uworld leukemia Flashcards
what is necesasrry for the diagnosis of TTP?
MAHA and thombocytopenia
what’s the problem in b thalaseemia?
mrna formation
pure red cell aplasia associated with?
when you lose red cells and nothing else.
thymoma, lymphocytic leukemias, parvovirus b19
what happens after autosplenetomy in SS?
predisposed to infections
sickle cell patient has macrocytic anemia now, why?
increased folate requirement
can happen in other hemolytic anemias too
what is the mutation in polycythemia vera?
its with the jaks2 (cystplasmi tyrosine kinase) which phosphorylate the erythropeiten receptor and then the stats -> uncontrolled proliferation
an alcohol man has a prolonged PT and wont even correct with witamin k, whats the problem?
f7 defiency because its the shortest half life and he has cirrhosis
a woman has hypertension who is pregnant and you can see a hematoma, shes having a placental abruption. she then bleeds from her vagina, gums, IV sites. whats happening?
she has DIC from the release of tissue factor (thromboplastin) into circulation
amniotic fluid relase (embolism) into maternal circulation can also cause DIC but would have hypotensenion and shock, not hypertension
which breast tumor marker means more agressive?
her2, but use the traztuzumab
estrogen/progesterone recetpro better
who is at risk for lead poisoning?
industrial workers like miners
a 4 year old boy dies of an overhwelming infection, erythroid cells are found in the liver and spleen, this indicates what?
chronic hemolysis, seen often in sever chronic hemolytic anemias, like beta thalsemmia
a smoker has notived weight gain, easy brusing, and skin getting darker, he also has abdominal epigastric pain and HTN. he has a mass in his lung field. Whats the deal?
ACTH production by the mass in the lung
a woman has a leukemoid reaction (increased LAP) what what you also see
dhole bodies in the neutrophils, which are basophilic oval inclusions in mature neutrophils
a 30 yo man with a history of hiv has abdominal distention and anorexia, ct scan shows ascites and a large mass surrounding the small intesting. the mass has a high proliferatin fraction (ki-67 fraction) of > 99%. which infection is associated with the development of this condition?
EBV
this man has burkitt lymphoma
EBV is associated with 40% of immunodifiency derived burkitt lymphomas and nearly all of the endemic ones
a 32 year old woman with dvts and pe has a normal ptt, add protein c and ptt still remains unchagned. whats up?
factor v leiden
a 12 year old sickle boy dies. spleen is firm and brown, this is most likely due to?
vaso occlusion -> splenic infarctions -> evneutal autosplenectomy
brown is from the hemosiderosis from all the extravascular hemolysis
a 3 day old baby has 99th percent head circunference, bulging anterior fontanelle, and downaward driven eyes. whats up?
vit k defiency, parents refused injection
causes intracranial hemmorhage (told in stem)
whats the worst prognosis for colon cancer?
penetration into the mecularis mucosa (stage is more important than grade, which is what all the other choices were)
an 8 year old boy has a one week history of fever and throat pain is brought to the ED with sever dyspnea, tachypnea, and inspiratory stridor. He has also been having dysphagia for solif food for two weeks. he has?
t all
a man dies of hepatocellulae carcinoma, all the cells of his liver have dna fragments integrated into their DNA. whats is it?
HBV which once integrated can continue to synthesise oncogenic genes like HBx that inactivate p53 tumor supressor
a 41 year old previously healthy woman has weakness and fatigue. She has epistaxis and mucosal pallowshe has?
aml, just thought it was a good description
decreased activity of what gene would increase risk of many cancers?
p53 because it is a tumor suppresor! only option that was a supressor
a boy after a dental extraction has bleeding. what to treat with?
thrombin, you had to assume he had a hemophilia
he cant make the the thrombin so just give it to him
question about lab value in HUD
said you would see elevated indirect bilirubin and LDH
a woman has muscle weakness, weight loss, subjective fevers, and occasional abdominal discomfort. A photo is shown with nodular lesions on her hands. what is this associated with?
overian adenocarcinoma
she has dermatomyositis, similar to polymyosits but with additional skin findings
you get proximal muscle weakness, grotton’s papules, heliotrope rash around eye lids and permysial infiltrate on biopsy
can occur alone or as paraneoplastic syndrome
a 60 year old hhad a valve replacement due and has helmet cells and burr cells…..
mechanical trauma
blc2 normally inhibits?
cell death cascade
g6pd answer?
heriditary enzyme deficiency
man with aortic valve replacement and helmet cells, wat lab value?
decreased haptoglobin
hematopoesis of the myeloid lineage
myeloid prognitor -> myeloblast, promyelocyte (almost always a malignancy when seen in peripheral smear) -> myelocyte, metamyelocyte (can sometimes be seen in leukemoid reaction) -> band and NEBs (both can normally be seen in peripheral blood smear
tumor invasion process
- detach from each other by decreased expression of e-cadherins
- adhere to the basement membrane with laminins
- invade the basement membrane with metalloproteinases
42 year old man has fever and persistent sore throat, bruises on his trunk. blood oozing from IV catheters.
aml
a person with heriditary sperhocytosis is at risk for?
pigmented gallstones because extravscula hemolysis
also showed ldh
a man has chronic pancreatitis from being an alchy, whats the problem with his macrocytic cells?
impaired thymidine synthesis (an purine)
could be from folate or b12
a man with colon cancer is expressing egfr, an inhibitor is used, what would make ineffective?
kras mutation
a man with polycythemia vera with ruddy complexion, what is causing?
increased bone marrow sensitivity to growth factors
dysplasia is?
reversible
a man devlops dic from n minigitidis what would u see on smear?
schistocytes
a man with bladder (transitional cell/urothelial) cancer and what would be the most imortant prognostic factor?
the stage, if it has involved the muscular layer of the bladder
warfarin skin necrosis is related to?
underlying protein c or s deficiecny
a man with multiple bouts of fever and sore throat depsite antibiotic therapies, bruises easily and feels run down has?
aml
what would you see in the renal biposy of a man with paroxysmal nocturnall hemoglobinuria?
hemosiderosis
what two key factors are most important in granulation tissue and neoplastic tissue to create bllood vessels?
vegf and fribroblast growth factor
a 6 year old kid has B all, what is it?
a neoplasm of precursos b cells
what does c myc do?
its a transcription activator
a person has iron deficiency and is treated with iron and several weeks later on peripheral you see enlarged RBCs that appear blue on wright giemsa stain. the bluish color is due to?
ribosomal RNA
can TTP have renal involvement?
yes
mono sighn?
petechial of the palat
family history of lots of tumors?
tp53 which is responsible for le fraumeni
iron deficiency in older men or post menopausual women?
think gi malagnancy
sepsis can be caused by?
gram - endotoxin or gram + (eg peptidoglycans and lipoteichoic acids)
