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Flashcards in Heme/Onc Deck (189):
1

name the important neutrophil chemotactic agents

C5a
IL-8
LTB4
kvllikrein
platelet-activating factor

2

lipid A from bacterial LPS binds what on macrophages to induce septic shock

CD 14

3

what causes eosinophilia

Neoplasm
Asthma
Allergic RXN
Chronic adrenal insufficniey
parasites

4

what lymphocyte mediate cell immunity

T cells

5

what lymphocyte mediates humoral immune response

b cells

6

cell wth clock face chromatin distribution and eccentric nucleus with well developed golgi

plasma cell

7

what makes oxidized vitamin k into reduced vitamin k so it can activate the coagulation factors

epoxide reductase

8

antithrombin inhibits wha factors

2
7
9
10
11
12

9

inhibit ADP induced expression of GpIIb/IIIa

Ticlopidine
clopidogrel
Prasugrel

10

inhibit GpIIb/IIIa directly

Abciximab, Eptifibatide, Tirofiban

11

what activates vWF to bind to GpIb

Ristocetin

12

spur cells are seen in

Abetalipoproteinemia and Liver disease

13

what test tests for autoimmune hemolytic anemia because the body produces AB to RBC

direct coombs test

14

a test that detects antibodies to RBC unbound in the patients serum. used in pregnant women and before blood transfusions

indirect coombs test

15

cis deletion of alpha globulin in alpha thalassemia means what

deletions are on the same chromosome

16

cis deletion of A thalamseima is seen in

Asians

17

trans deletion of A thalassemia is seen in

Black people

18

b thalesemia is present in what people

mediteraniean

19

what is protective against major beta thalassemia

HbF until 6 months

20

b thalassemia major patients have an increased chance of what problem

parvovirus B19 induced aplastic crisis

21

what is the chelation for lead poison used in children

Succimer

22

sideroblastic anemia has a defect in what

ALA synthase gene

23

treatment for sideroblastic anemia

ALA synthase or pyridoxine

24

historical test used to diagnose B12 def.

Schilling test ( tells if the problem is malabsorption or dietary insufficiency)

25

defect in UMP synthase that causes failure to thrive in children and megaloblastic anemia. No hyperammonemia is present

Orotic Aciduria

26

important physical symptom of Diamond Blackfan syndrome

triphalangeal thumb

27

haptoglobin are increased in what kind of hemolysis

extravascular hemolysis

28

haptoglobin are decreases in what kind of hemolysis

intravascular hemolysis ( paroxysmal nocturnal hemoglobunbria)

29

hemolytic anemia of the newborn because of decreased levels of ATP is seen because of

Pyruvate kinase deficiency

30

what is the terminal complement inhibitor that treats Paroxysmal Nocturnal Hemoglobinuria

Eculizumab

31

Cold IGM complement induced autoimmune hemolytic anemia can be caused by

Mycoplasma Pneumonia
Mono
Cll

32

acute intermittent porphyria is caused by a deficiency in what

porphobilinogen deaminase

33

porphyria cutanea tarde is a deficiency in what

uroprphyrinogen decarboxylase

34

what usually cause HUS in children

SHiga toxin producing E. Coli (O157:H7)

35

skin necrosis and hemorrhage after administration of warfarin is seen when

there is protein C and S deficiency

36

what should be given if you want to replace coagulation factors fibrinogen and factor 8

cryopercipitate

37

8:14t

burritos

38

14:18 t

follicular lymphoma

39

11:14 t

mantle cell lymphoma

40

starry sky appearance of lymphocytes associated with EBV and a jaw lesion in the african type

Burritos lymphoma

41

most common type of non hodgkin lymphoma in adults

diffuse large b cell lymphoma

42

waxing, winning lymphadenopathy lymphoma

follicular lymphoma

43

verry aggressive with patients mainly presenting in the alter stages lymphoma

mantel cell lymphoma

44

AIDS defining illness that needs to be differentiated from toxoplasma

primary central nervous system lymphoma

45

associated with IV drug abuse which presents with cutneoys lesions and lytic bone lesions and hypercalcemia

adult t cell lymphioma

46

skin patches are seen with atypical CD4 cells with cerebriform nuclei which may progress to Sezary Syndrome

Mycosis Fungicides

47

hyper viscosity syndrome associated with an Mspike and Raynaud phenomenon

Waldenstrom Macroglobulinemia

48

bone lytic lesions, anemia, renal involvement and hypercalcemia

multiple myeloma

49

monoclonal plasma cell expansions that is asymptomatic that could lead to multiple myeloma

MGUS

50

neutrophils with bilobed nuclei usually seen after chemo

Pseudo-Pelter Huet Anomaly

51

what is the ALL with a better prognosis

12:21

52

t cell All can present how

like a mediastinal mass like in SVC syndrome

53

when SLL/CLL progresses into aggressive diffuse large be cell lymphoma

Richter Transformation

54

marrow fibrosis that causes dry tap on aspiration and spleenomegaly

hairy cell leukemia

55

hairy cell leukemia stains with what

TRAP

56

tx for hair cell leukemia

pentostatin
cladribine

57

AML that responds t retinoid acid

15:17

58

philadelphia chromsome 9:22 BCR-ABL represent

CML

59

what is Imatinib

BCR-ABL tyrosine kinase inhibitor that treats CML

60

lytic bone lesions in kids with skin rash and recurrent otits media . a mass involving the mastoid bone

Langerhans cell histocytosis

61

what is characteristic on the EM of langerhans cell histocytosis

tennis rackets, Birbeck granules

62

when is there a decrease in EPO seen in a polycythemia

vera

63

innaprpriate absolute polycythemia its seen when

there is ectopic EPO secretion (renal cell carcinoma)

64

when is there appropriate absolute polycythemia

high altitude

65

when is there relative polycythemia

dehydration and burns

66

name the two LMW heparin

Enoxaparin
Dalteparin

67

What kind of virus is parvovirus b 19

Non envelopes single stranded DNA

68

What kind of virus is EBV

Envelopes double stranded Dna

69

What kind off virus is hep c

Envelopes single stranded positive sense rna

70

What kind of virus is hep e

Non envelopes single stranded positive sense RNA

71

What kind of virus is HIV

Enveloped single stranded positive sense RNA

72

What kind of virus is parvovirus b 19

Non envelopes single stranded DNA

73

What kind of virus is EBV

Envelopes double stranded Dna

74

What kind off virus is hep c

Envelopes single stranded positive sense rna

75

What kind of virus is hep e

Non envelopes single stranded positive sense RNA

76

What kind of virus is HIV

Enveloped single stranded positive sense RNA

77

In mono there is hyperplasia of what part of the lymph node

Paracortex (t cell)

78

Peri arterial lymphatic sheath is the part that is distended when

There is a T cell infection like mono ( this is the area of T cells)

79

What does mono spot test detect

IgM Heterophile antibodies

80

name the six protooncogenes

RAS
ABL
HER2
EGFR
MYC
BRAF

81

Name six tumor suppressor genes

WT1
VHL
RB
Tp53
APC
BRCA

82

protooncogene associated with hairy cell leukemia

BRAF

83

what do the BRCA genes do

they repair breaks in DNA

84

zinc containing enzymes that are used in wound healing and remodeling to break down collagen, laminin, and fibronectin

Metalloprotineases

85

CD 55 is used for what? and is missing in what

it is used to inactivate complement and it is missing in Paroxysmal Nocturnal Hemoblobinguria

86

hemolytic anemia, low haptons, pancytopenia and thrombosis of things like the mesenteric vein are associated with what disease

Paroxysmal Nocturnal Hemoglobinuria

87

explain hemosiderosis seen in PNH

there is a continuous destruction of RBC which leads to free iron being deposited in the kidney

88

cast nephropathy is seen in what disease

multiple myeloma

89

what diseases cause osteolytic bone metastasis

Multiple myeloma
non small cell lung cancer
non hodgkin lymphoma
renal cell carcinoma
melanoma

90

what diseases cause osteoblastic bone metastasis

prostate cancer
small cell lung cancer
hodgkin lymphoma

91

cancer associated with high parathyroid hormone related peptide (PTH rP) and hypercalcemia as well as osteolytic bone metastasis

non small cell lung cancer

92

diffuse medium sized lymphocytes and high proliferation index represented by the high Ki-67 fraction approaching 100% is seen in what disease

Burritk's Lymphoma

93

how can giving packed RBC to a patient who lost a lot of blood cause hypocalcemia

packed blood contains citrate which can chelate calcium and cause hypocalcemia (parathesias)
* usually seen after a massive transfusion

94

what infections induces heterophil antibodies that react with antigens from animal RBCs (sheep-PaulBunnell test or horse - Monospot test)

EBV infections

95

what are two malignancies that EBV is associated with

BurrKits lymphoma
Nasopharyngeal Carcinoma

96

the absence of factor 8 and 9 won't allow for the activation of factor 10 and subsequently won't allow for the activation of prothrombin to thrombin so clots won't be formed. What can you give to someone with hemophilia who won't quit bleeding

thrombin

97

what turns fibrinogen into fibrin, main part of a clot

thrombin

98

waxing and waning lymphadenopathy are common in what cancer

follicular lymphoma

99

what cells clonal expand because of EBV infected B cells


Cytotoxic T cells CD 8+

100

CD14 is a marker for what

macrophages, this is where LPS binds to activate them

101

decreased ferritin, increased transferrin and low MCV are seen in

IRON deficiency anemia

102

RECAM-1 is used for

transmigration

103

ICAM-1 is used for

tight adhesion

104

Leukocyte Adhesion Deficiency type 1 is what

when there is an absence of CD 18 so that interns Mac-1 and LFA1 aren't synthesized so there is no tight adhesion, crawling or trasnmigration

105

symptoms of LAD 1

skin infections with no puss, delayed detachment of umbilical cord and poor wound healing

106

small rings called trophozoites found on RBC is common in what disease

malaria p. falciparum

107

main treatment for malaria

chloroquine

108

treatment for malaria in chloroquine resistant areas

mefloquine

109

ivermectin treats>

Onchocerciasis "River Blindness"

110

Nifurtimox treats

Chagas Disease

111

Pentamide is used for what

prophylaxis of Pneumocystis Jirovecii in HIV patients
- african sleeping sickness and leishmaniasis

112

what is needed to kill P vivid and P oval liver hypnozoites

Primaquine

113

most cases of HUS are preceded by what

diarrhea from Shiga toxin producing bacteria (Shigella and Ecoli 0157:H7)

114

systemic autoimmune disease characterized by proximal muscle weakness resembling polio but with the additional inflammatory features that involved to skin

Dermatomyositis

115

Gottronsq Papules and Heliotrope rash are seen in what disease

Dermatomyositis

116

non enveloped single stranded DNA virus that can cause arthralgia in the hands, knees, wrist and feet without a rash

Parvovirus

117

Why is haptoglobin decreased in hemolytic anemia due to prosthetic valves

Because haptoglobin binds to free hemoglobin and with the increased destruction of red blood cells, there is more free hemoglobin binding to the haptoglobin making the number of haptoglobin decease

118

Repeated splenic infections seen in sickle cell disease makes what happen to the spleen

Fibrosis and atrophy

119

Splenic sequestration can cause what to happen to the spleen

Splenic congestion

120

Patients with sickle cell disease are lily to develop what because of high RBC turnover

Folic acid deficiency

121

Parvovirus in a pregnant woman can cause what in the fetus

interruption of erythropoiesis causing profound anemia which causes CHF. This CHF causes pleural effusion, lung hypoplasia and ascites

122

what kind of viruses are VZV, CMV and HSv

enveloped dsDNA

123

what kind od virus is rubella

enveloped ss RNA

124

What can VZV in a pregnant woman do to a fetus

cause limb hypoplasia

125

indirect bilirubin is the same as

unconjugated billirubin

126

what is the most specific red cell index for spherocytosis

increased mean corpuscular hemoglobin concentration

127

what is caused by a defective binding of the red cell cytoskeleton to the plasma membrane due to mutations involving ankyrin, band 3 and spectrum proteins

hereditary spherocytosis

128

pappenheimer bodies in RBCS are associates with what

sideroblastic anemia

129

increased osmotic fragility on acidified glycerol lysis test ( hemoglobin is released when the patients RBC are incubated with glycerol) is seen in

hereditary sphereocytosis

130

pigmented gallstones are a complication of what

hemolytic anemia like in hereditary spherocytosis

131

two factors that drive angiogensesis

VEGF
FGF

132

what can interferon-y do

INDIRECTLY PROMOTE neovascularization by activating macrophages (these release VEGF)

133

benzene is found in what

gasoline and tobacco smoke

134

what disease affects erythrocyte precursors and causes red cell aplasia ( anapestic crisis) in patients who already have a preexisting blood disease like nickel cell, or hereditary spherocytosis

Parvovirus B19

135

neuroblastoma has an over expression of what marker

n-myc

136

what is the function of the c-myc gene

transcription activation which controls cell proliferation, differentiation and apoptosis

137

cyclin D1 promotes what

g1--> s phase

138

what gives the toughness and rigidity to keratin protein

the disulfide bonds between the cysteine molecules

139

what gives keratin its small structure and ability to coil tightly and form many hydrogen bonds

alanine and glycine molecules

140

what are the two markers used for neuroendocrine tumors

Chromogranin A and neuron specific enolase

141

what is the intermediate filament seen in mesenchymal tissue

vimentin

142

what pathology is associated with an inversion of the short arm of chromosome 2 that creates a fusion gene between EML4 ( echinoderm microtubule associated protein like 4) and ALK ( analytic lymphoma kinase) that causes active tyrosine kinase that causes malignancy

non small cell lung cancer

143

treatment for the EML4-ALK fusion protein that causes malignancy in non small cell lung cancer

Crizotinib (tyrosine kinase inhibitor)

144

EML4-ALK non small cell lung cancer pathophysiology is the most similar to what cancer

CML ( it is also a fusion protein)

145

hemolytic anemia that presents after the administration of TMP-SMX is usually due to what disease

G6PD deficiency

146

increased vulnerability od RBC to oxidative stress manifesting as hemolytic anemia that is induced by
- infection
- drugs ( bacterium, dapsone, antimalarials, nitrofurantoin)
-fava beans

G6PDD

147

x linked disorders mainly seen in men in which presides of oxidative stress cause extra/intravascualr hemolysis. Haptoglobin are low and urine is dark read. Fave bean, and sulfa drugs canc cause this

G6PD D

148

what should be checked before administering dapsone so that you do not cause hemolytic anemia in your patient

G6PD levels

149

how does peripheral tolerance occur

by T cell anergy ( inactivation of t cells that react to self)

150

central tolerance happens where

in the fetal thymus during negative selction

151

where does isotoype switching of b cell occurs ( when they switch from IgM to something else by making antibodies)

in the germinal centers in the lymph nodes

152

interaction of the CD40 receptor on B cells and the CD40 ligand on activated T cells cause what

isotope switching

153

where are heterophiles antibodies found

in patients with EBV mono

154

when are ringed sideroblast found

in myelodysplastic syndrome

155

the hEr2 oncogene encodes for what

185-kD transmembrane glycoprotein that has intracellular tyrosine kinase activity

156

toll like receptors release what

cytokines

157

what is clathrin

an intracellular cytosolic protein the mediated endocytosis

158

autoimmune destruction of platelets by anti platelet antibodies likely IgG agains GpIIb/IIIa

Immune thrombocytopenia purpura

159

main clue for immune thrombocytopenia purport

isolated thrombocytopenia

160

small lymphoid cells with increased nuclei to cytoplasmic ration and cleaved nuclei are seen in what cancer

follicular lymphoma

161

what is the disease that presents as a benign leukocytosis that happens in response to an underlying condition like infection, hemorrhage, malignancy or acute hemolyisi.

Leukemiod reaction

162

Dhole bodies are basophilic granules inside of neutrophils seen in

leukemiod reaction

163

where dose positive selection happen

in the cortex of the thymus

164

where does negative selection occur

in the medulla of the thymus

165

interaction of the developing t cell with thyme medullary epithelial and dendritic cells in seen in

negative selection

166

eczematous nipple lesion is associated with what kind of disease

pagets

167

what causes black gall stone

chronic hemolysis

168

what causes brown gall stones because of the release of microbial B-glucuronidases

biliary tract infection

169

what are two things that the splenic red pulp is important for

1. destroying aged RBCs
2. Clearing out circulating bacteria

170

what are the three main encapsulated bacteria that can present as a problem for individuals with no spleen

Strep Pneumo
H. Influenza
N. Meningitides

171

what causes macrophages and t cells to be activated in viral infected cells

interferon a and b

172

pro carcinogens are metabolized by what

P450 monooxygenase

173

what makes bilirubin into soluble bilirubin

glucuronide transferase

174

PT prolongation seen in liver dysfunction is due to what

Factor 7 running out from the extrinsic pathway (shortest half life)

175

pure red cell aplasia is associated with what?

thymic tumor (thymoma)

176

MAIN MECHANISMS OF IONIZING RADIATION

double strand breaks in the DNA
free radical formation

177

hypophosphorylated RB is what

active

178

hyperphosphorylated RB is what

inactive

179

explain the pathophysiology of Thrombotic Thrombocytopenia Purpura

there is a decrease in ADAM13 activity which causes a larger vWF multiuser that causes microvascular platelet rich thrombi

180

name the clinic features of Thrombotic Thrombocytopneic Purpura

hemolytic anemia
low haptoglobin
thrombocytopenia
schistocytes

181

how to manage TTP

plasma exchange

182

what is the normal role of ADAM13

it cleaves vWF into smaller pieces so that clotting won't occur

183

IgA immune complex deposition and palpable purpura renal disease and arthritis

Hence Schonlein Puprpura

184

frequent nose bleeds and HEAVY menstrual periods is a good sign of what disease

vWF deficiency

185

deep tissue blessing into muscle and joints, g.i. bleeding is usually a sign of what disease

Factor 8 deficiency

186

clot instability and recurrent bleeding after surgery is a sign of what disease

Factor 13 deficiency

187

vWF is a protective carrier for what

factor 8

188

vWF binds to what

collagen

189

prolonged PTT and bleeding time is seen in what problem

vWF deficiency