Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > HemOnc (Step up son) > Flashcards

HemOnc (Step up son) Flashcards

1
Q

What can cause a left shift of the hgb-O2 dissociation curve?

A

Metabolic alkalosis
Decreased body temp
Increased Hgb F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cause a right shift of the Hgb-O2 dissociation curve?

A

Metabolic acidosis
Increased body temp
High altitude
Exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A patient presents with AMS, cherry lips, and hypoxia despite normal pulse ox reading. What is going on?

A

CO poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes microcytic anemias?

A 
Iron deficiency
Lead poisoning
Chronic disease
Sideroblastic 
Thalassemias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes normocytic anemia?

A

Hemolytic
Chronic disease
Hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes macrocytic anemia?

A

Folate deficiency
B12 deficiency
Liver disease
Booze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does agglutination with direct Coombs test indicate?

A

Presence of IgG and complement on RBC membranes (warm and cold agglutinin disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does agglutination with indirect Coombs test indicate?

A

Anti-RBC antibodies in serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Patient develops fatigue, pallor, and icterus after being treated with penicillin. What happened? What would be seen on a smear?

A

Drug induced hemolytic anemia (Direct Coombs +)

Burr cells and shistocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patient has a microcytic anemia with the following labs: low iron, normal/high ferritin, low TIBC, normal iron:TIBC (>18). What is this?

A

Anemia of chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patient has a microcytic anemia with the following labs: normal/high iron, normal ferritin, normal TIBC, and stippled, microcytic RBCs on smear. What is this?

A

Lead poisoning

Stippled means dotted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Patient has a microcytic anemia with the following labs: low iron, low ferritin, high TIBC, and low iron:TIBC (

A

Iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Patient has a microcytic anemia with the following labs: high iron, high ferritin, low TIBC and ringed sideroblasts. What is this? What can cause this? What can it progress to?

A

Sideroblastic anemia (cells of different sizes may be seen on smear)

Congenital: X-linked most common
Reversible: alcohol is most common; B6 deficiency (isoniazid); Cu deficiency; Pb poisoning

Acute leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes target cells? Basophilic stippling?

A

Thalassemia alpha –> microcytic target cells

Thalassemia beta –> variably sized target cells; basophilic stippling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

RECAP: how can iron deficiency anemia and ACD be differentiated?

A

TIBC…high in Fe deficiency and low in ACD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Besides anemia symptoms, what else is seen with lead poisoning?

A

Gingival lead lines

Peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which one, folate or B12 deficiency, causes a sore tongue?

A

Folate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which one, folate or B12 deficiency, causes neurologic symptoms?

A

B12 deficiency

symmetric paresthesias, ataxia, possible psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What kind of anemias can phenytoin cause?

A 
Folate deficiency (macro)
Aplastic anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A patient comes in with persistent infections, poor clotting, pallor, systolic murmur, and increased pulse pressure. What could be going on?

A

Aplastic anemia

Worse in old people

Caused by parvovirusB19 in sickle cell patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A smear shows target cells, sickle cells, and nucleated RBCs. What does the person have?

A

Sickle cell anemia…only deoxygenated cells would be sickled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does hydroxyurea help with sickle cell disease?

A

Increases HgB F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

An African patient with a history of recurrent infections comes in with bone pain. What could be going on?

A

Salmonella osteomyelitis…sickle cell patients are more susceptible to it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can cause neutropenia w/o immune deficiency (agranulocytosis)?

A

Viral infections: hepatitis, HIV, EBV
Drugs: clozapine, antithyroids, sulfasalzine, TMP-SMX
Chemo
Aplastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Asthma, allergic rhinitis, and anaphylaxis are examples of? which is mediated by?

A

Type I hypersensitivity reaction

IgE antibodies attached to mast cells –> mast cell and histamine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Drug-induced or immune hemolytic anemia are examples of? which is mediated by?

A

Type II hypersensitivity reaction

IgM and IgG antibodies –> complement cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Arthus reaction, serum sickness, and glomerulonephritis are examples of? which is mediated by?

A

Type III hypersensitivity reaction

IgM and IgG immune complexes –> deposit in tissue –> complement cascade

28
Q

Allergic contact dermatitis, transplant rejection, and PPD testing are examples of? which is mediated by?

A

Type IV hypersensitivity reaction

T cells and macrophages

29
Q

Warfarin is tracked with INR (normalized PT). How is heparin tracked? LMWH?

A

Heparin is monitored with PTT

LMWH does not need to be monitored

30
Q

What are the genetics of vWF disease? What labs are seen with it?

A

vWF disease is autosomal dominant

Increased PTT and bleeding time; decreased factor VIII antigen, decreased vWF antigen, decreased ristocetin cofactor activity

31
Q

How is vWF disease treated?

A

minor bleed –> desmopressin (increases factor VIII)
Major bleed/surgery –> vWF and factor VIII concentrate
Avoid ASA

32
Q

Patient comes in because of uncontrolled bleeding. Testing shows increased PTT, normal PT, and normal bleeding time. What could be going on?

A

Hemophilia A (VIII) or B (IX)

33
Q

How do thienopyridines work?

A

Clopidogrel and ticlopidine work by blocking ADP receptors

34
Q

Besides increased risk of hemorrhage, what else can be caused by GP IIb/IIIa inhibitors?

A

nausea, back pain, hypotension

35
Q

How does heparin work?

A

Binds to antithrombin to increase activity…decreasing clot formation

36
Q

How does LMWH work?

A

Binds to factor Xa to prevent clot formation

37
Q

How do direct throbbing inhibitors work?

A

Lepirudin and argatroban are highly selective inhibitors of thrombin to suppress activity of factors V, IX, and XIII and clot formation

38
Q

What causes Heparin-Induced Thrombocytopenia (HIT)? What is seen on labs? How is it treated?

A

Development of antiplatelet antibodies

Sudden >50% drop in platelets

Stop heparin
Start direct thrombin inhibitor (Lepirudin or argatroban)

39
Q

A patient has a platelet count

A

Idiopathic Thrombocytopenic Purpura…autoimmune B-cell directed production of anti-platelet antibodies

Adults…steroids, delayed splenectomy, IVIG, plasmapheresis, or recombinant factor VIIa

40
Q

E. coli O157:H7 can cause TTP-HUS. What is the path? What are the symptoms?

A

Diffuse platelet aggregation d/t autoantibodies against preventative enzyme

Hemolytic anemia
ARF
Thrombocytopenia
W/O severe bleeding
Neurologic sequela
41
Q

How is HIV diagnosed?

A

Positive ELISA –> repeat ELISA also positive –> positive Western Blot

ELISA = sensitive
Western Blot = specific

42
Q

What is a possible complication of polycythemia vera? How is PCV treated?

A

Leukemia

Serial phlebotomy
Antihistamines (for pruritus)
ASA (thrombus prophylaxis)
Hydroxyurea (bone marrow suppression)

43
Q

In what disease do IgA and IgG produce an abnormal monoclonal protein (M protein) and Bence Jones proteins? What can be seen on x-rays?

A

Multiple Myeloma…poor prognosis

Punched out bone lesions on skull and long bones

44
Q

Hodgkin Lymphoma originates in what kind of cells?

A

B cells

45
Q

What is the most common Hodgkin lymphoma?

A

Nodular sclerosis (low grade)

46
Q

A hodgkin lymphoma is found to have a lot of lymphocytes in it. Is that good or bad? Depleted of lymphocytes?

A

Lymphocyte rich is best prognosis

Lymphocyte depleted is worst prognosis

47
Q

Lymph node biopsy shows ‘owl-eyes’ (Reed-Sternberg cells). What is this?

A

Hodgkin lymphoma

48
Q

Is Hodgkin lymphoma generally fatal?

A

No, 80% cure rate…unless too far progressed

49
Q

Non-Hodgkin Lymphoma originates in what kind of cells?

A

Lymphocytes (mostly B cells)

Natural killer cells

50
Q

What is the most common NHL?

A

Diffuse large B cell

51
Q

Which NHL is relate to EBV? What is seen on biopsy?

A

Burkitt lymphoma t[8;14]

Starry sky

52
Q

Which type of NHL is of T cell origin?

A

Peripheral

53
Q

Besides EBV, what are other risk factors for NHL?

A

HIV
Congenital immunodeficiencies
Rheumatic disease

54
Q

An NHL shows cleaved cells. What kind is this?

A

Follicular small cell variant t[14;18]

55
Q

Which NHL is basically the same as CLL?

A

Small lymphocytic

56
Q

Is the prognosis as good for NHL as it is for HL?

A

NO…poor prognosis…palliative treatments

57
Q

Who commonly gets ALL? what is the cell of origin?

A

White kids (2-5yo)

B-cell precursor is most common

58
Q

What can be present in adult ALL? What is this usually found in?

A

Philadelphia chromosome (t[9;22])…carries poor prognosis

CML

59
Q

A bone marrow biopsy shows blasts of MYELOid origin and staining with MYELOperoxidase. What is it? What would be seen on a blood smear? What is the prognosis

A

Acute MYELOgenous Leukemia (AML)

Large myeloblasts with notched nuclei and Auer rods

Poor…multiple remissions, but relapse is common

60
Q

An older patient is in for a regular exam and CBC shows a really fuckin high WBC. What is a possible diagnosis? What is the cell of origin? What would be seen on smear?

A

This is possibly Chronic Lymphocytic Leukemia (CLL)

Which is a proliferation of mature B cells

Could see numerous small lymphocytes and smudge cells

61
Q

What is the survival with CLL?

A

Some > 10 years

some less than 4

62
Q

A middle aged patient with a history of radiation exposure is found to have a really freakin high WBC with high proportion of neutrophils. Cytogenic analysis shows t[9;22]. What is the likely disease? What is the progression?

A

Chronic Myeloid Leukemia

Doing fine for a while…start to have some fatigue, sweats, weight loss…gets worse (blast crisis) and bone pain…death

63
Q

A middle aged guy comes in because he’s lost some pep and has noticed a mass in his LUQ. A blood smear shows numerous lymphocytes with hair projections. What is this?

A

Hair cell leukemia…proliferation of B cells

64
Q

A child comes in for an infection and is found to have pancytopenia. On exam, cafe-au-lait spots are found. What does this kid likely have? What else could be seen? What is the prognosis?

A

This is likely Fanconi Anemia

Could find a horseshoe kidney on imaging

Death in childhood d/t bone marrow failure or leukemia

65
Q

A kid is found to have a microcytic anemia with decreased Hgb, Hct, and retic count, but increased erythropoietin. What could be going on?

A

Diamond-Blackfan anemia (pure RBC anemia)

66
Q

Where do neuroblastomas present? What are risk factors? What is the prognosis?

A

Adrenal glands or sympathetic ganglia

Turner syndrome
Low maternal folate intake

Found 1yo…bad, metastasize to brain and bone

67
Q

What is the most common soft tissue sarcoma in kids?

A

Rhabdomyosarcoma

Step 2 (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions