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Heme boards > Miscellaneous 2 > Flashcards

Miscellaneous 2 Flashcards

1
Q

Del 5q- prognostic significance in MDS

A

low risk

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2
Q

Del 7q- prognostic significance in MDS

A

adverse

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3
Q

Trisomy 8 prognostic significance in MDS

A

Intermediate risk

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4
Q

del20q- prognostic significance in MDS

A

adverse

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5
Q

What is G4 CRS?

A

multiple pressors and/or positive pressure ventilation

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6
Q

Management of G4 CRS

A

Toci + solumedrol 1 g/day
(solumedrol instead of dex)

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7
Q

Management of severe CRS per boards

A
  • toci + steroids concurrently (dex for G3, solumedrol for G4)
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8
Q

What does POEMS stand for

A

Polyneuropathy
Organomegaly
Endocrinopathy
Monoclonal (M) protein spike
Skin changes

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9
Q

Transplant criteria for AL amyloidosis

A

-Transplant eligible = 1) Age <70
* 2) SBP >90
- 3) NYHA <3
- 4) No more than 2 organs involved (liver, heart, kidney, or autonomic nerve)
- 5) Troponin T level <0.06 (high sensitivity troponin T <75 ng/ml)
- 6) NTproBNP <5 ng/L
- 7) ECOG 0-1
- 8) CrCl ?30 mL/minute

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10
Q

of cycles of induction for transplant eligible myeloma pts

A

4 (can give a couple more if they don’t have VGPR but answer choice will state 4)

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11
Q

Firstline for Castleman’s

A

Siltuximab

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12
Q

posaconazole issue w/ HMA+venetoclax

A
  • can increase serum concentration of venetoclax through CYP3A4 inhibition so need to dose reduce venetoclax if using
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13
Q

Management of AML patient in CR1 after induction who’s transplant ineligible after induction

A

maintenance with PO azacitadine

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14
Q

Induction for AML with myelodysplasia-related changes

A

Induction:
Liposomal cytarabine and daunorubicin (vyxeos)

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15
Q

Brentuximab mechanism

A

Targets CD30

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16
Q

Management of T-Dxd with ILD - continue vs. hold

A

G1:
steroids
hold until resolved to G0
continuation:
If resolved in 28 days or less, maintain dose
If resolved in greater than 28 days, dose reduce
If >G2, permanent discontinuation

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17
Q

Grade I ILD w/ T-Dxd

A

Asymptomatic

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18
Q

Most common CHIP mutations

A

DNMT3A, TET2, ASXL1

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19
Q

What defines CCUS?

A

1) Idiopathic, clinically meaningful cytopenia
2) >2 percent variant allele frequency (VAF) of a leukemia-associated gene
3) No other evidence of a hematologic malignancy

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20
Q

Lowest and highest risk serologic status for CMV transmission in transplant

A
  • highest = Donor+, recipient-
  • lowest = Donor-, recipient-
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21
Q

Grading of NET’s

A

G1 = <3
intermediate = 3-20
high = >20

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22
Q

Translocation that can be seen in DLBCL

A
  • t(14;18)
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23
Q

What is T4 disease in CRC

A
  • invasion of visceral peritoneum or invasion/adherence to adjacent organs/structures
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24
Q

What is high risk for stage III CRC?

A

T4 or N2

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25
Q

What is N2 disease in CRC

A

4 or more lymph nodes

26
Q

T3 in RCC

A
  • extension into major veins or perinephric tissues
27
Q

Most common SE of crizotinib

A

acneiform rash

28
Q

HLADR15 - 1) seen in what conditions 2) predictive of what

A
  • aplastic anemia + hypoplastic MDS + PNH
  • predicts response to immunosuppressive treatment (ATG + cyclosprine)
29
Q

What should increase in PTT after protein C concentrate make you think?

A

FVL

30
Q

Components of managing factor 8 inhibitor

A
  • suppress the antibody with rituxan or steroids
  • treat underlying precipitant
31
Q

Catheter associated VTE managemetn

A
  • keep catheter in if still functional and anticoagulate
32
Q

Adjuvant management of CRC patient w/ ESRD

A

5-Fu

33
Q

T cell leukemia/lymphoma immunophenotype

A

CD2+, CD3+, CD4+, CD5+, CD7-, CD8-.

34
Q

Smear finding with HTLV-1 -associated T cell leukemia/lymphoma

A

Flower cells
*see photo online

35
Q

Mechanism of promacta in AA

A

TPO receptor expression in hematopoietic stem cells

36
Q

luspatercept mechanism

A

Reduces aberrant Smad2/3 signaling by binding (“trapping”) transforming growth factor (TGF) beta superfamily ligands

37
Q

What defines CHIP?

A

Patient gets a bone marrow biopsy and a clonal myeloid mutation is found on sequencing
*DNMT3A, TET2, ASXL1 most commonly

38
Q

What defines ICUS?

A
  • cytopenia (s) unexplained after extensive workup
  • NO evidence of clonal hematopoiesis (if present, then it is CCUS)
39
Q

Studies needed for hypereosinophilia workup

A
  • PDGFR
  • FGFR1
  • TCR gene rearrangement
40
Q

Ferroportin function + change in AICD

A
  • iron transport protein
  • decreased
41
Q

sequence of correcting B12 and folate

A
  • Replete B12 first (folate repletion with severe B12 deficiency can worsen B12 neurologic deficits)
42
Q

When hydrea needs to be held in SCD per package instructions

A
  • plt count <80k
  • ANC <2000
  • hgb <4.5
43
Q

management of single bone lesion in langerhan’s

A

Biopsy/curretage then observe

44
Q

management of multiple bone lesion in langerhan’s

A
45
Q

Management of CNS disease in Langerhan’s

A

IF mutant, BRAF targeted therapy

46
Q

Preferred systemic therapy for Langerhan’s with multiorgan system involvement

A
  • single agent cytarabine
  • single agent cladribine
47
Q

How many cycles of HiDAC in favorable risk AML

A

3-4

48
Q

Second line for HCL w/ short PFS benefit from firstline (<2 years)

A

1) alternative purine analog + rituximab
2) vemurafenib +/- rituximab (classic HCL BRAF is uniformly positive)
3) Single agent rituximab

49
Q

T-PLL immunophenotype

A

Strong CD52 expression
CD3+

50
Q

Deauville score 5 vs 4

A

4= uptake moderately greater than liver (so less than 2x)
5 = at least 2x max SUV of liver

51
Q

Ratio of PRBC to platelet to FFP recommended in massive transfusion

A

1:1:1

52
Q

Folic acid is modified in a cell by means of which process

A

methylation

53
Q

Venetoclax mechanism

A

BH3-mimetic
- blocks the anti-apoptotic B-cell lymphoma-2 (Bcl-2) protein, leading to programmed cell death of CLL cells.

54
Q

HS managment

A
  • IF chronic hemolysis and splenomegaly, splenectomy
  • IF more benign course, transfusions and supportive care
55
Q

Hemoglobin M disease inheritance

A

Autosomal dominant

56
Q

Cyb5R deficiency inheritance

A

autosomal recessive

57
Q

Basophilic stippling on smear

A

*see photo
granules that are dispersed through the cytoplasm of erythrocytes in a peripheral blood smear

58
Q

basophilic stippling differential

A
  • thalassemia
  • hemolysis
  • MDS
  • alcoholism
  • lead poisoning
59
Q

PNH patient with liver failure - what is the cause?

A

Budd chiari from portal vein thrombosis

60
Q

When you can use IVIG to treat acquired Von Willebrand

A

SLE, plasma cell dyscrasias, some lymphoproliferative disorders (*these cause acquired von willebrand from anti-VWF autoantibodies)

61
Q

Next step for mild VWS deficiency diagnosis

A
  • check blood type (patients with blood type O have 25-30% lower VWF antigen at baseline) to ensure not misdiagnosis

Heme boards (58 decks)

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