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IHO > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What are the 3 types of APCs?

A
  • Dendritic cells (most effective)
  • Macrophages
  • B cells
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2
Q

What 2 classes of drugs are both CCS?

A 
Plant alkaloids (G2-M)
DNA synthesis inhibitors (S)
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3
Q

What 2 classes of drugs are CCNS?

A

Crosslinking agents

Anthracycline antibiotics

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4
Q

What enzyme creates somatic mutation in forming both Ig and T cell receptor molecules?

A

Rag 1 and 2

-no somatic hypermutation in T cell receptor formation

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5
Q

What type of reactions are hypersensitivity type 1-4?

A
  • type 1 = immediate (anaphylaxis, IgE antibody)
  • type 2 = antibody mediated (production of IgG, IgM leading to phagocytosis or lysis- Goodpasture Syndrome)
  • type 3 = immune complex mediated (deposition Ag-Ab complex recruits leukocytes - SLE, serum sickness)
  • type 4 = T cell mediated (contact dermatitis, type 1 diabetes, MS, TB, granuloma formation)
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6
Q

What drug can be used to treat breast cancer patients positive for HER-2/NEU gene?

A

-monoclonal Ab to Her2/neu receptor = trastuzumab (Herceptin)

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7
Q

Where does a T cell receptor receive its 2 activating “hits”?

A
  • 1 via TCR/CD3 complex

- 1 from dendritic cell cytokines

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8
Q

What cytokine do CTLs need to become activated? convert to memory cells?

A
  • activated by IL-2 from Th1

- convert to memory cells by IL-21

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9
Q

Co-receptors bind on TCR for MHC/peptide complex bind what?

  • CD2
  • LFA-1
  • CD28
  • CD45R
A

CD2 binds LFA-3
LFA-1 binds ICAM-1
CD28 binds B7 (CD80/86)
CD45R binds CD22

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10
Q

HLA-B27 individuals at risk for what?

A
  • alkylosing spondylities (destruction of vertebral cartilage)
  • also psoriasis, inflammatory bowel disease, Reiter’s syndrome
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11
Q

HLA-DR2 individuals at risk for?

A

narcolepsy

-also MS, hay fever, and SLE

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12
Q

HLA-A3/B14 individuals at risk for?

A

hemochromatosis

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13
Q

HLA-DQ2/GQ2 individuals at risk for?

A

Celiac disease

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14
Q

HLA-DR3 is linked to…

A

diabetes mellitus type 1, Grave’s disease

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15
Q

HLA-DR4 is linked to….

A

rheumatoid arthritis, diabetes melliuts type 1

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16
Q

What drug(s) are most likely to cause Radiation Recall Reaction?

A

-“rubicin” drugs (especially Doxorubicin in breast cancer treatment)

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17
Q

What 2 main drug categories are CCS?

A
  • Plant alkaloids (G2/M)

- Antimetabolites (S)

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18
Q

What 2 main drug categories are CCNS?

A
  • alkylating agents

- anthracycline antibiotics

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19
Q

What enzyme is needed to converte UMP to UDP in the pyrimidine synthesis pathway and is important in resistance to 5-FU?

A

-pyrimidine monophosphate kinase

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20
Q

What enzyme is involved in degradation of pyrimidines and without it, patient is more sensitive to 5-FU?

A

-dihydropyrimidine dehydrogenase

21
Q

What is used for treatment of cyanide poisoning?

A

hydroxocobalamin

22
Q

What action in cells gives MTX differential sensitivity for cancer cells?

A

-polyglutamination (traps folate in cell and increases affinity for enzyme thymidylate synthase

23
Q

Antimetabolites: analogues of what?

-CCS or CCNS?

A
  • analogues of folate, pyrimidine, or purine

- CCS for S phase

24
Q

What drugs cause Tumor Lysis Syndrome?

-treatment

A
  • any drug that causes sudden, rapid death of millions of cells (Ex: leukemia and lymphoma drugs)
  • Allopurinol to treat (prevents hyperuricemia)
25
Q

What are the main resistance mechanisms for folic acid analogues (MTX, Pemetrexed, Pralatrexate)

A
  • change target enzyme
  • increase DHFR expression
  • decrease polyglutamination
  • decrease accumulation (decrease RFC expression)
26
Q

Can Leucovorin be given intrathecally?

A

No. that would be fatal

27
Q

What are main resistance mechanisms of pyrimidine analogues? (5-FU and Capecitabine)
-blocking which enzyme can block drug?

A
  • change target enzyme (TS)
  • decrease activation of drug (enters pathway as UMP or dUMP)
  • increase inactivation
  • blocking pyrimidine monophosphate kinase= resistance
28
Q

What are the 2 ways to make purines? How do 6-MP and 6-TG fit in?

A
  1. primary purine synthesis pathway (enzymes PRPS and GPAT)
  2. salvage pathway (enzyme HGPRT)
    - 6MP and 6TG block guanylyl kinase (when activated by HGPRT to T-IMP and 6-thioGMP- poor substrates for guanylyl kinase); IMP and GMP accumulate triggering “pseudofeedback inhibition” of PRPS, GPAT, HGPRT enzymes
29
Q

What drug can cause hemorrhagic cystitis? How to treat

A
  • Cyclophosphamide

- add Mesna

30
Q

What is the common unique side effect of Anthracycline Antibiotics?

A
  • cardiomyopathy corresponding with total amount of drug taken
  • ex: doxorubicin
31
Q

What is unique about Bleomycin’s mechanism? What major toxicity?

A
  • generates free radicals to cut DNA strands (“blasts DNA”)

- causes skin and lung damage (those tissues lack hydrolase enzyme to metabolize Bleomycin)

32
Q

What are the common resistance mechanisms for crosslinking agents?
-MOA?

A

-increased DNA repair
-increased glutathione production (trapping agent)
-oral = decreased activation
MOA: must be activated so nucleophile can attack DNA and cause damage

33
Q

What are main resistance mechanisms for intercalating agents- anthracycline antibiotics?

A
  • decreased accumulation due to P-glycoprotein (MDR)
  • decreased topo 2 activity (temporarily)
  • increased inactivation
34
Q

What drug is associated with nephrotoxicity?

A

Cisplatin

-should also be avoided with renal insufficiency)

35
Q 
What drug class is associated with neurons/ RBCs
-peripheral neuropathy
A

vinca alkaloids

-ex: Vincristine

36
Q

Which species of malaria are the most common?

A

-P. vivax and P. falciparum

37
Q

Which specie of malaria is the most deadly?

A

Plasmodium flaciparum (able to infect RBCs of any age; Rosettes form, impede blood flow)

38
Q

Which 2 species of malaria cause relapses?

A

-P. vivax and P. ovale

39
Q

Basic life cycle of malaria?

A

injected as sporozoites, released from liver as merozoites
-enter RBC, trophozoite (ring form), schizont, merozoites released from RBC and either infect new RBC or become gametocytes

40
Q

What is the main prophylactic drug for malaria? Alternative?

A

Chloroquine

-alternative: Atavaquone/ proguanil

41
Q

What drug is for the “radical cure” but may cause hemolytic anemia in people with G6PD deficiency?

A

Primaquine

42
Q

What drugs are used for treating chloroquine resistant P. falciparum?

A
  • Mefloquine (also for prevention)

- Quinine and Quinidine

43
Q

What is the main drug for prevention of malaria in Chloroquine resistant areas?

A
  • Atovaquone/ proguanil

- alternative: Doxycycline or Mefloquine

44
Q

What classification of AML has Auer rods?

A

-AML M1

acute myeloblastic leukemia without maturation

45
Q

What AML classification has Faggot cells?

A

-AML M3
(acute promyelocytic leukemia)
-all have t(15;17) translocation

46
Q

Which AML classification is associated with t(8;21) translocation?

A

-AML-M2

acute myeloblastic leukemia with maturation

47
Q

Which AML classification is associated with inv(16) inversion?

A

-AML M4
(acute myelomonocytic leukemia)
-extramedullary tumors

48
Q

Which new classification of AML is associated with the elderly and pancytopenia?

A
  • AML with multi-lineage dysplasia

- poor prognosis

49
Q

Most common acute leukemia in children?

A

Acute lymphoblastic leukemia (ALL)

IHO (7 decks)

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