Heme/Onc Path, MSK, Immuno

Question 1

Increased hepcidin (released by liver, binds ferroportin on intestinal mucosal cells and macrophages, inhibiting Fe transport). What’s the treatment?

Answer 1

Anemia of Chronic Disease (see with RA, SLE, and CKD, and some cancers). Treatment is EPO for CKD only.

Question 2

Anemia of Chronic Disease hides Fe. What are it’s lab findings?

Answer 2

Decreased Fe, decreased TIBC, Increased Ferritin (iron is being stored)

Question 3

What kind of anemia is Anemia of Chronic Disease

Answer 3

Normocytic

Question 4

destruction of myeloid stem cells, pancytopenia, and increased EPO

Answer 4

Aplastic anemia

Question 5

Transferrin?

Answer 5

Transports Fe in blood (Increased TIBC means low iron, decreased TIBC means high iron)

Question 6

TIBC?

Answer 6

Indirectly measures transferrin

Question 7

Ferritin?

Answer 7

Fe storage protein of body

Question 8

Polycythemia Vera Tx?

Answer 8

Aspirin

Question 9

Supracondylar fracture of humerus

Answer 9

Median Nerve (ape’s hand and pope’s blessing)

Question 10

Fracture of Medial Epicondyle

Answer 10

Ulnar (this is your funny bone)

Question 11

Superficial Laceration of the Palm

Answer 11

Recurrent branch of the median nerve

Question 12

C5 - C6 roots (erb’s palsy)

Answer 12

Waiter tip. Traction on neck during delivery.

Question 13

Claw Hand

Answer 13

Tear of lower trunk (C8-T1)

Question 14

C1 esterase inhibitor deficiency

Answer 14

Hereditary angioedema due to unregulated activation of Kallikrein. You get increased bradykinin too so don’t give them an ACE.

Question 15

C3 deficiency

Answer 15

Increased risk of pyogenic sinus and respiratory tract infections. Increased susceptibility to hypersensitivity reactions.

Question 16

C5 - C9 deficiency

Answer 16

Increased susceptibility to Neisseria

Question 17

This is secreted by macrophages and causes cachexia in malignancy?

Answer 17

TNF-alpha

Question 18

This is secreted by macrophages and mediates septic shock. Ita lso activates endothelium.

Answer 18

TNF-alpha

Question 19

This is secreted by NK cells and T cells inresponse to IL-12 from macrophages.

Answer 19

Interferon-gamma

Question 20

This stimulates macrophages to kill phagocytosed pathogens and inhibits Th2 cell differentiation.

Answer 20

Interferon-gamma

Question 21

This increases MHC expression and antigen presentation and activates NK cells to kill virus infected cells.

Answer 21

Interferon-gamma

Question 22

Induces differentiation of T cells to Th2 cells.

Answer 22

IL-4

Question 23

Induces growth and differentiation of B cells. And differentiation/ growth of eosinophils.

Answer 23

IL-5

Question 24

NADPH oxidase deficiency

Answer 24

Chronic Granulomatis disease. At risk for infection with Cat+ organisms.

Question 25

How do Interferon alpha and beta work?

Answer 25

They are glycoproteins synthesized by viral infected cells that act locally on uninfected cells. Priming them for viral defense by showing them how to selectively degrade viral nucleic acid and protein.

Question 26

Hep C attacks what protein

Answer 26

CD81

Question 27

CD56

Answer 27

NK cells (and sometimes CD16)

Question 28

Hematopoietic stem cells

Answer 28

CD34

Question 29

Immune complex disease in which antibodies to foreign proteins are produced (takes 5 days). Immune complexes are deposited in membranes where they fix complement (leading to tissue damage). Usually caused by drugs.

Answer 29

Serum Sickness

Question 30

Serum Sickness Sx:

Answer 30

Fever, urticaria, arthralgia, proteinuria, and lymphadenopathy (5-10 days) after antigen exposure

Question 31

Type 3 hypersensitivities

Answer 31

Arthrus reactoin, SLE, PAN, PSGN, & Serum Sickness

Question 32

Blood trasnfusion then sx: dyspnea, bronchospasm, respiratory arrest, and hypotension

Answer 32

Anaphylactic reaction due to IgA deficient individuals receiving blood with IgA