Medical Onco, Hema And Coag Flashcards
To which platelet glycoprotein does Vol Willebrand factor bind to enhance platelet aggregation
Glycoprotein Ib
Fibrinogen forms BRIDGES between activated platelets by binding to which platelet glycoprotein
Glycoprotein IIb/IIIa
Chromosomal abnormality in Burkitt’s lymphoma
Chromosomal translocation (8:14)
Neoplasm associated with Beta-napthylamine
Bladder cancer
Activated factor X (Xa), in combination with which 2 cofactors, activates prothrombin on the surface of platelets
Ionized calcium
Factor Va
Complex activates protein C on the surface of endothelial cells
Thrombin-thrombomodulin complex
Most central natural anticoagulant protein
Antithrombin III
Major endogenous activators of plasminogen
Tissue plasminogen activator (tPA) and
Urokinase
Prevents the reduction of Vit K once it has functioned as a cofactor for carboxylation of factor II, VII, IX and X
Sodium warfarin (Coumadin) as an anticoagulant
MC lab abnormality associated with antiphospholipid syndrome
Elevated aPTT not corrected by normal plasma
Laboratory test of hemophilia A
Prolongation of aPTT
Molecular abnormality in hemophilia B
X-linked recessive deficiency of factor IX (Christmas Factor)
MOA of METHOTREXATE
Binds dihydrofolate reductase, preventing reduction of folate to tetrahydrofolate, which is necessary for production of thymidine purines
Best tumor marker for choriocarcinoma
Beta-hCG
MOA of PACLITAXEL
Enhancement of tubulin polymerization
Drug usually associated with hemolytic uremic syndrome
Mitomycin C
Factors shift the oxygen curve to the RIGHT
High CO2
Low pH (Acidosis)
High DPG
High Temp
Only clotting factor NOT made in liver
Factor 8
Clotting abnormalities in Von Willibbrand disease
Long PTT and long bleeding time or functional platelet assay
Drug tx for Gestational trophoblastic neoplasm
Actinomycin D
MOA: blocks RNA synthesis by intercalating DNA nucleotide pairs
Most significant side effect associated with BLEOMYCIN
Interstitial pneumonitis
Most important factor in predicting efficacy of progestin therapy in endometrial cancer
Progesterone receptor status of tumor
Finding in peripheral blood smear characteristic of surgical or functional splenectomy
Howell-jolly bodies
Storage form of iron
Ferritin
Hemolytic anemia associated with ulcerative colitis
Autoimmune hemolytic anemia
A graft placed in the anatomic position normally occupied by such tissue
Orthotopic graft
Chromosome contains the Major Histocompatibility Complex (MHC)
Chromosome 6
MHC antigens bets trigger the proliferation of allogenic lymphocytes
HLA class II antigen (HLA-D, DR, DQ, and DW/DR)
Cells that have HLA Class I molecules
All nucleated cells
Cells that have HLA Class II molecules
Macrophage
Dendritic cells
B cells
Activated T cells
Cells produce IFN-alpha
Fibroblasts
Methods to determine the degree of histocompatibility between donor and recipient
MHC matching
Mixed lymphocyte culture (MLC)
Critical cytokines that influence lineage maturation
Granulocyte-macrophage colony stimukating factor (GM-CSF)
Interleukin 1 (IL-1)
Erythropoietin
Climical use of GM-CSF
Decrease infection in neutropenic patients
2ndary lymphoid organs
Spleen
Peripheral lymph nodes
Skin
Peyer’s patches
Required for lymphocyte to become sensitized
Accessory antigen-presenting cell (APC) or monocyte-macrophage line
It amplifies the immune response by exerting an autocrine feedback on the same cell and a paraceine effect to activate other T cells in the local microenvironment
Function of IL-2
ABO incompatibility
Hyoersensitivity?
Type II
Cells stimulated by Class II alloantigens
CD4 and T-helper cells
Forms tubular transmembrane pores (once cytotoxic T cell binds to the antigen on the target cell) to allow unidirectional granule exocytosis with destruction of the target cell
Released by sensitized T cells
Perforin
Acts synergistically with IL-1 to mediate acute phase changes, including tumor necrosis, hypotension and inflammatory reactions
Effects of Tumor Necrosis Factor (TNF)
Macrophage derived cytokines
IL-1, IL-6, and TNF-alpha
Causes release of histamine from mast cells, is chemotactic for PMNs, has a kinin activity, and causes immune adhrence
C3a - biologic actions
Factor initiates intrinsic pathway of clotting system
Hageman factor (factor XII)
MOA of MYCOPHENOLATE MOFETIL
Blockade of purine synthesis in proliferating T cells with minimal effect on bone marrow
Stage(s) of the cells cycle is radiation most effective
The M and G2 phase
Lymphocytes are also sensitive in the G0 phase
MC cause of death in transplant recipients
Infection
Candida albicans then Aspergilus
Viral - herpes group DNA (CMV)
Vaccines should be given before elective splenectomy
H. Flu
Meningococcus
S. Pneumonia
Given 1week before sx
Marker of hepatocellular carcinoma
Alpha fetoprotein
Why is left kidney preferred for donor nephrectomy
Longer left renal vein
