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UWorld step 2 > Heme/onc Uworld > Flashcards

Heme/onc Uworld Flashcards

1
Q

anemia of chronic disease pathogenesis:

A

increased inflammatory cytokines (hepcidin)

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2
Q

pt with ESRD on HD, now receiving Erythropoietin therapy for anemia but still has anemia, what next to improve sxms?

A

Iron supplementation: MCC of inadequate response to Erythropoietin tx on dialysis

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3
Q

pt on phenytoin + increased MCV

A

folic acid deficiency

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4
Q

G6PD flaire, bite cells, but normal limits on assay of g6pd activity

A

G6PD ;; takes a week for it to show, low sensitivity
XR

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5
Q

mechanical aortic valve s/p severe aortic stenosis, now has hepatosplenomegaly, low platelets and elevated reticulocytes

A

mechanical aortic valve causing traumatic injury to RBCs –> schistocytes
next step: echocardiogram

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6
Q

spherocytes without central pallor:

Coombs positive:

Coombs negative:

A

Autoimmune hemolytic Anemia (AIHA)

Hereditary Spherocytosis

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7
Q

Coombs negative, positive eosin-5 maleimide, positive osmotic fragility

A

Hereditary Spherocytosis

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8
Q

evaluation of anemia

A
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9
Q

aquagenic pruritis, facial plethora, splenomegaly
elevated hemoglobin, thrombocytosis

A

LOW EPO!
POLYCYTHEMIA VERA
tx: PHLEBOTOMY

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10
Q

pt with polycythemia vera symptoms, and now has hepatomegaly, splenomegaly, flank dullness and distension
what next?

A

budd chiari: abdominal doppler ultrasound!!

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11
Q

isoniazid induced syderoblastic anemia:
tx:

A

pyridoxine

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12
Q

Scleroderma blood cells:

A

schistocytes and microangiopathic hemolytic anemia, and thrombocytopenia

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13
Q

pt with microcytic anemia, gets iron therapy but with no response

A

thalassemia
hemoglobin defect

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14
Q

MACRO-cytic anemia, mild thrombocytosis, glossitis(smooth, shiny tongue)
and happens to have vitiligo

A

vitamin b-12 deficiency
has more auto-immune diseases

can cause gastric cancer** (gastric atrophy)

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15
Q

Prolonged PTT with mixing study correcting PTT
vs
Prolonged PTT with mixing study NOT correcting PTT

A

Von willebrand disease

Antiphospholipid antibody (lupus) can also present with arthralgia

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16
Q

isolated thrombocytopenia

A
17
Q

hypercalcemia with normocytic anemia

A

multiple myeloma

18
Q

pt with headaches, confusion, mild fever, renal (creatinine elevated), hemolytic anemia, low platelets (thrombocytopenia), fragmented red blood cells
dx
tx

A

TTP
plasma exchange

19
Q

DIC
dx
tx?

A

acute Pro-myelocytic leukemia associated with DIC
**TUMOR induced consumptive coagulopathy –> can cause hemorrhage –> activation of tissue factor (DIC), and increased plasmin
tx: all trans retinoid acid

20
Q

traumatic accident got shot several times years ago and now has pancytopenia (all 3 blood lines low leukocytes, erythrocytes, platelets)

A

acquired deficiency of hematopoietic stem cells
aplastic anemia

21
Q

65F with mature lymphocytes with lymphocytosis and cervical and supcralavicular large lymph nodes

A
22
Q

CML

A

abnormal fusion of BCR-ABL t:9,22 causing leukemogenesis d/t lots of active tyrosine kinase

tx: tyrosine kinase inhibitor : IMAN-tinib

23
Q

leukemia reaction vs CML

A

LAP score: high and more metamyelocytes (mature)

vs

lap score: LOW and more myelocytes

24
Q
A
25
Q

17M with pruritus, fever, cervical and supraclavicular painless lymph nodes
dx

A

hodgkin lymphoma
excision lymph node biopsy

26
Q

follicular lymphoma

A

elderly patients
non-hodgkin lymphoma type
painless lymphadenopathy
t:14,18
over expression of BCL-2

27
Q

CHRONIC autoimmune diseases like SLE and elevated LDH and weight loss

A

non-hodgkin lymphoma

28
Q

pt gets shot and then lots of abdominal surgeries – years later gets severe fever, and septic shock presentation with gram positive cocci in blood

A

impaired antibody facilitated phagocytosis (OPSONIZATION)
pt probably had a splenectomy and now is more affected by encapsulated organisms like Strep Pneumonia, H- influenza, and Neisseria Meningitidis

29
Q

nausea with chemotherapy
tx?

A

serotonin 5-HT-3 receptor antagonist (ondansetron)

30
Q

gets cytotoxic chemotherapy: what to Also give to reduce Aki?

different case: pt gets chemo and now has hyperuricemia

A

normal saline

tumor lysis syndrome:
hyperuricemia, hyperphosphatemia, hyperkalemia
but hypo-calcemia

UWorld step 2 (16 decks)

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