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USMLE STEP 1 > Heme/Onco > Flashcards

Heme/Onco Flashcards

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1
Q

CD 34+

A

hematopoietic stem cell

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2
Q

membrane contains Cl-/HCO3- antiporter

A

RBC

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3
Q

don;t produce net ATP during glycolysis

A

RBC

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4
Q

2,3, BPG in RBC

A

produced from 1,3 BPG by bisphosphoglycerate mutase using ATP

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5
Q

platelet contents

A

dense granules (ADP, Ca2+), alpha granules (vWF, fibrinogen)

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6
Q

where is 1/3 of platelets stored

A

spleen

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7
Q

blood cell differentiation fro highest to lowest

A

neutrophils, lymphocytes, monocytes, eosinophils, basophils

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8
Q

hypersegmented polys

A

B12/folate deficiency

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9
Q

high cortisol state and neutrophils

A

disrupts ability of neutrophils to adhere to wall of damaged tissue releasing them into circulation

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10
Q

frosted glass cytoplasm

A

monocytes

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11
Q

what activates macrophages

A

gamma interferon

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12
Q

surfacemarker for macrophages

A

CD 14

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13
Q

eosinophils produce

A

histaminase and arylsulfatase

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14
Q

causes of eosinophilia

A

neoplastic, asthma, allergic, collagen vascular disease, parasites

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15
Q

mediates allergic reaction

A

basophil

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16
Q

contain heparin, histamine, LTD4

A

basophil

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17
Q

basophilia

A

usually seen with CML

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18
Q

can bind Fc portion of IgE

A

mast cell

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19
Q

involved in type 1 hypersensitivity

A

mast cell

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20
Q

chromolyn sodium

A

prevents mast cell degranulation

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21
Q

increased production of gastric acid by parietal cells

A

systemic mastocytosis

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22
Q

most sensitive cells to radiation

A

lymphocytes

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23
Q

produces lymphocytosis promoting factor and blocks lymphocytes from leaving blood

A

Bordetella pertussis

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24
Q

express CD8, recognize MHC I

A

cytotoxic T cells

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25
Q

express CD28

A

regulatory T cells

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26
Q

universal plasma donor

A

AB

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27
Q

Rho immune globulin

A

given to mother at first delivery

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28
Q

clot instability, delayed, recurrent bleeding after trauma

A

factor XII deficiency

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29
Q

decreased ESR

A

polycythemia, sickle cell anemia, CHF, microcytosis, hypofibrinogenemia

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30
Q

acanthocyte (spur cell)

A

liver disease, abetalipoproteinemia

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31
Q

basophilic stippling

A

TAL: thalassemia, anemia of chronic disease, lead poisoning

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32
Q

bite cell

A

G6PD deficiency

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33
Q

elliptocyte

A

hereditary elliptocytosis

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34
Q

macro-ovalocyte

A

megaloblastic anemia (also hypersegmented PMNs), marrow failure

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35
Q

ringed sideroblasts

A

sideroblastic anemia (excess iron in mitochondria)

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36
Q

schistocyte

A

DIC, TTP/HUS, traumatic hemolysis

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37
Q

spherocyte

A

hereditary spherocytosis, autoimmune hemolysis

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38
Q

teardrop cell

A

bone marrow infiltration (myelofibrosis)

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39
Q

target cell

A

HALT: HbC disease, asplenia, liver disease, thalassemia

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40
Q

Heinz bodies

A

oxidation of iron, G6PD, similar in alpha-thalassemia

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41
Q

Howell-Jolly bodies

A

basophilic nuclear remnant normally removed by splenic macrophages; hyposplenia or asplenia, mothball ingestion (naphthalene)

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42
Q

Plummer-Vinson syndrome

A

iron deficiency anemia, esophageal webs, atrophic glossitis

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43
Q

koilonychia, pica

A

iron deficiency anemia

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44
Q

alpha thalassemia cis deletion

A

Asians, worse than trans

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45
Q

alpha thalassemia trans deletion

A

Africans

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46
Q

4 gene deletion alpha thalassemia

A

Hb Barts, hydrops fetalis

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47
Q

3 gene deletion alpha thalassemia

A

HbH

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48
Q

which chromosome is the mutations on in alpha thalassemia

A

16

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49
Q

which chromosome is the mutation on in beta thalassemia

A

11

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50
Q

point mutations in splice sites and promoter sequences

A

beta thalassemia

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51
Q

prevalent in mediterranean population

A

beta thalassemia

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52
Q

asymptomatic, increased HbA2 on electrophoresis, target cells

A

beta thalassemia minor

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53
Q

severe anemia, risk for aplastic crisis with parvovirus B19, marrow expansion

A

beta thalassemia major

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54
Q

increased HbF

A

beta thalassemia major

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55
Q

inhibits ferrochelatase and ALA dehydratase

A

lead poisoning

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56
Q

house with chipped paint, basophilic stippling

A

lead poisoning

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57
Q

lead poisoning

A

LEADS” lead lines on gingiva, encephalopathy and erythrocyte basophilic stippling, abdominal colic, sideroblastic anemia, drops (wrist, foot), dimercaprol and EDTA for treatment, succimer for chelation in kids

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58
Q

sideroblastic anemia causes

A

X-linked defect in gamma-ALA synthase, alcohol, lead, isoniazid

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59
Q

sideroblastic anemia treatment

A

B6 (cofactor for gamma-ALA synthase)

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60
Q

anemic of chronic disease treatment

A

exogenous erythropoetin

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61
Q

can cause folate deficiency

A

methotrexate, trimethoprim, phenytoin

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62
Q

macrocytic anemia, hypersegmented neutrophils, glossitis, increased homocysteine, normal methylmalonate

A

folate deficiency anemia

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63
Q

macrocytic anemia, hypersegmented neutrophils, glossitis, increased homocysteine, increased methylmalonic acid

A

B12 deficiency anemia (converts methylmalonic acid to succinyl CoA

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64
Q

normal Schilling test

A

low dietary intake of B12

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65
Q

cause of B12 deficiency

A

Crohns, pernicious anemia, Diphyllobothrium latum, PPI

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66
Q

can’t cleave off R-binder from B12

A

pancreatic insufficiency

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67
Q

megaloblastic anemia in a child that can’t be cured with folate or B12

A

orotic aciduria

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68
Q

hypersegmented neutrophils, glossitis, orotic acid in urine

A

orotic aciduria

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69
Q

orotic aciduria treatment

A

uridine monophosphate

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70
Q

decreased haptoglobin, increased LDH, Hn in urine

A

intravascular hemolysis

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71
Q

increased LDH, increased UCB, jaundice

A

extravascular hemolysis

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72
Q

correct for falsely elevated reticulocytes

A

multiply by Hct/45

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73
Q

master regulator of iron homeostasis

A

hepcidin (produced in the liver); inhibits iron transport across gut mucosa

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74
Q

anemia without splenomegaly

A

aplastic anemia

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75
Q

pancytopenia, dry bone marrow tap, pallor, purpura, mucasal bleeding

A

aplastic anemia

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76
Q

aplastic anemia causes

A

radiation, benzene, chroramphenicol, alkylating agents, antimetabolites, parvovirus B19, EBV, HIV, HCV, fanconi’s anemia (DNA repair defect)

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77
Q

thymoma

A

associated with pure red cell aplasia

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78
Q

complication of any hemolytic anemia

A

pigmented gallstones, predisposes to folic acid deficiency

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79
Q

autosomal dominant defect in spectrin, ankryrin, increased MCHC, premature removal of RBCs by spleen

A

hereditary spherocytosis

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80
Q

splenomegaly, aplastic crisis (B19), positive osmotic fragility test

A

hereditary spherocytosis

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81
Q

hereditary spherocytosis treatment

A

splenectomy

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82
Q

X-linked recessive decrease in glutathione

A

G6PD

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83
Q

hemolytic anemia following oxidant stress

A

G6PD

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84
Q

back pain, hemoglobinuria, Heinz bodies, bite cells, dercreased production of 6-phosphogluconate

A

G6PD

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85
Q

decreased ATP, hemolytic anemia in newborn

A

puryvate kinase deficiency

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86
Q

HbC

A

glutamic acid to lysine mutation at residue 6 in beta globin

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87
Q

complement-mediated RBC lysis, absent GPI

A

paroxysmal nocturnal hemoglobinuria

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88
Q

hemolytic anemia, pancytopenia, venous thrombosis

A

paroxysmal nocturnal hemoglobinuria

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89
Q

CD55/59 negative on flow cytometry

A

paroxysmal nocturnal hemoglobinuria

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90
Q

treatment for paroxysmal nocturnal hemoglobinuria

A

eculizumab

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91
Q

paroxysmal nucturnal hemoglobinuria screening

A

sucrose test

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92
Q

substitution of glutamic acid with valine at position 6 of beta chain

A

sickle cells anemia

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93
Q

low O2 in sickle cell

A

precipitates sickling–> deoxygenated HbS polymerizes–>promotes hydrophobic interaction among Hb molecules

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94
Q

crew cut skull on x-ray, aplastic crisis, autosplenectomy, increased risk of infection with encapsulated organisms, salmonella osteomyelitis, renal papillary necrosis

A

sickle cell anemia

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95
Q

sickle cell anemia treatment

A

hydroxyurea (increases HbF)

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96
Q

gardos channel blockers

A

hinder efflux of K+ and water from cells, preventing dehydration of RBCs and decrease polymerization of HbS

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97
Q

metabisulfite screen

A

causes cells with any amount of HbS to sickle, predisposed to develop folic acid deficiency

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98
Q

HbC

A

normocytic anemia with extravascular hemolysis, mutation in beta chain

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99
Q

IgG

A

extravascular hemolysis, spherocytes, warm agglutinin

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100
Q

IgM

A

intravascular hemolysis, cold agglutinin

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101
Q

warm agglutinin

A

SLE, CLL, alpha-methyldopa

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102
Q

cold agglutinin

A

acute anemia triggered by cold; CML, Mycoplasma pneuminia, mono

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103
Q

direct Coombs test

A

anti-Ig Ab added to pts serum

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104
Q

indirect Coombs test

A

normal RBCs added to pts serum

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105
Q

infectious mono

A

EBV infection, lymphocytic leukocytosis, reactive CD8+, generalized LAD (paracortex), splenomegaly (PALS), risk for splenic rupture

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106
Q

monospot test

A

detects IgM heterophile Ab; negative–>CMV cause

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107
Q

definitive diagnosis for mono

A

testing EBV viral capsid antigen

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108
Q

rash if exposed to penicillin

A

mono

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109
Q

often fatal leukemia, pigmentary skin changes, malformation of heart, kidney, and limbs

A

Fanconi anemia (mutation in gene that functions in BRCA)

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110
Q

BRCA

A

repairs damage to DNA caused by cross-linking agents

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111
Q

accumulation of protoporphyrin, gamma-ALA in blood

A

lead poisoning

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112
Q

defective porphobilibogen deaminase

A

acute intermittent porphyria

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113
Q

accumulation of porphobilinogen, gamma-ALA, uroporphyrin in urine

A

acute intermittent porphyria

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114
Q

acute intermittent porphyria treatment

A

glucose and heme (inhibit ALA synthase)

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115
Q

painful abdomen, port-wine colored urine, polyneuropathy, psychological disturbances, precipitated by drugs

A

acute intermittent porphyria

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116
Q

defective uroporphyrinogen decarboxylase

A

porphyria cutanea tarda

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117
Q

uroporphyrin in urine (tea-colored urine)

A

porphyria cutanea tarda

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118
Q

blistering cutaneous photosensitivity

A

porphyria cutane tarda

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119
Q

normal bleeding time

A

2-7 min

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120
Q

normal PT time

A

11-15 s

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121
Q

normal PTT time

A

25-40 s

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122
Q

factor VIII deficiency, increased PTT

A

hemopylia A

123
Q

deficiency of factor IX, increased PTT

A

hemophylia B

124
Q

activated by epoxide reductase in liver, generated by bacteria in gut

A

vitamin K

125
Q

decreased synthesis of factors II, VII, IX, X, protein C, and protein S

A

vitamin K deficiency

126
Q

decreased Gp1b, defect in adhesion, increased bleeding time

A

Bernard-Soulier syndrome

127
Q

decreased GpIIb/IIIa, defect in aggregation, no platelet clumping on smear

A

Glanzmann’s thrombasthemia

128
Q

anti-GpIIb/IIIa Ab, increased magakaryocytes, increased bleeding time

A

ITP

129
Q

deficiency of ADAMSTS 13–>decreased degradation of vWF multimers–>platelet aggregation and thrombosis, schistocytes, increased LDH and magakaryocytes

A

TTP

130
Q

neurologic and renal symptoms, fever, thrombocytopenia, microangiopathic hemolytic anemia

A

TTP

131
Q

liver failure effect on coagulation monitored by

A

PT

132
Q

uremic platelet dysfunction

A

can occur in dialysis pts

133
Q

diagnosed by ristocetin cofactor assay

A

von Willebrand’s disease

134
Q

von Willebrand disease treatment

A

desmopressin (DDAVP)–>releases vWF stored in endothelium

135
Q

easy bleeding from mucosal surfaces, normal platelet count

A

von Willebrand disease

136
Q

DIC treatment

A

transfuse blood products and cryoprecipitate

137
Q

DIC causes

A

sepsis (gram -), trauma, OB, acute pancreatitis, malignancy, nephrotic syndrome, transfusions

138
Q

increased fibrin split products (D dimer)

A

DIC

139
Q

factor V resistant to degradation by activated protein C

A

factor V Leiden

140
Q

most common cause of inherited hypercoagulability in whites

A

factor V Leiden

141
Q

prothrombin gene mutation

A

in 3’ untranslated region–>increased production of prothrombin

142
Q

increase in PTT is blunted after heparin

A

antithrombin deficiency

143
Q

decreased ability to inactivate factors V and VIII, increased risk for thrombotic skin necrosis with hemorrhage following warfarin administration

A

protein C or S deficiency

144
Q

used to treat deficiencies in fibrinogen and factor VIII

A

cryoprecipitate

145
Q

blood transfusion risks

A

hypocalcemia (citrate is Ca2+ chelator), hyperkalemia

146
Q

protamine

A

heparin reversal

147
Q

CML vs leukemoid reaction

A

decreased leucocyte alkaline phosphatase in CML

148
Q

Reed-Steinberg cells, associated with EBV, colalized, contignous spread, low-grade fever, night sweats, weight loss

A

Hodgkin’s lymphoma

149
Q

multiple peripheral nodes, noncontiguos spread, common in 2-40 y.o., associated with HIV and immunosuppression

A

non-Hodgkin’s lymphoma

150
Q

CD30+and CD15+ B cell origin

A

Reed-Steinberg cell

151
Q

Hodgkin’s lymphoma that is most common with best prognosis

A

nodular sclerosing form

152
Q

t(8,14)

A

Burkitt’s lymphoma, c-myc(8), heavy chain Ig (14)

153
Q

starry sky, associated with EBV, jaw lesion endemic in Africa

A

Burkitt lymphoma; high ki67 proliferative fraction

154
Q

enlarging lymph node

A

diffuse large B cell lymphoma

155
Q

t(11,14)

A

Mantle cell lymphoma, cyclin d1(11), heavy chain Ig(14)–>, poor prognosis, CD5+

156
Q

heavy chain Ig

A

promotes G1/S transition

157
Q

painless LAD in an older male

A

mantle cell lymphoma

158
Q

t(14,18)

A

follicular lymphoma, heavy chain Ig(14), bcl-2(18)

159
Q

bcl-2

A

inhibits apoptosis

160
Q

follicular lymphoma treatment

A

rituximab (anti CD20)

161
Q

adult from Japan, West Africa, or Caribbean with cutaneous lesions

A

adult T-cell lymphoma, caused by HTLV-1

162
Q

adults with cutaneous patches/nodule, CD4+

A

mycosis fungoides/Sezary syndromeq

163
Q

can produce erythropoietin, associated with polycythemia

A

cerebellar hemangioblastoma

164
Q

associated with chronic inflammatory states

A

marginal zone lymphoma

165
Q

fried egg cells that produce IgG or IgA

A

multiple myeloma

166
Q

hypercalcemia, renal insufficiency, anemia, bone lytic lesions, back pain

A

multiple myeloma; activates RANK receptors on osteoclasts, eosinophilic casts

167
Q

increased susceptibility to infection, primary amyloidosis, punched out lytic bone lesions on X-ray, M spike, Bence-Jones protein (Ig light chain), rouleaux

A

multiple myeloma

168
Q

M spike (IgM), no lytic bone lesions, visual and neuro deficits

A

Waldenstrom’s macroglobulinemia

169
Q

asymptomatic precursor to multiple myeloma

A

MGUS

170
Q

leukemia common in <15 y.o., increased lymphoblasts in peripheral blood smear

A

ALL

171
Q

leukemia with mediastinal mass

A

T-cell ALL

172
Q

TdT+, CALLA+, most responsive to therapy

A

ALL

173
Q

associated with Down syndrome after 5 y.o.

A

ALL

174
Q

ALL with better prognosis

A

t(12,21)

175
Q

ALL with poor prognosis

A

t(9,22)

176
Q

asymptomatic leukemia in adults >60 y.o., smudge cells

A

CLL (deletion of 13q)

177
Q

leukemia associated with autoimmune hemolytic anemia

A

CLL

178
Q

splenomegaly, pancytopenia, dry tap on boe marrow, absent lymphadenopathy, TRAP positive

A

hairy cell leukemia

179
Q

hairy cell leukemia treatment

A

cladribine, adenosine analog (2-CDA)

180
Q

rash, generalized LAD with HSM, lytic bone lesions

A

ATLL

181
Q

leukemia common at 65, Auer rods

A

AML, myeloperoxidase crystalized as Auer rods; release of Auer rods can lead to DIC

182
Q

t(15,17)

A

M3 subtype of AML

183
Q

responds to all-trans retinoic acid (vitamin A)

A

M3 AML

184
Q

leukemia in 30-60 y.o., increased basophils, splenomegaly

A

CML

185
Q

t(9,22)

A

CML (bcr-abl)

186
Q

CML treatment

A

imatinib

187
Q

LAP negative granulocytes

A

CML

188
Q

associated with Down syndrome before age 5

A

AML

189
Q

child with erythematous papulaes, nodules, scaling plaques, lytic bone lesions

A

Langerhans cell histiocytosis

190
Q

cells express S-100 and CD1a, birbeck granules

A

Langerhans cell histiocytosis

191
Q

pathogenic fracture in adolescent

A

eosinophilic granuloma, benign

192
Q

scalp rash, lytic skull defects, diabetes insipidus, exophthalmos in a child

A

Hard-Schuller-Christian disease, malignant

193
Q

constitutively active JAK 2 receptors, proliferate without EPO stimulation

A

polycythemia vera

194
Q

intense itching after hot shower

A

polycythemia vera

195
Q

essential thrombocytosis

A

JAK 2 kinase mutation, platelet proliferation

196
Q

JAK 2 kinase mutation, fibrotic obliteration of bone marrow, teardrop cell

A

myelofibrosis

197
Q

polycythemia vera treatment

A

phlebotomy, hydroxyurea

198
Q

cofactor for activation of antithrombin

A

heparin

199
Q

decreases thrombin, decreases factor Xa, short half-life

A

heparin

200
Q

anticoagulant used during pregnancy

A

heparin

201
Q

which test to follow heparin

A

PTT

202
Q

heparin antidote

A

protamine sulfate

203
Q

act more on factor Xa

A

LMW heparin (enoxaparin, dalteparin)

204
Q

IgG Ab against heparin bound to platelet factor 4

A

HIT

205
Q

HIT treatment

A

argatroban (direct thrombin inhibitor)

206
Q

treating HIT with this produces possibility of skin necrosis

A

coumadin

207
Q

inhibit thrombin

A

lepirudin, bivalirudin

208
Q

alternative to heparin for anticoagulating HIT

A

lepirudin, bivalirudin

209
Q

interferes with normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors

A

warfarin

210
Q

anticoagulant metabolized by p450

A

warfarin

211
Q

test used to follow warfarin effects

A

PT

212
Q

can predispose to paradoxical thrombosis in pts with congenital deficiency of protein C or S

A

warfarin

213
Q

used for chronic anticoagulation

A

warfarin

214
Q

warfarin overdose

A

fresh frozen plasma or vitamin K

215
Q

aid in conversion of plasminogen to plasmin

A

thrombolytics (PAs, streptokinase, urokinase)

216
Q

may cause reperfusion arrhythmia, bleeding, contraindicated with history of intracranial bleeding

A

thrombolytics

217
Q

thrombolytics toxicity

A

treat with aminocaproic acid (inhibitor of fibrinolysis)

218
Q

irreversibly inhibits COX-1 and COX-2 by covalent acetylation, no effects on PT, PTT

A

aspirin

219
Q

side effects: gastric ulceration, tinnitus

A

aspirin

220
Q

aspirin overdose

A

respiratory alkalosis, metabolic acidosis

221
Q

alternative treatment for aspirin allergy

A

clopidogrel

222
Q

ADP receptor inhibitors

A

clopidogrel, ticlopidine, prasugrel, ticagrelor

223
Q

side effects of neutropenia, fever, mouth ulcers

A

ADP receptor inhibitors(esp. ticlopidine)

224
Q

factor Xa inhibitors

A

no significant antithrombin activity, can be used for DVT; ex: fondaparinux

225
Q

phosphodiesterase III inhibitors, increase cAMP in platelets–>inhibiting platelet aggregation

A

cilostazol, dipyridamole, milrinone

226
Q

used for intermittent claudication, prevent stroke or TIA, angina prophylaxis, increased contractility

A

phosphodiesterase III inhibitors

227
Q

side effects of nausea, headache, facial flushing, hypotension, abdominal pain

A

phosphodiesterase III inhibitors

228
Q

GpIIb/IIIa inhibitors

A

abciximab, eptifibatide, tirofiban

229
Q

made from monoclonal Ab Fab fragments

A

abciximab

230
Q

used for acute coronary syndromes, percutaneous transluminal coronary angioplasty

A

GpIIb/IIIa inhibitors

231
Q

side effects of bleeding, thrombocytopenia

A

GpIIb/IIIa inhibitors

232
Q

inhibit fibrinolysis

A

aminocaproic acid, tranexamic acid

233
Q

folic acid analog that inhibits dihydrofolate reductase, decreased dTMP–>decreased DNA and protein synthesis

A

methotrexate

234
Q

used for leukemias, lymphomas, choriocarcinomas, sarcomas

A

methotrexate

235
Q

used for abortion, ectopic pregnancy, RA, psoriasis

A

methotrexate

236
Q

effects can be overcome by adding THF

A

methotrexate

237
Q

side effect of myelosuppression

A

methotrexate(reversible with leucovorin: folinic acid)

238
Q

side effects of macrovesicular fatty change in liver, mucositis, teratogenic

A

methotrexate

239
Q

effect can’t be overcome by adding THF

A

5-FU

240
Q

pyrimidine analog bioactivated to 5F-dUMP which covalentrly complexes folic acid–>inhibits thymidylate synthase

A

5-FU

241
Q

used for colon cancer, basal cell carcinoma

A

5-FU

242
Q

side effects of myelosuppression not reversible with leucovorin, photosensitivity

A

5-FU

243
Q

5-FU overdose

A

thymidine

244
Q

pyrimidine analog used for leukemia, lymphoma

A

cytarabine (arabinofuranosyl cytidine)

245
Q

side effects of leukopenia, thrombocytopenia, megaloblastic anemia

A

cytarabine

246
Q

purine analogs–>decrease de novo purine synthesis

A

azathioprine, 6-MP, 6-TG

247
Q

activated by HGPRT, used to treat leukemias

A

azathioprine, 6-MP, 6-TG

248
Q

side effects of bone marrow, GI liver

A

azathioprene, 6-MP, 6-TG

249
Q

metabolized by xanthine oxidase–>increased toxicity with allopurinol

A

azathioprine, 6-MP, 6-TG

250
Q

intercalates in DNA with side effect of myelosuppression

A

dactinomycin (actinomycin D)

251
Q

used to treat Wilms tumor, Ewig’s sarcoma, rhabdomyosarcoma, childhood tumors

A

dactinomycin

252
Q

generate free radicals, noncovalently intercalate in DNA

A

doxorubicin (adriamycin), daunorubicin

253
Q

used to treat solid tumors, leukemias, lymphomas

A

doxorubicin (adriamycin), daunorubicin

254
Q

side effects of dilated cardiomyopathy, myelosuppression, alopecia

A

doxorubicin (adriamycin), daunorubicin

255
Q

iron chelating agent used to prevent cardiotoxicity

A

dexrazoxane

256
Q

induces free radical formation which causes breaks in DNA strands

A

bleomycin

257
Q

used to treat testicular cancer, Hodgkin’s lymphoma

A

bleomycin

258
Q

side effects of pulmonary fibrosis, skin changes, minimal myelosuppression

A

bleomycin

259
Q

covalently x link DNA at guanine N-7, require bioactivation by liver

A

cyclophosphamide, ifosfamide

260
Q

used for solid tumors, leukemia, lymphoma, some brain cancers

A

cyclophosphamide, ifosfamide

261
Q

side effects of myelosuppression, hemirrhagic cystitis, partially prevented with mesna (thiol group binds toxic metabolite)

A

cyclophosphamide, ifosfamide

262
Q

used to treat brain tumors, require bioactivation

A

nitrosoureas (carmustine, lomustine, semustine, streptozocin)

263
Q

CNS toxicity

A

nitrosoureas (carmustine, lomustine, semustine, streptozocin)

264
Q

alkylates DNA

A

busulfan

265
Q

used to treat CML, prior to bone marrow transplant

A

busulfan

266
Q

side effects of pulmonary fibrosis, hyperpigmentation

A

busulfan

267
Q

tumor lysis syndrome prevention

A

hydration, allopurinol or rasburicase

268
Q

cell-cycle methylating agent that requires enzymatic activation in liver

A

dacarbazine

269
Q

alkaloids that bind to tubulin in M phase and block polymerization

A

vincristine, vinblastine

270
Q

vincristine, vinblastine use

A

solid tumors, leukemias, lymphomas

271
Q

side effects of neurotoxicity, paralytic ileus

A

vincristine

272
Q

side effect of bone marrow suppression

A

vinblastine

273
Q

hyperstabilize polymerized microtubules in M phase–> mitotic spindles can’t break down

A

paclitaxel, taxols

274
Q

used for ovarian and breast carcinomas

A

paclitaxel, taxols

275
Q

paclitaxel side effects

A

myelosuppression, hypersensitivity

276
Q

cross-link DNA

A

cisplatin, carboplatin

277
Q

used for testicular, bladder, ovary, and lung carcinomas

A

cisplatin, carboplatin

278
Q

side effects of nephrotoxicity, acoustic nerve damage

A

cisplatin, carboplatin

279
Q

cisplatin, carboplatin nephrotoxicity prevention

A

amifostine (free radical scavenger) and chloride diuresis

280
Q

inhibit topoisomerase II

A

etoposide, teniposide

281
Q

etoposide, teniposide uses

A

solid tumors, leukemias, lymphomas

282
Q

etoposide, teniposide side effects

A

myelosuppression, GI irritation, alopecia

283
Q

inhibit topoisomerase I

A

irinotecan, topotecan

284
Q

inhibits ribonucleotide reductase–>s phase specific

A

hydroxyurea

285
Q

used to treat melanoma, CML, sickle cell

A

hydroxyurea

286
Q

hydrozyurea side effects

A

bone marrow suppression, GI upset

287
Q

may trigger apoptosis, may even work on non-dividing cells

A

prednisone, prednisolone

288
Q

used to treat CLL, non-Hodgkin’s lymphoma, immunosuppressant for autoimmune diseases

A

prednisone

289
Q

side effects fo Cushing-like symptoms, immunosuppression, cataracts, acne, osteoporosis, hypertension, peptic ulcers, hyperglycemia, psychosis

A

prednisone

290
Q

SERMs: receptor antagonists in breast and agonists in bone; block binding of estrogen to estrogen receptor-positive cells

A

tamoxifen, raloxifene

291
Q

used in breast cancer treatment and prevention

A

tamoxifen, raloxifene

292
Q

side effect of increased risk of endometrial cancer, hot flashes

A

tamoxifen

293
Q

monoclonal Ab against HER-2, tyrosine kinase

A

trastuzumab (herceptin)

294
Q

trastuzumab toxicity

A

cardiotoxicity

295
Q

philadelphia chromosome bcr-able tyrosine kinase inhibitor

A

imatinib (gleevec)

296
Q

used to treat CML, GI stromal tumors, with side effect of fluid retention

A

imatinib

297
Q

monoclonal Ab against CD20

A

rituximab

298
Q

used for non-Hodgkin’s lymphoma, RA (With methotrexate)

A

rituximab

299
Q

small molecule inhibitor of forms of B-Raf kinase with V600E mutation

A

vemurafenib

300
Q

used for metastatic melanoma

A

vemurafenib

301
Q

monoclonal Ab against VEGF, inhibits angiogenesis

A

bevacizumab

302
Q

bevacizumab use

A

solid tumors

303
Q

decreased CD16

A

increase in immature neutrophils

USMLE STEP 1 (21 decks)

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