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Heme./Onc > Malaria/Test 2 > Flashcards

Malaria/Test 2 Flashcards

1
Q

What is the only species of malaria that can use animals as a vector?

A

Knowlesi

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2
Q

Where do merozoites transform into trophozoites?

A

RBCs

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3
Q

What are the two most common species of malaria?

A

vivax and ovale

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4
Q

Many of the symtpoms of malaria are thought to be caused by what cytokine?

A

TNF

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5
Q

What two cytokines inhibit erythropoiesis in malaria infected people?

A

TNF and IL1

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6
Q

Which two species of malaria infect both mature and young erythroctes?

A

falciparum and knowlesi

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7
Q

Which two species of malaria infect only young erythroctes?

A

vivax and ovale

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8
Q

Which species of malaria prefers older erythrocytes?

A

Malariae

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9
Q

The most severe form of anemia is caused by what species of plasmodium?

A

Falciparum

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10
Q

What are the two metabolic symptoms of Plasmodium infection?

A

hypoglycemia and lactic acidosis

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11
Q

What anti-malarial drug can release insulin? In what species could this cause a deleterious effect?

A

Quinine

falciparum

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12
Q

What is the most serious side effect of Vivax and Ovale infection?

A

splenic rupture

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13
Q

Which species of malaria causes RBCs to produce knobs? What is the effect of this?

A

Falciparum

adhere to microvascular endothelium

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14
Q

What are the three most common complications of falciparum malaria?

A

renal failure

pulmonary edema

cerebral edema

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15
Q

Vivax uses what RBC protein to gain access? What two population groups express this protein?

A

Duffy antigen

Caucasians and and Asians

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16
Q

What antibiotic is used to treat malaria?

A

Doxycycline

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17
Q

What two species are resistant to Chloroquine?

A

falciparum and vivax

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18
Q

Which anti-malarial is equally effective for all plasmodium species?

A

Mefloquine

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19
Q

Primaquine is effective against which two species?

A

vivax and ovale

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20
Q

In what patient group is primaquine contraindicated?

A

G6PDase deficiency

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21
Q

What drug is most effective in the Tx of Falciparum?

A

Malarone

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22
Q

What does clinical cure mean?

A

eradication of erythrocytic forms of malaria

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23
Q

What does radical cure mean?

A

elimination of hypozite of vivax and ovale

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24
Q

Babesiosis is carried by what organism?

A

Tick

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25
Q

Does Babesiosis effect animals?

A

yes

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26
Q

What are the two most common babeiosis species?

A

microti

divergens

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27
Q

What genus of tick carries babeoisis?

A

Lxodes

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28
Q

What three patient populations are at risk of babesiosis?

A

elderly, asplenic, immunocompromised

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29
Q

Does sexual reproduction of Babesia occur in the tick or human?

A

tick

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30
Q

What two drugs are used to treat babeoisis?

A

Quinine and Clindamycin

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31
Q

What genus of species transmits malaria?

A

Anopheles

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32
Q

Where is Knowlesi found?

A

Malaysia

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33
Q

How often does Plasmodium Malariae present with symptoms?

A

every 72 hours

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34
Q

What stage of replication of plasmodium destroys RBCs in humans?

A

asexual

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35
Q

Lack of which antigen on RBCs can confer resistance to plasmodium?

A

Duffy

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36
Q

Maltese cross = ?

A

Babesia

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37
Q

Where is the use of chloroquine recommended?

A

west of panama canal

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38
Q

What is the only drug that can kill the liver forms? What species?

A

Primaquine

vivax and ovale

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39
Q

Are there differences in clinical outcome of new blood vs. old blood ?

A

nope

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40
Q

What is the best strategy, restrictive or non-restrictive? What does this mean?

A

restrictive

wait until Hb is low to transfuse

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41
Q

What is the most common reason to leukoreduce?

A

CMV

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42
Q

How many RBC units in the US have been leukoreduced?

A

all

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43
Q

What is irradiation used for?

A

to prevent graft versus host disease

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44
Q

In what patient type is it necessary to irradiate?

A

immunocompromised

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45
Q

When is volume reduction used?

A

circulatory overload

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46
Q

When is plasma given?

A

when you want to replease coagulation factors

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47
Q

What does platelet refractoriness mean?

A

pt’s receiving platelets may make antibodies to platelets

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48
Q

What are the four components of cryoprecipitate?

A

vWF, fibrinogen, 8 and 13

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49
Q

Which four factors are found in prothrombin complex concentrate?

A

two, seven, nine and ten

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50
Q

What is a normal WBC count in newborns?

A

9K - 30K

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51
Q

AML presents most often in what age group?

A

adults

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52
Q

What is more common, BALL or TALL?

A

BALL

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53
Q

Are ALL seen more common in children or adults?

A

children

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54
Q

What is the average age of Dx for CLL?

A

70

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55
Q

What is a normal Hb level for a 6-month old?

A

11.5 mg/dL

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56
Q

At what age should a child and adults Hb be roughly the same?

A

Age 12

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57
Q

How often do Vivax and ovale cause fever?

A

every 48 hrs

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58
Q

How often does Knowlesi cause fever?

A

24 hours

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59
Q

What is the name for the characteristic appearance of vivax and ovale in infected RBCs?

A

Schuffner dots

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60
Q

What does P. malariae look like in an infected RBC?

A

band

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61
Q

What two animals serve as a reservoir for ticks?

A

cattle and rodents

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62
Q

What are the two side effects of quinine?

A

cinchocism and hypoglycemia

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63
Q

What drug is used in the replacement of chloroquine?

A

Mefloquine

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64
Q

What antibacterial can be used for malaria?

A

doxycycline

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65
Q

What are the two major side effects of doxycycline?

A

staining of the teeth

photosensitivity

66
Q

What immunoglobulin can cross the placenta?

A

IgG

67
Q

What is the function of H-antigen?

A

precursor antigen for A and B

68
Q

What is the antigen of type A blood?

A

N-acetylgalactosamine

69
Q

What is the antigen of type B blood?

A

galactosamine

70
Q

Around what week of fetal life do antigens develop?

A

6th week

71
Q

When do ABO antibodies develop?

A

6th month of life

72
Q

What deficiency is a reason to wash RBCs?

A

IgA deficiency

73
Q

What three diseases are cryoprecipitate used?

A

Hemphilia A

vWF deficiency

Factor XIII deficiency

74
Q

When is the transfusion of blood best indicated?

A

massive trauma

75
Q

What is the result of a febrile transfusion reaction?

A

almost always benign

76
Q

What is the most common cause of febrile transfusion reaction?

A

cytokines being released by leukocytes

77
Q

What medicine is given to avoid a febrile transfusion rxn?

A

acetaminophen

78
Q

What are the two most often reasons for an allergic transfusion reaction?

A

plasma

platelets

79
Q

An anaphylactic rxn to a transfusion is most often caused by what deficiency? Does pretreatment work in these patients?

A

IgA

no

80
Q

What are the two most common signs of TACO?

A

increased BP and HR

81
Q

TRALI is most often caused by what two components of blood?

A

platelets and plasma

82
Q

What is the timespan for TRALI?

A

within six hours

83
Q

What is the treatment for TRALI?

A

O2

84
Q

What should not be given during TRALI? What is given?

A

diuretic

pressors

85
Q

What is the common antibody responsible for hemolytic anemia?

A

anti-Kidd

86
Q

What does Rho-GAM do?

A

bind to RH antigen on baby’s cells

87
Q

In a child, when is WBC highest?

A

at birth

88
Q

An I:T ratio greater than what indicates a risk of sepsis?

A

0.20

89
Q

Why are Hb and HCT high at birth?

A

High affinity of HbF is interpreted as hypoxia and EPO is released

90
Q

What are normal Hb values for a newborn?

A

14-22

91
Q

What is the definition of polycythemia in an infant ?

A

greater than 65%

92
Q

Does polycythemia need to be taken from a venous or arterial sample?

A

venous

93
Q

What is the lifespan of RBCs in a newborn?

A

80 days

94
Q

What is a nadir ?

A

trough of HB concentration

95
Q

When is nadir usually reached?

A

6-8 weeks

96
Q

What is the equation for the low-end of MCV in children under 10?

A

70 + age

97
Q

What is the equation for the high-end of MCV in children under 10?

A

84 + (0.6*age)

98
Q

What type of milk can cause a folate deficiency?

A

goat

99
Q

What is the most common cause of iron deficiency anemia in an infant?

A

excessive milk intake

100
Q

What causes Diamond Blackfan anemia?

A

congenital abnormality in ribosomal protein synthesis

101
Q

What is the Tx of iron overload in infants?

A

deferoxamine

102
Q

Which species causes the highest parasitemia?

A

falciparum

103
Q

Does TRALI have hypertension or hypotension?

A

hypotension

104
Q

What blood component is most likely to contain bacteria?

A

platelets

105
Q

Does TACO present with fever?

A

no

106
Q

What are the two mutations in essential thrombocytosis? What cell is over-produced?

A

JAK2 and MPL

megakaryocytes

107
Q

What are the two mutations in primary myelofibrosis?

A

JAK2 and MPL

108
Q

Is the reticulocyte count high or low in TEC?

A

low

109
Q

Is the reticulocyte count high or low in DBA?

A

low

110
Q

What is increased during DBA?

A

HbF

111
Q

WHat drug is given to treat DBA?

A

prednisone

112
Q

What species of malaria can remain dormant for years?

A

vivax and ovale

113
Q

Which species of malaria can only infect RBCs containing Duffy antigens?

A

Vivax

114
Q

What form of malaria does chloroquine kill?

A

intra-erythrocytic

115
Q

In what two patient populations is doxycycline contraindicated?

A

children and pregnant women

116
Q

Do RBC carbohydrate antigens tend to stimulate IgG or IgM?

A

IgM

117
Q

Do RBC protein antigens tend to stimulate IgG or IgM?

A

IgG

118
Q

What is the anitgen of H-antigen?

A

H-antigen

119
Q

How long can a febrile rxn take place after a transfusion?

A

up to 4 hours

120
Q

At what age does Hb reach adult levels?

A

two years

121
Q

What is the treatment for TEC?

A

supportive

122
Q

What dietary supplement is given during sickle cell disease?

A

folic acid

123
Q

What is the most fatal cancer?

A

lung

124
Q

What is the most important prognostic criteria for cancer?

A

staging

125
Q

Why can malaria cause hypoglycemia?

A

induced insulin release from pancreas

126
Q

Which malarial species likes to consume blood glucose?

A

falciparum

127
Q

Which malarial species likes to consume blood glucose?

A

falciparum

128
Q

Is glycophorin A an IgG or IgM antigen?

A

IgM

129
Q

Is glycophorin A an IgG or IgM antigen?

A

IgM

130
Q

Is glycophorin B an IgG or IgM antigen?

A

IgG

131
Q

What sugar is present in H-antigen?

A

fucose

132
Q

What happens sooner, TACO or TRALI?

A

TACO

133
Q

At what age should iron supplementation begin for a child that is exclusively breast fed?

A

4 months

134
Q

At what age should iron supplementation begin for a child that is exclusively breast fed?

A

6 months

135
Q

What procedure is used to Dx most plasma cell disorders?

A

Bone marrow biopsy

136
Q

How big is a Stage 1A renal cell carcinoma?

A

less than 4 centimeters

137
Q

What did Nish say two drugs are used to treat liver?

A

doxorubicin and irinotecan

138
Q

What three cancers can cause a malignant pleural effusion?

A

lung, breast and ovarian

139
Q

What three types of cancer are relatively resistant to radiation?

A

sarcoma, melanoma, renal cell

140
Q

What does radiosensitive mean?

A

melts to radiation

141
Q

What does radioresponsive mean?

A

melts quickly to radiation

142
Q

Does radiation work better on poorly oxygenated or well oxygenated cancer cells?

A

well oxygenated

143
Q

What is the radiosensitive phase of the cell cycle?

A

G2/M

144
Q

What is the radioresistant phase of the cell cycle?

A

S

145
Q

What penetrates superficially, electrons or photons?

A

electrons

146
Q

What penetrates deep, electrons or photons?

A

photons

147
Q

What is IGRT useful for?

A

tumors that can move

148
Q

What does radical cure mean?

A

parasites are no longer present in liver

149
Q

What does recrudescence mean?

A

reappearance of detectable blood stream forms

150
Q

What are the two platelet antibodies?

A

anti-HLA and anti-HPA

151
Q

What is given to support a patient with TRALI?

A

O2

152
Q

What is the normal WBC at birth?

A

9K-30K

153
Q

At what age should a child and adults WBC be roughly the same?

A

12 years

154
Q

What is a normal lymphocyte percentage?

A

35%

155
Q

What is a normal nadir for a full-term infant?

A

9 mg/dL

156
Q

What is the upper limit of MCV for children?

A

96

157
Q

What are the two viruses that are known to cause HCC?

A

HBV and HCV

158
Q

Hepatic tumors have almost exclusive blood supply from what vessel?

A

hepatic artery

159
Q

What two cancers are radioemobilization used for?

A

HCC and colorectal carcinoma

160
Q

What two species of malaria can lay dormant for years?

A

vivax and ovale

161
Q

According to Nguyen, what cells expand during CLL?

A

granulocytic and megakaryocytic

Heme./Onc (15 decks)

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