hemonc 402-406

Question 1

path associated with recurrent otitis media with mass involving the mastoid bone?

Answer 1

Langerhans cell histiocytes

Question 2

2 options to correct factor def?

Answer 2

cryoprecipitate and fresh frozen plasma

Question 3

what is the name for leukemic cell infiltration to skin?

Answer 3

leukemia cutis

Question 4

in ALL what two parts of organs are easily affected and why?

Answer 4

CNS and testes (b/c the barriers prevent chemo access)

Question 5

in ALL, what CD marker is found in pre-B cell only?

Answer 5

CD10

Question 6

in ALL, what is the marker for both pre-T and pre-B cell?

Answer 6

TdT

Question 7

what path mimics the SVC syndrome?

Answer 7

ALL (mediastinal mass)

Question 8

DOC for DVT/PE prophylaxis?

Answer 8

apixaban, rivaroxaban

Question 9

what is heparin bridging?

Answer 9

heparin i used when starting warfarin which causes transient hypercoagulable state.

Question 10

initial heparin therapy with warfarin reduces risk of

Answer 10

recurrent venous thromboembolism and skin/tissue necrosis

Question 11

in warfarin toxicity, what causes the skin/tissue necrosis?

Answer 11

small vessel microthromboses

Question 12

what gene polymorphism can affect the efficacy of warfarin?

Answer 12

VKORC1 (vit K epxoide reductase complex)

Question 13

name 2 blood malignancies associated with splenomegaly?

Answer 13

CML, myelofribrosis

Question 14

name 2 blood malignancies associated with dry tap of the bone marrow aspiration

Answer 14

hairy cell leukemia, myelofibrosis

Question 15

in myelofibrosis, what is responsible for the obliteration of bone marrow?

Answer 15

inc fibroblast activity

Question 16

what path is associated with intense itching after shower ?

Answer 16

polycythemia vera due to inc basophil

Question 17

name 3 low molecular weight heparins

Answer 17

enoxaparin, dalteparin, fondaparinux

Question 18

what are the 5 characteristics of fondaparinux?

Answer 18

1. act more on factor Xa
2. better bioavailability
3. 2-4 times longer half life
4. can be administered subcutaneously without lab monitoring
5. not easily reversible

Question 19

what leukemia is associated with CD5 marker?

Answer 19

small lymphocytic lymphoma/chronic lymphocytic leukemia

Question 20

treatment for CLL?

Answer 20

anti-CD52 (alemtuzumab)

Question 21

treatment for hairy cell luekemia

Answer 21

cladribine (adenosine analog, 2CDA), pentostatin

Question 22

in CML, LAP is low why?

Answer 22

low activity in mature granulocyte (vs. leukemoid reaction when LAP is high)

Question 23

3 paths associated with inc ectopic EPO

Answer 23

1. renal cell carcinoma
2. hepatocellular carcinoma
3. hydronephrosis

Question 24

3 examples with dec O2 sat leading to high EPO

Answer 24

1. lung dz
2. congenital heart dz (Eisenmenger)
3. high altitude

Question 25

5 clinical applications of heparin?

Answer 25

1. immediate anticoagulant for PE 2. acute coronary syndrome 3. MI 4. DVT 5. for pregnancy (does not cross placenta)

Question 26

in heparin induced thrombocytopenia what is the target of the IgG antibodies?

Answer 26

heparin bound platelet factor 4

Question 27

what is the most common adult leukemia?

Answer 27

SLL/CLL

Question 28

what gene is activated in mantle cell lymphoma?

Answer 28

cyclin D1

Question 29

explain the mech of thrombolytics

Answer 29

directly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and fibirn clots

Question 30

what are the 3 clinical applications for thrombolytics?

Answer 30

1. early MI 2. early ischemic stroke 3. direct thrombolysis of severe PE

Question 31

what are the 5 contraindications with thrombolytics?

Answer 31

1. active bleeding 2. hx of intracranial bleeding 3. recent surgery 4. known bleeding diatheses (hypocoagulable) 5. severe HPT

Question 32

what is the antidote for thrombolytics?

Answer 32

aminocaproic acid