Hem/Onc

Question 1

Biphasic Bartonella. Carrion dz vs dx vs tx

Answer 1

Infect RBC then endothelial cells. Oriya fever w/ anemia then verruga peruana w/ angioprolif vs presentation vs amox/clav, cipro

Question 2

Pertactin in Bordetella. Dx?

Answer 2

Bind heparin sulfate on glycoproteins and CR3. Presentation & cx

Question 3

Dx vs tx ana/Ehr. Bacteriology?

Answer 3

Clinical + PCR vs doxy. Weak gram stain; Obligate intracellilar -> no lysosome fusion -> lysis of morula -> more infxn

Question 4

Dx w/ ELISA for proteins or ag, PCR viral genome. Tx by watch or chemo

Answer 4

HTLV1/ATL

Question 5

Biphasic fever, leukopenia, rash but not on palms/soles. Dx by immunofluorescence. Tx supportive

Answer 5

Colorado tick fever

Question 6

Conjunctivitis, low grade fever, maculopapular rash; dx urine/serum RNA NAAT or sero igM; tx supportive but inc Guillain Barre

Answer 6

Zika

Question 7

Blood smear = good standard; can chk ring trophozoites or crescent gametocytes

Answer 7

Malaria

Question 8

Iron absorbed in where? What 3 meds blocks absorption? What specially inc vs Dec absorption?

Answer 8

Duo/upper jeju. Phytares, antacids, tannins. Gastric acid vs iron overload

Question 9

Inc MCV but no anemia means? Meds causing macrocytosis? What part of B12 pathways causes hereditary megalo anemia vs abnl myelin?

Answer 9

Alc, liver dz/cirrhosis -> acetald -> acantho/sour cells. MTX, hydroxyurea, AZA/6MP, cap/cladribine, chemo, RA pts. Abnl cubulin vs no met aa

Question 10

Splenectomy concerns:

Answer 10

Encaps from H flu, S pneu, N men -> 3 vax; PCN x2y post splenectomy, prompt care after animal bite, malaria prophylaxis for travel; inc CVD risk

Question 11

Hydros fetalis

Answer 11

Mom O blood, baby A/B blood; mom Rh-, baby Rh+ -> baby anemia/hemolysis, jaundice, hypoglycemia -> pos Coombs & retic count -> RBC transfusion, phototherapy, IVIG

Question 12

When to do rapid ELISA & fxnal assay? How to tx typical vs atypical HUS?

Answer 12

Heparin induced thrombocytopenia. IV fluids/electrolytes, dialysis vs plasmapheresis, ecluzimab

Question 13

What’s the underlying cause: mucous bleed, immediate surg bleed, petechiae, small superficial bruise vs soft tissue bleed/hemarthroses, delayed surg bleed, deeper bruise

Answer 13

Primary vs secondary hemostasis issue

Question 14

Liver dz: you clot and bleed simult, tx?

Answer 14

Tx underlying, FFP replacement factors, cryoprecipitate

Question 15

When do you need RBC vs plasma transfusion? When to cryoprecipitate? Which blood component most likely cause bacterial sepsis?

Answer 15

Hb<7 vs massive transfusion, warfarin reversal, TTP. Fibrinogen <100, DIC, liver fail, intracranial hem post tPA. PLT