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high yield Flashcards

1
Q

vitamin K dependent coagulation factors

A

Factors 7, 9, 10 and prothrombin

protein C and protein S

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2
Q

important details of coagulation cascade

A
  • major site of synthesis of factors is liver (liver disease=bleeding)
  • Factor 7 has a very short half-life
  • vitamin K dependent factors: 2, 7, 9, 10 (procoag) protein C and S (anticoag.)
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3
Q

plasma cell neoplasm def

A

expansion of a clone of plasma cells (terminally differentiated Ig secreting B cells) that typically secrete a monoclonal Ig (paraprotein/M protein)

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4
Q

cancers that produce parathyroid hormone and result in hypercalcemia

A

kidney cancer

lung cancer

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5
Q

treatment of tumor lysis syndrome

A

hydration + allopurinol

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6
Q

signs and symptoms of superior vena cava syndrome

A
  • venous dilatation of arms and chest
  • facial flushing and swelling
  • dyspnea
  • cerebral edema
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7
Q

signs of spinal cord compression

A

back pain followed by leg weakness
evere back pain in radicular, band-like pattern which precedes motor or sensory deficit
• Weakness in distribution below dermatomal level of pain
• Sensory defect below same dermatomal level
• Hyerreflexia and pathologic long tract signs
• Urinary and rectal incontinence

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8
Q

treatment of hypercalcemia in lymphomas and plasma cell neoplasms

A

steroid responsive

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9
Q

signs/symptoms of hypercalcemia

A
  • CNS changes
  • Polyuria
  • Constipation and dysphagia
  • Anorexia
  • Severe bone pain
  • Rarely pancreatitis and kidney stones
  • Shortened QT-interval
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10
Q

pericardial tamponade

A

depends on rapidity of accumulation of pericardial fluid

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11
Q

t(9;22)

A

philadelpha chromosome; BCR-ABL
CML
small % ALL (poor prognosis; adult form)
treat w/ imatinib

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12
Q

t(8;14)

A

burkitt lymphoma

myc activation

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13
Q

t(11;14)

A

mantle cell lymphoma

cyclin D1 activation

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14
Q

t(14;18)

A

follicular lymphoma

BCL-2 activation

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15
Q

t(15;17)

A

APL subtype of AML

PML-RAR fusion (treat w/ ATRA)

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16
Q

most common aggressvie lymphoma

A

diffuse large B cell

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17
Q

most common indolent lymphoma

A

follicular lymphoma

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18
Q

therapy for diffuse large B cell lymphoma

A

R CHOP (cyclophosphadmide=alkylating agent, doxorubicin (topo II inhib), vincristine (inhibts MT polymerization), prednisone)

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19
Q

follicular lymphoma vs follicular hyperplasia

A

follicular lymphoma express BCL2 t(14;18)

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20
Q

symptoms of polycythemia vera

A

persistent leukocytosis, thrombocytosis, splenomegaly, generalized pruritus (usually after bathing), thrombosis and erythromelagia

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21
Q

Which diseases have JAK2 mutations?

A

polycythemia vera, essential thrombocythemia, primary myelofibrosis

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22
Q

Which acute leukemia more commonly presents w/ adenopathy?

A

ALL (and also Burkitt’s lymphoma)

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23
Q

APL key facts

A

more likely to present with DIC
t(15;17)=PML-RAR fusion
treated w/ ATRA + chemo or arsenic

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24
Q

Which chemotherapy drug is most likely to be later associated with secondary AML?

A

akylating agents

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25
myelophtisic anemia
• replacement of marrow by infiltrative process→fragmented RBCs in peripheral blood
26
symptoms of MM
``` CRAB hyperCalcemia Renal insufficiency Anemia Bone lesions ```
27
Anisocytosis
blood cells of unequal size
28
GI bleed, ulcer, menstrual irregularities
iron deficiency anemia
29
What do you think of w/ aplastic anemia
parvovirus B19
30
hyposegmented neutrophils
pegler heut anomaly
31
African american pt limping
avascular necrosis femoral head
32
hydroxyurea
treatment sickle cell | inc. HbF
33
COLD AIHA
IgM, intravascular hemolsys
34
Warm AIHA
pt has lupus--warm autoimmune hemolytic anemia
35
pt w/ recurrent miscarriages
antiphospholipid antibody syndrome | labs: paradoxically elevated PTT w/ lupus anticoagulant
36
ALL
median age onset 10; lymphoblasts occupy > 20% marrow space; TdT+; CD2, 3, 7 positive; mets can occur to the CNS so you want to look for CNS disease in these patients by doing an LP +/- CT, MRI
37
CLL
median age onset 65 years; functionally incompetent mature b-lymphocytes; CD19, 20, 22, 23 positive; SMUDGE CELLS pts asymptomatic, discovered on routine blood smear
38
AML
median age onset is 60 years old; POSITIVE FOR MYELOPEROXIDASE
39
APL
= rare disease, t(15;17) PML-RARa fusion protein; treat with All-trans retinoic acid; release of auer rods can lead to DIC
40
CML
Philadelphia chromosome t(9;22); three course disease→ chronic phase → accelerated phase → blast phase (counts can get so high that cells cause infacts, stroke); NOTE: You can distinguish this from leukemoid reaction because CML has low levels of leukocyte alkaline phosphatase
41
Burkitt lymphoma
starry sky appearance on pathology (know this); t(8;14); EBV associated; you can also see this in people with HIV
42
Lung cancer
: small cell is the most deadly; squamous cell can produce PTHrP causing hypercalcemia; small cell can secrete ACTH (leading to cushings) and ADH (causing SIADH); know that small cell cancer is treated with chemotherapy and not surgery
43
adenocarcinoma of the lung
located peripherally in the lung (pleural puckering seen on path…google image this) and can result in hypertrophic osteoarthropathy (polyarthritis and periostosis of long bones) → so if you get a patient with PAIN IN HIS SHINS, think of this **MOST COMMON TYPE OF LUNG CANCER IN NON-SMOKERS
44
colon cancer screening in brief
a. NormalL colonoscopy @ 50 then every 10 yrs if normal; every 3-5 years if abnormal findings b. Strong Family Hx of Colon Ca: colonoscopy @ age 40 or 10 years before diagnosis in relative, then every 5 years c. Ulcerative colitis: colonoscopy 8-10 years after diagnosis , then every 1-2 years.
45
clopidogrel side effect
clopidogrel can cause neutropenia
46
target cells assoc. w/
``` HALT HbC Asplenia Liver disease Thalassemia ```
47
basophilic stippling assoc w/
``` TAIL thalassemia anemia chronic disease iron deficiency Lead poisoning ```
48
tear drop cell
infiltrative d/o of bone marrow
49
howell-jolly body in rbc
asplenia
50
TTP
autoimmune attack on ADAMTS13-->large vWF-->platelet overactivation Dx: dec. PC (normal PT, PTT, D-dimer) systemi sx>renal sx low ADAMTS13 activity
51
HUS
caused by E. coli O157:H7 dec. PC (normal PT, PTT, D-dimer) renal sx>systemic Sx normal ADAMTS13 activity
52
DIC
widespread endothelial damage, overactivation of both platelets and coagulation cascade dec. PC, inc. PT/PTT/D-dimer clotting and bleeding at same time
53
bloody discharge from nipple in premenopausal woman
intraductal papilloma=benign
54
pancreatic cancer staging
o T-stage: • T1: limited to pancreas 2cm • T3: extends beyond pancreas, not to celiac axis, SMA • T4: involves celiac axis or SMA o N-stage: • N0: no regional LN • N1: + regional LN o M-stage: M0 (no mets) M1 (mets)
55
criteria for surgical resection pancreatic cancer
* No distant mets * Clear fat plane around celiac artery and SMA * Patent SMV/portal vein
56
screening for HCC
for high risk pts (HBV, HCV, cirrhotics) serial US and AFP testing every 6-12months follow up w/ CT/MRI if abnormal
57
radiographic Diagnosis of HCC
lesions 1-2cm w/ classic appearance on 2 imaging modalites, lesions >2cm w/ one imaging modality, AFP>200 w/ classic arterial enhancement
58
peutz jeghers syndrome
perioral pigmentation; AD; STK11/LKB1 gene mutation; small intestinal hamartomas w/ increased risk other GI cancers
59
amsterdam criteria to identify HNPCC kindred
* 3 or more relatives w/ an associated cancer (CRC, small bowel, endometrial, renal, gastric, ovarian) * 2 successive generations involved * 1 of cancers diagnosed before age 50 * **criteria misses 50% of HNPCC families
60
follow-up surveillance for resected CRC
o H&P w/ digital rectal exam q3-6months for 2 years then q6 months for 3 years o CEA testing q3-6months for 2 years, then q6months for 3 years o Colonoscopy at 1 year, repeat in 1 year if abnormal or if negative then 5 years o CT chest, abdomen, pelvis annually x 5 years for high risk patients o No evidence for routine CBC, LFT, CXR, PET scan
61
squamous cell lung cancer
``` most common cancer in smokers central hypercalcemia due to PTH-like substance bone mets CK5/6+, P63+ ```
62
adenocarcinoma of the lung
most common in nonsmokers peripheral brian mets, hypertrophic osteoarthropathy (shin pain) TTF-1+, CK7+, CK20-, NAPSIN A+
63
large cell lung cancer
giant cell, clear cell, spindle cell | brain mets
64
smal cell lung cancer
most deadly neurosecretory granules, chromogranin+, synaptophysin+ central (hilar/mediastinal adenopathy) paraneoplastic syndrome (SIADH, cushings, eaton lambert) brain mets-->must image!

Heme/onc (5 decks)

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