Misc

Question 1

What conditions require treatment with acute dialysis?

Answer 1

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)

Question 2

Filgrastim

Answer 2

GCSF recombinant cytokine that activates PMNs

can be given as infection prevention during chemo for ALL patients

Question 3

Vit K and antibiotics

Answer 3

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)

Question 4

What are prolymphocytes pathognomonic for?

Answer 4

CLL/SLL high nuclear to cytomplasmic ratio

Question 5

What are potential complications from mono?

Answer 5

Cold hemolytic anemoa

Progression to Hodgkins lymphoma

Question 6

Treatment for Hodgkins lymphoma

Answer 6

Chemo (Vincristine)

ABVD (Adriamycin, Bleiomycin, Vinblastine, Dicarbazamine)

Question 7

Traztuzumab

Answer 7

Treatment of HER2 breast cancer by blocking tyrosine kinase (c-erbB2)
“traz2zumab”
herceptin is also a name
Heart toxicity “heart-ceptin”

Question 8

What specific enzyme does warfarin block?

Answer 8

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

Question 9

What are the most commonly mutated proteins in HS v HE?

Answer 9

HS: ankrin
HE: alpha spectrin

Question 10

What are the tests you can do to confirm HS?

Answer 10

Osmotic fragility test

5-eosin maleimide binding test for screening

Question 11

Eosinopenia

Answer 11

Cushings
corticosteriods
*sequester eosinophils in LN (destroy lymphocytes, increase neutrophils by releasing marginated pool)

Question 12

What is the relative cell count cut off for neutropenia lymphopenia?

Answer 12

less than 1,500

Question 13

What medication inhibits mast cell degranulation? What is it used for?

Answer 13

Chromolyn sodium
Asthma treatment
(mast cells release heparin, histamine, and eosinophilic chemotaxtic factors in response to IgE crosslinking that is caused by allergens)

Question 14

What is warfarin skin necrosis indicative of?

Answer 14

Protein C or S deficiency

“C cancels Coagulation”

Question 15

Peptic Ulcer disease symptom constellation

Answer 15

epigastric burning or aching pain 1-3 hrs after eating during the day
worse at night
better with alkali or food

Question 16

Primary underlying cause of PUD

Answer 16

NSAIDs (block PG which are bicarb stimulators and increase vascular flow to wash out H+ that gets into lamina propria)
H. pylori

Question 17

Main precipitating condition of PUD

Answer 17

Chronic gastritis

Question 18

Anatomical area most often affected with PUD

Answer 18

proximal duodenum (4* more common than in stomach)
junction between body and antrum

Question 19

Zollinger-Ellison

Answer 19

tumor that secrets gastrin resulting in a ton of H+ production and ulcers in the stomach, duodenum, and jejunum

Question 20

What two conditions do you see peptic ulcer disease in not directly effecting the stomach and what is the pathogenesis?

Answer 20

Chronic renal failure
Hyper parathyroidism
Hypercalcemia stimulates gastrin production and thus acid

Question 21

What symptoms due you usually see in R sided colon cancer?

Answer 21

Fatigue, weakness, iron deficiency anemia

Question 22

What symptoms due you usually see in L sided colon cancer?

Answer 22

Occult blood, cramping, left sided pain

Question 23

What are the two most important prognostic factors in colon cancer?

Answer 23

Depth of invasion

Lymph node involvement

Question 24

What is the most common site of metastatic lesions from colonic adenocarcinoma?

Answer 24

Liver (drainage) EXCEPT the rectum which can circumvent the portal circulation