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88 Cards in this Set
- Front
- Back
Rate-limiting enzymes:
Glucose |
Phosphofructokinase
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Rate-limiting enzymes:
Gluconeogenesis |
Fructose-1,6-bisphosphatase
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Rate-limiting enzymes:
TCA cycle |
Isocirtate dehydrogenase
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Rate-limiting enzymes:
Glycogen synthesis |
Glycogen synthease
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Rate-limiting enzymes:
Glycogenolysis |
Glycogen phosphorylase
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Characteristics of Type II DM medications:
Lactic acidosis is a rare but worrisome SE |
Metformin
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Characteristics of Type II DM medications:
Most common SE is hypoglycemia |
Sulfonylureas
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Characteristics of Type II DM medications:
MOA: closes K+ channel on Beta cells → depolarization → Ca2+ influx → insulin release |
Sulfonylureas
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Characteristics of Type II DM medications:
MOA: inhibit a-glucosidease at intestinal brush border |
a-glucosidase inhibitors
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Characteristics of Type II DM medications:
MOA: agonist at PPAR-gamma receptors |
Thiazolidinediones (TZDs)
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3 mineral compounds to tx esophageal reflux:
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-Aluminum hydroxide
-Magnesium hydroxide -Calcium carbonate |
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What coag factor is deficient in Hemophilia A
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Factor VIII
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What coag factor is deficient in Hemophilia B
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Factor IX
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Clinical deficiency in protein C or protein S?
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both anticoagulants, deficiency in anticoagulant → hypercoagulable state, makes too many blood clots
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Overdose for Heparin
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Protamine Sulfate
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Overdose for Warfarin
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Fresh frozen plasma and Vitamin K
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What do you do with a pt who has HIT (heparin induced thrombocytopenia)?
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-Stop heparin
-Anticoagulate c. Lepirudin or Argatroban |
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Vitamin K dependent clotting factors
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Factors II, VII, IX, X, Protein C, and Protein S
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Substances eliminated by Zero-order kinetics
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“PEA” – Phenytoin, Ethanol, ASA
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What enzymes are used to metabolize EtOH
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-Ethanol – alcohol dehydrogenase → Acetaldehyde
-Acetaldehyde – Acetaldehyde dehydrogenase → Acetate |
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What allows RBCs to change shape while passing through vessels
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Spectrin
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Where does fetal erythropoiesis take place and what bones in adult?
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-Fetal: Yolk sac, Liver, Spleen, Bones
-Adult: Vertebrae, Ribs, Pelvis, Sternum, Tibia & femur |
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Name of immature erythrocytes
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Reticulocytes
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What enzymes for heme synthesis are inhibited by lead toxicity?
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Ferrochelatase and ALA Dehydratase
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In addition to colon cancer, what is one of the most common causes of GI bleeding in the elderly?
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Angiodysplasia
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What is a likely scenario that would lead to a pt being exposed to arsenic?
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Living in an arsenic-rich region and ingesting ground water c. arsenic
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What test is used to diagnose beta thalassemia minor?
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Hemoglobin electrophoresis
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Lab values to tell the difference between iron deficiency and thalassemia
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Iron deficiency: low serum iron, increased TIBC, low ferritin
Thalassemia: NL iron, NL TIBC, NL ferritin, target cells on blood smear |
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What diagnosis do you need to r/o in a male >50yrs with new onset iron deficiency anemia?
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colon cancer
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Microcytic anemia c. swallowing difficulty and glossitis
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Plummer-Vinson syndrome
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Microcytic anemia and >3.5% HbA2
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Beta thalassemia minor
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Megaloblastic anemia not correctable by B12 or Folate supplementation
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Orotic aciduria
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Megaloblastic anemia along c. peripheral neuropathy
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B12 deficiency
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Microcytic anemia and basophilic stippling
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lead poisoning
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Microcytic anemia reversible c. B6
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Sideroblastic anemia
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HIV (+) pt c. macrocytic anemia
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Zidovudine
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Normocytic anemia + red urine in the morning
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paroxysmal nocturnal hemoglobinuria
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Normocytic anemia and elevated Creatinine
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Chronic kidney disease
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What are the causes of Aplastic anemia
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Radiation, Benzene, Chloramphenicol, alkylating agent, Anti-metabolites, viruses, fanconi anemia
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3 mechanisms that cells use to breakdown proteins
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Ubiquitin protein ligase
Lysosomes Calcium-dependent enzymes |
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Which HIV medication is known to cause bone marrow suppression?
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Zidovudine
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What is the treatment for lead poisoning?
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Adults: EDTA and succimer
Children: EDTA, succimer, and dimercaprol |
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A child, anemic since birth, has now been cured with splenectomy. What is the disease?
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Hereditary spherocytosis
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Finding associated c. hereditary spherocytosis
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Anemia and jaundice, pigmented gallstones, splenomegaly, spherocytes on peripheral smear, (+) osmotic fragility test, Coombs’ test (-) (b/c antibodies are not causing the hemolysis)
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What 2 protozal diseases that can cause hemolytic anemia
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Malaria and Babesiosis
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What conditions are associated c. Target Cells?
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“HALT”
HbC disease, Asplenia, Liver disease, and Thalassemia |
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Name given to anemia due to mechanical destruction of erythrocytes due to aortic stenosis or prosthetic heart valve
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Macroangiopathic anemia
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What is the cause of ITP
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Anti-glycoprotein IIb/IIIa antibodies on platelets
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What is the defect in Bernard-Soulier disease?
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Deficiency in glycoprotein Ib
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What is the lifespan of a platelet?
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8-10days
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What molecule is expressed on the surface of an activated platelet?
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Glycoprotein IIb/IIIa
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What lab values do you expect to see in DIC?
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Increased bleeding time, increased PT and PTT, decreased platelets, increased D-Dimer
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MOA Streptokinase
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convert plasminogen to plasmin
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MOA ASA
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Irreversibly inhibits COX-1 and COX-2
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MOA Clopidogrel
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Blocks ADP receptors
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MOA Abciximab
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Gp IIb/IIIa inhibitor
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MOA Tirofiban
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Gp IIB/IIIa inhibitor
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MOA Ticlopidine
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Blocks ADP receptors
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MOA Enoxaparin
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LMWH; inhibits factor Xa
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MOA Eptifibatide
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Gp IIb/IIIa inhibitor
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What neoplasms are associated c. AIDS?
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Kapossi Sarcoma (HHV-8)
Invasive squamous cell cancer CNS lymphoma Non-Hodgkin lymphoma |
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What is the most common inherited bleed disorder?
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von Willebrand Disease
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What cancer is associated c. Hashimotot thyroiditis?
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Marginal cell lymphoma
-arises outside of lymph nodes and in chronically inflamed tissues |
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Most common lymphoma in US (and among adults)
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Diffuse large B-cell
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Reed-Sternberg cells
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Hodgkin’s Lymphoma
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Particularly associated c. EBV
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Burkitt and maybe Hodgkin’s Lymphoma
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Associated c. long-term celiac disease
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Intestinal T-cell Lymphoma
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Lymphoma equivalent of CLL
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Small lymphocytic lymphoma
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“Starry-sky pattern”
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due to phagocytosis of apoptotic tumor cells → Burkitt’s Lymphoma
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Associated c. Sjogren’s syndrome, Hashimoto thyroiditis, and H. pylori
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Marginal Cell MALToma
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Age distribution of Hodgkin’s Lymphoma
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Bimodal distribution, ages 20 and 65
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Age distribution of Non-Hodgkin’s Lymphoma
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Widely variable
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Most common type of Non-Hodgkin lymphoma in adults?
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Diffuse Large B-Cell
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Most common type of Non-Hodgkin lymphoma in children?
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Lymphoblastic lymphoma
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Pt present c. anemia, bone pain, and hypercalcemia. Bone marrow biopsy demonstrates plasma cells. What is the diagnosis and what will be seen in the urine?
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Diagnosis: Multiple Myeloma
Urinalysis: nothing Urine protein electrophoresis (UPEP): Monoclonal antibody spike |
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Most common leukemia in children
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ALL
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Most common leukemia in adults (in US)
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CLL
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Characteristic Auer Rods
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AML (M2 and M3)
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More than 20% blasts in marrow
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Acute leukemia
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Leukemia c. more mature cells and less than 5% blasts
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Chronic leukemia
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PAS (+) acute leukemia
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ALL
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Commonly presents c. bone pain
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ALL
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Numerous basophils, splenomegaly, and negative for LAP
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CML
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Always positive for the Philadelphia chromosome t(9;22)
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CML
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Acute leukemia positive for peroxidase
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AML
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Solid sheets of lymphoblasts in marrow
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ALL
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PAS (-) acute leukemia
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AML
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Always associated c. the BCR-ABL genes
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CML
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