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214 Cards in this Set
- Front
- Back
initial precursor for platelets
|
megakaryocyte
|
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immature RBC
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reticulocyte
|
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plasma cells are derived from what
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B cells
|
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most abundant WBC
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netrophils
|
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least abundant WBC
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basophils
|
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RBCs source of energy
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glucose (90% from lactate)
|
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lifespan of an RBC
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120 days
|
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what is anisocytosis
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varying sizes of RBCs
|
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what is poikilocytosis
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varying shapes of RBCs
|
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what do the dense granules of a platelet secrete
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ADP and calcium
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what do the alpha granules of a platelet secrete
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vWF and fibrinogen
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life span of a platelet
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8-10 days
|
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whats the main vWF receptor
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Gp1b
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whats the main fibrinogen receptor
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GpIIb/IIIa
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main WBC in acute inflammation and bacterial infection
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neutrophils
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which WBC are barr bodies found in
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neutrophils
|
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which WBC are hypersegmented in B12 or folate deficiency
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neutrophils
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which WBC differentiates into macrophages
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monocytes
|
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what cytokine activates macrophages
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IFN-y
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main WBC that mediates parasitic infection
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eosinophils
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which cells secrete histamine
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mast cells and basophils
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which cells secrete heparin
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basophils
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which WBC undergo stippling in lead poisoning
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basophils
|
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MAIN antigen presenting cell
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dendritic cells
|
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these cells have a clock-face chromatin distribution
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plasma cells
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which cells produce antibodies
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B cells
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neoplasm of the plasma cells
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multiple myeloma
|
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Rh- mother and Rh+ father can have a child with what condition
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erythroblastosis fetalis
|
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how to prevent erythroblastosis in susceptible children
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administer Rhogam to mother before birth during 1st pregnancy
|
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which child does erythroblastosis normally FIRST affect
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2nd child
|
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universal donor blood type
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type O
|
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universal recipient blood type
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type AB
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someone with type A blood has which antigen on the RBCs and which antibody in the plasma
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type A blood: A antigen on RBCs and B antibodies in plasma
type B blood: B antigen on RBCs and A antibodies in plasma type AB blood: A and B antigens on RBCs and no antibodies in plasma type O blood: no antigens on RBCs and A&B antibodies in plasma |
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deficiency of factor VIII
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hemophilia A
|
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deficiency of factor IX
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hemophilia B
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which clotting factors are Vit K dependent
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Factors II, VII, IX, X, proteins C&S
"diSCo was invented in 1972" |
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antithrombin inhibits which factors
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factors IX, X, XI, XII, and thrombin
|
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drug that binds and activates antithrombin III
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heparin
|
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which clotting pathway is triggered by tissue damage
|
extrinsic
|
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which clotting pathway is triggered by the Hageman Factor (factor XII)
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intrinsic
|
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what is the tissue factor that activates the extrinsic pathway
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thromboplastin
|
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clotting factor that unites the extrinsic and intrinsic pathways
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factor X
|
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thrombin activates which clotting factors
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thrombin activates V, VIII, XI
|
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calcium is required for which clotting factors
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calcium is required for factors I, II, X, XIII
|
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what binds to and inactivates thrombin
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thrombomodulin
|
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what activates protein C
|
thrombomodulin
|
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are proteins C & S pro-coagulants or anti-coagulants
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C & S are anti-coagulants
|
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rate-limiting step of clotting
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forming prothrombin
|
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converts fibrinogen into fibrin
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thrombin
|
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prothrombin is formed in what organ and whats its function
|
formed in the liver and it activates thrombin
|
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which clotting factor cross-links fibrin
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factor XIII
|
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function of plasmin
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breaks down clots to form fibrin degeneration products; also activates C3
|
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what activates plasminogen
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tPA
|
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condition in which factor V is resistant to protein C thus there is increased clotting
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Factor V Leiden mutation
|
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enzyme inhibited by warfarin
|
Vit K dependent epoxide reductase
|
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platelets adhere to a site of injury and bind via what?
|
vWF (GpIb receptors)
|
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after platelet adherence, they release calcium and ADP; ADP then induces expression of which receptors which ultimately binds fibrinogen
|
GpIIb/IIIa
|
|
thromboxane's effect on clotting
|
promotes clotting (increases platelet aggregation)
|
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prostaglandin's effect on clotting
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inhibits clotting (decreases platelet aggregation)
|
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which drug inhibits GpIIb/IIIa
|
Abciximab
|
|
pathologic RBC found in abetalipoproteinemia
|
Acanthocyte (spur cells)
|
|
basophilic stippling is seen in what 4 conditions
|
Thalassemias
Anemia of chronic disease Iron deficiency Lead poisoning ("TAIL") |
|
pathologic RBCs seen in G6PD deficiency
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bite cells and Heinz bodies
|
|
treatment of sideroblastic anemia
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B6
|
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treatment of megaloblastic anemia
|
B12 and folic acid
|
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conditions associated with schistocytes (aka helmet cells)
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DIC, TTP, HUS
|
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pathologic RBC associated with myelofibrosis
|
dacrocytes ("tear-drop cells")
|
|
how are heinz bodies formed
|
oxidation of iron from ferrous to ferric form causes denaturation of hemoglobin
|
|
Howell-Jolly bodies suggest what
|
spleen dysfunction
|
|
examples of microcytic, hypochromic anemias
|
iron deficiency
alpha-thalassemia beta-thalassemia lead poisoning sideroblastic anemia |
|
characterized by the clinical triad of iron deficiency anemia, esophageal webs, and atrophic glossitis
|
Plummer Vinson syndrome
|
|
characterized by gene mutations in alpha-globin
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alpha-thalassemia
|
|
deletion of how many genes in alpha-thalassemia forms Hb Barts (y4) causing hydrops fetalis
|
deletion of 4 genes
|
|
deletion of how many genes in alpha-thalassemia forms Hb B4 (HbH disease)
|
deletion of 3 genes
|
|
this hematologic condition is characterized by point mutations in the splicing sites and promoter sequences of hemoglobin
|
beta-thalassemia
|
|
difference in pathogenesis of B-thalassemia minor and B-thalassemia major
|
B-thalassemia minor (heterozygote): B chain is UNDERPRODUCED; increased HbA2
B-thalassemia major (homozygote): B chain is ABSENT; expansion of marrow causes skeletal deformities (chipmunk facies and crew cut appearance on xray) |
|
common finding in both minor and major B-thalassemia
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increased fetal hemoglobin
|
|
lead inhibits what 2 enzymes
|
ferrochelatase and ALA dehydratase
|
|
cause of sideroblastic anemia
|
X-linked defect in ALA synthase thus blocking heme synthesis
|
|
blue/black lines (Burtons lines) on the gingiva suggest what
|
lead poisoning
|
|
treatment for lead poisoning
|
dimercaprol and EDTA
(succimer in kids) |
|
hematologic disorder linked to defects in ankyrin, band 4.1, and spectrin
|
hereditary spherocytosis
|
|
xray appearance of the skull in Sickle Cell patients
|
crew-cut appearance
|
|
what amino acids are substituted for each other in Sickle cell
|
glutamic acid is replaced with valine
|
|
which chain is mutated in sickle cell
|
B-chain
|
|
patient with sickle cell trait (i.e. heterozygotes) are resistant to what disease
|
malaria
|
|
cause of osteomyelitis in sickle cell patients
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salmonella
|
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kidney condition linked to sickle cell
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papillary necrosis
|
|
DOC for sickle cell patients
|
hydroxyurea
|
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lab findings reveal increased hemosiderin in the urine; complement if found to be inhibited in the RBCs
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paroxysmal nocturnal hemoglobinuria
|
|
warm agglutinins are linked to what immunoglobulins
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IgG
|
|
cold agglutinins are linked to what immunoglobulins
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IgM
|
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2 conditions that test positive for warm agglutinins
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SLE and CLL
|
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infections associated with cold agglutinins
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mycoplasma pneumonia and mononucleosis
|
|
test to assess for autoimmune hemolytic anemias
|
Coombs test
|
|
what substance accumulates in the blood in lead poisoning
|
protoporphyrin
|
|
accumulations of porphobilinogen, ALA, and uroporphyrin are suggestive of what disease
|
acute intermittent porphyria
|
|
accumulation of uroporphyrin is suggestive of what disease
|
porphyria cutanea tarda
|
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deficiency in porphobilinogen deaminase
|
acute intermittent porphyria
|
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deficiency in uroporphyrinogen decarboxylase
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porphyria cutanea tarda
|
|
Major presenting symptom is blistering cutaneous photosensitivity
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porphyria cutanea tarda
|
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initial 2 precursors for heme synthesis
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glycine and succinyl-CoA
|
|
PT assesses which clotting pathway
|
extrinsic
|
|
PTT assesses which clotting pathway
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intrinsic
|
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heparin affects which clotting pathway
|
intrinsic
|
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warfarin affects which clotting pathway
|
extrinsic
|
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defect in Bernard-Soulier disease
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defective Gp1b thus defect in platelet to collagen adhesion
|
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defect in Glanzmann's thrombasthenia
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defective GpIIb/IIIa thus defect in platelet to platelet aggregation
|
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lab value difference between Bernard-Soulier and Glanzmann's
|
Bernard-Soulier has thrombocytopenia
Glanzmanns has normal platelet count |
|
anti-GpIIb/IIIa antibodies are suggestive of what disease
|
ITP
|
|
characterized by a deficiency in ADAMTS13 (vWF metalloprotease)
|
TTP
|
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MOST common bleeding disorder
|
von Willebrand disease
|
|
DOC for von Willebrand disease
|
desmopressin (releases vWF stored in the endothelium)
|
|
lab values in DIC
|
decreased platelets, increased bleeding time, increased PT, increased PTT, decreased fibrinogen, increased fibrin degradation products (d-dimer), schistocytes, decreased factors V and VIII
|
|
2 MOST common bacterial causes of DIC
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E.coli and N. meningitidis
|
|
is the anemia in DIC macrocytic, microcytic, or normocytic?
|
normocytic
|
|
morphologic cells in Hodgkins lymphoma
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Reed-Sternberg cells
|
|
CD markers of Reed-Sternberg cells
|
CD15 and CD30
|
|
virus associated with Hodgkin lymphoma
|
EBV
|
|
virus most commonly associated with Non-Hodgkins lymphoma
|
HIV
|
|
these are bi-lobed cells that appear as "owl's eyes" and are pathologic for a certain cancer
|
Reed-Sternberg cells
|
|
MOST common type of Hodgkins lymphoma
|
nodular sclerosis (type 1)
|
|
which Hodgkins lymphoma type has a lacunar variant
|
nodular sclerosis (type 1)
|
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which Hodgkins lymphoma type has the WORST prognosis
|
lymphocyte depletion (type IV)
|
|
which Hodgkins lymphoma type is characterized by "popcorn cells"
|
lymphocyte predominance (type V)
|
|
MOST common translocation in Burkitts lymphoma
|
8;14
(additional translocations include 8;22 and 2;8) |
|
gene mutation linked to Burkitts lymphoma
|
c-myc
|
|
morphologic appearance of the cells in Burkitts lymphoma
|
starry-sky appearance
|
|
2 viruses linked to Burkitts lymphoma
|
EBV and HIV
|
|
MOST common presentation of Burkitts in Africa
|
lesion in the jaw (mandible)
|
|
MOST common presentation of Burkitts in the US
|
mass in the pelvis or abdomen
|
|
diffuse large B-cell lymphoma usually arises from what special tissue
|
Waldeyers ring
|
|
gene mutation in diffuse large B-cell lymphoma
|
bcl-6
|
|
translocation in mantle cell lymphoma
|
11;14
|
|
translocation in follicular lymphoma
|
14;18
|
|
gene mutation in follicular lymphoma
|
bcl-2
|
|
which lymphoma follows an indolent waxing/waning course
|
follicular lymphoma
|
|
virus linked to adult T cell lymphoma
|
HTLV-1
|
|
patient presents with back pain and weight loss; xray reveals punched-out bone lesions; UA reveals pathologic proteins suggestive of primary amyloidosis; an RBC smear shows stacking
|
multiple myeloma
|
|
what is rouleaux formations
|
stacking of RBCs seen in multiple myeloma
|
|
proteins found in the urine in multiple myeloma
|
bence jones proteins (AL type)
|
|
morphologic cells in multiple myeloma
|
flame cells, mott cells, russell bodies, and dutcher bodies
|
|
genetic mutation linked to multiple myeloma
|
RANKL
|
|
MOST common overall cancer in children
|
ALL
|
|
ALL is linked to what chromosomal abnormality
|
trisomy 21 (Down's)
|
|
tumor marker for ALL
|
terminal deoxynucleotidyl transferase (TdT)
|
|
translocation linked to ALL
|
12;21
|
|
MOST common leukemia in adults
|
CLL
|
|
morphologic cells in CLL
|
smudge cells
|
|
test to check for hairy cell leukemia
|
TRAP test (yields a "dry tap")
|
|
2 translocations linked to AML
|
8;21 and 15;17
|
|
treatment of AML
|
target the retinoic acid receptors (RAR-a)
|
|
morphologic feature of AML
|
auer rods
|
|
translocation in CML
|
9;22
|
|
combination gene mutation in CML
|
bcr-abl
|
|
MOST common presenting symptom of CML
|
splenomegaly (dragging sensation)
|
|
the Philadelphia chromosome is linked to what cancer
|
CML (9;22)
|
|
DOC to treat CML
|
bcr-abl inhibitors (imatinib)
|
|
increased myeloblasts suggest which leukemia
|
AML
|
|
increased myeloid stem cells ("blast crisis") suggest which leukemia
|
CML
|
|
translocation linked to Ewing sarcoma
|
11;22
|
|
morphologic feature of Langerhans cells histiocytosis
|
Birbeck granules
|
|
mutation linked to chronic myeloproliferative disorders
|
JAK2 mutation
|
|
erythropoietin levels in PCV
|
decreased
(increased in all other polycythemias) |
|
antidote for heparin overdose
|
protamine
|
|
major SE of heparin
|
HIT (hypercoagulable state)
|
|
DOC for patient who experiences HIT while taking heparin
|
Lepirudin or Bivalirudin
|
|
blood thinner given as prophylaxis during heart surgery
|
warfarin
|
|
blood thinner that is absolutely contraindicated in pregnancy (category X)
|
warfarin
|
|
treatment for warfarin overdose
|
vit K, FFP
|
|
major SE of warfarin
|
skin/tissue necrosis
(occurs 3-10 days after starting treatment secondary to blocking protein C) |
|
clinical uses of thrombolytics (tPA, streptokinase)
|
MI, stroke, PE
|
|
MOA of aspirin
|
irreversibly blocks cyclooxygenase which directly prevents the formation of thromboxane A2 and prostaglandins from arachidonic acid
|
|
drug linked to Reye's syndrome
|
aspirin
|
|
major SE of aspirin
|
GI bleeding, nephrotoxicity, tinnitus
|
|
MOA of clopidogrel and ticlopidine
|
blocks ADP receptors which inhibits platelet aggregation (indirectly inhibits GpIIb/IIIa)
|
|
SE of ticlopidine
|
neutropenia
|
|
SE of methotrexate
|
myelosuppression, fatty change in liver, mucositis, teratogenic
|
|
DOC to reverse SE of methotrexate
|
leucovorin
|
|
non-cancer conditions that methotrexate is used for
|
rheumatoid arthritis
psoriaisis abortions ectopic pregnancy |
|
MOA of methotrexate
|
inhibits dihydrofolate reductase decreasing DNA/protein synthesis
|
|
MOA of 5-FU
|
inhibits thymidylate synthase thus decreasing DNA/protein synthesis
|
|
treatment for overdose of 5-FU
|
thymidine
|
|
MOA of 6-MP
|
decreases de novo purine synthesis (activated by HGPRTase)
|
|
toxicity of 6-MP increases when combined with what drug
|
allopurinol
|
|
MOA of cytarabine
|
inhibits DNA polymerase
|
|
DOC for common childhood tumors including Wilms tumor, Ewing sarcoma, and rhabdomyosarcoma
|
dactinomycin (actinomycin D)
|
|
SE of doxorubicin
|
cardiotoxicity, myelosuppression, alopecia
|
|
MOA of bleomycin
|
induces free radicals to form breaks in the DNA
|
|
SE of bleomycin
|
pulmonary fibrosis
|
|
MOA of etoposide
|
inhibits topoisomerase II
|
|
SE of cyclophosphamide
|
hemorrhagic cystitis, myelosuppression
|
|
DOC to prevent SE of cyclophosphamide
|
MESNA
|
|
DOC for brain tumors
|
Nitrosoureas (carmustine, lomustine)
|
|
MOA of vincristine/vinblastine
|
bind tubulin in M phase and block polymerization of microtubules so that mitotic spindle don't form
|
|
MOA of paclitaxel
|
hyperstabilizes microtubules in M phase so that mitotic spindles can't break down
|
|
SE of vincristine
|
neurotoxicity, paralytic ileus
|
|
SE of vinblastine
|
myelosuppression
|
|
MOA of cisplastin/carboplastin
|
cross-links DNA
|
|
MOA of hydroxyurea
|
inhibits ribonucleotide reductase during S phase
|
|
DOC for estrogen-positive breast cancer
|
tamoxifen
|
|
SE of tamoxifen
|
increases risk for endometrial cancer
|
|
alternative drug to tamoxifen with same MOA but does NOT increase risk for endometrial cancer
|
raloxifene
|
|
DOC for breast cancer that expresses HER-2 (erb-B2)
|
Trastuzumab
|
|
DOC for GI stromal tumors
|
Imatinib
|
|
cell cycle specific cancer drugs
|
bleomycin
vincristine 5-FU 6-MP methotrexate etoposide |
|
cell cycle nonspecific cancer drugs
|
alkylating drugs
doxorubicin cisplastin nitrosoureas |
|
MOA of cyclophosphamide
|
alkylate DNA
|
|
MOA of nitrosoureas (carmustine, lomustine)
|
alkylate DNA
|
|
common chemo combination used against testicular cancer
|
bleomycin
vinblastine etoposide cisplastin |
|
common chemo combination used against Non-Hodgkins lymphoma/leukemia
|
cyclophosphamide
doxorubicin vincristine rituximab prednisone |
|
common chemo combination used in estrogen-positive breast cancer
|
cyclophosphamide
methotrexate 5-FU tamoxifen ("5CMT" --> 5-country music television) |
|
DOC for prostate cancer
|
flutamide
|
|
MOA of flutamide
|
antagonist of testosterone (androgen) receptors
|