Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CAM III > Heme part 2 > Flashcards

Heme part 2 Flashcards

1
Q

Thrombosis

A

Occurs when balance is disturbed between:
Procoagulant factors
Anticoagulant factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Procoagulant factors that get disturbed in thrombosis

A

Coagulation factors
Platelets
Leukocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anticoagulant factors that get disturbed in thrombosis

A

Protein C
Protein S
Antithrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thrombosis RFs

A

Age
Smoking
Obesity
Estrogen use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of thrombophilia

A

Inherited thrombophilic conditions

Acquired thrombophilic conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Factor V Leiden

A

The MC inherited thrombophilia
Point mutation (G1691A) in the factor V gene
Leads to an amino acid substitution that renders factor V resistant to inactivation by activated protein C (APC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dx of factor V Leiden

A

APC resistance assay
-Assess the ability of protein C to inactivate factor Va
PCR testing of the gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prothrombin G20210A

A

Gene mutation is the second most common inherited risk factor for VTE
Pts have slightly higher levels of circulating prothrombin (factor II)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dx of prothrombin G20210A

A

PCR testing of the prothrombin gene

Obtaining factor II activity levels is NOT helpful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pathophysiology of antithrombin deficiency

A

Antithrombin is an enzyme that interrupts the coagulation process, mainly by inhibitin thrombin and activated factors IX and X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antithrombin deficiency types

A

Type I: quantitative

Type II: qualitative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antithrombin deficiencies are typically _______

A

Heterozygous

Homozygous deficiencies are typically not compatible with life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acquired cases of antihrombin deficiency that must be ruled out

A 
Acute thrombosis
Heparin therapy
Liver dz
Nephrotic dz
Protein-loosing enteropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Labs for antithrombin deficiency

A

Genetic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tx for antithrombin deficiency

A

Antithrombin concentrates may be used as adjunctive therapy with routine pharmacologic VTE prophylaxis or as a supplement when treateing VTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pathophysiology of Protein C deficiency

A

Protein C is a vit K-dependent natural anticoagulant

It is converted during the coagulation process to APC (which inactivates coagulation factors Va and VIIIa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of protein C deficiency

A

Type I: quantitative

Type II: qualitative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acquired conditions in protein C deficiency

A

Acute thrombosis
Warfarin therapy
Liver dz
Protein-losing enteropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Labs for protein C deficiency

A

Protein C activity assay

Genetic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is protein C deficiency a risk factor for?

A

Primary VTE
Recurrent VTE
Arterial thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When can protein C concentrate be given?

A

Indicated in infants with catastrophic thrombotic complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pathophys of Protein S deficiency

A

Natural vit K-dependent anticoagulant

Cofactor for APC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Labs for protein S deficiency

A

Protein S activity

Free protein S antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Acquired conditions in protein S deficiencies

A 
Acute thrombosis
Warfarin therapy
Liver dz
Inflammatory states
Estrogens
Protein-loosing enteropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is protein S deficiency a RF for?
Primary VTE Recurrent VTE Arterial thromboembolism
26
Other inherited disorders
Dysfibrinogenemias- rare Elevated homocysteine level -Polymorphisms in the methylene tetrahydrofolate reductase (MTHFR) gene Elevated plasma factor VIII levels
27
RFs for acquired thrombotic conditions
``` Surgery Trauma Hospital or nursing home confinement/immobility Malignancy Central venous catheters Pacemaker placement Estrogen Pregnancy Obesity Inflammatory disorders Chemo Glucocorticoid therapy Smoking ```
28
Surgery, trauma, hospitalization and immobility in acquired thrombotic conditions
``` Higher risk with: Hip and knee arthroplasty CA surgery Pelvic surgery Abdominal surgery ```
29
40% of VTEs are associated with _________
Hospitalization | Either during or within 3 mos after d/c
30
CA and VTE
20% of all VTEs occur in pts with CA Active CA increases VTE risk 5-6 fold -Hx of CA, or CA that has undergone curative therapy without residual dz 6% of pts with unprovoked VTE have an undiagnosed CA at the time of the VTE 10% of pts with unprovoked VTE will be diagnosed with a CA in the year following the VTE dx
31
Antiphospholipid antibody syndrome
Acquired autoantibodies against phospholipids and phospholipid-binding proteins such as cardiolipin and B2-glycoprotein Autoimmune, malignancy, drugs Increases the risk of venous and arterial thrombosis
32
Labs for antiphospholipid antibody syndrome
``` Lupus anticoagulant Anticardiolipin antibodies -False pos syphilis test Anti-B2-GPI antibodies Presence of APLAs are found in nearly 505 of pts with SLE but only 1-5% of the general population ```
33
Tx of antiphospholipid antibody syndrome
Pts with APS and a hx of unprovoked VTE should received anticoag therapy for life -Target INR range is 2-3 Catastophic APS is rare and results in multiorgan failure -Tx includes: anticoagulation, high-dose glucocorticoids and other immunosuppressants, and plasma exchange
34
Meds in acquired thrombotic conditions
``` Estrogen-progestin contraceptives -Highest with progesting drospirenone Contraceptive patches and rings Hormone replacement therapy Chemo Tamoxifen Anastrozole Bevacizumba Erythropoiesis-stimulating agents ```
35
Hemodynamically stable pts and transfusions
Transfusion threshold hgb level of < 7 g/dL is recommended based on data
36
Transfusion strategies
Erythropoietin and darbepoetin are used to promote RBC production and reduce the need for transfusion -Higher hemoglobins have increased risks Preoperative autologous blood donation -Reduces blood transfusion risks Interoperative hemodilution or use of intraoperative cell salvage technology
37
FFP
Replacement solution for plasma exchange Prevention of coagulopathy form massive transfusion Tx of bleeding associated with multiple acquired clotting factor deficiencies (DIC) Major warfarin-associated hemorrhage
38
Cryoprecipitate
Congenital or acquired fibrinogen deficiency Dysfibrinogenemia Factor XIII deficiency Tx of hemophilia A and vWB dz when another more suitable product is not available
39
Immune globulin
Acquired or congenital hypogammaglobulinemia | Autoimmune disorders
40
Albumin
Replacement solution for plasma exchange | Spontaneous bacterial peritonitis
41
Prothrombin complex concentrates
Major warfarin-associated hemorrhage
42
Factor VIII
Hemophilia A | Tx and prevention of bleeding
43
Von Willebrand protein-rich factor VIII
Von Willebrand dz | Tx and prevention of bleeding
44
Factor IX
Hemophilia B | Tx and prevention of bleeding
45
Fibrinogen
Congenital fibrinogen deficiency | Tx of bleeding
46
Thrombin
Small vessel bleeding despite standard surgical techniques or when surgical intervention is not feasible (topical application)
47
Protein C concentrate
Severe congenital protein C deficiency | Prevention and tx of venous thrombosis and purpura fulminans
48
Antithrombin
Hereditary antithrombin deficiency
49
Alpha 1 antitrypsin
Congenital alpha 1 antitrypsin deficiency
50
C1-esterase inhibitor
Hereditary angioedema | Acute attacks
51
Conventional approaches to medical oncology
Histologic dx and clinical staging | Surgery, radiation therapy, chemo
52
New approaches to medical oncology
Molecular profiling | Targeted therapy, immunotherapy, use of immunoconjugates
53
What must be done before oncology pts can be treated?
Staging Individualized clinical assessment Mutually determine goals of therapy
54
T staging oncology- size or direct extent of the primary tumor
Tx: tumor cannot be assessed Tis: carcinoma in situ T0: no evidence of tumor T1, T2, T3, T4: size and/or extension of the primary tumor
55
N staging oncology: degree of spread to regional lymph nodes
Nx: LNs cannot be assessed N0: no regional lymph nodes metastasis N1: regional lymph node metastasis present; at some sites, tumor spread to closest or small number of regional LNs N2: tumor spread to an extent between N1 and N3 N3: tumor spread to more distant or numerous lymph nodes
56
M staging oncology- presence of distant metastasis
M0: no distant metastasis M1: metastasis to distant organs (beyond regional lymph nodes)
57
Performance status in oncology
Indicates a pt's well-being and ability to perform daily activities -Karnofsky score -Zubrod score Pts with an excellent performance status typically have a better overall prognosis and the ability to tolerate more aggressive therapies
58
How is Karnofsky performance status scale scored?
100 is best, 0 is dead
59
How is the Zubrod scale scored?
O is nl activity, 4 is bedridden
60
MItotic rate
Measure of how fast CA cells are dividing and growing | Higher mitotic rates are linked with lower survival rates in oncology
61
Overall survival
Refers to the time from initiation of therapy until death | Frequently quoted as the median survival time
62
Progression-free survival (progression-free interval)
The time from initiation of therapy until the time therapy is not longer controlling the tumor growth
63
Overall response rate
The percentage of pts involved in a clinical trial whose tumor undergoes a prespecifed degree of shrinkage in imaging studies
64
Surgical resection
Primary tx for locoregional solid tumor malignancies
65
Adjuvant therapy
Chemo and/or radiation given after definitive surgery with curative intent
66
Neoadjuvant therapy
Chemo and/or radiation given before planned definitive surgery with curative intent
67
Traditional CA chemo
Cytotoxic agents with minimal selectivity for tumor cells over nl cells
68
Personalized targeted agents
Have more selective toxicity on tumor cells based on specific tumor biology Tumor markers
69
Ovarian CA
Leading cause of GYN cancer-related deaths | Median age is 63 yrs
70
RF for ovarian CA
FHx (BRCA1/2 mutations) PCOS Endometriosis Smoking
71
Decreased RF for ovarian cancer
Previous pregnancy Prior OC Tubal ligation or hysterectomy
72
Dx of ovarian CA
U/s Bx CA-125
73
Tx of ovarian CA
Surgery | +/- adjuvant chemo
74
Cervical CA
Mean age is 48 yrs Invasive cervical CA incidence in the US by more than 80% since the 1940s owing to Pap smear screening HPV subtypes 16 and 18
75
S/sx of cervical CA
Postcoital bleeding | Vaginal bleeding between menstrual cycles or after menopause
76
Colon Ca sx
Bright Red Blood Per Rectum Melena Chronic diarrhea or constipation Cramping and bloating
77
Dx of colon CA
Colonoscopy | CEA
78
Tx of colon CA
Surgical resection +/- adjuvant tx 5-fluorouracil
79
Rectal CA: details and tx
Adenocarcinoma | Tx: surgery +/- neoadjuvant chemoradiotherapy
80
Anal cancer
Epidermoid or squamous cell carcinoma | Typically associated with HPV
81
Tx of anal cancer
Often curable with radiation therapy and concurrent chemo with mitomycin plus 5-FU
82
Pancreatic CA
Surgical resection is the only potential curative intervention (CA 19-9) Only 15-20% of cases are considered resectable at presentation -Resectable tumors: IA, IB, IIA -Borderline resectable- extends to nearby blood vessels but may be removed completely by surgery -Unresectable
83
Gastroesophageal CA
Virtual all gastric and gastroesophageal junction CAs are adenocarcinomas, as are approximately 95% of esophageal CAs Pts with adenocarcinomas and squamous cell carcinoma receive the same tx
84
Tx of gastroesophageal CA
Surgery | Chemoradiation
85
Non-small cell lung CA
80-90% Adenocarcinoma is MC subtype +/- paraneoplastic syndromes (hypercalcemia) Tx: surgery, radiation, chemo
86
Small cell lung CA
``` Neuroendocrine tumor- smokers +/- paraneoplastic syndromes (SIADH, hyponatremia) Limited-stage: 1 hemithorax Extensive-stage: beyond Tx: mostly chemo ```

CAM III (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions