells that cause lesions = surface marker

secondary tuberculosis macrophages CD14

fresh frozen plasma rapidly reverses ______ effects whereas vitamin K requires time for clotting factor re synthesis

warfarins

hydroxyurea increase _____ synthesis by an unknown mechanism and is used to treat _______ patients with frequent pain crises _______ channel blockers hinder the efflux of K and H2O from the cell, preventing ________ of RBCs and reducing polymerization of ______

HbF Sickle cell anemia Gardos dehydration HbS

different mRNA sizes, same gene, due to

alternative splicing

recurrent epigastric pain, hepatomegaly, macrocytic anemia, pancreatic calcifications = anemia is due to

chronic alcoholic pancreatitis diminished thymidine synthesis: megaloblastosis

carbon tetrachloride poisoning causes fatty change and hepatocyte necorsis via _____ injury

free radical

electrophoresis shows a single band that migrates less than HbA and HbS band in an African American boy with easy fatiguability: indicative of _____ that is caused by a ________ mutation that results in a glutamate residue being substituted by ______ in the beta globin chain

HbC missense lysine

HA, weakness, aquagenic pruritus, facial plethora, and splenomegaly, along with PUD and gouty arthritis = due to a mutation in ______, which is a cytoplasmic tyrosine kinase

polycythemia vera JAK2

individuals who demonstrate increased activity of ______ are more susceptible to developing chemical induced cancers

P450 cytochrome microsomal oxygenase

young female with new onset of thrombocytopenia, ecchymoses, petechiae, mucosal bleeding, and no other obvious causes = due to

Immune thrombocytopenic purpura autoimmune destruction of platelets

child with cystic fibrosis, seizure, and confirmed intracranial hemorrhage due to decreased _______ as a result of ________ deficiency, a fat soluble vitamin coagulation factors affected

gamma carboxylation Vitamin K II, VII, IX, X

hypochromic, microcytic anemia is most commonly due to ________, especially in the presence of _______ loss

iron deficiency occult blood

venous thromboembolism arises due to the ______ triad of __________, _________. and ________

virchow endothelial injury venous stasis hypercoaguable state

cytokeratin is a commonly used immunohistochemical marker of _____ cell carcinomas

epithelial

HER2 oncogene encodes for a _______ glycoprotein with intrinsic ________ activity and is a family of ________. Overexpression is associated witha worse prognosis and an increased risk of disease recurrence. Treatment is a monoclonal antibody against HER2 called _______

transmembrane tyrosine kinase epidermal growth factor receptors trastuzumab

treatment using a double stranded RNA molecule consisting of 20-30 base pairs = interferes w/ =

small interfering RNA and microRNA mRNA translation

tumors harboring activating mutations in _____ are resistant to chemotherapy with _______ such as cetuximab and panitumumab

KRAS anti EGFR drugs

rivaroxaban, apixaban = fondaparinux = argatroban, bivalirudin, and dabigatran =

DIrect Factor Xa inhibitors INidrect Factor Xa inhibitor Direct Thrombin inhibitors

many transfusions, frontal bossing, HSM, jaundice, liver biopsy showing kupffer cells containing coarse, yellowish brown cytoplasmic granules composed of_____. This is due to______

hemosiderin iron overload from transfusion therapy

cachexia and muscle wasting are due to _____ in a paraneoplastic setting

TNF-alpha

prognosis of colorectal adenocarcinoma is directly related to __________, not the ________

stage of invasion anaplastic grade

fever, pharyngitis, LAD in young adult is suggestive of _________ caused by? associated with

infectious mononucleosis EBV nasopharyngeal carcinoma

rifampin, phenobarbital, and phenytoin are universal enhancers of ________ and decrease the effect of _____ in contrast, cimetidine, amiodarone, and TMP-SMX ______ _______ metabolism, increasing risk of bleeding

CP450 warfarin inhibit warfarin

people with down syndrome are at an increased risk of developing

ALL and AML

if chemotherapy induced emesis is not refractory after -setron use, _______ tend to be effective. The drugs in this category are (2)

neurokinin 1 receptor antagonists aprepitant, fosaprepitant

recurrent infections, pallor (anemia), and ecchymoses with a peripheral blood smear that shows cells with Auer rods = translocation

APML M3 t15;17 RARa/PML

aggregates of packed follicles, LAD in the cervical area = translocation effect

follicular lymphoma t14;18 BCL-2

DiGeorge syndrome is caused by maldevelopment of the ____ and ___ pharyngeal pouch derivatives. This causes a lack of development of the thymus, an extreme deficiency of mature T lymphocytes, leading to poor development of ________ ______

3rd and 4th lymph node paracortex

____ and leukemoid reaction can have presentations similar to leukocytosis. Leukemoid reaction has an ________ alkaline phosphatase level, while CML has a ______ level and an increase in precursor _______. Definitive diagnosis of CML is depending on _______

CML elevated decreased myelocytes philidelphia chromosome, BCR-ABL, t(9;22)

cells that express both CD4 and CD8 are classified as

immature cortical T cells

fibrinolytics such as _____ may cause reperfusion arrhythmias that are benign during arterial reopening.

tPA, reteplase, tenecteplase

erythrocytes use ______ as the major pathway to generate energy as they do not have ______

glycolysis mitochondria

________ syndrome in a patient with small cell or _____ lung cancer, and is a result of a paraneoplastic syndrome involving ectopic production of _____ by tumor cells

Cushing oat cell ACTH

TB treatment, ________ inhibits pyridoxine phosphokinase, leading to _________ (b6) deficiency. Pyridoxines active form is the cofactor for ________, which catalyzes the rate limiting step of heme synthesis. Inhibition of this step can result in ___________

isoniazid pyridoxine delta aminolevulinate synthase sideroblastic anemia

atrophic gastritis can result in _______ and elevated methymalonic acid levels. The _______ count increases dramatically once ______ replacement therapy is initiated, but normalize quickly

vitamin b12 deficiecy due to inadequate intrinsic factor production reticulocyte b12 replacement

G6PD is the rate limiting step of glucose 6 phosphate to 6 phosphogluconate. Deficiency results in bite cells and weakness, malaise, fatigue, and anemia after oxidative stress, such as treatment with (3)

sulfonamides antimalarials antibiotics

neuro deficit and hypersegmented neutrophils = no neuro deficits but still megaloblastic anemia

B12 folate

desmopressin can alleviate bleeding through _______ release of _______

endothelial vWF

only ________ heparin is able to bind both antithrombin and thrombin to allow antithrombin to inactivate thrombin.

unfractionated

excessive bleeding + hemarthroses = inheritence = phenotypically normal parents, probability of a female sibling with give birth to affected child is

hemophilia A or B X recessive 1/8

somnolence, lethargy, oliguria, diarrhea that become blood, elevated blood urea nitrogen and creatinine, peripheral blood smear show fragmented erythrocytes = due to =

HUS EHEC from undercooked beef

_________ can lead to both dose dependent cytopenia and dose independent aplastic anemia

chlorophenicol

flushing, watery diarrhea, bronchospasm, elevated 5-HIAA = due to =

carcinoid syndrome carcinoid metastatic to liver

pancytopenia post infection with no LAD or splenomegaly = infectious causes diangosis

aplastic anemia EBV, parvo B19 hypocellular bone marrow

individual subunits of hemoglobin similar to _______ and shows a ______ shift on dissociation curve

myoglobin left

Kaposis sarcoma presents with a blue violet or brownish skin plaque in ______ + patients and is due to _________

HIV HHV8

______________ which is modified to resist activated protein C and results in a hypercoaguable state and predisposes to DVT

Factor V Leiden

hypophosphorylated retinoblastoma protein is most likely to

prevent G1/S cell cycle transition

___________ attacks are characterized by abdominal pain and vomiting, reddish brown urine, and neuropsych symptoms. Treatment consists of IV glucose/dextrose or heme preparations which downregulate _______ activity

acute intermittent porphyria ALA synthase

________ lymphoma is characterized by starry sky microscopic appearance. Translocation of _______ on t____, and functions as a trascription activator

Burkitts C-myc 8;14

bilobed or double nuclei and inclusion like eosinophilic nucleoli = diagnostic of

Reed-Sternberg cell Hodgkin lymphoma

kid with pancytopenia, HSM, distended macrophages with wrinkled tissue paper appearance = inheritence deficiency in

Gacher disease autosomal recessive B glucocerebrosidases

Beta globin with impaired ionic interaction between beta subunit and 2,3 bisphosphoglycerate is most similar to

HbF

patients with sickle cell trait have relative protection from _______

malaria caused by plasmodium falciparum

carbon monoxide ________ binds to hemoglobin with a much greater affinity than oxygen

competitively

Ig___ cannot cross placenta, while Ig___ can

IgM IgG

undifferentiated (anaplasti) tumors bear ______ to tissue of origin

no resemblence

abnormal ______ is seen in patients with chronic ____ and ________

bleeding time kidney disease uremia

tumor with cystic and solid component in cerebellum in a child is most lilkely a completely solid tumor is most likely =

pilocytic astrocytoma medulloblastoma

bone metastases are either ______, _______, or mixed. Increased uptake on radionuclide bone imaging is indicative of _________. multiple myeloma, non small cell lung cancer, NHL, RCC, and melanoma tend to be ________ Prostate cancer, small cell lung cancer, HL tend to be ________ GI and breast cancer tend to be _________

osteoblastic, osteolytic osteoblastic osteolytic osteoblastic mixed

HER2 is a _______ kinase receptor

tyrosine

sore throat, malaise, LAD, myalgias, splenomegaly in young = cell that attacks EBV in IM?

IM CD8 CTL activated

patients with ______ present with lifelong mucosal bleeding, heavy menstruation, normal platelet levels, but prolonged bleeding time due to impaired platelet functioning

von Willebrand disease

von Willebrand factor promotes ________ by binding to and crosslinking __________ with exposed ______. It also functions as a protective carrier protein for ______

platelet adhesion platelet glycoproteins GpIb collagen factor VIII

prostate cancer is usually _______ dependent. In combination with long acting gonadotropin releasing hormone agonsts, ________ is added and acts as a ___________ of testosterone receptors

testosterone dependent Flutamide competitive inhibitor

ALL is the most common malignancy of childhood. _____ ALL often presents with a _______ that can cause respiratory symptoms, dysphagia, and SVC syndrome

T cell mediastinal mass

_________, or fragmented RBCs suggest ____________ such as HUS, TTP, DIC, or mechanical damage (prosthetic valve). In childhood, HUS is often preceded by ______. Coaguation studies (Prothrombin time and partial thromboplastin time) are normal in _______ and _______ but abnormal in ______

schistocytes microangiopathic hemolytic anemia bloody diarrhea HUS, TTP DIC

___________ is the most common disorder of porphyrin (heme) synthesis and is caused by ________ defciency, and manifests as a vesicle and blister on sun exposed areas along with edema, pruritus, pain, and erythema. exacerbated by ____, smoking, halogenated hydrocarbons, hep C, HIV

porphyria cutanea tarda - late step porphyria uroporphyringoen decarboxylase (UROD) alchol

_______ prevents chromosomal shortening

telomerase

____________ syndrome is characterized by dysphagia from ________ formation and ________ deficiency anemia. Patients also exhibit koilonychia or spoon shaped nails and a shiny red tongue

Plummer Vinson esophageal web iron

prolonged bleeding and hemoarthosis = desmospressin can be used for treatment of mild hemophilia A by increasing the circulating level of ______

hemophilia Factor VIII

methotrexate competitively inhibits ______, which causes this intermediate to accumulate intracellularly

dihydrofolate reducatse dihydrofolate

G6PD presents in a similar way to __________ deficiency

glutathione reductase

low immunoglobulins and recurrent infections is indicative of ________. A positive response to candida antigens indicates that ________ is intact. In this disorder, the ______ and primary lymphoid follicles doe not form due to an absence of B cells. This condition results from a mutation in _____

X linked agammaglobulinemia T cell function germinal centers bruton tyr kinase

__________ is a significant adverse of effect of ganciclovir and is increased with co adminstration of zidovudine or TMP SMX

neutropenia

Auer rods are found in blast cells of ______ but not in _____. More mature cells and fewer blasts are found in ______

AML ALL CML

HIV with diffuse medium sized lymphocytes with basophilic cytoplasm and high proliferation index (high Ki67 fraction) = due to = translocation

burkitt lymphoma EBV t8;14 c-myc

hemophilia due to decreased levels of ______ or _______. The addition of _______ to the blood of a patient with hemophilia results in clotting

factor VIII Factor IX thrombin

painless gross hematuria with lack of other symptoms = usual form? most likely prognostic factor?

bladder cancer urothelial (transitional cell) carcinoma depth of invasion into the muscular layer

adhesion of cells to the ECM involves _______ mediated binding to ________, collagen, and laminin

integrin fibronectin

drug used for heparin reversal

protamine

constitutive active tyrosine kinase lymphoma =

CML: BCR-ABL

BCRA1 and BCRA1 gene mutations are associated with ___________ and are involved in _______

hereditary breast cancer DNA repair

most common opportunistic mycosis (fever, dyspnea, malaise while immunosuppressed) is show ______ on light microscopy

candida albicans yeasts and pseudohyphae

the _______ is the site of ribsomal subunit maturation and assembly and houses ______

nucleolus RNA polymerase I

polycythemia vera, essential thrombocytosis, and primary myelofibrosis are the often have mutations in

chronic myeloproliferative disorders JAK2

severe fatigue, HSM, early satiety, bone marrow fibrosis =

primary myelofibrosis

AL amyloidosis is associated with

multiple myelomas

DNA synthesis can occur only in the ____ direction _______ are short stretches of DNA that form the discontinous synthesis of DNA on the lagging strand

5 --> 3 Okazaki fragments

alcoholic with neutrophils that have hypersegmented nuclei due to ______ deficiency

folic acid

iron deficiency anemia is associated with _____ ferritin, ________ total iron binding capacity (transferrin) and _______ ______ RBCs

decreased increased microcytic hypochromic

HUS presents with ______ diarrhea, hemolyic anemai with schistocytes, ______, AKI, and elevated ________

bloody thrombocytopenia elevated serum indirect bilirubin

the process of ______ in T cell maturation is essential for eliminating T cells that bind to self MHC or self antigens with high affinity. THis occurs in the _______

negative selection thymic medulla

intravascular hemolytic anemias are characterized by decreased____ and increased _______ and _______

serum haptoglobin LDH bilirubin

splenic infarcts in SCD are due to

microvascular occlusion

monoclonal lymphocytic proliferation is strong evidence of

malignancy

methotrexate and 5-FU effectively inhibit

thymidylate formation

heparin induced thrombocytopenia is treat with ______ such as argatroban

direct thrombin inhibitors

the most common causes of thrombocytopenia in hospitalize patients is

heparin

back pain not relieved with rest or NSAIDs =

metastatic cancer

nitrites are oxidizing agents used to treat ____ poisoning by inducing methemoglobinemia during occupational exposure from fumes

cyanide

Squares on a pedigree are circles are

males females

enlarging jaw mass from east africa =

Burkitt lymphoma

ristocertin aggregation test will show _______ aggregation of platelets in vW disease

decreased

Irinotecan and topotecan inhibit etoposide inhibits

topoisomerase I II

conditions that increase RBC turnover rate such as ____ can cause falsely low HbA1c levels

Beta thalassemia trait

_______ leukemia is a indolent B cell neoplasm found in middle aged men and characterized by bone marrow failure, pancytopenia, and massive splenomegaly. Presents with dry tap, lymphocytes with ____ and TRAP+

Hairy cell cytoplasmic projections

BCL2 normally inhibits

cell death cascade

pure RBC aplaisa is associated with (3)

thymoma, lymphocytic leukemias, and parvo B19 infection

thrombotic occlusion of microvasculature with skin necrosis following initiation of warfarin therapy due to

Protein C deficiency

HbS promotes _____ interaction among Hb moleclues and results in HbS polymerization and erythrocyte sickling

hydrophobic

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Heme/Onc/Lymph U WORLD Questions Flashcards

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