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Path SJSM > Myeloproliferative neoplasms (crash cards) > Flashcards

Myeloproliferative neoplasms (crash cards) Flashcards

1
Q

Myeloproliferative neoplasms:

Low EPO
Normal SaO2
High RBC#
High WBC#
High Platelet #
Increased plasma volume
Increased MCV

A

Polycythemia Vera (primary)

A JAK2 mutation that leads to the production of too many RBCs

Signs:
- Aquagenic pruritis
- Erythromelalgia
- Thrombotic episodes

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2
Q

Myeloproliferative neoplasms:

Normal EPO
Normal SaO2
Normal MCV
Low Plasma volume

A

Relative Polycythemia

Caused by dehydration or burns

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3
Q

Myeloproliferative neoplasms:

High EPO
High MCV
Normal Plasma volume
Low SaO2

A

Secondary appropriate polycythemia

Caused by:
- Lung disease
- Congenital heart disease (Right-left shunt)
- High altitude
- Smoking

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4
Q

Myeloproliferative neoplasms:

Normal Plasma volume
Normal SaO2
High MCV
High EPO

A

Secondary Inappropriate Polycythemia

Caused by
- Exogenous EPO (blood doping)
or
- Malignancy (RCC, HCC)

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5
Q

Myeloproliferative neoplasms:

AV Malformations
Recurrent epistaxis
Telangiectasias (blanching lesions)
Gi bleeding
Hematuria

A

Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu)

AUTO DOM mutations in either ENG (Endoglin) or ALK1 which both modulate TGF-B signaling leading to uncontrolled bleeding

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6
Q

Shock:

High SVR (afterload)
Low PCWP (preload)
Low CO
Cold + clammy skin

A

Hypovolemic Shock

Caused by:
- Hemorrhages
- Dehydration
- Burns

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7
Q

Shock:

High/Low PCWP (preload)
High SVR (afterload)
Very Low CO
Cold + clammy skin

A

Cardiogenic shock

Caused by:
- Acute MI
- Valve dysfunction
- Arrythmia

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8
Q

Shock:

High/Low PCWP
High SVR (afterload)
Very Low CO
Cold + clammy skin

A

Obstructive shock

Caused by
- Cardiac tamponade
- Pulmonary embolism
- Tension pneumothorax

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9
Q

Shock:

Warm skin
Low PCWP (preload)
Very Low SVR (afterload)
High CO

A

Distributive shock

Caused by:
- Sepsis
- Anaphylaxis
- CNS injury

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10
Q

Shock:

Dry skin
Low PCWP (preload)
Very Low SVR (afterload)
Low CO

A

Distributive shock

Caused by:
- Sepsis
- Anaphylaxis
- CNS injury

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11
Q

Heart:

Low CO
Low QRS
High HR

A

Cardiac Tamponade

Heart is compressed by fluid (blood & effusions in the pericardial sac)

Signs:
- Pulsus paradox
- Becks triad (Hypotension, Distended Jugular vein, Distant heart sounds)
- Electrican alternans

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12
Q

Heart:

ST Elevation
Pathological Q waves
Full thickness of myocardial wall involved
Transmural infarcts

A

Myocardial infarction

Usually from a ruptured coronary artery atherosclerotic plaque causing acute thrombosis with elevated CKMB & Troponins

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13
Q

MI:

Coagulative necrosis
Delineated Myocardium
No nuclei

A

0-24Hr Mi caused by ventricular arrythmia, Heart failure, & Cardiogenic shock

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14
Q

MI:

Heavy neutrophilic infiltrates

A

24-48Hrs

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15
Q

MI:

Macrophages with granulation
&
Angiogenesis

A

3-5 Days

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16
Q

MI:

Some normal myocardium with type 1collagen
&
Macrophage-granulation

A

1-2 week MI

17
Q

MI:

Low Cellularity
High collagen deposition
Higher risk of balloon aneurysm
Complication is Dressler syndrome

A

3-4 week MI

18
Q

Heart:

Abnormally fast conduction from the atria to the ventricle (bypasses the AV node)
&
Shortened PR interval
Wide QRS
Delta waves
Supraventricular tachycardia

A

Wolf-Parkinson White syndrome

19
Q

Wolf-Parkinson White syndrome

A

Heart:

Abnormally fast conduction from the atria to the ventricle (bypasses the AV node)
&
Shortened PR interval
Wide QRS
Delta waves
Supraventricular tachycardia

20
Q

ECG:

Absent P waves

A

A fibrillation

21
Q

ECG:

Saw tooth patterns

A

Atrial flutter

22
Q

ECG:

No discernable rhythm

A

Ventricular fibrillation

23
Q

Heart failure:

High EDV
Low Ejection fraction
Low Contractility
Poor perfusion

Complications:
- Ischemia
- Dilated cardiomyopathy

A

Systolic dysfunction

Signs:
- Congestion
- Dyspnea
- Orthopnea
- Fatigue
- Heart sounds
- JVD
- Pitting edema

24
Q

Heart failure:

Normal Ejection fraction
Normal EDV
Low Compliance
High EDP

Complications:
- Myocardial hypertrophy

A

Diastolic dysfunction

Signs:
- Congestion
- Dyspnea
- Orthopnea
- Fatigue
- Heart sounds
- JVD
- Pitting edema

25
Q

Heart failure:

  • Pulmonary edema with
    Hemosiderin laden-macrophages
  • Orthopnea
  • Paroxysmal nocturnal dyspnea
A

Left-sided heart failure

26
Q

Heart failure:

  • Hepatomegaly with more central venous pressure
  • Nutmeg liver
  • Peripheral edema
  • JVD
A

Right-sided Heart failure

27
Q

Bleeding disorders:

  • Hinge pain (arthralgias)
  • Stomach pain
  • Palpable purpura on butt/legs
  • Fever with sudden onset
  • Arthritis
  • Hematuria
A

Henoch-Schönlein purpura (Immunoglobin A vasculitis)

A common systemic vasculitis that follows a URI. IgA’s are deposited in tissues (skin, gut, renal, & joints)

28
Q

Endothelial injury
Turbulent blood flow
Hypercoagulability

A

Virchow’s triad

29
Q

Locally invasive (doesn’t metastasize) pearly nodule with telangiectasia & rolled borders, non-healing ulcers, & palisading nuclei

A

Basal cell carcinoma

30
Q
  • A chronic non-healing ulcers of the face, lower lip & ears
  • Locally invasive that can metastasize with keratin pearls
A

Squamous cell carcinoma

31
Q
  • Follows the administration of post fractioned heparin (5-14 days post admin)
  • Antibodies against heparin complexes & platelet 4 factor on platelets & platelet 4 factor like proteins & heparin like molecules on endothelial cells
A

Heparin-Induced Thrombocytopenia

Platelets activate & aggregate (a prothrombotic state) even with heparin because the low platelet count

32
Q
  • Recurrent abortion
  • Recurrent thrombosis
  • Cardiac valve vegetations
  • Thrombocytopenia
  • False positive syphilis test
  • Recurrent DVT
A

Antiphospholipid Antibody Syndrome

Usually in SLE

Ab’s target B2-glycoprotein I (B2GP1) on plasma membranes & endothelial cells

33
Q

Anemia:

Short stature
Cafe-au-lait spots
Absent thumbs/radii
High tumor risk
Leukemia
Aplastic anemia

A

Fanconi anemia

AUTO REC, DNA repair deficiency causing bone marrow failure

34
Q

Anemia:

Mutated SPECTRIN causing elliptocytes

A

Hereditary elliptocytosis

35
Q

Anemia:

Deficient intrinsic factor

A

Pernicious anemia

Autoimmune destruction of parietal cells leading to B12 deficiency

36
Q
A

Path SJSM (26 decks)

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