Bocock Uworld Week 5.3

Front 1

What is the formula for physiologic dead space...which is the volume of air that does not take part in gas exchange?

Back 1

Vd=Vt X (PaCO2-PeCO2)/ PaCO2

note: taco, paco, peco, paco

Front 2

What are the locations and structures perforating the diaphragm?

Back 2

T8--> IVC

T10--> esophagus

T12--> aorta

note: I 8 10 eggs at 12?

Front 3

Formula for alveolar collapsing pressure?

Back 3

P= 2xsurface tension/radius

Front 4

Pneumonic for what shifts the Hg-O2 dissociation curve to the right causing a release of oxygen from Hb?

Back 4

"CBEAT"
CO2, BPG, Exercise, Acid/Altitude, Temp

Front 5

How do you rx cyanide poisoning?

Back 5

give nitrates--> methemoglobin--> binds cyanide allowing cytochrome C to function

use thiosulfate to bind cyanide--> thiocyanate is renally excreted

Front 6

What is the alveolar gas equation?

Back 6

PAO2=150-PaCO2/0.8

Front 7

What is the formula for the A-a gradient?

Back 7

Aa gradient=PAO2-PaO2

note: = normal <10...>10 indicates..diffusion defect, V/Q defect, or R-L shunt

Front 8

Parts of Virchows triad that predispose a pt to DVT?

Back 8

stasis, hypercoagulability, and endothelial damage

Front 9

What is the route of flow of csf in the ventricular system?

Back 9

Lat ventricles-->foramen of monroe-->third ventricle--> cerebral aqueduct--> fourth ventricle--> subarachnoid space

note: foramen of luschka-Lat
foramen of magendie-Medial

Front 10

This condition is caused by a a structural blockage of csf circulation within the ventricular system?

Back 10

obstructive hydrocephalus

Front 11

On an anterior view of the knee, how is the ACL positioned?

Back 11

it runs downward and medially from the lateral condyle of the femur to the medial meniscus of the tibia

Front 12

Anti-IgE antibody used in refractory asthma?

Back 12

omalizumab

Front 13

What is the molecular pathway of colorectal cancer?

Back 13

defect in APC-->K-ras-->P53

Front 14

What are the normal values of bicarb and PCO2 to use in order to figure out acid base chemistries?

Back 14

PCO2=40

HCO3=25

Front 15

Findings include failure to thrive, steatorrhea, acanthocytosis, ataxia, and night blindness?

Back 15

abetalipoproteinemia

Front 16

Formula for anion gap?

Back 16

AG=Na-(Cl-HCO3)

note: normal anion gap=8-12

Front 17

What is the mneumonic for the differentials associated with an increased anion gap?

Back 17

"MUDPILES"
methanol, uremia, DKA, paraldehyde/phenfomin, iron tablets/INH, lactic acidosis, ethylene glycol, salicylates

Front 18

Deficiencies in cobalamin and folate cause megaloblastosis because what process is inhibited?

Back 18

DNA synthesis

Front 19

In invasive carcinoma of the breast, what causes dimpling of the skin and inversion of the nipple?

Back 19

invasion of the suspensory cooper ligament

Front 20

What type of tapeworm causes cysts in the liver?

Back 20

echinococcus granulosus


note: causes anaphylaxis if relased upon surgery; inject ethanol to kill daughter cysts

Front 21

What are the cells that are damaged first by radiation?

Back 21

lymphocytes

Front 22

Name for..
A low WBC count--->
A high WBC count--->

Back 22

leukopenia

leukocytosis

Front 23

How are immature neutrophils characterized during a left shift?

Back 23

by a decrease in fc receptors (CD16)

Front 24

What are three causes of neutrophilic leukocytosis?

Back 24

bacterial infections

tissue necrosis

a high cortisol state

Front 25

Name three causes of eosinophilia?

Back 25

allergic reactions

parasitic infections

hodgkin lymphoma

Front 26

How does eosinophilia occur in hodgkins lymphoma?

Back 26

via IL5

Front 27

Basophilia is classically associated with what disease?

Back 27

CML

Front 28

Only bacteria that can cause a lymphocytic leukocytosis?

Back 28

bordetella pertussis

Front 29

3 areas of the lymph node and the cells in each region?

Back 29

cortex--> B cells

paracortex--> T cells

medulla

Front 30

What causes LAD in mononucleosis?

Back 30

T cell hyperplasia in the paracortex

Front 31

T cell hyperplasia takes place in what area of the spleen causing splenomegally in mono?

Back 31

periarterial lymphatic sheeth (PALS)

Front 32

What are the atypical lymphocytes you see in mono?

Back 32

CD 8+ T cells

Front 33

A negative monospot test with mono suggests...

Back 33

CMV as a possible cause of mono

Front 34

B/c of this complication of mono...pts are advised to avoid contact sports?

Back 34

increased risk of splenic rupture

Front 35

Hallmark of acute leukemia?

Back 35

>20% blasts in the BM

note: can be lymphoblasts or nyeloblasts

Front 36

Flow of hematopoeisis?

Back 36

CD34+ HSC becomes a myeloblast or a lymphoblast

Front 37

Key cell marker that shows you are dealing with a lymphoblast?

Back 37

TdT

Note: this is a DNA polymerase

Front 38

What is acute lymphoblastic leukemia?

Back 38

neoplastic proliferation of lymphoblasts >20% in the BM

Front 39

Two types of ALL based on surface markers?

Back 39

B-ALL and T-ALL

Front 40

Classic cell markers seen in B-ALL?

Back 40

CD 10, CD 19, CD 20

Front 41

What age of patient will you see with ALL?

Back 41

kids

Front 42

What are the cell markers associated with T-ALL?

Back 42

CD2-8

Front 43

Type of leukemia that presents in teenagers with a mediatsinal (thymic) mass?

Back 43

T-ALL of acute lymphoblastic lymphoma

Front 44

Neoplastic accumulation of myeloblasts (>20%) in the BM?

Back 44

acute myeloid leukemia

Front 45

What are the crystal aggregates of myeloperoxidase seen in AML?

Back 45

auer rods

Front 46

Cytogenetic abnormality seen in ALL with kids?

Back 46

t(12:21)

Front 47

This AML subtype is associated w a t(15;17) which involves the translocation of the retinoic acid receptor?

Back 47

acute promyelocytic leukemia

Front 48

What is the rx for acute promyelocytic leukemia that causes the blasts to mature?

Back 48

all-trans retinoic acid

Front 49

Subtype of AML that is a proliferation of monoblasts that infiltrates the gums?

Back 49

acute monocytic leukemia

Front 50

Types of leukemia associated with downs syndrome?

Back 50

ALL--> after 5

AML--> before 5

Front 51

Neoplastic proliferation of MATURE circulating lymphocytes?

Back 51

chronic leukemia

Front 52

MC leukemia associated with a neoplastic proliferation of naive B cells?

Back 52

Chronic lymphocytic leukemia

Front 53

Cells classically seen on blood smear in pts with CLL?

Back 53

smudge cells

Front 54

Neoplastic proliferation of mature B cells that show hairy cytoplasmic processes?

Back 54

hairy cell leukemia

Front 55

Type of stain used for hairy cell leukemia?

Back 55

tartrate resistant acid phosphatase (TRAP)

Front 56

Neoplastic proliferation of mature CD4+ T cells associated with HTLV-1?

Back 56

adult T-cell leukemia/lymphoma (ATLL)

Front 57

Neoplastic proliferation of CD 4+ T cells that infiltrate the epidermis causing pautrier micro abcesses?

Back 57

mycosis fungoides

Front 58

What is a serious complication of rx of AML with ATRA?

Back 58

DIC

Front 59

Cells seen on blood smear when mycosis fungoides enters the blood to cause sezary syndrome?

Back 59

sezary cells-->lymphocytes w/ cerebriform nuclei

Front 60

Driven by a t(9;22) which generates a bcr-abl fusion protein w/ increased tyrosine kinase activity?

Back 60

CML

note: rx w/ imatinib

Front 61

How do you distinguish CML from a leukemoid reation?

Back 61

CML granulocytes are LAP negative

CML is associated with basophilia

CML exhibits t(9:22)

Front 62

Myeloproliferative disorders associated with a JAK 2 kinase mutation?

Back 62

polcythemia vera

essential thombocythemia

myelofibrosis

Front 63

Neoplastic proliferation of RBCs?

Back 63

polycythemia vera

Front 64

Sxs include blurry vision & HA, risk of venous thrombosis, and itching after bathing?

Back 64

hyperviscosity of blood due to polycythemia vera

Front 65

How would you distinguish polycythemia vera from a reactive polycythemia?

Back 65

in PV...EPO is decreased and SaO2 is normal

Front 66

Neoplastic prolif. of megakaryocytes driven by a JAK 2 kinase mutation that causes marrow fibrosis?

Back 66

myelofibrosis

Front 67

In what myeloproliferative diorder do you see tear drop cells?

Back 67

myelofibrosis

Front 68

Types of NHL where there is neoplastic proliferation of small b cells?

Back 68

follicular lymphoma

mantle cell lymphoma

marginal cell lymphoma

Front 69

Type of NHL that has a t(14;18) w/ an overexpression of Bcl2 which inhibits apoptosis?

Back 69

follicular lymphoma

Front 70

Type of NHL where there is a proliferation of small B cells that expands the area immediately adjacent to the follicle?

Back 70

mantle cell lymphoma

Front 71

Name the three area of the cortex or B cell area of a lymph node?

Back 71

follicle, mantle, and margin

Front 72

What is overexpressed by a t(14;18) in follicular lymphoma?

Back 72

bcl2

note: this inhibits apoptosis

Front 73

What is overexpressed by the t(11;14) associated with mantle cell lymphoma?

Back 73

cyclin D

note : cyclin D1 promotes the G1/S phase transition

Front 74

Type of NHL that expands the region outside of the mantle?

Back 74

marginal zone lymphoma

Front 75

Chronic inflammatory states associated with marginal zone lymphoma?

Back 75

hashimotos thyroiditis

sjogren syndrome

H pylori gastritis

Front 76

This is marginal zone lymphoma in mucosal sites?

Back 76

Maltoma

Front 77

The t(8;14) associated with burkitt lymphoma promotes overexpression of what oncogene?

Back 77

c-myc

Front 78

While the african form of burkitt lymphoma involves the jaw, the sporadic form involves what area?

Back 78

the abdomen

Front 79

The MC form of NHL that is a proliferation of LARGE b cells?

Back 79

diffuse large b cell lymphoma

Front 80

The reed sternberg cells in hodgkin lymphoma secrete cytokines that result in what B symptoms?

Back 80

fevers, chills, and night sweats

Front 81

Type of reed sternberg cell present in the HL subtype nodular sclerosis?

Back 81

lacunar cells


note: RS cells are present in lake like spaces

Front 82

Neoplastic proliferation of large B cell reed sternberg cells w/ multi-lobed nuclei and prominent nucleoli (owl-eyed nuclei)

Back 82

hodgkin lymphoma

Front 83

High levels of this cytokine are seen in multiple myeloma which stimulates plasma cell growth and Ig production?

Back 83

IL6

Front 84

What does the M spike in multiple myeloma respresent?

Back 84

monoclonal IgG or IgA

Front 85

Sxs include lytic bone lesions, hypercalcemia, AL amyloid, and BJ proteinuria?

Back 85

mutliple myeloma

Front 86

Isolated M spike on SPEP w/ no clinical sxs of multiple myeloma?

Back 86

monclonal gammopathy of undetermined significance
(MGUS)

Front 87

Clinical sxs include a generalized LAD, no bone lesions, and an M spike composed of a pentamer IgM?

Back 87

walderstrom macroglobulinemia

Front 88

Thes are specialized dendritic cells that present ag to naive T cells and are found predominately in the skin?

Back 88

langerhans cell

Front 89

Neoplastic proliferation of langerhans cells that have characteristic birbeck (tennis racket) granules on EM?

Back 89

langerhans cell histiocytosis