ITE - Heme/Onc

Question 1

Adverse effects of tyrosine kinase inhibitors.

Answer 1

Fluid retention, QTc prolongation, contraindicated during surgery

Question 2

Hemochromatosis: Clues, Dx, Tx.

Answer 2

Clues; Nonspecific aminotransferase elevation, 2nd/3rd MCP joint arthropathy, darkening pigmentation of skin.
Dx: Iron studies followed by genetic testing
Screening: 1st deg relatives.
Tx: therapeutic phlebotomy

Question 3

Pure red cell aplasia: Dx, Tx.

Answer 3

Dx: bone marrow biopsy with selective decrease in erythrocyte precursurs
Tx: immunosuppression

Question 4

EGFR-mutated lung cancers: testing, Tx.

Answer 4

Indicated in advanced stage adenocarcinoma or mixed cancers for targeted treatment.

Question 5

Massive pulmonary embolism: Tx.

Answer 5

Thrombolytics, or if contraindications, surgical embolectomy.

Question 6

HIT: Dx, Tx.

Answer 6

Platelets drop >50% from baseline orr less than 150k after treatment with heparin.
4T: thrombocytopenia, timing, thrombosis, other causes (0-2 points for each section)
Dx: ELISA for factor 4 Abs, confirm with serotonin release assay or Hep-induced platelet aggregation assay)
Tx: discontinuation and supportive care

Question 7

High risk prostate cancer: Tx

Answer 7

Radiation therapy followed by gonadotropin deprivation.

Question 8

MALT: Tx.

Answer 8

If H. pylori ass’d, treat with abx and PPI

If not, radiation.