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Medicine > Uworld Heme/Onc > Flashcards

Uworld Heme/Onc Flashcards

0
Q

Febrile neutropenia?

A

Temperature > 38

Absolute neutrophil count < 1500

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1
Q

Patient with smoking history, hilar fullness, Mediastinal lymphadenopathy, hypertension, hypokalemia?

A

Cushing’s from small cell lung cancer

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2
Q

Treatment for febrile neutropenic patient?

A

Monotherapy with antipseudomonal agent (cefepime, Meropenem, Bactrim)

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3
Q

Signs of polycythemia vera?

A

Increased blood pressure, Increased RBC mass, elevated platelet count

Peptic ulceration, gouty arthritis, splenomegaly, plethoric face

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4
Q

Fibrocystic disease – type of nodule? Draining yields?

A

Rubbery, firm, mobile and painful during menses. Clear fluid.

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5
Q

Signs of G6PD in smear? Drugs that provoke it?

A

Heinz bodies. Sulfa drugs, Antimalarial drugs, nitrofurantoin

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6
Q

Tumor lysis syndrome - expected effect on PO4, K, uric acid, Ca?

A

Hyperphosphatemia, hyperkalemia, hyperuricemia

hypocalcemia

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7
Q

Tumors that cause tumor lysis syndrome?

A

Burkitt’s lymphoma and ALL

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8
Q

Treatment for HER2 positive cancer? Test needed before treatment?

A

Herceptin. EKG (can cause cardio toxicity in pts with systolic dysfunction)

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9
Q

Tx for sickle cell pt with stoke-like Sx?

A

Exchange transfusion (fibrinolytics don’t help because stroke is caused by sickled cells, not thrombus)

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10
Q

Tx of mild, moderate and severe hyperCa?

A

Mild (<12): none

Moderate (12-14): none unless symptomatic

Severe (14+): saline with calcitonin (no loop diuretics unless CHF). Bisphosphonate for long term.

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11
Q

Anti-PPL - give what false positive? Coags? Platelet count? Tx?

A

False positive VDRL, prolonged PTT, and thrombocytopenia. Lovanox.

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12
Q

Macro vs micro vascular hemolysis?

A

Mechanical valves/stenosis vs vessel occlusion

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16
Q

Transferrin saturation?

A

Iron/TIBC

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17
Q

Drug to increase appetite in cancer patients?

A

Progesterone analogs (megesteol acetate)

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18
Q

3 basic symptoms of EBV?

A

Sore throat, fever, maculopapular rash

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19
Q

Mech of spleen in immune response?

Why is the immune system impaired after splenectomy?

A
  1. Normally, antigens enter spleen and are phagocytosed by DC cells
  2. DC cells present antigens to T helper cells, activating them
  3. T-helper cells migrate to marginal zone of spleen and activate B-cells
  4. B-cells activation increases germinal centers and antibody production that facilitate phagocytosis of pathogenic organisms

Therefore, no spleen = impaired phagocytosis

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20
Q

Warfarin leads to skin necrosis due to?

A

Protein C deficiency

21
Q

Hairy cell leukemia: stain? Effect on bone marrow? Drug to treat?

A

Tartrate-resistant acid phosphatase (TRAP) stain

Bone marrow fibrosis (dry taps)

Cladribine (Purine analog)

22
Q

Patient diagnosed with myasthenia gravis. Next test to order?

A

Chest CT scan to look for thymoma

23
Q

Waldenström’s versus multiple myeloma: immunoglobulin?

A

IgM spike vs IgA/IgG spike

24
Q

Symptoms of Waldenström’s that is not present in multiple myeloma?

A

Hyperviscosity syndromes – retinal vein engorgement

25
Q

Patient with HNPCC should also be evaluated for what other cancer?

A

Endometrial cancer

26
Q

Signs of lead poisoning?

A
  1. Microcytic anemia
  2. Neurologic abnormalities (difficulty concentrating, myalgias, peripheral neuropathy, extensor weakness)
  3. Nephropathy
27
Q

Patient with tumor secreting ADH – treatment?

A
  1. Fluid restriction (<800 mL)

2. If still symptomatic/resistant use hypertonic saline

28
Q

Signs of glucagonoma?

A
  1. G.I. symptoms (diarrhea, abdominal pain)
  2. Diabetes
  3. Necrolytic migratory erythematous plaques
  4. Anemia
  5. Weight loss
29
Q

Drugs that can impair folate absorption in the gut?

A

Phenytoin, pentobarbital, primidone

30
Q

Vitamin deficiency that can cause a microcytic anemia? Mechanism? Common Scenario?

A

Pyridoxine deficiency causing sideroblastic anemia. Post Isoniazid therapy.

31
Q

Anisocytosis vs poikilocytosis?

A

Cells of abnormal sizes vs shapes

32
Q

Benign vs worrisome lymph nodes?

A

2 cm, firm and immobile

33
Q

Senile purpura?

A

ecchymotic lesion in the elderly (usually dorsum of hands) due to connective tissue atrophy

34
Q

Test to confirm CLL?

A

flow-cytometry

35
Q

Complications of hereditary spherocytosis?

A

Splenomegaly, jaundice, gallstones

Red blood cells get trapped in fenestrations of spleen (Splenomegaly). Hemolysis leads to jaundice and calcium bilirubinate stones.

36
Q

Not graft vs. host without?

A

Skin rash

37
Q

Leukoreduction? Purpose?

Cell washing?

A

Depleting leukocytes in transfusions. Prevents febrile reactions caused by pt antibodies reacting with donor leukocyte; reduced CMV transmission

Removes IgA

38
Q

Diseases with low leukocyte alkaline phosphatase?

A
  1. CML
  2. paroxysmal nocturnal hemoglobinuria
  3. hypophosphtemia
39
Q

Laboratory findings in Steroid abuse?

A

erythrocytosis
Heptatotoxicity
Dyslipidemia

40
Q

Classic findings in CML?

A

Leukocytosis with low leukocyte alkaline phosphatase

41
Q

Management based on CHADS2 score?

A

0 = no treatment
1 - anticoagulant therapy > aspirin
2+ - Oral anticoagulant therapy

42
Q

MCHC (mean cell hemoglobin concentration) elevated in?

A

Spherocytosis

43
Q

Patient receives blood and becomes:

  1. febrile with chills. Self limited and resolves within 1 to 6 hours? Prevention?
  2. Febrile with Flank pain and hemoglobinuria. Progresses to renal failure and DIC. Diagnosis? Tests?
A
  1. Non-hemolytic reaction due to cytokines in transfused blood. Luekoreduction
  2. Acute hemolytic reaction (unmatched blood). Positive Coombs test and free plasma hemoglobin.
44
Q

Intravascular vs extravsacular hemolysis - haptoglobin?

A

Very low (lots of Hgb release) versus low-normal (cells phagocytized)

45
Q

Coombs test in Autoimmune hemolytic anemia vs hereditary spherocytosis?

A

Positive vs negative

Medicine (106 decks)

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