Misc Flashcards
What conditions require treatment with acute dialysis?
AEIOU
A: Metabolic acidosis refractory to bicarb
E: Electrolytic imbalances esp K hyper refractory to medical intervention
I: Intoxication with certain drugs
O: Overload volume refractory to diuretics
U: Uremic symptoms (cardiac friction rub, altered mental status)
Filgrastim
GCSF recombinant cytokine that activates PMNs
can be given as infection prevention during chemo for ALL patients
Vit K and antibiotics
Vit K is synthesized by gut flora
Long term antibiotics (or antibiotics in general) can lead to a vit K deficiency (which is need for the carboxylation of glutamic acid residues ) and bleeding issues (hematuria, melena, easy bruising)
What are prolymphocytes pathognomonic for?
CLL/SLL high nuclear to cytomplasmic ratio
What are potential complications from mono?
Cold hemolytic anemoa
Progression to Hodgkins lymphoma
Treatment for Hodgkins lymphoma
Chemo (Vincristine)
ABVD (Adriamycin, Bleiomycin, Vinblastine, Dicarbazamine)
Traztuzumab
Treatment of HER2 breast cancer by blocking tyrosine kinase (c-erbB2)
“traz2zumab”
herceptin is also a name
Heart toxicity “heart-ceptin”
What specific enzyme does warfarin block?
vitamin K expoxide reductase
Reduses vit K back to reduced form which can then aid in the y carboxylation of 2,7,9,10 that allows these factors to bind Ca and participate in the clotting cascade
What are the most commonly mutated proteins in HS v HE?
HS: ankrin
HE: alpha spectrin
What are the tests you can do to confirm HS?
Osmotic fragility test
5-eosin maleimide binding test for screening
Eosinopenia
Cushings
corticosteriods
*sequester eosinophils in LN (destroy lymphocytes, increase neutrophils by releasing marginated pool)
What is the relative cell count cut off for neutropenia lymphopenia?
less than 1,500
What medication inhibits mast cell degranulation? What is it used for?
Chromolyn sodium
Asthma treatment
(mast cells release heparin, histamine, and eosinophilic chemotaxtic factors in response to IgE crosslinking that is caused by allergens)
What is warfarin skin necrosis indicative of?
Protein C or S deficiency
“C cancels Coagulation”
Peptic Ulcer disease symptom constellation
epigastric burning or aching pain 1-3 hrs after eating during the day
worse at night
better with alkali or food
Primary underlying cause of PUD
NSAIDs (block PG which are bicarb stimulators and increase vascular flow to wash out H+ that gets into lamina propria)
H. pylori
Main precipitating condition of PUD
Chronic gastritis
Anatomical area most often affected with PUD
proximal duodenum (4* more common than in stomach) junction between body and antrum
Zollinger-Ellison
tumor that secrets gastrin resulting in a ton of H+ production and ulcers in the stomach, duodenum, and jejunum
What two conditions do you see peptic ulcer disease in not directly effecting the stomach and what is the pathogenesis?
Chronic renal failure
Hyper parathyroidism
Hypercalcemia stimulates gastrin production and thus acid
What symptoms due you usually see in R sided colon cancer?
Fatigue, weakness, iron deficiency anemia
What symptoms due you usually see in L sided colon cancer?
Occult blood, cramping, left sided pain
What are the two most important prognostic factors in colon cancer?
Depth of invasion
Lymph node involvement
What is the most common site of metastatic lesions from colonic adenocarcinoma?
Liver (drainage) EXCEPT the rectum which can circumvent the portal circulation
