Hem Onc Flashcards Preview

USMLE Step 1-2015 > Hem Onc > Flashcards

Flashcards in Hem Onc Deck (47):
1

Fibrinogen receptor

Gp IIb/IIIa

2

vWF receptor

Gp Ib

3

What are in platelets dense granules and alpha granules

Dense granules-ADP, Ca2+
Alpha granules-vWF, fibrinogen

4

Protein C inhibits what 2 cofactors?

Va, VIIIa

5

When would you see a target cell?

Hbc disease, Asplenia, Liver disease, Thalassemia

6

When are howell-jolly bodies seen?

patients with functional hyposplenia or asplenia

7

What encompasses association with thalassemia intermedia?

Kozak sequence is gccRccAUGG, where R normally takes place of adenine or guaning 3 bases uptream of mRNA molecule methionine AUG. Adenine or guanine 3 bases upstream is a key initiation process Mutation with G-->C in B globin gene assoc. with thalassemia intermedia (decrease protein synthesis, but not as severe as b thal major)

8

What would you see in a megaloblastic macrocytic anemia cs non megaloblastic macrocytic anemia?

Difference would be presence of hypersegmented neutrophils

9

How do u calculate corrected reticulocyte count?

RC *Hct/45

10

HbC point mutation

Glutamic acid with lysine

11

4 diseases with increased risk of parvovirus b19 induced aplastic crisis

Aplastic anemia, hereditary spherocytosis, b-thal, sickle cell

12

Most structural abnormalities follow a ______ pattern while most enzyme abnormalities follow an ________ pattern

Auto dominant
Auto recessive

13

What effect does cortidcosteroids have on neutrophils, eosinophils, and lymphocytes?

Causes neutrophilia becasue decrease activation of neutrophil adhesion molecules, impairing migration out of the vasculature to site of inflammation. In contrast, corticosteroids sequester eosinophils in lymph notes and cause apoptosis of lymphocytes (lymphopenia). This would also be seen in Cushings

14

What is most sensitive cell in the body to radiation?

Lymphocytes causing lymphopenia

15

Inheritance of acute intermittent porphyria

auto dominant

16

Bevacizumab MOA and toxicity

Monoclonal antibody to VEGF. inihibits angiogenesis
Hemorrhage, clots, impaired wound healing

17

Erlotinib

EGFR tyrosine kinase inhibitor
used for non-small cell carcinoma
rash

18

Imatinib

Tyrosine kinase inhibitor of Bcr-ABL (philadelphia chromosome) and c-kit (common GI stromal tumors). inhibits cellular proliferation of bcr/abl w/o inducing apoptosis
Toxicity: fluid retention

19

Rituximab

monoclonal antibody against CD20 found on most b cell neoplasms
increase risk of progressive multifocal leukoencephalopathy

20

trastuzumab (herceptin)

monoclonal antibody to her-2 (c-erbB2), a tyrosine kinase receptor. Helps kill cancer cells that overexpress HER-2 through inhibition of her 2 initiated cellular signaling and antibody dependent toxicity
used for her2 positive breast and gastric cancer
cardiotoxicty

21

vemurafenib

small molecule inhibitor of BRAF oncogene + melanoma (v600 e mutation subtype)

metastatic melanoma

22

Leukemoid reaction vs. Leukemia

Leukemoid rxn increase WBC with left shift and increase in leukocyte alkaline phosphatase
Leukemia- increase WBC count with left shift, but decrease LAP

23

Reason for lymphadenopathy in follicles, paracortex, medulla

Follicles-B-cell origin due to HIV infection or rheumatoid arthritis
Paracortex hyperplasia-T-cell origin seen with viral infections
Medulla-hyperplasia of sinus histiocytes seen in lymph nodes that are draining a tissue with cancer

24

Burkitt lymphioma
Translocation?
Gene involved?

t (8;14)
c-myc (8) w/ heavy chain Ig (14)

25

Follicular lymphoma
Translocation?
Gene involved?

t (14,18)
Heavy-chain Ig (14) and bcl-2 (18)

26

Mantle cell lymphoma
Translocation?
Gene involved?

t (11;14)
cyclin d1 (11) and heavy chain Ig (14)

27

Adult t cell lymphoma associated with what virus

Human t lymphotropic virus

28

T (8;14)

Burkitt lymphoma

29

t (9;22)

CML (BCR-ABL hybrid) philadelphia chromosome

30

t (11;14)

Mantcle cell lymphoma (cyclin D1 activation)

31

t (14;18)

Follicular lymphoma (BCL-2 activation)

32

t (15;17)

M3 type of AML

33

Tdt+

Lymphoblast

34

Precursor B cell type ALL expresses what?

CD19 CD 10+ Tdt+

35

Precursor T cell type ALL expresses what?

CD 2-CD8 Tdt+

36

Tdt+ is absent in what?

Myeloid blasts and mature lymphocytes

37

What is the name of the M3 subtype of AML?

Acute promyelocytic leukemia

38

CD5 + lymphoma

Mantle cell lymphoma

39

CLL expresses what?

CD 5+ CD 20 + co expression as a B cell neoplasma

40

What can small lymphocytic lymphoma progress to?

Large B-cell lymphoma (Richter transformation)

41

Hairy cell leukemia treatment and explain mechanism?

Cladribine (adenosine deaminase inhibitor causes adenosine to accumulate to toxic levels in neoplastic B cells)

42

Splenomegaly is different in chronic leukemia than hairy cell leukemia how?

Chronic leukemia you will see splenomegaly due to expansion of white pulp. In hairy cell, its due to expansion of red pulp

43

CML characterized by increased?

Neutrophils, metamyelocytes, and basophils (within granulocytes basophilia is characteristic)

44

What cell line are langerhans cells derived from?

myeloid

45

Mutation involved in myeloproliferative disorders

Everything JAK 2 besides CML (BCR-ABL)

46

Mutation specific of myeloproliferative disorders

All have V617 mutation with tyrosine kinase activity and cytokine independent activation of STAT transcription factors. Valine replaces phenylalanine making hematopoietic cells more sensitive to growth factors. THIS MUTATION IS NOT PRESENT IN CML

47

JAK2 inhibitor approved for treating primary myelofibrosis

Ruxolitinib