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USMLE Step Two > Hematology/Oncology Disorders > Flashcards

Hematology/Oncology Disorders Flashcards

(95 cards)

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1
Q

teenage African American male presents to the ER with right hip pain and a hematocrit of 25%

A

sickle cell anemia with osteonecrosis of the femoral head

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2
Q

next step in management of patient with febrile neutropenia due to chemotherapy

A

admission, neutropenic precautions, blood culture, urine culture, CXR, and broad spectrum IV antibiotics

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3
Q

most common cause of anemia in elderly patients

A

folate deficiency

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4
Q

blood smear of patient with anemia due to lead poisoning

A

microcytic, hypochromic, basophilic stippling, and sideroblastic anemia

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5
Q

cause of anemia in an alcoholic patient with an elevated MCV

A

folate deficiency

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6
Q

cause of anemia that develops after taking a sulfa drug

A

G6PD deficiency

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7
Q

medication used in long-term management of sickle cell anemia

A

hydroxyurea

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8
Q

compare serum iron, ferritin, and transferrin levels in iron deficiency anemia v. anemia of chronic disease

A

iron low in both
ferritin increased in chronic disease
transferrin increased in iron deficiency

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9
Q

what lab markers suggest anemia due to hemolysis

A

increased indirect bilirubin, reticulocyte count, LDH
MCV normal
H/H decreased
decreased haptoglobin

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10
Q

schistocytes

A

mechanical hemolysis, drug-induced hemolysis

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11
Q

RBC disorder associated with acanthocytes (spur cells)

A

abetalipoproteinemia

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12
Q

RBC disorder associated with bite cells

A

G6PD deficiency

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13
Q

RBC disorder associated with basophilic stippling of RBCs

A

lead poisoning, thalassemia, alcoholism

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14
Q

RBC disorder associated with peripheral neuropathy, sideroblastic RBCs

A

lead poisoning

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15
Q

RBC disorder associated with hypersegmented neutrophils

A

folate, B12 deficiecny

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16
Q

RBC disorder associated with heinz bodies

A

G6PD deficiency

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17
Q

which vaccines are particularly important in children with sickle cell disease

A

pneumococcal, HiB vaccines

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18
Q

other than vaccination, how is pneumococcal infection prevented in children

A

prophylactic penicillin until the age of 5

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19
Q

complication that occurs in 10% of patients with sideroblastic anemia

A

leukemia

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20
Q

differential diagnosis for serum eosinophilia

A

drugs (NSAIDs, penicillins/cephalosporins)
neoplasms
allergies, asthma, allergic bronchopulmonary aspergillosis
adrenal insufficiency
acute interstitial nephritis
collage vascular disease (PAD, dermatomyositis)
parasites, HIV, hyper-IgE, cocciodiomycosis, hypereosinophilic syndrome

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21
Q

drugs known for causing thrombocytopenia

A 
heparin, abciximab
carbamazepine, phenytoin, valproate
cimetidine
acyclovir, rifampin
sulfonamides (sulfasalazine, bactrim)
procainamide, quinidine
quinine, gold compounds
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22
Q

most common causes of DIC

A

sepsis, trauma, pancreatitis, neoplasm, obstetric complications, transfusions

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23
Q

inherited diseases of hypercoagulation

A

factor V leiden, antithrombin III def, protein C/S def, prothrombin gene mutation
hyperhomocysteinemia (MTHFR gene mutation)
rare: dysfibrinogenemia, plasminogen deficiency

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24
Q

treatment for mononucleosis

A

no antiviral medication
NSAIDs, tylenol, hydration
return to contact sport after 4 weeks, non-contact sport after 3 weeks

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25
classic pentad for thrombotic thrombocytopenic purpura
hemolytic anemia, thrombocytopenia, acute renal failure | fever, neurological symptoms
26
most common mutation in white patients that predisposes to hypercoagulability
factor V leiden
27
mechanism of action of streptokinase
thrombolytic, cleaves fibrinogen
28
mechanism of action of aspirin
COX-inhibitor, blocks platelet aggregation
29
mechanism of action of clopidogrel
ADP inhibitor
30
mechanism of action of abciximab
gIIbIIIa inhibitor
31
mechanism of action of tirofiban
gIIbIIIa inhibitor
32
mechanism of action of ticlopidine
ADP inhibitor
33
mechanism of action of enoxaparin
binds factor Xa
34
mechanism of action of eptifibatide
gIIbIIIa inhibitor
35
lab test used to monitor warfarin, heparin, LMWH
warfarin: PT, INR heparin: PTT LMWH: anti-factor Xa
36
treatment for von Willebrand disease
DDAVP, vWF or factor VIII infusion for surgery, OCP for menorrhagia
37
platelet count, bleeding time, PT, PTT in HUS/TTP
platelet count decreased bleeding time increased PT normal PTT normal
38
platelet count, bleeding time, PT, PTT in hemophilia A/B
platelet count normal bleeding time normal PT normal PTT increased
39
platelet count, bleeding time, PT, PTT in von Willebrand's disease
platelet count normal bleeding time increased PT normal PTT increased
40
platelet count, bleeding time, PT, PTT in DIC
platelet count decreased bleeding time increased PT increased PTT increased
41
platelet count, bleeding time, PT, PTT in warfarin use
platelet count normal bleeding time normal PT increased PTT increased
42
platelet count, bleeding time, PT, PTT in end stage liver disease
platelet count decreased or normal bleeding time increased or normal PT increased PTT increased
43
platelet count, bleeding time, PT, PTT in aspirin use
platelet count normal bleeding time increased PT normal PTT normal
44
what are the SIRS criteria
temperature < 35 OR > 38 WBC < 4,000 OR > 12,000 or > 10% bandemia RR > 20 HR > 90
45
most important medication in treatment of anaphylaxis
subcutaneous/IM epinephrine
46
most common neoplasm in children
ALL
47
most common leukemia in adults
CLL
48
philadelphia chromosome is almost always seen
CML
49
smudge cells on peripheral smear
CLL
50
peripheral blasts are PAS+ and TdT+
ALL
51
peripheral blasts are PAS-, myeloperoxidase+, and have Auer rods
AML
52
pancytopenia in a down syndrome patient
ALL
53
medication associated with remission in 95% of patients with CML
imatinib
54
21 year-old male presents with recent weight loss, pruritis, night sweats, hepatosplenomegaly, and a nontender cervical lymphadenopathy
hodgkin's lymphoma
55
blood cell pathology associated with EBV in Africa
burkitt's lymphoma
56
reed-sternberg cells, cervical lymphadenopathy, and night sweats
hodgkin's lymphoma
57
bence-jones proteins, osteolytic lesions, high calcium
multiple myeloma
58
translocation 14;18
follicular lymphoma
59
most common lymphoma in the US
diffuse large B-cell
60
translocation 8;14
burkitt's lymphoma
61
translocation 9;22
CML philadelphia chromosome
62
most common form of hodgkin's lymphoma
nodular sclerosis
63
starry-sky pattern due to phagocytosis of apoptotic tumor cells
burkitt's lymphoma
64
high hematocrit/hemoglobin, pruritis, burnign pain in hands or feet
polycythemia vera
65
blood smear with hair-like projections, splenomegaly
hairy cell leukemia
66
antiretroviral that causes lactic acidosis
NRTIs
67
antiretroviral that causes GI intolerance
protease inhibitors
68
antiretroviral that causes pancreatitis
didanosine, stavudine, zalcitabine, ritonavir
69
antiretroviral that causes peripheral neuropathy
didanosine, stavudine, zalcitabine
70
antiretroviral that causes megaloblastic anemia
zidovudine
71
antiretroviral that causes rash
NNRTIs
72
antiretroviral that causes hyperglycemia, diabetes mellitus, and lipid abnormalities
protease inhibitors
73
antiretroviral that causes bone marrow suprression
zidovudine
74
antiretroviral that is given to pregnant women with HIV
HAART therapy +/- ziduvodine during labor
75
antiretroviral regimen for occupational HIV exposures
HAART: 2 NRTIS + NNRTI/protease inhibitor | zidovudine + lamivudine
76
antibiotic prophylaxis for HIV patients
< 200: TMP-SMX/dapsone for PCP | < 100: erythryomycin/clarithromycin for MAC
77
treatment for CLL
rituximab
78
no alpha-globin production, fetal death occurs
hydrops fetalis | 4 abnormal alpha genes
79
minimal alpha-globin production, chronic hemolytic anemia, pallor, splenomegaly, microcytic RBCs on blood smear, decreased lifespan
hemoglobin H disease | 3 abnormal alpha genes
80
reduced alpha-globin production, mild anemia, microcytic RBCs and target cells
alpha-thalassemia minor | 2 abnormal alpha genes
81
generally asymptomatic hematologic disorder, children are at increased risk for alpha-thalassemia
alpha-thalassemia minima | 1 abnormal alpha gene
82
no beta-globin production, asymptomatic until decline of fetal hemoglobin, growth retardation, increase in hemoglobin A2 and F, patients die in childhood without transfusions
beta-thalassemia major | 2 abnormal beta genes
83
reduced beta-globin production, mild anemia, transfusions may be needed during periods of stress
beta-thalassemia minor | 1 abnormal beta gene
84
treatment for anti-phospholipid syndrome
heparin, warfarin | hydroxychloroquine
85
prophylaxis when CD4 < 200
TMP-SMX for toxoplasmosis and PCP
86
treatment for porphyria cutanea tarda
phlebotomy and chloroquine
87
treatment for coxsackie virus herpangina
reassurance and symptomatic treatment
88
causes of distributive shock
sepsis, anaphylaxis, burns, adrenal insufficiency, drug reactions, and CNS injury
89
ovalo-macrocytes, leukopenia, thrombocytopenia, neutrophils with decreased segmentation
myelodysplastic syndrome
90
treatment for polycythemia vera
serial phlebotomy, antihistamines (for pruritis), aspirin (prevent strokes), hydroxyurea (bone marrow suppression) interferon-alpha is a refractory treatment
91
HIV medication that causes weird, colorful dreams
efavirens (NNRTI)
92
congenital marrow failure with poor growth, morphologic abnormalities, and macrocytic anemia
fanconi's anemia
93
genetic cause of fanconi's anemia
chromosomal breaks
94
decreased red blood cells, craniofacial abnormalities, limb deformities, elevated adenosine deaminase
diamond-blackfan anemia
95
treatment for minor cat bites
amoxicillin/clavulanate (for pasturella))

USMLE Step Two (17 decks)

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