Heme/onc

Front 1

Causes of eosinophilia =

Back 1

1) neoplasm
2) asthma
3) allergy
4) collagen vascular dz
5) parasites

Front 2

Which leukocyte has a bilobate nucleus, makes histaminase & arylsulfatase, and is highly phagocytic for Ag:Ab complexes?

Back 2

eosinophils

Front 3

Which type of cell resembles basophils structurally and functionally, but is found in tissue instead of blood, and binds IgE to its membrane?

Back 3

mast cells - mediate allergic reaction

Front 4

Which leukocyte mediates the acute inflammatory response, is multi-lobate, and phagocytic?

Back 4

neutrophil

Front 5

What can be found inside a neutrophil granule/lysosome?

Back 5

1) myeloperoxidase
2) hydrolytic enzymes
3) lactoferrin
4) lysozyme

Front 6

Which type of blood cell has an eccentric nucleus, "clock face" chromatin, lots of RER, and a well-developed Golgi?

Back 6

plasma cell - makes lots of Ab specific to a particular Ag

Front 7

What type of cell phagocytizes bacteria, cellular debris, old RBCs, and can present Ag on MHC II?

Back 7

macrophages - differentiated from monocytes, activated by gamma IFN

Front 8

I am an antigen presenting cell. I have MHC II and Fc receptor on my surface. I induce the primary Ab response. What am I?

Back 8

dendritic cell - called Langerhans cells on skin

Front 9

What do Protein C & S do?

Back 9

inactivate Va & VIIIa

Front 10

In the extrinsic pathway, Factor VIIa + ___ activate Factor X.

Back 10

tissue factor

Front 11

In the intrinsic pathway, Factors ___a + ___a activate Factor X.

Back 11

IXa + VIIIa

Front 12

Factor Xa + ___ cleave prothrombin to thrombin.

Back 12

Va

Front 13

Thrombin cleaves ___ to ___, then Factor ___a will help form a cross linked clot.

Back 13

fibrinogen, fibrin, XIIIa

Front 14

What does antithrombin III do?

Back 14

inactivates: thrombin, IXa, Xa, XIa

Front 15

What does tPA do?

Back 15

generates plasmin to cleave fibrin (thrombolytic agent)

Front 16

What effects does bradykinin have?

Back 16

1) inc. pain
2) inc. vasodilation
3) inc. vascular permeability

Front 17

Metaplasia =

Back 17

replacement of 1 cell type by another, often 2ndary to irritation or environmental exposure (smoker's trachea)

Front 18

Dysplasia =

Back 18

abnormal cell growth and maturation w/loss of orientation, shape, and size, often neoplastic but still reversible

Front 19

Anaplasia =

Back 19

abnormal cells lacking differentiation, look like primitive cells of same tissue but can be undifferentiated malignant neoplasm

Front 20

Neoplasia =

Back 20

CLONAL proliferation that is uncontrolled and excessive

Front 21

Tumor grade refers to:

Back 21

histology, degree of differentiation, # mitoses per hpf

Front 22

Tumor stage refers to:

Back 22

metastases, degree of spread based on site and size of lesion, more PROGNOSTIC value than grade

Front 23

A papilloma is:

Back 23

benign epithelial tumor

Front 24

A hemangioma is:

Back 24

benign blood vessel tumor

Front 25

An angiosarcoma is:

Back 25

malignant blood vessel tumor

Front 26

"Carcinoma" implies ___ origin.

Back 26

epithelial

Front 27

"Sarcoma" implies ___ origin.

Back 27

mesenchymal (bone, muscle, fat, blood vessels)

Front 28

What neoplasms are associated w/Down syndrome?

Back 28

ALL, AML

Front 29

What neoplasms are associated w/xeroderma pigmentosum and albinism?

Back 29

melanoma, basal cell CA, squamous cell CA of skin

Front 30

What neoplasm is associated w/chronic atrophic gastritis and pernicious anemia?

Back 30

gastric ACA

Front 31

What neoplasms are associated w/tuberous sclerosis? (recall: cortical hamartomas, facial angiofibromas, seizures, mental retard)

Back 31

astrocytoma, cardiac rhabdomyoma

Front 32

What neoplasm is associated w/actinic keratosis?

Back 32

squamous cell CA of skin

Front 33

What neoplasm is associated with Barrett's esophagus?

Back 33

esophageal ACA

Front 34

What is Plummer-Vinson syndrome and what neoplasm is it associated with?

Back 34

P-V syndrome is iron deficiency --> anemia, atrophic glossitis, esophageal webs; associated w/squamous cell CA of esophagus!

Front 35

What neoplasm is associated w/ulcerative colitis?

Back 35

colon ACA

Front 36

What neoplasms are associated w/Paget's bone disease?

Back 36

osteosarcoma, fibrosarcoma

Front 37

An immunocompromised state predisposes one to which kind of neoplasm?

Back 37

malignant lymphomas

Front 38

Having AIDS predisposes one to which neoplasms?

Back 38

NHL, Kaposi's sarcoma

Front 39

Having an autoimmune disease, such as Hashimoto's or myasthenia gravis, predisposes one to which neoplasm?

Back 39

benign and malignant thymomas

Front 40

Acanthosis nigricans (hyperpigmented, thick skin) predisposes a person to which neoplasms?

Back 40

visceral malignancies, like stomach, lung, breast, uterus

Front 41

abl

Back 41

CML

Front 42

c-myc

Back 42

Burkitt's lymphoma

Front 43

bcl-2

Back 43

follicular and undifferentiated lymphomas

Front 44

erb-B2

Back 44

breast, ovarian, gastric CA

Front 45

ras

Back 45

colon CA

Front 46

L-myc

Back 46

lung tumor

Front 47

N-myc

Back 47

neuroblastoma (Homer-Wright rosettes)

Front 48

ret

Back 48

- MEN II (parathyroid, medullary CA of thyroid, pheochromocytoma)
- MEN III (medullary CA of thyroid, pheochromocytoma, mucosal neuromas)

Front 49

Rb

Back 49

13q - retinoblastoma, osteosarcoma

Front 50

BRCA-1, 2

Back 50

17q, 13q - breast and ovarian CA

Front 51

p53

Back 51

17p - most human cancers, Li-Fraumeni syndrome

Front 52

p16

Back 52

9p - melanoma

Front 53

APC

Back 53

5q - colorectal CA

Front 54

WT1

Back 54

11q - Wilm's tumor

Front 55

NF1

Back 55

17q - neurofibromatosis type 1 (cafe au lait spots, Lisch iris hamartomas, scoliosis, pheochromocytoma)

Front 56

NF2

Back 56

22q - neurofibromatosis type 2 (bilateral acoustic schwannomas, optic gliomas, juvenile cataracts)

Front 57

DPC

Back 57

18q - pancreatic CA

Front 58

DCC

Back 58

18q - colon CA

Front 59

PSA (prostatic acid phosphatase)

Back 59

prostate-specific antigen; screen for prostate CA (but first use the digital technology because it's the most cost-effective screening method!)

Front 60

CEA (carcinoembryonic antigen)

Back 60

very nonspecific, made by 70% of pancreatic and colorectal CA, also gastric and breast CA

Front 61

a-fetoprotein

Back 61

hepatocellular CA, yolk sac tumor

Front 62

b-hCG

Back 62

hydatidiform moles, choriocarcinoma, gestational trophoblastic tumors (also some germinomas make b-hCG)

Front 63

CA-125

Back 63

ovarian, malignant epithelial tumors

Front 64

S-100

Back 64

melanoma, astrocytoma, neural tumors

Front 65

alkaline phosphatase

Back 65

mets to bone, obstructive biliary disease, Paget's bone disease

Front 66

bombesin!!

Back 66

neuroBLASToma, lung, gastric CA

Front 67

TRAP (tartrate resistant acid phosphatase)

Back 67

hairy B-cell leukemia

Front 68

Psammoma bodies can be seen in which malignancies?

Back 68

1) papillary serous cystadenocarcinoma of thyroid
2) serous cystadenocarcinoma of ovary
3) meningioma
4) malignant mesothelioma

Front 69

HTLV-1

Back 69

adult T-cell leukemia

Front 70

HBV, HCV

Back 70

hepatocellular carcinoma

Front 71

EBV

Back 71

Burkitt's lymphoma, nasopharyngeal carcinoma

Front 72

HPV

Back 72

cervical carcinoma, penile/anal carcinoma

Front 73

HHV-8

Back 73

Kaposi's sarcoma, body cavity fluid B-cell lymphoma

Front 74

aflatoxins

Back 74

hepatocellular carcinoma

Front 75

vinyl chloride

Back 75

liver angiosarcoma (recall: ugly bloody picture from QBank)

Front 76

CCl4

Back 76

liver centrilobular necrosis and fatty change

Front 77

nitrosamines

Back 77

esophageal and gastric CA

Front 78

cigarette smoke

Back 78

laryngeal and lung CA

Front 79

asbestos

Back 79

malignant mesothelioma and bronchogenic CA

Front 80

arsenic

Back 80

squamous cell CA of skin

Front 81

naphtalene (aniline) dyes

Back 81

bladder transitional cell CA (can also be caused by phenacetin, smoking, cyclophosphamide)

Front 82

alkylating agents

Back 82

blood (leukemia)

Front 83

ACTH or ACTH-like peptide

Back 83

small cell CA of lung; Cushing's syndrome

Front 84

ADH

Back 84

small cell CA of lung, intracranial neoplasms; SIADH (tx with demeclocycline)

Front 85

PTH-related peptide, TGF-b, TNF-a, IL-1

Back 85

squamous cell CA of lung, renal cell CA, breast CA, multiple myeloma, lytic bone metastasis; hypercalcemia

Front 86

erythropoietin

Back 86

renal cell CA, hemangioblastoma

Front 87

antibodies against presynaptic Ca channels at nmj

Back 87

thymoma, small cell CA of lung; Lambert-Eaton syndrome of muscle weakness

Front 88

hyperuricemia

Back 88

leukemia, lymphoma (tumor lysis syndrome); gout, urate nephropathy (radiolucent)

Front 89

Tumor mets to brain:

Back 89

lung, bone, melanoma, renal cell CA, GI

Front 90

Tumor mets to liver:

Back 90

colon > stomach > pancreas > breast > lung

Front 91

Tumor mets to bone:

Back 91

BREAST, lung, thyroid, PROSTATE, kidney, testes

Front 92

Blastic bone mets =

Back 92

prostate OR breast

Front 93

Cancer is the ___ leading cause of death in the US.

Back 93

2nd - heart disease is 1st

Front 94

___ cancer is the leading cause of cancer death in the US.

Back 94

Lung

Front 95

Spherocytes could mean:

Back 95

hereditary spherocytosis, autoimmune hemolysis

Front 96

Macro-ovalocytes:

Back 96

megaloblastic anemia, marrow failure

Front 97

Helmet cells, schistocytes:

Back 97

traumatic hemolysis, DIC

Front 98

Teardrop cell:

Back 98

myelometaplasia with myelofibrosis (marrow fibrosis)

Front 99

Acanthocyte "spur cell":

Back 99

liver disease (abetlipoproteinemia)

Front 100

Target cell:

Back 100

HbC disease (mild hemolytic anemia), aspenia, liver disease, thalassemia

Front 101

Poikilocytes:

Back 101

TTP, HUS, microvascular damage, DIC

Front 102

Burr cell:

Back 102

Kidney disease (TTP, HUS)

Front 103

High serum bilirubin, pigment gallstones, and high reticulocyte count indicate (generally speaking) ___ anemia.

Back 103

hemolytic

Front 104

How do you determine if a patient's hemolysis is due to an autoimmune cause?

Back 104

Direct Coomb's test: take patient's RBCs and add anti-Ig Ab --> if RBC agglutinate, means RBCs covered with Ig and it is autoimmune hemolysis

Front 105

After you've determined the RBC hemolysis is autoimmune, what do you do to narrow down the differential?

Back 105

Agglutinin test: warm agglutinin positive (IgG) means chronic anemia seen in diseases like lupus and CLL or on meds like methyldopa; cold agglutinin positive (IgM) means an acute anemia seen during recovery from Mycoplasma pneumoniae or infectious mononucleosis

Front 106

Erythroblastosis fetalis =

Back 106

Rh(-) mother's anti-Rh antibodies attack Rh(+) baby's RBCs

Front 107

What is the indirect Coomb's test?

Back 107

take patient's serum and add normal RBCs --> if these agglutinate, means patient serum had anti-RBC immunoglobulins

Front 108

Hereditary spherocytosis =

Back 108

intrinsic defect in RBC membrane (problem with spectrin, ankyrin) --> less membrane --> extravascular hemolysis; don't see central pallor, have high MCHC and RDW

Front 109

How do you confirm a suspected diagnosis of hereditary spherocytosis?

Back 109

osmotic fragility test - this is not autoimmune hemolysis so it's Coomb's negative

Front 110

Paroxysmal nocturnal hemoglobinuria =

Back 110

intrinsic RBC membrane defect (missing CD55, CD59) --> susceptible to complement lysis --> urine hemosiderin

Front 111

Microangiopathic anemia =

Back 111

intravascular hemolysis seen in DIC, TTP, HUS, lupus, malignant HTN; see schistocytes

Front 112

Causes of DIC:

Back 112

1) OBSTETRIC complications
2) sepsis
3) transfusion
4) trauma
5) malignancy
6) acute pancreatitis
7) nephrotic syndrome

Front 113

Prolonged PT, prolonged PTT, low platelets, high fibrin split products (D-dimers) =

Back 113

DIC

Front 114

Microthrombi, global consumption of platelets and clotting factors =

Back 114

DIC