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Heme
notes from qbank
37
Medical
Graduate
06/09/2012

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Term
6 OTC supplements that can increase warfarin activity and the INR:
Definition
1. alcohol
2. vitamin E
3. garlic
4. ginko biloba
5. ginseng
6. St John's wort
Term
Clincial manifestations of Fanconi Anemia (bone marrow, appearance, skin, eyes/ears):
Definition
Bone marrow:
- aplastic anemia and progressive bone marrow failure.
Appearance:
- short stature, microcephaly, abnormal thumbs, hypogonadism
Skin:
- hypopigmented/hyperpigmented areas, cafe au lait spots, and large freckles.
Eyes/ears:
- strabismus, low-set ears, and middle ear abnormalities (hemorrhage, incomplete development, chronic infections, deafness).
Term
How is Fanconi Anemia tranmitted, and how is it diagnosed?
Definition
- Autosomal recessive
- Diagnosis is make by chromosomal breaks on genetic analysis combined with clinical findings.
Term
Asymptomatic thrombocytopenia is the presenting feature of ____ in 10% of patients.
Definition
- HIV
Term
HIT 1 vs HIT 2:
Definition
- HIT I has a non-immune mechanism, and occurs within the first 2 days of heparin tx.
- HIT II is an autoimmune d/o where antiboies form against the heparin-platelet factor 4 complex. HIT II occurs within 4-10 days of tx.
Term
What immediate anticoagulants are indicated after a person develops HIT?
Definition
- danaparoid: lepirudin
- direct thrombin inhibitor: argatroban
Term
A hospitalized patient on bedrest develops both arterial and venous throboses. She also has thrombocytopenia. Dx?
Definition
- HIT II: antibody mediated platelet activation and destruction.
Term
Patient with new-onset diabetes, arthropathy, and hepatomegaly.
Definition
- Hemochromatosis.
Term
Teen presents with colonic polyps and a brain tumor:
Definition
- Turcot's syndrome. This syndrome is an association between brain tumors and FAP or HNPCC.
- AR inheritance
Term
Intestinal hamartomatous polyps and mucocutaneous melanocytic macules:
Definition
- Peutz-Jeghers syndrome
Term
Cancers that (almost) do not metastasize to the brain (4):
Definition
1. non-melanomatous skin cancer
2. oropharyngeal cancer
3. esophageal carcinoma
4. prostate cancer
Term
Wtf is the classic triad of a glucagonoma?
Definition
1. hyperglycemia
2. necrotizing dermatitis
3. weight loss
Term
atypical lymphocytes with a 'smudge' appearance:
Definition
- CLL. Confirm the diagnosis with flow cytometry.
Term
What is hereditary telangiectasia or Osler-Weber-Rendu syndrome?
Definition
- AD d/o with diffuse telangiectasias, recurrent epistaxis, and widespread AVMs. Pts can develop pulmonary AVMs a/w hemoptysis and/or right to left shunts.
Term
bone tumor with a 'soap bubble' appearance on radiography:
Definition
- Giant cell tumor
Term
"sunburst" appearance of a bone lesion on radiograph:
Definition
- osteosarcoma
Term
Which lung cancer has the least association with smoking?
Definition
- Adenocarcinoma, which is also the most common type of lung cancer.
Term
Pt with hair-like irregular projections seen from the lymphocytes:
Definition
- Hairy cell leukemia. Cytochemical feature includes tartrate-resistant acid phosphatase (TRAP) stain, and the CD11c marker.
Term
What is the treatment for MALT lymphoma at the pylorus?
Definition
- triple therapy to eradicate H. pylori. Who knew? It may regress after eradication of the bug.
Term
First line treatment for anorexia in cancer patients?
Definition
- Progestins like megestrol acetate and medroxyprogesterone acetate. These have a better side effect profile than corticosteroids, which may also be used.
Term
Hereditary spherocytosis is a __ inherited disorder of ________.
Definition
- AD, spectrin.
- In this disease, RBCs are not deformable and get trapped in the fenestrations of the red pulp of the spleen.
- Chronic hemolysis can cause jaundice and pigmented gallstones (which may cause R upper quadrant pain.)
- Treatment is folate supplementation and splenectomy.
Term
wtf is antiphospholipid antibody syndrome? (= The 'lupus anticoagulant')
Definition
- a syndrome a/w false + VDRL, prolonged PTT, and thrombocytopenia.
- APS can promote arterial and venous thromboses, and a resultant tendency towards spontaneous abortions.
- Prophylaxis with low dose ASA or LMWH are recommended ot avoid pregnancy loss.
Term
When treating breast cancer, trastuzumab and chemotherapy together can lead to ______ toxicity.
Definition
- cardiac. For that reason, an echocardiogram is indicated before starting therapy.
Term
What is the TOC for TTP-HUS?
Definition
- plasmapheresis. Begin it immediately.
Term
Senile purpura:
Definition
- characterized by ecchymoses that occur on elderly patients' extensor surfaces due to perivascular connective tissue atrophy. This is not dangerous and does not require further work up.
Term
4 Ts in a differential diagnosis of an anterior mediastinal mass:
Definition
1. thymoma
2. teratoma (and germ cell tumors)
3. thyroid neoplasm
4. terrible lymphoma
Term
hormone markers in a seminoma:
Definition
- 1/3 of patients will have an elevated beta-HCG
- AFP will be normal
Term
Hormone markers in a non-seminomatous germ cell tumor:
Definition
- most will have elevated AFP
- Some will ahve elevated beta-HCG
Term
"leukocytes that have undergone partial breakdown during preparation of a stained smear because of their greater fragility"
Definition
= smudge cells of CLL.
- thrombocytopenia indicates a poor prognosis.
Term
Skin cancer with: proliferating malignant cells which arise from the epidermis and extend into the dermis in lobules or strands.
Definition
- basal cell carcinoma.
Term
4 metabolic abnormalities a/w tumor lysis syndrome:
Definition
1. hyperphosphatemia
2. hyperkalemia
3. hyperuricemia
4. hypOcalcemia
Term
Anemia, mild thrombocytopenia, increased indirect bili, and hepatic vein thrombosis:
Definition
- Paroxysmal nocturnal hemoglobinuria
Term
Pt with hemolytic anemia and thrombocytopenia, AMS, renal failure, and fever:
Definition
- Thrombotic thrombocytopenic purpura.
Term
Acute treatment of stroke in a sickle cell patient:
Definition
- exchange transfusion (not fibrinolytics).
Term
positive alpha-naphthyl esterase test:
Definition
- acute monocytic (FAB M5) leukemia.
Term
Either folate or B12 deficiency will cause an increase in ___________, but only a deficiency in B12 will cause an increase in ____________.
Definition
homocysteine,
methylmalonic acid
Term
What is the treatment for CLL?
Definition
- Rituximab, a monoclonal antibody against the CD20 antigen on B lymphocytes.
- CLL may also have autoimmune hemolytic anemia and thrombocytopenia
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