Deck 4 Flashcards

(40 cards)

1
Q

What factors does PT time measure

A

VII, X, V (extrinsic)

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2
Q

What factors does PTT measure

A

XIII, IX, XI, XII and X, V, prothrombin, fibrinogen

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3
Q

What drug do you not take with digoxin?

A

Quinidine- decreases digoxin clearance and displaces it from tissue binding sites

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4
Q

What drug increases fetal hemoglobin to prevent sickle cell attackes?

A

Hydroxyurea

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5
Q

Features of DiGeorge?

A

CATCH 22- Cleft palate, abnormal facies, thymic dysplasia, cardiac defects, hypocalcemia (loss 3rd/4th pharyngeal pouch and thymus/PTH gland)

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6
Q

What embronic structure does the thymus come from?

A

3rd pharyngeal pouch

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7
Q

Why do you use desmopressin with vWF dz?

A

releases vWF stored in endothelium and incr. factor VIII activity

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8
Q

Child with viral infection that has low platelets?

A

ITP - most common cause of thrombocytopenia in children

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9
Q

Thrombotic thrombocytopenic purpura is caused by Abs against what protease?

A

ADAMTS13 (vWF metalloprotease that cleaves vWF)

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10
Q

Symptoms of TTP?

A

FAT RN: Fever, microangiopathic hemolytic Anemia (schistocytes), Thrombocytopenia, Renal problems, Neurologic problems

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11
Q

When would you see an IgM cold hemolytic anemia?

A

After EBV infection, HIV, Mycoplasma pneumonia, leukemia - HELM

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12
Q

When you see target cells, HALT..?

A

Hemoglobin C, Asplenia, liver disease, thalassemia

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13
Q

von Hippel Lindau dz characteristics?

A

Autosomal dominant Chr. 3- hemangioblastomas (retina, cerebellum, medulla), ataxia, polycythemia, Incr. risk of bilateral renal cell carcinoma.

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14
Q

What tumors does Turcot syndrome cause?

A

Colon- APC gene, Brain - glioblastoma multiforme

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15
Q

Gardner syndrome = ?

A

Variant of FAP with colorectal polyposis, osteomas, bone and soft tissue tumors, congenital hypertrophy of retinal pigment epithelium, dental abnormalities

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16
Q

Symptoms of tuberous sclerosis?

A

Autosomal dominant. Intellectual disability, seizures, CNS tumors, angiomyolipomas of kidneys, leptomeningeal tumors, skin lesions such as ash-leaf spots and shagreen patches. Infantile spasms common

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17
Q

Fanconi anemia disorder

A

Autosomal recessive disorder resulting in marrow hypofunction and eventually pancytopenia. Hypoplastic bone abnormalities. Hallmark = incr. chromosomal breaking in response to DNA-damaging agents. More sensitive to cyclophosphamide and chemo agents. Incr. risk of AML and myelodyplastic syndrome.

18
Q

What does warfarin block?

A

Inhibits epoxide reductase –> blocks gamma-carboxylation of vitamin K dependent clotting factors

19
Q

What tumors are psammoma bodies found in?

A

PSMMa vody = papillary carcinoma of thyroid, Serous papillary cystadenocarcinoma of ovary, Meningioma, Mesothelioma

20
Q

Tumor in brain- whorled pattern, seizure, headache, visual field defect

21
Q

What are Bence Jones proteins from multiple myeloma?

A

Antibody light chains produced by plasma cells. Result in renal insufficiency by forming large eosinophilic casts

22
Q

What is the mutation in Li fraumeni and what cancers are caused?

A

Pp53 tumor suppressor gene. Osteosarcomas, soft tissue sarcomas, breast cancer, adrenocortical tumors, leukemias. Autosomal dominant

23
Q

Howell Jolly bodies seen in what?

24
Q

Paraneoplastic syndromes from small cell lung carcinoma?

A

SIADH - hyponatremia, Cushing - ACTH, Lambert eaton myasthenic syndrome from host antibody response that cross reacts with Ca channels at neuromuscular junction

25
5 P's for acute intermittent porphyria?
Painful abdomen, port wine colored urine, polyneuropathy, psychological distrubance, precipitated by drugs
26
AFP marker with what two cancers?
Yolk sac germ cell carcinoma, hepatocellular carcinoma (hep C)
27
Cancer associated with NF-2?
Vestibular schwannoma. Also blurry vision and meningiomas
28
What condition with kid with large flank mass and abnormal enlargement of one side of body?
Wilm's tumor. Deletion of tumor suppressor gene- WT1 on chromosone 11. Wilms tumor arises from neoplastic embryonic renal cells of metanephros
29
MEN 1?
Pituitary (GnRH, prolactinoma), pancreatic (ZE, VIPomas, insulinomas), PTH
30
MEN 2A?
2A = pheo, medullary of thyroid, PTH
31
MEN 2B?
2B = pheo, medullary of thyroid, marfanoid habitus
32
Most common cause of osteomyelitis? In sickle cell patients?
1) Staph aereus 2) Salmonella
33
What things is intereferon alpha used for?
leukocytic effects for kaposi, Hep B, Hep C, leukemias, malignant melanoma
34
How does factor V Leiden lead to a hypercoaguable state?
Normally activated protein C cleaves factor five terminating clotting cascade, but factor Va is resistant to cleavage
35
Difference between vWF and hemophilia lab values?
vWF has increased BLEED TIME and PTT. Hemo has just increased PTT and normal BT
36
What is Zollinger Ellison?
Gastrinoma- gastrin secreting tumor of pancreas. Check for multiple duodenal ulcers
37
Trousseau syndrome?
pancreatic adenocarcinoma with migratory thrombophlebitis
38
Ewing sarcoma
in boys <15 years old. Aggressive malingnant tumor of bone, commonly in diaphysis. Lamellated "onion skin" periosteal reactions. Uniform sheets of anaplastic small blue cells
39
How does diarrhea affect metabolic labs?
Bicarb lost in GI is exchanged for Cl- leading to hyperchloric non anion gap metabolic acidosis.
40
Why do statins cause renal failure?
Rhabdomyolysis. Myoglobin and heme damage. Heme precipitates and induces ATN. BUN:Cr <15:1.