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usmle rx qbank > hematology > Flashcards

hematology Flashcards

(124 cards)

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1
Q

woman from middle east …. grayish skin, hepatomegaly, massive splenomegaly, and edema
anemia and leukocytes less than 4000

A

sandfly
leishmanias
KALA AZAR

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2
Q

ixodes tick transfers

A

babesiosis , lyme, erichiliosis

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3
Q

anopheles mosquito

A

malaria

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4
Q

aedes mosquito

A

flavivirus—- yellow fever and dengue

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5
Q

Defective actin cytoskeleton formation

A

wiskot aldrich .. WASp … XLR
disorder of B and T cells
eczema pyogenic infections thrombocytopenia

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6
Q

Impaired migration and adhesion to the vascular endothelium

A

LFA-1 integrin (CD18) on the surface of leukocytes, which impairs their ability to bind intracellular adhesion molecules (ICAMs) on the vascular endothelium.

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7
Q

Microtubule dysfunction with failure of phagosome-lysosome fusion

A

partial albinism with hypopigmentation of the skin, eyes, and hair.
chediak higashi … LYST

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8
Q

soldier myalgia diarrhea stomach pain…
liver enlarged and spleen enlarged
eosinophilia

A

katayama fever
unsanitary drinking water
schistosoma mansoni
txt - praziquantil

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9
Q

trichinella symptoms and what causes it

A

Trichinella infection would cause muscle inflammation and periorbital edema.
undercooked meat

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10
Q

dissolve clot mechanism and drug

A

alteplase reteplase ….

plasminogen to plasmin

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11
Q

pancytopenia , nosebleeds, deformed thumbs, other skeletal abnormalities

A

fanconi anemia
txt with bone marrow transplant
age of diagnosis - around 8n yrs

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12
Q

congenital pure red cell aplasia …. cleft lip … shield chest… webbed neck,,, short stature

A

diamond blackfan syndrome\txt with setroids

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13
Q

decreased surface expression of glycoprotein Ib

A

bernard soulliere …. increased BT

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14
Q

plateltes dont have glycoprotein IIb IIIa receptor

A

glanzman

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15
Q

what is a hapten give example

A

a moleculre that cannot induce an immune response on its own but when it binds to a protein it can activate helper T cell
penicillin induced hypersins reaction … type II .. pt presents with fatigue splenomegaly pallor

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16
Q

sickle cell anemia shifts oxxygen curve to

A

the RIGHT

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17
Q

auer rods are +ve for?

A

myeloperoxidase

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18
Q

prognosis of AML what can happen

A

auer rods can disseminate … activate coag cascade throughout the body… causing platelet-fibrin microthrombi …. can damge passing RB
hemolytic anemia and DIC

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19
Q

increased INR means?

A

blood taking longer to clot … so if pt taking warfarin check for CP450 inhibitors
SICKFACES.COM

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20
Q

is hogkin lymphoma a neoplasm of stem cells ?

A

no
thats why pt can use autologous grafts ( taken from other parts of body)
least likely to be rejected

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21
Q

a short-acting anesthetic that potentiates chloride through GABA-A receptors

A

propofol

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22
Q

This explains the rapid onset and short duration of action

A

high lipid solubility

redistribution

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23
Q

58 man …..small tense vesicles, bullae and erosions over the dorsal aspect of both forearms and hands.
tea coloured urine

A

PCT

defect in enzyme…. uroporphyrinogen decarboxylase in cytoplasm

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24
Q

effective way to reduce the incidence of catheter-related bloodstream infections and has minimal adverse effects; it is recommended for all patients in the ICU.

A

daily chlorhexidine bathing

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25
increased HbF ,,, decreased HbA2,,,,,, NO hbA1
b thalassemia major | due to complete absence of A1
26
define Hb A1
means 2 alpha 2 beta
27
pt has a history of DVT ... comes in the clinic and is started on intravenous anticoag .... develops severe thrombocytopenia and increased PTT bleeding time also large brusies can be noted
this is heparin induced thrombocytopenia antibodies to platelet factor 4 develop and bind heparin... they activate platelets and cause thrombosis TXT with direct thrombin inhibitos ARGATROBAN or bivalirudin
28
abdominal pain, nausea, hematemesis, hypotension, and tachypnea are signs of
acute iron overload
29
a child has really high WBC count sea of blast cells seen on smear fatigue night sweats fever seen what is the diagnosis and what else could be seen in blood test
ALL | blast crises .... leads to neutropenia
30
marginal zone
B cells in spleen
31
which viruses have humoral response ONLY
RIP killed vaccines rabies influenza (intramus) polio salk and hepA
32
ristocetin test
The ristocetin factor activates vWF to bind the platelet receptor gylcoprotein Ib (GpIb). When ristocetin is added to normal blood, it causes agglutination. Failure of aggregation with ristocetin assay occurs in von Willebrand disease and Bernard-Soulier syndrome.
33
pregnant woman..... complains of shivering and chills .... develops ecchymoses on legs .... low BP inadequate bleeding control
amniotic fluid embolism DIC thrombocytopenia ,... increased BT PT PTT
34
acanthocytes
are also known as spur cells and are found in liver disease and abetalipoproteinemia
35
inhibition of porphobilinogen deaminase
acute intermittent porphyria
36
treated for meningitis in russia | signs of aplastic anemia
chloramphenicol
37
preferred anticoagulants in the setting of AF.
Direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban) or dabigatran (a direct thrombin inhibitor)
38
osteomyelitis in sickle cell patient
salmonella ... capsule is virulence
39
ITP what can be seen in peripheral blood smear
large platelets
40
RBCs with cytoplasmic basophilic remnants
howell joley bodies ... in aasplenic pts
41
medulla of the lymph node house the cords n sinuses
contain b cells and plasma cells | sinuses contain reticular cells n macrophages
42
taut hb
deoxy form .... peripheral capillaries
43
MGUS diagnosis
no CRAB symptoms | m protein <3g/dl
44
classical complement pathway can be triggered by igM or igG after binding to a specific part on the ig .... where is this
CH2 Fc portion of heavy chain
45
VH and VL, on the Fab fragment, that together are known as
antigen bindng domain
46
pregnant woman ... DVT what meds to use
enoxaparin over LMWH | after 37 weeks of gestation LMWH can be used
47
5 Ps for AIP
``` porphobilinogen deaminase painful abd port wine urine psychological polyneuropathy precipitated by drugs (alcohol starvation) ```
48
Aminolevulinate synthase deficiency
XL sideroblstic anemia
49
which type of graft rejection presents with erythematous macules and papules all over body
GVHD | 5 weeks
50
mechanism of MTX
DHF to THF | inhibits dehydrofolate reductase
51
signs and symptoms of spontaneous bleeding, purpura, elevated levels of PT and PTT, and decreased fibrinogen are signs of ….. which leukemia is this assoc with?
DIC | AML t 15 17
52
mother has a mechanical heart valve, gives birth to a child nasal and midface hypoplasia; shortened limbs and digits; calcifications of the vertebral, humeral, and femoral epiphyses what meds was she taking?
warfarin long term anticoag due to valve warfarin can cross the placenta
53
chronic lymphocytic leukemia (CLL) is a low-grade malignancy of
b cells | CD 23 5 20
54
CLL can progress to
autoimmune hemolytic anemia
55
blast crisis in which type of leukemia
CML ---- ALL OR AML blast crises
56
richter transformation
CLL ----- DLBCL which is an aggressive lymphoma
57
intrinsic apoptosis pathway
BCL2 BCLx are antiapoptotic molecules that prevent release of cytochrome c BAX and BAK are proapoptotic that can trigger release of the cytochrome c
58
extrinsic apoptosis pathway
binding of FasL to Fas and TNF-α to its receptor or the release of perforin and granzyme B in immune cells activate caspases.
59
most common antibiotic to cause aplastic anemia
chloramphenicol … binds 50s
60
``` low serum iron low TIBC high ferritin +dsDNA and high creatine diagnose and treat ```
anemia of chronic disease due to SLE nephropathy give EPO
61
how is the majority of CO2 transported
plasma as hCO3-
62
Spike and dome” on electron microscopy is associated with
membranous glomerulonephritis | subepithelial deposits
63
risk factors for an ischemic stroke
. Risk factors include hypertension, high cholesterol, cigarette smoking, advanced age, and diabetes mellitus
64
txt for ischemic stroke
ADP inhibitors | clopidogrel ticagrelor
65
how to calculate corrected reticulocyte count for a pt with EPO def
reticulocyte count x pt hct/normal hct
66
highly mitotic, basophilic lymphocytes, surrounding clear zones of macrophages biopsy from abdoiminal mass
Burkitt 814 cmyc | starry sky
67
T cell acute lymphoblastic leukemia
T-ALL, Thymic mass, Teenagers, Testosterone (more likely in males).
68
light blue, scanty, and nongranular cytoplasm
lymphoblasts
69
anemia in SLE
Anemia in patients with SLE is most commonly caused by anemia of chronic disease or autoimmune hemolytic anemia. Autoimmune hemolytic anemia is caused by a type II hypersensitivity reaction and presents with an increased reticulocyte count, spherocytes on peripheral blood smear, and a positive direct antiglobulin (Coombs) test.
70
PGI2 function
Prostaglandin I2 (PGI2) inhibits platelet aggregation, causes relaxation of smooth muscle, reduces systemic and pulmonary vascular resistance by direct vasodilation, and causes natriuresis in the kidneys.
71
baby 8 months old has anemia | drinks breast milk and produces normal wet diapers
iron def | after 6 months iron must be given with diet --- as in formula milk or solid food
72
describe schilling test in context of pernicious anemia
stage 1 --oral b12 … if in urine means absp is OK if not in urine go to stage 2 stage2 ---radiolabeled b12 and IF given … now if b12 in urine diagnosis is pernicious anemia because the issue was with IF … if still no b12 in urine then problem with malabsp
73
commonly used in the treatment of myeloproliferative disorders such as polycythemia vera and essential thrombocythemia, as well as sickle cell disease.
hydroxyurea
74
partially double-stranded DNA virus that is found to have RNA-dependent DNA polymerase.
hep B
75
has an RNA-dependent DNA polymerase (reverse transcriptase). however, is an RNA virus
HIV
76
with a severe normocytic anemia, ptosis, and double vision.
MG thymoma low erythroblasts as it caauses pure RBC aplasia
77
why is sulfamethoxazole CI in pregnancy
Sulfamethoxazole is contraindicated in pregnancy because it binds to albumin and can displace unconjugated bilirubin, leading to cerebral toxicity in the fetus. damages basal ganglia
78
is used for anticoagulation in patients with heparin-induced thrombocytopenia
argatroban | direct thrombin inhibitor
79
patient presents with weight loss, signs of anemia, generalized lymphadenopathy, and hepatosplenomegaly
non-Hodgkin lymphoma often involves multiple lymph nodes, while extranodal involvement is also common.
80
(mutation in IL-2R gamma chain)
scid
81
ymphocyte apoptosis due to increased intracellular dATP)
scid ... adenosine deaminase def
82
bleeding from different parts of her body, throbbing and burning in her hands and feet, and an enlarged spleen platelet count high only
Essential thrombocythemia
83
co admin of cyclosporine and erythromycin will have wha effect
macrolides are CP450 inhibitrs | so increase levels of cyclosprn
84
how does GCSF work
binds to the SURFACE RECEPTOR in bone marrow cells
85
CD16
CD16 is found on natural killer cells
86
overproduction of antiapoptotic protein happens in wch type on non hodgkin lymphoma
follicular t 14 18 BCL2
87
an overactive transcription factor.
ewing sarcoma | 11 22
88
pt has seizure ... given a med and comes back with macrocytic anemia ... wat meds is he taking
phenytoin | folate def
89
warm reactive autoimmune hemolytic anemia with spherocytes treatment
corticosteroids
90
b7 marker
on APC that interact with CD28 on t cells
91
CD28
t cells
92
CD40
macrophages
93
CD56
NK cells
94
CD34
human stem cells
95
inhibits IMP dehydrogenase
mycophenolate
96
mechanism of griseofulvin
disrupts microtubule
97
acute anticoagulation use
heparin
98
to prevent MI use
aspirin
99
chadvasc score of 2 or more .. afib pt ...
warfarin | apixaban rivaroxaban dabigatran
100
steven johnson syndrome caused by
s allopurinol, acetaminophen, ibuprofen, penicillin, and anticonvulsants.
101
sunburn like rash is a hallmark feature for
TSST
102
staph toxic shock syndrime
Gastrointestinal (nausea/vomiting) Muscular (myalgia with elevated creatine phosphokinase level) Renal (elevated serum blood urea nitrogen and/or creatinine levels, or pyuria) Hepatic (elevated aspartate aminotransferase, alanine aminotransferase, and/or bilirubin) Hematologic (platelet count <100,000/mm3, leukocytosis) Central nervous system (altered mentation/consciousness without focal findings).
103
folate fujnction in the body
transfer carbon
104
transplant patient presents with vessel occlusion, ischemia ,fibrinoid necrosis which type of reaction is this
hyperacute
105
Recipient antigen-presenting cells presenting donor peptides after transplant
chronic rejection
106
acute graft rejection
recepient cytotoxic t cells | only against SOLID transplants not bone marrow
107
Daclizumab
Dacluzimab is an interleukin-2 receptor antagonist
108
reatment of acute myelogenous leukemia (AML).
Daunorubicin (intercalate between strands of DNA) and cytarabine (pyramidine analogue)
109
CLL treatment
Fludarabine and rituximab
110
doxorubicin SE and prophylaxis
dexrazoxane iron chelating | dialated cardiomyopathy
111
plummer vinson
esophageal webs iron def anemia atrophic glossitis
112
Broken and destroyed lymphocytes
smudgec ells | CLL
113
Mutations in the phosphatidylinositol glycosyltransferase gene
PIGA gene | PNH
114
A prolonged partial thromboplastin time (PTT) that is corrected by fresh-frozen plasma
in hemophilia for example
115
female reports many miscarriages joint pain weight loss +ve RPR but negative treponemal test
antiphospholipid syndrome +ve B2glycoprotein and crdiolipin (igM igG)
116
when to use FFP
extrinsic pathway problems ... like overdose with wrfarin
117
cryoprecipitate
this has factor 1 (fibrinogen) that is converted to fibrin .... use this in DIC
118
HLA3
hemochromatosis
119
HLAB8
addison Myasthenia Graves
120
HLADR5
hashimoto | pernicious
121
Splenic macrophages consuming RBCs with IgG bound to the surface is seen
in warm autoimmune hemolytic anemia, which would present with anemia with splenomegaly and jaundice. There would be marrow hyperplasia with a corrected reticulocyte count > 3%.
122
CD 14 is a marker on
macriphages
123
aspirin mechanism
irresversibly inhibit COX 1 COX 2
124
pegylated interferon (IFN) for hep b
he most worrisome complications include bone marrow suppression, resulting in cytopenias (eg, neutropenia) and life-threatening infections, neuropsychiatric symptoms, worsening of autoimmune disorders, and ischemic disorders.

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