Term
| 6 OTC supplements that can increase warfarin activity and the INR: |
|
Definition
1. alcohol
2. vitamin E
3. garlic
4. ginko biloba
5. ginseng
6. St John's wort |
|
|
Term
| Clincial manifestations of Fanconi Anemia (bone marrow, appearance, skin, eyes/ears): |
|
Definition
Bone marrow:
- aplastic anemia and progressive bone marrow failure.
Appearance:
- short stature, microcephaly, abnormal thumbs, hypogonadism
Skin:
- hypopigmented/hyperpigmented areas, cafe au lait spots, and large freckles.
Eyes/ears:
- strabismus, low-set ears, and middle ear abnormalities (hemorrhage, incomplete development, chronic infections, deafness). |
|
|
Term
| How is Fanconi Anemia tranmitted, and how is it diagnosed? |
|
Definition
- Autosomal recessive
- Diagnosis is make by chromosomal breaks on genetic analysis combined with clinical findings. |
|
|
Term
| Asymptomatic thrombocytopenia is the presenting feature of ____ in 10% of patients. |
|
Definition
|
|
Term
|
Definition
- HIT I has a non-immune mechanism, and occurs within the first 2 days of heparin tx.
- HIT II is an autoimmune d/o where antiboies form against the heparin-platelet factor 4 complex. HIT II occurs within 4-10 days of tx. |
|
|
Term
| What immediate anticoagulants are indicated after a person develops HIT? |
|
Definition
- danaparoid: lepirudin
- direct thrombin inhibitor: argatroban |
|
|
Term
| A hospitalized patient on bedrest develops both arterial and venous throboses. She also has thrombocytopenia. Dx? |
|
Definition
| - HIT II: antibody mediated platelet activation and destruction. |
|
|
Term
| Patient with new-onset diabetes, arthropathy, and hepatomegaly. |
|
Definition
|
|
Term
| Teen presents with colonic polyps and a brain tumor: |
|
Definition
- Turcot's syndrome. This syndrome is an association between brain tumors and FAP or HNPCC.
- AR inheritance |
|
|
Term
| Intestinal hamartomatous polyps and mucocutaneous melanocytic macules: |
|
Definition
|
|
Term
| Cancers that (almost) do not metastasize to the brain (4): |
|
Definition
1. non-melanomatous skin cancer
2. oropharyngeal cancer
3. esophageal carcinoma
4. prostate cancer |
|
|
Term
| Wtf is the classic triad of a glucagonoma? |
|
Definition
1. hyperglycemia
2. necrotizing dermatitis
3. weight loss |
|
|
Term
| atypical lymphocytes with a 'smudge' appearance: |
|
Definition
| - CLL. Confirm the diagnosis with flow cytometry. |
|
|
Term
| What is hereditary telangiectasia or Osler-Weber-Rendu syndrome? |
|
Definition
| - AD d/o with diffuse telangiectasias, recurrent epistaxis, and widespread AVMs. Pts can develop pulmonary AVMs a/w hemoptysis and/or right to left shunts. |
|
|
Term
| bone tumor with a 'soap bubble' appearance on radiography: |
|
Definition
|
|
Term
| "sunburst" appearance of a bone lesion on radiograph: |
|
Definition
|
|
Term
| Which lung cancer has the least association with smoking? |
|
Definition
| - Adenocarcinoma, which is also the most common type of lung cancer. |
|
|
Term
| Pt with hair-like irregular projections seen from the lymphocytes: |
|
Definition
| - Hairy cell leukemia. Cytochemical feature includes tartrate-resistant acid phosphatase (TRAP) stain, and the CD11c marker. |
|
|
Term
| What is the treatment for MALT lymphoma at the pylorus? |
|
Definition
| - triple therapy to eradicate H. pylori. Who knew? It may regress after eradication of the bug. |
|
|
Term
| First line treatment for anorexia in cancer patients? |
|
Definition
| - Progestins like megestrol acetate and medroxyprogesterone acetate. These have a better side effect profile than corticosteroids, which may also be used. |
|
|
Term
| Hereditary spherocytosis is a __ inherited disorder of ________. |
|
Definition
- AD, spectrin.
- In this disease, RBCs are not deformable and get trapped in the fenestrations of the red pulp of the spleen.
- Chronic hemolysis can cause jaundice and pigmented gallstones (which may cause R upper quadrant pain.)
- Treatment is folate supplementation and splenectomy. |
|
|
Term
| wtf is antiphospholipid antibody syndrome? (= The 'lupus anticoagulant') |
|
Definition
- a syndrome a/w false + VDRL, prolonged PTT, and thrombocytopenia.
- APS can promote arterial and venous thromboses, and a resultant tendency towards spontaneous abortions.
- Prophylaxis with low dose ASA or LMWH are recommended ot avoid pregnancy loss. |
|
|
Term
| When treating breast cancer, trastuzumab and chemotherapy together can lead to ______ toxicity. |
|
Definition
| - cardiac. For that reason, an echocardiogram is indicated before starting therapy. |
|
|
Term
| What is the TOC for TTP-HUS? |
|
Definition
| - plasmapheresis. Begin it immediately. |
|
|
Term
|
Definition
| - characterized by ecchymoses that occur on elderly patients' extensor surfaces due to perivascular connective tissue atrophy. This is not dangerous and does not require further work up. |
|
|
Term
| 4 Ts in a differential diagnosis of an anterior mediastinal mass: |
|
Definition
1. thymoma
2. teratoma (and germ cell tumors)
3. thyroid neoplasm
4. terrible lymphoma |
|
|
Term
| hormone markers in a seminoma: |
|
Definition
- 1/3 of patients will have an elevated beta-HCG
- AFP will be normal |
|
|
Term
| Hormone markers in a non-seminomatous germ cell tumor: |
|
Definition
- most will have elevated AFP
- Some will ahve elevated beta-HCG |
|
|
Term
| "leukocytes that have undergone partial breakdown during preparation of a stained smear because of their greater fragility" |
|
Definition
= smudge cells of CLL.
- thrombocytopenia indicates a poor prognosis. |
|
|
Term
| Skin cancer with: proliferating malignant cells which arise from the epidermis and extend into the dermis in lobules or strands. |
|
Definition
|
|
Term
| 4 metabolic abnormalities a/w tumor lysis syndrome: |
|
Definition
1. hyperphosphatemia
2. hyperkalemia
3. hyperuricemia
4. hypOcalcemia |
|
|
Term
| Anemia, mild thrombocytopenia, increased indirect bili, and hepatic vein thrombosis: |
|
Definition
| - Paroxysmal nocturnal hemoglobinuria |
|
|
Term
| Pt with hemolytic anemia and thrombocytopenia, AMS, renal failure, and fever: |
|
Definition
| - Thrombotic thrombocytopenic purpura. |
|
|
Term
| Acute treatment of stroke in a sickle cell patient: |
|
Definition
| - exchange transfusion (not fibrinolytics). |
|
|
Term
| positive alpha-naphthyl esterase test: |
|
Definition
| - acute monocytic (FAB M5) leukemia. |
|
|
Term
| Either folate or B12 deficiency will cause an increase in ___________, but only a deficiency in B12 will cause an increase in ____________. |
|
Definition
homocysteine,
methylmalonic acid |
|
|
Term
| What is the treatment for CLL? |
|
Definition
- Rituximab, a monoclonal antibody against the CD20 antigen on B lymphocytes.
- CLL may also have autoimmune hemolytic anemia and thrombocytopenia |
|
|
