Immunology/Hematology Flashcards
1) Reed Sternberg cells (OO), Pel-Ebstein fevers (come & go every few weeks), and lymph node pain induced by alcohol consumption are highly specific for what lymphoma?
2) Reed Sternberg cells originate from B cells and are CD_/_ +
HODGKIN lymphoma
CD15/30+
EBV, SLE, and RA increases risk of developing what lymphoma?
Hodgkin lymphoma
GOAL and 3 drug treatment for CEREBRAL toxoplasmosis?
GOAL: inhibit folate (= stops toxoplasmosis parasite from spreading) + replace lost folate
1) pyrimethamine (inhibits DHF reductase)
2) sulfadiazine (sulfonamide)
3) leucovorin (folinic acid).
A prolonged PT is associated with a deficiency in only one factor: ____
Factor 7.
Factor 7 is the only one standing outside (Extrinsic); all other factors (PTT) are inside (Intrinsic)
Which factor is responsible for the activation of factor 7?
Which vitamin is responsible for the activation of factor 7?
factor 9!!!
Vitamin K
Which immunosuppressant causes: Hyperglycemia, CMV infection, and PML of brain
Mycophenolate mofetil
Which immunosupressants do NOT cause pancytopenia?
Tacrolimus
Cyclosporine
- these are neuro & nephro toxic
which immunosuppressant causes :
Gingival hyperplasia!!
Hypertrichosis
hirsutism,
Cyclosporine
How do you manage a displaced vs non displaced clavicular fracture?
Displaced (skin puncture, nerve damage, floating/shortened bone)= clavicular plate
non displaced = simple shoulder sling (will heal on own)
Tx for Hepatitis B infection?
Supportive therapy. Hep B resolves on own. Do not immunize ppl with active HepB.
What is the most effective way to prevent tumor lysis syndrome?
IV hydration!!
rasburicase/allopurinol are second line
Newborn with echinocytes (burr cells), indirect bilirubinemia, and FHx of hydrops fetalis has what hereditary disorder?
Pyruvate kinase deficiency
what is Ketotifen?
what eye condition does it treat?
Ketotifen is a second generation antihistamine
Tx seasonal allergy conjuctivitis
what blood condition presents with:
- elevated RDW (size)
- low MCV
Iron deficiency anemia
what blood condition presents with:
- elevated RDW (size)
- elevated MCV
B12 or folate deficiency
Liver disease
Why is IDA so common in EXCLUSIVELY fed newborns (only breast milk or only cows milk)?
bc they aren’t intaking any meals high in Iron (breast milk and cows milk have no iron)
you must give them iron supplementation until they start eating iron enriched foods
numerous BLASTS on a blood smear is red flag for what 2 blood cancers?
what are the CBC findings in this cancers?
BLASTS cells (immature cells) = LEUKEMIA - either lymphoid (ALL) or myeloid (AML) origin
CBC= -penia (since no cells mature, theres a decrease in cell lines)
- thrombocytopenia, neutropenia, anemia, dec B&T cells
which acute leukemia is ALLways in children?
acute lymphoblastic leukemia (ALL)
which acute leukemia is always in older adults?
acute myeloid leukemia (AML)
which acute leukemia stains positive for myeloperoxidase?
Acute MYELOID Leukemia (AML)
which acute leukemia stains positive for:
terminal deoxynucleotidyl transferase (TdT) and
Periodic acid-Schiff (PAS)
acute lymphoblastic leukemia (ALL)
which cells are positive on flow cytometry for acute lymphoblastic leukemia (ALL) ?
since its lymphoblastic = lymph origin = B and T cells.
B cells: CD10, 19, 20
T cells: CD2, 3, 8
which cells are positive on flow cytometry for acute myeloid leukemia (AML)?
CD13, CD33, CD34, CD117, and HLA-DR
what translocations are associated with acute myeloid leukemia?
t(15:17)
especially in acute promyelocytic leukemia (M3 AML)
what translocations are associated with acute lymphoblastic leukemia?
t(12:21)== in B-ALL children = POOR prognosis
hint: 21 = trisomy 21 = downs syndrome associated with ALL
How can you remember which trisomy is associated with acute lymphoblast leukemia & where the leukemia metastasizes to?
ALL children are DOWN to grow up and have BRAINS and SEX (testes)
what acute leukemia presents with fever and testicular enlargement?
Acute lymphoblastic leukemia
auer rods are seen in which leukemia ?
AML & APML
what leukemia presents with gingival hyperplasia?
acute myeloid leukemia (AML)
what is the immediate management for a patient with Heparin induced thrombocytopenia (HIT)?
stop heparin!
switch to a NON-heparin anticoag typically a direct thrombin inhibitor (e.g., argatroban, bivalirudin) or a non-coumarin factor Xa inhibitor (e.g., rivaroxaban, dabigatran, fondaparinux).
how does Lauryn confirm G6PD deficiency before choosing it as an answer
anemia
blood smear abnl : Heinz bodies
what are cryoglobulins?
regular proteins (IgG & IgM) in the blood that CLUMP together when its COLD outside
what are the symptoms of mixed cryoglobulinemia?
mixed = complement deposition = vasculitis
arthralgia
red, non blanching purpura/macules (bc vessels are extravasating blood & not filling back up)
hypocomplementemia
hematuria
and increased serum concentration of polyclonal IgG and IgM
Why are pts with mixed cryoglobulinemia positive for rheumatoid factor?
IgM has the activity of RF; the HIGH levels of serum IgM (+IgG)»_space;> + RF
what virus precipitates mixed cryoglobulinemia?
Hep C for Cryoglobulinemia. also HIV
all pts with cryoglobulinemia have Hep C so make sure you do a serology
anti-dsDNA is associated with what connective tissue diseases?
SLE
Anti-Sm is associated with what connective tissue diseases
SLE
Anti-Ro/SSA
Anti-La/SSB is associated with what connective tissue diseases
Sjogrens
Anti-histone is associated with what connective tissue diseases
SLE
anti C1q is associated with what connective tissue diseases
SLE
anti Jo1 & anti Mi2 are anti-synthetase ABs associated with what connective tissue diseases
Polymyositis and dermatomyositis
Mi & Jo are synners
Anti-U1-RNP is a Anti-ribonucleoprotein antibodiy associated with what connective tissue diseases
mixed connective tissue disease
Anticentromere is associated with what connective tissue diseases
systemic sclerosis
Centromere Cyctemic Clerosis
Antiphospholipid antibodies is associated with
SLE
what are the 3 types of antiphospholipid antibodies that point to SLE?
which antiphospholipid AB prolongs aPTT?
anti-cardiolipin (most common type) Anti-β2-glycoprotein 1 antibodies lupus anticoagulant (LA)
lupus anticoagulant
Anti-cyclical citrullinated peptide antibodies are specific for what disease?
RA
Anti-DNA topoisomerase I antibodies is associated with what connective tissue diseases
systemic sclerosis
a prolonged BLEEDING TIME will always be mnemonic for what blood disorder?
what other mnemonic symptoms are there?
BLEEDING TIME = vWF (regardless of what PTT/PT says!!!!)
++++ nosebleeds/tooth bleeds
why may you see a prolonged PTT in addition to the prolonged BT seen in vWF disease?
Factor 8 circulates on vWF.
so no vWF factor = low F8 = prolonged PTT
what bleeding disorder presents with an isolated prolonged PTT?
Hemophilia A (Factor 8 deficiency)