Hemonc And Poisoning

Front 1

elderly patient with bone pain
renal failure
hypercalcemia

Back 1

Multiple Myeloma

Front 2

Bence Jones proteins
immunoelectrophoresis shows M-spike
Rouleaux on blood smear

Back 2

Multiple Myeloma

Front 3

Amitriptyline causes urinary retension
mechanism?

Back 3

decreased detrusor contraction
prevent urethral sphincter relaxation

Front 4

tx for uncomplicated cystitis

Back 4

trimethoprim-sulfameth

Front 5

emperic tx for neutrapenic fever

Back 5

IV cefepime

Front 6

Heparin Induced Thrombocytopenia
when?
resolution?
theraputic effect of heparin?

Back 6

onset is 3 - 15 days after initiation of heparin
resolution is 4 -5 days after d/c
heparin increases PTT

Front 7

tx of hypercalcemia of malignancy

Back 7

bisphosphonates
ex. zoledronic acid

Front 8

hematuria, hypertension, red cell casts, mild proteinuria
LOW C3 COMPLEMENT
10 - 20 days after sore throat

Back 8

Post-Strep glomerulonephritis

Front 9

hyperglycemia, diarrhea, necrolytic migratory erythemia
dx?

Back 9

Glucagonoma

Front 10

Glucagonoma
tx?

Back 10

removal of tumor
Does not respond to chem

Front 11

SIADH is associated with this cancer

Back 11

small cell lung cancer

Front 12

firm, solitary lymph nodes in the head and neck is concerning for

Back 12

squamous cell carcinoma

Front 13

SIADH
1st step in tx

Back 13

fluid restriction

Front 14

smoker
hypercalcemia
hilar mass
=

Back 14

squamous cell carcinoma

Front 15

smudge cells

Back 15

CLL

Front 16

CLL
poor prognosis is associated with:

Back 16

thrombocytopenia

Front 17

leukocyte alkaline phosphase score is low

Back 17

CLL

Front 18

high leukocyte alkaline phosphase score

Back 18

leukomoid reaction

Front 19

CLL
dx
tx

Back 19

flow cytometry of peripheral blood
chlorambucil and prednisone

Front 20

eczematous rash on the nipple

Back 20

Padget's
adenocarcinoma of the breast

Front 21

Lynch syndrome

Back 21

HNPCC
associated with endometrial cancer

Front 22

patient with migratory thrombophlebitis
look for?

Back 22

adenocarcinoma

Front 23

adolescent male with epistaxis, localized mass and bony erosion of back of nose

Back 23

angiofibroma

Front 24

decreased iron, decreased TIBC, decreased iron saturation, increased ferritin
normocytic

Back 24

anemia of chronic disease

Front 25

macrocytic anemia with hypersegmented neutrophils
increased homocysteine

Back 25

folic acid or cobalamin deficiency

Front 26

common anemia with vitiligo or autoimmune thyroid disease

Back 26

pernicious anemia

Front 27

decreased serum iron, decreased iron saturation, increased TIBC
hypochromatic, microcytic
pica

Back 27

iron deficiency anemia

Front 28

+ Prussian Blue Staining
hemolytic anemia form oxidative stress

Back 28

G6PD deficiency

Front 29

Hereditary Spherocytosis
Dx:
Genetics:
Tx:

Back 29

Dx: osmotic fragility test
Autosomal dominant
Tx: folate supplement, splenectomy

Front 30

cholelithiasis
chronic leg ulcers
episodes of aplastic crisis
increased bilirubin
increased reticulocytes, spherocytes
splenomegaly

Back 30

Hereditary Spherocytosis

Front 31

patient who is NPO with increased PT

Back 31

vitamin K deficiency

Front 32

Lupus anticoagulent

Back 32

anti-phospholipid antibody
leads to prolonged PTT

Front 33

telangiectasia
pulmonary AVMs leading to hemoptysis
recurrent nose bleeds and oral lesions

Back 33

Osler-Weber-Rendu Syndrome

Front 34

hemosiderin deposition and fibrosis in joints

Back 34

hemarthroses
seen in hemophilia

Front 35

child with infection, lymphadenopathy, splenomegaly
>25% lymphoblast on bone marrow

Back 35

ALL

Front 36

+ PAS lymphoblast

+ immuno TdT staining

Back 36

ALL

Front 37

metastatic hemorrhagic mass in brain =

Back 37

malignant melanoma

Front 38

one brain met with stable extracranial disease
tx:

Back 38

surgical resection with whole brain radiation

Front 39

multiple brain mets
tx:

Back 39

palliative whole brain radiation

Front 40

highly increased IgM
hepatosplenomegaly
fatigue, night sweats, headache, dizziness, vision problems, pain/numbness

Back 40

Waldenstrom's Macroglobulinemia

Front 41

G6PD deficiency
Genetics:
Findings:

Back 41

x-linked recessive
(AA males)

acute hemolytic crisis: bite cells, Heinz bodies (crystal violet staining)

Front 42

germ cell tumor with increased BHCG and normal AFP

Back 42

Seminoma

Front 43

how do you prevent febrile reaction to donor blood that is correctly crossed matched?

Back 43

washing cells

Front 44

this leads to increased production in erythropoietin

Back 44

obstructive sleep apnea

Front 45

most important prognostic factor in breast cancer

Back 45

TNM staging

Front 46

stroke in sickle cell patient
do?

Back 46

exchange transfusion

Front 47

hairy cell leukemia
tx:

Back 47

cladribine

Front 48

warfarin associated skin necrosis is caused by ?

Back 48

protein C deficiency

Front 49

Trastuzuamb
treats what?
what should be done before tx?

Back 49

treats + Her 2 breast cancer

echocardiogram due to increased risk of cardiotoxicity in patients with decreased EF

Front 50

weight loss in patients with advanced cancer
treat with?

Back 50

progestin

Front 51

>50yo patient with fatigue, malaise, fever, anorexia, weight loss, bone pain

Back 51

CML

Front 52

CML
genetics

Back 52

9:22 translocation
abnormal BCR-ABL gene
abnormal tyrosine kinase

Front 53

CML
tx:

Back 53

Tyrosine kinase inhibitor
Imatinib (Gleevec)

Front 54

heartburn, significant wt loss, fatigue, history of smoking =
affirm dx :

Back 54

Esophageal Cancer

barium swallow followed by endoscopy

Front 55

painless hard mass solid mass in testicle
next step:

Back 55

radical orchiectomy

Front 56

familial colonic polyposis
genetics:
tx:

Back 56

autosomal dominant
requires protocolectomy because there is a 100% risk of cancer

Front 57

HER2 oncogene
detected by:
tx with:

Back 57

FISH
trastuzumab and anthracycline

Front 58

low grade MALT lymphoma
origin:
tx:

Back 58

H. pylori
omeprazole, clarithromycin, amoxicillin

Front 59

target cells
microcytosis
anemia

Back 59

thalassemias

Front 60

NSAIDs can lead to this deficiency

Back 60

iron

Front 61

decreased haptoglobin
increased LDH
increased bilirubin

Back 61

hemolytic anemia

Front 62

phenytoin impairs absorption of this vitamin

Back 62

folate

Front 63

abdominal pain, constipation, difficulty concentrating, fatigue, myalgias, anemia
Basophilic stippling

Back 63

Lead Poisoning

Front 64

Lead Poisoning
Tx
#1 cause

Back 64

EDTA or succimer
occupational

Front 65

abnormal cell membrane anchor protein GP1
venous thrombosis, especially in hepatic veins

Back 65

paroxysmal nocturnal hemoglobinuria

Front 66

5-10 days after exposure
pro-thrombotic condition
BOTH arterial and venous clots

Back 66

Heparin Induced Thrombocytopenia

Front 67

increased monoblasts, promonocytes
NO Auer rods
+ esterase

Back 67

AML

Front 68

erythroblasts with irregular outline and increased nuclear:cytoplasm ratio

Back 68

Acute erythroleukemia

Front 69

several Auer rods in each cell
hypergranular promyelocytes

Back 69

Acute Promyelocytic leukemia

Front 70

Shilling test:
diminished urinary excretion after unlabeled B12 and normal excretion after dose of intrinsic factor
2. and if diminished excretion after intrinsic factor

Back 70

1. pernicious anemia
2. malabsorption syndrome (ex. short gut)

Front 71

patient with renal failure, thrombocytopenia and unexplained hemolytic anemia

Back 71

TTP-HUS

Front 72

TTP-HUS
cause:
tx:

Back 72

high accumulation of von Willebrand factor leading to platelet aggregation
tx: plasmaphoresis

Front 73

Senile Purpura
cause:

Back 73

perivascular connective tissue atrophy

Front 74

acetaminophen overdose
administer this within how many hours?

Back 74

n-acetylcysteine
within 8 hours of tylenol ingestion

Front 75

tx for organophosphate poisoning

Back 75

atropine

Front 76

lye ingestion
next step:

Back 76

early upper gastrointestinal contrast studies and/or endoscopy are critical

Front 77

abdominal pain, hematemsis, hypovolemic shock, metabolic acidosis
toxic amount of:
tx:

Back 77

iron poisoning
tx deferoxamine

Front 78

bradycardia, AV block, hypotension, diffuse wheezing
cold, clammy extremities
OD of:
tx

Back 78

Beta blockers
tx: atropine and IV fluids first
second glucagon

Front 79

decreased respiratory rate, hypotension, hypothermia
OD of:
tx

Back 79

Opiods
tx: naloxone (or methodone)

Front 80

hyperthermia, dilated pupils, ileus, seizures, prolonged QTC, hypotension
OD on:
tx:

Back 80

Tricyclics
Tx: sodium bicarbonate

Front 81

mechanism of sodium bicarbonate in tricylic overdose

Back 81

increases extracellular sodium thereby improving blood pressure, QRS, and decreasing incidence of arrhythmia

Front 82

headache, nausea, vomiting, epigastric pain, anion gap metabolic acidosis
vision loss
toxic dx and tx

Back 82

methanol
tx: fomepizole or ethanol

Front 83

ethylene glycol leads to this organ damage

Back 83

kidney damage

Front 84

fluphenazine
class of drug
important side effect

Back 84

typical antipsychotic
can cause hypothermia

Front 85

tx for NMS

Back 85

dantrolene

Front 86

tx for Torsades de Point

Back 86

magnesium sulfate

Front 87

slurred speech, unsteady gait, drowsiness, normal pupil, mild decrease in respiratory rate
overdose on:

Back 87

benzo

Front 88

horizontal nystagmus, cerebellar ataxia, confusion
overdose on:

Back 88

phenytoin

Front 89

tremor, hyperreflexia, ataxia, seizures
overdose on:

Back 89

lithium

Front 90

decreased respiratory rate
miosis, sedation
overdose on:

Back 90

opiods