HemeOnc Flashcards
bradykinin
vasodilates art, constricts vv, incrs permeability, incrs pain
-incrs brady when no C1 esterase inhib (high brady when low C1)
c1 Esterase inhib
incrs C1
-blocks kallikrein
direct Xa inhib (anticoags)
apiXaban, rivaroXaban, fondaparinuX
direct THROMBIN inhibs
argatroban, bivalirudin, dabigatran
prothrombin——–+?——>thrombin
factor Va
Plasminogen——+/- (tpa)—->plasmin
+ :thrombolytics: altepase, reteplase, streptokinase
- :Aminocaproic acid
no clinically signif bleeding
factor12 deficiency
req. Ca2+ and phospholipid
factors 8a, 5a, 7—->7a
first abnormal factor in liver dz
7
Acanthocyte/spur cell
liver dz, abetalipoproteinemia, chol. dysreg.
degmacyte/bite cell
G6PD def
where is excess iron in a sideroblast
mito
schistocyte/helmet
DIC, TTP/HUS, HELLP, uremia, pyruvate kinase def
malignant skin cancers
melanoma, basal cell
clonality of B lymphoctyes
determined by Ig light chain (light chain either Kappa or Lambda)
screening
catches dysplasia (reversible)
Arsennic/cig smoke
Sqaumous cell carc, lung cancer, angiosarcoma of the liver
angiosarcoma of the liver
arsenic, vinyl chloride
EBV in a chinese/african male
nasopharyngeal carc, burkitt, CNS lymphoma in AIDS
High risk HPV
Squamous cell carc of vag, adenocarc of cervix
ionizing radiation
AML, CML, papillary carc of thyroid—>hydroxyl free radicals
NONionizing radiation
UVB–>basal cell, squamous cell, melanoma00>pyrimidine dimers
func of CDK4
CDK phosphorylates RB—> promotes cell cycle going thru G1/S checkpt
-mutation= melanoma
RAS-GDP
inactive
GTPase
if no GTPase, RAS cant shut off GTP so get too much growth
CND1
make sure cell goes G1 to S without mutations
p53
g1–>s regulation and upregs DNA repair enzymes (BAX)
BAX
disrputs BCL2 and now cytC leaks out and activates apop.
Rb
G1—>S
-if RB mutated, lots of E2F around and get too much growth
E2F transcription factor
goes to S phase
-E2F is released when Rb is phosphorylated by CDK4
role of BCL2
stabilize mito mem so nothing leaks
-bcl2 overexpressed in follicular lymphoma
pdgf overexpressed
astrocytoma
RET point mutation
medullary carc of thyroid
KIT point mutation
GI stromal tumor
CYCLIN D1 (11;14) translocation
mantle cell lymphoma
telomerase
leads to immortality if cancers upreg it
carcinoma
spread via lymph (some spread via blood like choriocarc, RCC, HCC, follicular carc thyroid). KERATIN+
poorly differentiated
malignant
chromogranin
neuroendocrine cells- SCC of lung and carcinoid tumors
S-100
melanoma, schwannoma, langerhans cell histoicytes
vimentin
mesenchyme, sarcomas
desmin
muscles
grading
assess differentiation; determines Px
staging
size and spread (S-S-S); BETTER determines Px
painless gross hematuria
bladder cancer
MAHA
DIC, TTP, HUS
scd
high LDH, Indirect Bilirubin. LOW haptoglobin
platelet plug
coagulation cascade stabilizes it
links plates to aggregate
fibrinogen
t(12:21)
ALL
Tx for hairy cell
cladribine, pentostatin
smudge cells
CLL
BCR-ABL, 9;22
CML
imatinib is Tx for
CML
which leukemia has low LAP d/t malignant neuts
CML
follicular lymphoma
BCL2, 14;18, abnorm GCs
BRAF oncogene
ser/threonine kinase
-melanoma, NHL
KRAS oncogene
colon/lung/pancreatic cancer,
which lymphoma is assoc with EBV
hodgkin
Immune thrombocytopenia purpura
megakarocytes, few but large plates, AntiplatletAbs
-HIGH bleeding time
TTP
schostocytes, HIGH LDH
-neuro, renal sx
what is the problem with Fe in Anemia of chronic dz
prob with Fe utilization, not Fe deficiency
Hepcidin is high in what dz
SLE
hepcidin MOA
block transfer of Fe from Macrophages to RBC
-and decrs Fe absorption from gut
OCP/preggers and Fe
high tranferin (transports Fe in blood) or TPO
sideroblastic anemia signs
HIGH Fe,ferritin.
sideroblastic anemia Tx
vitB6
what enzyme is def in CGD
NADPHoxidase (CGD would show up negative on NBT test)
which anemia has a POSITIVE direct coombs test
autoimmune hemolyic anemia
direct coombs test
anti-Ig ab is added to pts serum; RBS coag if RBCs are coated with Ig
indirect coombs
normal RBCs are added to pts serum; if serum has anti-RBC ab, you see RBCs coag
Heinz bodies are
denatured Hb
Bite cells are
phag removal of Heinz bodies by splenic macrophages
G6P DH def
cant form NADPH (NADP+—G6PDH—->NADPH), so cant keep glutathione reduced
-LOW NADPH= hemolytic anemia
what causes basophilic stippling
not degrading rRNA (so RBCs retain aggregates of rRNA)
kid has needed blood tranfusions since birth
Bthal. major
high HbF and HbA2 NO HbA1(no HbA2B2=no Bchain)
Bthal. major
most likely place for colon (GI tract)metastasis
liver
where is the primary tumor in brain cancer
lung
which clotting factors are made in the liver
2,7,9,10
intrisic pathway deals with
PTT
what causes itching in Polycythemia vera
basophils
TTP labs
high LDH, schistocytes, low platelets, high bleeding time
Bcr-abl
9:22
always active tyr-kin
indirect coombs test
to test blood compatibility before a transfusion
brown blood
Tx with methylene blue; means there is too much Fe3+ in the blood