1. reticuloendothelial

2.  antigens

3.  antibodies

4.  hematopoiesis

Which of the following regarding stem cells is false?

1.  They are self-generating

2.  They are pluripotent

3.  They are mature/differentiated cells

4.  CSFs push their maturation

          \                       /

            \___________/

            /                    \

          /                        \

Fill in:

          \        Hgb          /

  WBC   \___________/    PLT

            /                    \

          /          Hct         \

Hold chemo if:

WBC < ____

or

ANC <  ____

hold chemo if:

WBC < 4000

or

ANC < 1500

Which of the following is false regarding granulocytes (neutrophils, eosinophils, basophils) and monocytes:

1.  50% in circulation and 50% marginated in cell walls

2.  Takes 2 weeks for immature precursors to develop into mature cells

3.  Have a life span of 1-2 years

4.  First line of defense against infection

neutrophilia can occur from two major ways, 1. _____ (occurs with infection, epinephrine, corticosteroids, and neoplasms)  and 2.  ______ _______ (increased # of granulocytes, decreased # other cell components, causes sludging of neutrophils)

Treat neutrophilia with 3.  ________

1.  demargination

2.  myeloproliferative disorders

3.  hydroxyurea 500mg q6h (short term only)

immunologic (auto or alloimmune) ITP, drug induced HIT, purpura posttransfusion

nonimmunologic (thrombotic microangiopathies: DIC, TTP/HUS, HELLP) or (abnormal vascular surfaces: hemangioma, aortic aneurysms, metastatic cancer, artificial heart valves)

Hgb or RBCs

oxygen-carrying

which of the following is true about anemias - they can be caused by:

1.  reduction of number of RBC from decreased production or increased destruction

2.  reduction of size of RBCs

3.  reduction in the hemoglobin of RBCs

A.  1 only

B.  2 only

C.  1 and 3

D.  2 and 3

E.  All of the above

E. all of the above:  anemias can be caused by

1.  reduction of number of RBC from decreased production or increased destruction

2.  reduction of size of RBCs

3.  reduction in the hemoglobin of RBCs

Erythropoiesis steps (RBC formation):

pluripotent stem cells (progenitors) found in ____ ^>form>> erythroid burst-forming units (BFU-E) ^{>which get stimulated by>>}____, _____, and _____ ^{>to form>>}colony forming units (CFU-E) in the marrow^{>which is sensitive to>>}____^{>and produces>>}proerythroblasts --> divides to form basophilic, polychromatic, pyknotic, reticulocytes and finally an erythrocyte

pluripotent stem cells found in marrow form BFU-E which get stimulated by EPO, IL-3, and GM-CSF to form CFU-E in the marrow which is sensitive to EPO and produces proerythroblasts that divide to form basophilic, polychromatic, pyknotic, reticulocytes and finally an erythrocyte.

progenitors > BFU-E > CFU-E > proerythroblasts > erythroblasts > erythrocytes

EPO -

1.  stimulates stem cells to differentiate into ____

2.  increases rate of mitosis of ____ _____

3.  increase release of _____ from marrow

4.  induces _____ formation

1. proerythroblasts

2.  immature RBCs

3.  reticulocytes

4.  hemoglobin

if liver is unable to conjugate bilirubin because of disease or oversaturation of enzymes that means elevated (direct/indirect) bilirub lab value?

4.2-5.4 x 10⁶/mm³ in women

4.5-5.9x 10⁶/mm³ in men

Mean corpuscular hemoglobin concentration MCHC  is defined as:

a low MCHC always indicates:

average concentration of Hgb in each RBC

low MCHC always indicates hypochromia (iron deficient anemia)

observed %reticulocytes x (pt's observed Hct/average normal Hct)

serum iron is defined as:

serum iron is decreased with ____ and increased with ____

concentration of iron bound to transferrin

decreased with iron deficiency anemia and is increased with ehmolytic anemias and iron overload

total iron-binding capacity (TIBC) is defined as an indirect measurement of iron-binding capacity of _____ _____. 

a low serum iron and a high TIBC indicates what?

TIBC is an indirect measurement of iron-binding capacity of serum transferrin. 

low serum iron and high TIBC indicate iron deficiency anemia

serum iron to TIBC

serum iron decreases and TIBC increases in iron deficiency anemia

low serum ferritin levels are diagnostic of

serum ferritin can be elevated in patients iwth what type of diseases

iron deficiency anemia

renal or liver, or infection/inflammation

Iron dextran (InFED),

ferric gluconate (ferrlecit) and iron sucrose (venofer) don't require test doses

is sickle cell disease a homozygous or heterozygous condition

all pts. with h/o stroke or pts. who have trouble with hydroxyurea

goal HgS < 30%

blood cultures immediately

ceftriaxone 50-75 mg/kg q8h plus macrolide PO

O2 prn to keep pulse ox sat > 90%

IV fliuds

pain mgmt

PRBCs as needed (keep Hg < 11gm/dL)

bronchodilators as needed

the hallmarks of cancer are (6):

1. sustaining proliferative signaling

2.  evading growth suppressors

3.  activating invasion and metastasis

4.  enabling replicative immortality

5.  inducing angiogenesis

6.  resisting cell death

testing of tumors, lymph node testing, blood circulating tumor cells and whole body imaging

constant dna synthesis

high metabolic rate

continuous cell dvision

new blood supply

hormones

cell cycle specific agents:

S phase specific:

M specific:

G2 specific:

Non-specific:

S phase specific: antimetabolites

M specific:taxanes, vinca

G2 specific: bleomycin, etoposide

Non-specific: alkylators, cisplatin, most abx

bind covalently to DNA molecule, act as elctrophiles and inhibit dna synthesis (stop clel growth), prevent polymerase from passing adduct

attack ANY dividing cell

mechlorethamine, cyclophosphamide, ifosfamide, thiotepa, carmustine (penetrates CNS), cisplatin, carboplatin, oxaliplatin, hydroxyurea, temozolomide (penetrates CNS) procarbazine

drug class

anthracyclines (doxorubicin, epirubicin, idarubicin)

misc. mitoxantrone, bleomycin, mitomycin-C

decrease dna synth and decrease cell growth

antimetabolites can act to inhibit dna synthesis via:

removing ____  _____

or being ___ _____

removing critical proteins

or being false substrates

6-MP, cladribine, fludarabine, pentostatin

the "udarabine)

vinca alkaloids MOA

arrest ___ ___ by preventing formation of ____ ____

usually human proteins

purified from human cells or recominantly produced

unstable and cannot be administered PO

expensive

immune rxns - rash, flu-like, anaphylaxis

EGFR-1

both have prevalent resistance

a drug that is a BCR-abl kinase inhibitor, commonly causes pulmonary and peripheral edema, myelosuppression and hepatotoxicity

which is the proliferation-apoptosis pathway - RAS or PI3K?

10⁹

lethal at 10¹²

toxicities

morbidity

qol

treat some pts. with no residual cancer cells

increased risk of secondary cancer (leukemia)

cost

√ [height(cm)  x weight (kg)]

3600

   |  1   |   2   /3  

|  4    |  5    \3

where on fishbone is Scr found?

5

[image]

WHAT MECHANISM IS BELOW?

[image]

what class of drugs is unstable - decompose in aqueous cell mediums - yielding two reactive intermediates to alkylate DNA?

direcT: fluorouracil

indirect: MTX

methotrexate

whew :(

what drug is this:

[image]

this drug is an antrhacene derivative: aqueous solutions of it are colored dark blue, has sam MOA as anthracyclines, and free-radical formation causes cardiotoxicity but less than anthracyclines:

[image]

this drug is isolated from streptomyces parvulus, binds strongly but reversibly to DNA, inhibits topo II, and is photosensitive:

[image]

this drug is a glycopeptide that generates free radicals:

[image]

semisynthetic derivative of podophyllotoxin, causes M arrest, does NOT inhibit microtubule assembly

[image]

this is a protein tyrosine kinase inhibitor, which one?!?!?

[image]

this estrogen RA binds competitively with affinity similar to estradiol

[image]

this is a proteasome inhibitor that is modified dipeptidyl boronic acid (how boron! no kidding!), a reversible inhibitor of 26S

[image]