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Heme/Onc Flashcards

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1
Q

Dark urine in the morning that improves throughout the day, + sucrose test

A

PNH

  • precipitated by iron, vaccines, infections
  • Inc COMPLEMENT destruction d/t impaired GPI anchor
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2
Q

Osmotic fragility test +

A

Hereditary spherocytosis

  • spectrin, ankyrin gene
  • aplastic crisis
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3
Q

Cigar-shaped RBCs

A

Hereditary elliptiocytosis

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4
Q

+ coombs, normocytic anemia

A

Auto-immune hemolytic anemia

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5
Q

Back pain with hemoglobinuria a few days later, Heinz bodies, Bite cells

A

G6PD deficiency

- sulfas, anti-malarials, fava beans

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6
Q

Burr cells/echinocytes/acanthocytes

A

Pyruvate kinase deficiency

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7
Q

Babesia DOCs

A

Quinine

Clindamycin

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8
Q

Metabolite of cyclophosphamide responsible for hemmorrhagic cystitis

A

Acrolein

- mercaptoethansulfate (mensa) binds this

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9
Q

Drug used in 9:22 translocation leukemia

A

Imatinib used in CML

- Inhibits TK activity from BCR-ABL fusion

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10
Q

Inc TIBC

Dec, ferritin, Serum Fe, % sat, free protoporphyrin

A

Iron deficiency anemia

- Duodenctomy, Breast fed, Ulcers, Pregnancy, Polyps, Hookworm

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11
Q

Inc Ferritin, protoporphyrin

Dec TIBC, Serum Fe, % sat

A

Anemia of chronic disease

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12
Q

Iron-laden mitochondria
Inc Ferritin, Serum Iron % Sat
Dec TIBC

A

Sideroblastic anemia

  • aminolevulinic acid synthase deficiency (ALAS)
  • alcohol, lead, B6 deficiency
  • Tx = pyridoxine (B6)
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13
Q

Pale line on gingiva, basophilic stippling of RBCs, abdominal colic, siderblastic anemia

A

Lead poisoning

  • Inhibits ferrochelatase & ALA dehydratase
  • Tx = Dimercaprol + EDTA
  • Kids = Succimer
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14
Q

Alpha-Thal

A

1-2 deletions = no Sx

3 deletions = HbH (B4)

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15
Q

B-Thal Minor (B/B+)

A

Usually ASx

HbA2 >3.5%

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16
Q

B-Thal Major (B0/B0)

A

ABSENT B chain –> (a2, y2)

  • Ineffective erythoporesis
  • Erythroid hyperplasia –> crew cut, chipmunk facies
  • Extramedullar hematopoesis –> nucleated RBCs
  • Aplastic crisis
  • No HbA, inc HbA2, HbF
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17
Q

Anemia w/ >3% corrected Retic count, inc LDH, inc unconjugated bilirubin & jaundice, no hemoglobinuria, bile stones, splenomegaly

A

Extravascular hemolysis

  • Spherocytosis
  • Sickle Cell
  • Pyruvate kinase
  • HbC
  • G6PD
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18
Q

Anemia w/ >3% corrected Retic count, inc LDH, dec haptoglobin, hemoglobinuria

A

Intravascular hemolysis

  • PNH
  • G6PD
  • Immune hemolytic
  • Microangiopathic
  • Malaria
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19
Q

Howell-Jolly bodies

A

Hereditary spherocytosis after splenectomy

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20
Q

HbC defect

A

Glut –> Lysine

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21
Q

Sickle Cell defect

A

Glut –> Valine

  • Low O2, or dehydration –> inc sickling
  • Extramedullary hematopoesis
  • AUTOSPLENECTOMY
  • dactylitis in kids
  • HU –> inc HbF
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22
Q

SLE CLL, methyldopa, warm IgG anemia, Coombs +

A

Warm agglutinin auto-immune hemolytic anemia

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23
Q

Triggered by cold, mycoplasma, Mono, CLL, IgM, Coombs +

A

Cold agglutinin auto-immune hemolytic anemia

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24
Q

Helmet cells on blood smear (schistocytes)

A

Microangiopathic

- DIC, TTP-HUS, SLE, HTN, prosthetic valves

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25
Dec TIBC
Hemochromatosis
26
Urine that turns tea color when exposed to light
PCT | - Uroporphyrinogen decarboxylase
27
Painful abdomen, Red-wine colored urine, polyneuropathy, psych disturbances
Acute intermittent porphyria | - Defect in porphobilinogen deminase
28
Dec GP1b
Bernard-Soulier | - can't bind vXF
29
Dec GPIIb/IIIa
Glansmann's | - Defect in platelet-platelet
30
Anti-GPIIb/IIIa Abs
Idiopathic thrombocytopenic purpura | - platelet-AB complex consumed by MO
31
ADAMTS 13 deficiency
``` Thrombocytopenic purpura (TTP) - LARGE vWF multimers --> thrombosis ```
32
Most common inherited bleeding disorder
vWF disease | - Tx = DDAVP
33
Most common inherited hypercoagulability
Factor V Leiden | - Can't be degraded by protein C
34
Reed-sternberg cells (bilobed nuclei w/ prominent nucleoli surrounded by clear cytoplasm)
Hodgkin lymphoma - CD15, 30+ - CD20 - - Tx = brentuximab (CD30 Ab)
35
Young female, bands of sclerosis, lacunar cells, enlarging LN
Nodular sclerosing HL
36
Best prognosis HL
Lymphocyte rich
37
Worst prognosis HL
Lymphocyte depleted
38
(8;14) c-myc, starry sky
Burkitt's - CD20+ - EBV - africa = Jaw - sporadic = abdomen
39
Most common adult NHL
Diffuse
40
(11;14) cyclin D, CD23-
Mantle cell | - Cyclin promotes G1-->S
41
(14;18) bcl-2, CD10+, CD5-
Follicular - prevents apoptosis - Tx = Rituximab CD20 Ab
42
CD20+, assoc w/ auto-immune diseases/chronic inflammatory - Hasimoto's, Sjogren, H. pylori
Marginal zone | - MALTOMA - H. pylori
43
Most common primary malignancy of bone
Multiple myeloma
44
High IL-6, bone pain w/ hyperCa, M-spike of IgG on SPEP, Rouleaux formation, clock-face chromatin
Multiple myeloma - Bence-Jones proteins --> renal failure - Light chain amyloidosis - M-spike = IgG or IgA - Lytic bone lesions
45
Bence-Jones Proteins
Multiple myeloma
46
M-spike w/ IgM, retinal hemorrhage, papilledema, bleeding from nose and gums, no lytic bone lesions or renal impairment, HA
Waldenstroms - Tx = plasmaphoresis MGUS = Asx + <10% plasma cells on BM Bx
47
``` 10 y/o w/ infections, fatigue, bone pain, petechiae, bleeding Down >5 CNS, testicular, LA Tdt + (9;22) Lymphoblasts ```
ALL - B-type most common - CALLA Ag
48
``` 65 y/o Down <5 Auer rods MPO & Sudan black stains Myeloblasts (15;17) ```
AML - M3 = ATRA, Auer rods --> DIC, 15;17 - M5 = no MPO, GUMS - M7 = Down <5
49
Auer rods
AML
50
(9;22)
CML & ALL
51
(11;22)
Ewing sarcoma
52
(15;17)
M3 type of AML (all trans retinoid acid)
53
T-ALL
``` Tdt CD2, 8 NO CD10 Thymic mass Teens (remember all the Ts) ```
54
*CD5*, CD20, CD23+ Smudge cells >60 y/o
CLL
55
Stains with tartrate resistant acid phosphatase, splenomegaly, dry bone aspirate, fried egg appearance
Hairy cell leukemia - All the TRAPs - Tx = 2-CDA
56
Cerebriform nuclei, CD4 and CD3 cell aggregate in epidermis (Pautrier microabscesses)
Mycosis fungiodes
57
30-60 (9;22) bcr-abl (-) Leukocyte alkaline phosphatase
CML - Tx = imatinib (TK inhibitor for bcl-abl) - 2/3 --> AML - 1/3 --> ALL
58
Myeloproliferative disorders assoc w/ JAK mutations
Polycythemia Thrombocytosis Myelofibrosis - tear-drop cell
59
Heparin
Activates AT-III | Ok for preggers
60
Enoxaparin
LMW - more predictable, low HIT - selective Xa inhibitor
61
Direct thrombin inhibitors
Lepirudin | Bivalrudin
62
Fondaparinux
Binds only AT-III | DVT prophylaxis*
63
Clopidogrel, ticlopidine
Block ADP receptors --> inhibit platelet aggregation | Ticlopidine --> neutropenia
64
Cilostazol, dipyridamole
PDE III- inhibitor --> inc cAMP --> inhibits platelet aggregation Used for claudication, prevention of stroke
65
Abciximab
GPIIb/IIIa inhibitor
66
Inhibits M-phase
Vinca alkyoids & paclitaxol
67
Bind tubulin preventing spindle formation
Colchicine, Vincristine, Vinblastine | - Block polymerization in M-phase
68
Bind microtubules preventing DEploymerization
Paclitaxel
69
Inhibits topoisomerase
Etoposide
70
Alkylating agents
Cisplatin
71
DNA intercalators
Dactinomycin | Doxorubicin
72
Inhibits thymidylate synthase
MTX | 5-FU
73
Dec purine synthesis
6-MP - Inc toxicity w/ allopurinol - 6-TG ok w/ allopurinol
74
MTX antidote for myelosuppression
Leucovorin (folinic acid)
75
Used for kids tumors
ACTinomycin D - intercalates
76
DNA intercalator assoc w/ cardiotoxicity
Dox and danrubicin
77
Used in brain tumors
Nitroureas - carmustin, lomustine, semustine | Croses BBB
78
Inhibits cycophilin to inhibit T-cell activiation
Cyclosporine
79
Inhibits immunophilin FKBP
Tacrolimus
80
Inhibits FKBP-12, m-TOR, T-cell response
Sacrolimus
81
Inhibits CD52 in lymphoma
Alemtuzumab
82
Inhibits VEGF in Colorectal cancer
Bevacizumab
83
Inhibits CD33 in AML
Gemtuximab
84
Inhibits EGFR in colorectal cancer
Cetuximab
85
Drugs cause peripheral neuropathy, BM suppression
Vincristine | VinBlastine = BM
86
Drugs cause nephro and ototoxicity
Cisplatin, carboplatin
87
Drug specific for S-phase inhibit RnR
HU
88
Monclonal Ab to HER-2/neu
Traztuzumab
89
Dapsone
Inhibits dihydropteroate synthase Used for Malaria, Toxo, M. leprae can --> hemolysis in G6PD
90
Hyperproliferation of megakaryocytes, thrombocytosis,
Essential thrombocytosis - JAK2 mutation - Tx = aspirin
91
VTs and skin necrosis w/ warfarin use
Protein C deficiency
92
Inc Hct, WBCs, platelets | Vertigo, HA, tinnitus, thrombosis, gout, digital ischemia, CVA/MI/DVT/PEs, PRURITIS AFTER SHOWER, Erythromelagia
* Polycythemia vera* - JAK2 mutation - Erythromelagia = red burning extremities relived by cold and aspirin
93
Splenomegaly, mild anemia, dry bone marrow aspirate, tear-drop cell
Myelofibrosis - JAK2 mutation - Fibrosis of BM
94
Pt being treated for CML has developed pulmonary fibrosis and hematuria is most likely on what drug?
Busulfan | - Alkylating agent --> N7 of guanosine
95
Functions to bind factor VIII and prevent degradation by protein C, deficiency presents with excessive epistaxis, menorrhagia
vWF disease | - Tx = DDAVP --> retains water --> hypoNa, K
96
Anaphylaxis after blood transfusion
IgA deficiency
97
7 y/o w/ short stature, cafe au lati, short thumb, pancytopenia
Fanconi anemia | - DNA repair genes

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