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USMLE > USMLE Hem Onc > Flashcards

USMLE Hem Onc Flashcards

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USMLE® Step 1 flashcards
1
Q

EBV is associated with what cancers?

A

HL, NHL, Nasopharyngeal Carcinoma

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2
Q

What complication might people who receive more than one body’s worth of transfusions experience?

A

Hypocalcemia as citrate binds up calcium

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3
Q

Shifting partial pressure of O2 at 50% Hb concentration from 26-20 mmHg will result in what response?

A

Erythrocytosis b/c left shift = higher affinity

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4
Q

What is the mechanism behind megaloblastic macrocytic anemia?

A

Diminished thymidine synthesis

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5
Q

What do you use to rapidly reverse warfarin?

A

Fresh frozen plasma

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6
Q

What serum level do you monitor for DIC?

A

Serum fibrinogen

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7
Q

What does blocking the HIV gp41 protein inhibit?

A

Viral penetration into the cells

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8
Q

What drug do you use to prevent DIC in pregnancy?

A

Heparin

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9
Q

What kind of receptor is JAK2?

A

Non-receptor tyrosine kinase

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10
Q

Biopsy reveals uniform, round medium-size tumour cells with basophilic cytoplasm and a proliferation fraction (Ki-67 fraction) of >99%. Dx and cause?

A

Burkitt’s lymphoma from EBV infection.

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11
Q

What drugs do you have to watch out for when using methotrexate/6MP/6TG?

A

Allopurinol and febuxostat b/c block xanthine oxidase, which metabolizes MTX/6MP

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12
Q

Where is vWF released from?

A

Weibel Palade bodies and platelets

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13
Q

Platelet binding onto vWF leads to the release of what chemicals?

A

ADP (promotes GpIIbIIIa expression) and TxA2

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14
Q

Transient vasoconstriction in response to bleeding is triggered by?

A

Neural stimulation and endothelin

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15
Q

What should be on your differential for a presentation of hemophilia A/B/C?

A

Coagulation factor inhibitor, distinguish with a mixing study

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16
Q

What test do you use to follow liver failure?

A

PT

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17
Q

How do you diagnose VWD?

A

With a ristocetin cofactor assay test showing decreased agglutination

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18
Q

How do you differentiate between DIC and a disorder of fibrinolysis?

A

PC is normal and no D-dimer (only fibrinogen broken down) in fibrinolysis disorders

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19
Q

Squamous cells and keratin debris in clot. What kind of clot is it?

A

Amniotic fluid clot.

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20
Q

Vessel thrombosis, lens subluxation, mental disability, and long slender fingers. Dx?

A

Cystathionine beta synthase deficiency (requires B6 to convert homocysteine to cystathionine)

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21
Q

Embolus with cholesterol crystals. What kind is it?

A

Atherosclerotic

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22
Q

Lymphocytic lymphocytosis. DDx?

A 
Viral infections (handled by CD8+ T cells)
B. Pertussis
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23
Q

Eosinophilia ddx?

A

Parasites, allergy, Hodgkin Lymphoma **via increased IL-5

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24
Q

Basophilia ddx?

A

CML

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25
Q

Monocytosis ddx?

A

Chronic inflammation, malignancy

26
Q

What cancer do you expect in kids with Down syndrome > 5 y/o and children generally?

A

ALL

27
Q

What cancer do you expect in kids with DS

A

Acute megakaryoblastic leukemia

28
Q

Lymphocytes with smudge cells that are CD5 and CD20 positive. Dx?

A

Chronic lymphocytic leukemia (of naive B cells)

29
Q

What’s the most serious complication of CLL?

A

Transformation into large B cell lymphoma

30
Q

Leukemia that infiltrates the gums. Dx?

A

Acute monoblastic leukemia

31
Q

Blasts that are positive for MPO and Auer rods?

A

AML

32
Q

Blasts that are positive for tDt (DNA polymerase)?

A

ALL

33
Q

What distinguishes CML from a typical lymphoid reaction?

A

LAP -ve, t9:22, basophilia

34
Q

Itching post bathing - what disease and why?

A

Polycythemia vera b/c of mast cells

35
Q

What distinguishes PV from typical reactive polycythemia?

A

Reactive polycythemia = low SaO2, high Epo.

PV = normal SaO2, low Epo.

36
Q

How do you distinguish follicular lymphoma from normal LAD from infection?

A

1) No white spaces in germinal centres
2) Monoclonality
3) Bcl2 expression in follicles

37
Q

Teardrop cell with leukoerythroblastic smear and splenomegaly. Dx?

A

Myelofibrosis (Myeloproliferative d/o)

38
Q

Painless LAD with proliferation that expands region immediately adjacent to the follicle. Dx?

A

Mantle Cell Lymphoma

39
Q

What diseases put you at risk for a marginal zone lymphoma?

A

Hashimoto’s, Sjogren’s, H. pylori gastritis (MALToma)

40
Q

LAD with high mitotic rate and starry sky appearance. Dx?

A

Burkitt lymphoma

41
Q

Bulk of LAD is reactive cells and fibrosis. Dx?

A

Hodgkin’s Lymphoma

42
Q

Lymph node bx divided by broad bands of fibrosis?

A

Hodgkin’s Lymphoma, nodular sclerosis subtype (most common)

43
Q

Spoon shaped nails, anemia, pica. Dx?

A

IDA

44
Q

What are some causes of B12 deficiency?

A

Pernicious anemia, Pancreatic insufficiency, damage to the terminal ileum (Crohn’s)

45
Q

How do you differentiate between B12 and folate deficiency macrocytic anemia?

A

Methylmalonic acid is high in B12, normal in folate.

46
Q

Increased RDW and MCHC, splenomegaly with macrophage hypertrophy. Dx?

A

Hereditary spherocytosis

47
Q

What conditions do you see spherocytes in?

A

Major Sickle Spheres
B-thal Major
Sickle Cell Anemia
Hereditary spherocytosis

48
Q

5 month old kid comes in with swollen hands and feet. Dx?

A

Sickle Cell Disease

49
Q

What is the most common cause of death in paroxysmal nocturnal hemoglobinuria?

A

Thrombosis b/c complement attacks platelets and causes activation of coagulation cascade.

50
Q

What are you in danger of progressing to in PNH?

A

AML b/c of acquired mutation in myeloid stem cells

51
Q

What are you in danger of progressing to in PNH?

A

AML b/c of acquired mutation in myeloid stem cells

52
Q

Why does the PTT rise in vWD?

A

Because vWF escorts F VIII

53
Q

Heinz bodies and bite cells in blood. Dx

A

G6PD deficiency

54
Q

A person comes with a Mycoplasma or infectious mono infection with anemia. What kind of anemia is it?

A

IHA, cold agglutinin, IgM

55
Q

What do you give to reverse heparin?

A

Protamine sulfate

56
Q

What is leucovorin used for?

A

Rescues BM in MTX, can’t in 5-FU

57
Q

t8:14

A

Burkitt Lymphoma (c-myc)

58
Q

IL3

A

like GMCSF

59
Q

t9:22

A

Philadelphia Chromosome Bcr Abl CML

60
Q

t11:14

A

Mantle Cell Lymphoma (cyclin D1 activation)

61
Q

t14:18

A

Follicular Lymphoma (BCl2)

62
Q

t15:17

A

Acute promyelocytic leukemia (Vit A, tx with ATRA)

USMLE (23 decks)

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