Rx_3.3 (HemOnc) Flashcards Preview

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Flashcards in Rx_3.3 (HemOnc) Deck (22)
1

Presentation/dx criteria of multiple myeloma

  • monoclonal plasma cell proliferation ==> serum myeloma protein (M protein)
    • ==> M spike on serum protein electrophoresis
  • dx criteria
    • renal insuffiency
    • anemia
    • proteinuria <== Bence Jones' protein = monoclonal light chains
      • urine dipstick neg. for albumin
    • bone pain/lytic bone lesions
    • hypercalcemia

2

Schistosoma mansoni presentation

  • parasitic fluke
  • ==> fever, hepatosplenomegaly, peripheral eosinophilia
  • suspect in person w/recent travel history to M. East, sub-saharan Africa, S. America + exp. to fresh water

3

Characteristics of Babesia microti

  • blood parasite ==> babesiosis = malaria-like illness
  • ==> fever + hemolytic anemia (RBC lysing when parasites are released)

4

Characteristics of Trichinella

  • ==> muscle inflammation + periorbital edema
  • comes from eating undercooked meat.

5

CLL course/presentation

  • pts. > 60 
  • usually asymptomatic
  • ==> accumulation of immune incompetent mature B lymphs ==> hypogammaglobulinemia ==> risk for bacterial infection (reccurent)
  • eventually ==> hepatosplenomegaly, lymphocytosis, and smudge cells

6

Characteristics of ALL (acute lymphoblastic leukemia)

  • B-ALL or T-ALL
  • associated w/Down syndrome
  • T-ALL ==> mediastinal mass
  • Age < 15 yrs
  • markers
    • TdT+ = premature T & B cells
    • CD10+ = pre-B cells only

7

Cause of gray baby syndrome + presentation

  • chloramphenicol
  • sx
    • cyanotic
    • difficult to arouse
    • abdominal distention
    • hypotension

8

Chloramphenicol: MOA, use,  toxicity effects

  • MOA: blocks peptidyltransferase @ 50S ribosomal subunit
  • use
    • meningitis (H. flu, N. mening, S. pneumo)
    • Rickettsia
    • limited use due to toxicity, but still used in developing countries
  • Toxicity
    • gray baby syndrome
      • preme infants that lack liver UDP-glucuronyl transferase
    • aplastic anemia
    • anemia

9

Ototoxicity associated w/antibiotics

  • aminoglycosides
  • vancomycin

10

Vincristine/vinblastine: toxicity

  • vincristine
    • neurotoxicity
    • paralytic ileus
  • vinblastine
    • "vinblastine blasts bone" = bone marrow suppression

11

Peripheral smear in ALL

  • lymphoblasts
    • cells w/large nuclei + condensed chromatin & scant cytoplasm

12

Presentation of ALL

  • abrupt onset of sx of bone marrow suppression
    • weakness & fatigue due to anemia
    • easy bleeding & petechiae due to thrombocytopenia
    • susc. to infection due to neutropenia
  • fever

13

Common sickle cell presentation

  • african-american child
  • ischemic pain secondary to vaso-occlusion in microvasculature
    • commonly limb/foot and abdomen
  • ongoing autosplenectomy

14

Tx for sickle cell dz

  • hydroxyurea ==> increased fetal hemoglobin production in place of hemoglobin S
  • ==> reduced chance of RBC sickling + complications
  • used to reduce painful event and recurrence of acute chest syndrome
  • in acute crisis, e.g. acute chest:
    • exchange transfusion w/fresh donor blood or plasma

15

Characteristics of Ann Arbor staging of lymphoma

  • I = single lymph node or single extralymphatic organ
  • II == two sites on same side of diagram
  • III = two sites on both sides of the diagram
  • IV = disseminated disease
  • A = w/out constitutional sx
  • B = w/constitutional sx (fever, night sweats, weight loss)

16

Pregnant woman w/vaginal bleeding + uterus larger than expected for gest. age + elevated serum B-hCG ==> dx?

  • hydatidiform mole = cystic swelling of chorionic villi
  • partial vs. complete
    • fertilization of egg that has lost chromosomes
    • fertilization by two sperm
    • partial = some fetal tissue, some norm. villi
    • complete = no fetal tissue, no norm. villi

17

Risk with hydatidiform mole

  • mole ==> choriocarcinoma w/out remobal

18

Dx?

  • auer rods
  • AML (acute promyelocytic variant)

19

Dx?

  • Heinz bodies = denatured, precipitated hemoglobin
  • seen @ alpha-thal & G6PD deficiency

20

Dx?

  • Howell-Jolly body = basophillic nuclear remnants found in RBCs
  • seen @ patients w/asplenia or fxn hyposplenia

21

Dx?

  • Mallory bodies = intracytoplasmic eosinophilic inclusion
  • seen @ alcoholic hepatitis

22

  • councilman bodies = apoptotic hepatocytes seen in various types of liver failure

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