Usmle Ck - Heme/onc 2

Front 1

pt/ with enlarged lymph node presenting with anemia

Back 1

autoimmune hemolytic anemia 2/2 lymphoproliferative malignancy
- often warm AHA
- tx: prednisone, if not effective then splenctomy

Front 2

microangiopathic hemolytic anemia?

Back 2

= HUS

Front 3

HUS vs thalassemia vs DIC vs ITP?

Back 3

- HUS: young pt s/p diarrheal illness (E. Coli, shigella, salmonella, yersinia, campy) ==> thrombocytopenia purpura, schistocytes, giant platelets, renal failure, normal PT, PTT; UA = hemoglobin, hemosiderin, albumin, RBC, WBC, casts

- thalassemia: hepatosplenomegaly, blood smear: target cells, microcytosis, hypochromia, anisopoikilocytosis, no schitocytes

- DIC: increased PT, PTT

- ITP: isolated thrombocytopenia, rest of blood smear is normal

Front 4

what do you see in blood smear in mono?

Back 4

atypical lymphocytes or variant lymphocytes
- heterophile Ab may be negative early on

Front 5

ALL vs CLL vs CML?

Back 5

- ALL: young, see blasts
- CLL: old, see mature small lymphocytes
- CML: adult: see basophilia, splenomegaly; NO lymphadenopathy

Front 6

tx of increased homocyteine?

Back 6

pyridoxine (B6) and folate to help metabolize homocysteine

Front 7

ddx HUS and DIC and TTP?

Back 7

- HUS: young, s/p diarrhea, NORMAL PT, PTT; DIC has high PT, PTT; TTP is HUS PLUS NEUROLOGICAL FEATURES

Front 8

transfuse w/ blood, dvlp fever, chills. - antiglobulin test? if it had been Coombs +?

Back 8

- febrile transfusion reaction
- don't see hemodynamic abnormalites, no renal dysfunction
- 2/2 ab in pt reacting to donor's leuk
- prevent by leuk depletion technique (filter or cell washing)
- tx acetaminophen

- if coombs+: bad crossmatching

Front 9

paget's dz? path? which ca?

Back 9

breast papillomas- large cells surrounded by halos (clear area)
- adenocarcinoma

Front 10

horner's syndrome?breast ca associated with nipple discharge?

Back 10

ptosis, aniosis, anhidriosis
- get CXR

Front 11

glossitis and increased MCV?

Back 11

b12 deficiency

Front 12

pernicious anemia is associated with which ca?

Back 12

- pernicious anemia = b12 def
- gastric carcinoid tumor

Front 13

what test for paroxysmal nocturnal hemoglobinemia?

Back 13

- sugar water test

Front 14

MCV and basophilic stipling?

Back 14

- low mcv = lead
- high mcv = b12/folate macrocytic anemia

Front 15

pt with nonspecific complaints, low MCV, anemia, increased Cr?

Back 15

lead poisoning 2/2 occupational exposure
- lots of nonspecific complians: abd pain, constipation, decraesed concentration
- give EDTA

Front 16

anemia of chronic disease is 2/2

Back 16

- infx, cancer, autoimmune dz (rheumatoid arthritis)

Front 17

when to start screening for CRC in UC?

Back 17

- after 8 years of the disease and then every eyar

Front 18

soap bubble appearance of end of long bone?

Back 18

giant cell tumor, benign but locally aggressive

Front 19

9:22?

Back 19

philadelphia chromosome, BCR-ABL, tyrosine kinase associated with CML, imatininib

Front 20

acute promyelocytic leukemia

Back 20

- subtype of AML
- tx by targeting retinoic acid receptor

Front 21

pt with hereditary spherocytosis?

Back 21

increased MCHC, normal MCH, increased or normal MCV

Front 22

Anemia in SLE?

Back 22

- Ab against RBC = peripherally destroyed
- spherocytosis and +coombs

Front 23

colon polyps +
- dermoid tumors?
- gingival hyperplasia?
- glioblastoma?

Back 23

- gardner
- multiple harmartoma
- Turcot

Front 24

path on IBD?

Back 24

- neutrophilic cryptisis

Front 25

what does gaucher's dz present w/?

Back 25

- bone pain, animea, thrombocytopenia, hepatosplenomegaly

Front 26

asplenia?

Back 26

- impaired phagocytosis

Front 27

trousseau's syndrome?

Back 27

pt with migratory thrombophlebitis: pain, redness, itching in arm and chest, cord like veins
- do CT abdomen: most likely adenocarcinoma of pancreas, lung., prostate, stomach

Front 28

pt with well defined solitary met to lung?

Back 28

- surgery, no chemo

Front 29

lupus anticoag?

Back 29

- IgG or IgM that prolongs PTT by binding phospholid in LAB only
- increases risk of thrombosis, abortion

Front 30

serum protein electrophoresis shows IgM spikes?

Back 30

- Walderstrom's macroglobulinemia; see dilated retinal vessels

Front 31

Walderstroms vs MM vs MGUS, heavy chain dz?

Back 31

- W: IgM spike, dilated retinal vessels
- MM: IgG or IgA, no retinal dilation
- MGUS: asympt
- heavy chain dz: abd lymphoma, IgA

Front 32

athlete with increased Hct?

Back 32

steroid abuse (will have normal WBC)

Front 33

whento dx pernicious anemia vs diet b12 deficiency?

Back 33

- pt with signs of autoimmune dz (vitiligo) = pernicious

Front 34

pt with increased PTT w/ signs of stroke?

Back 34

- SE of heparin therapy = thrombocytopenia along with thrombosis = acute ischemic stroke

Front 35

fibrin degredation products?

Back 35

- DIC

Front 36

smudge cells

Back 36

= leukocytoes that have partially broken b/c increased fragility
- seen in CLL

Front 37

poor dx in CLL?

Back 37

- if associated with thrombocytopenia
- intermeidate dx: anemia

Front 38

pt with sickle cell dz presents with neuro/stroke sx?

Back 38

- exchange transfusion

Front 39

role of G6PD? B12 deficiency?

Back 39

- glutatione synthesis ==> anemia
- purine/DNA synthesis ==> anemia

Front 40

best initial test for SCC of head and neck?

Back 40

- PANendoscopy: look at esoph, bronch, larynx

Front 41

tx of low grade gastric mucosa associated lymphoid tissue lymphoma (MALT)?

Back 41

- tx h. pylori: omep, amox, clarith

Front 42

leukocytosis w/ increased mature granulocytic forms?

Back 42

- increased neutrophils, bands)
- CML
- ALSO SEE LOW LEUK ALK PHOS