First Aid Q&A: Hematology & Oncology 2
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| Chemotherapeutic agent shown to cause nephrotoxicity and acoustic nerve damage. | Cisplatin
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| Chemotherapeutic agent toxicities include life threatening pulmonary fibrosis and minimal myelosuppression. | Bleomycin
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| Chemotherapeutic agent that is cardiotoxic | Doxorubicin (Trastuzumab is also cardiotoxic)
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| 3 yro girl with history of acute viral infection one month ago, nonblanching purple skin lesion, and large platelets on blood smear. Diagnosis? | Idiopathic Thrombocytopenic Purpura
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| Patient with small-cell lung carcinoma is associated with ectopic production of what two hormones? | ADH and ACTH
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| What are the symptoms of Cushing syndrome? | Moon facies from fat redistribution, weight gain, poor wound healing due to inhibition of collagen synthesis by glucocorticoids, and hirsutism due to stimulation of androgen production by ACTH, Hyperpigmentation
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| 45 yro woman with intense abdominal pain; history of flulike infection and prolonged feeling of fatigue; scleral icterus, pigmented palate, skin a yellow hue; Coombs' negative; small RBC's, many have no central pallor. Diagnosis? | Hereditary Spherocytosis; ankyrin or spectrin mutation
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| How do you distinguish between G6PD and Hereditary Spherocytosis? | G6PD is X-linked and therefore mostly found in males. G6PD shows Heinz bodies and bite cells on blood smear, whereas spherocytes are found in HS
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| Chemotherapeutic agents known for generating megaloblastic anemia. (Hint: one is an antibiotic) | Dihydrofolate reductase inhibitors. Trimethoprim (the antibiotic) and methotrexate
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| Broad spectrum antibiotic effective against bacterial meningitis; associated with aplastic anemia and gray baby syndrome | Chloramphenicol
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| Antibiotic associated with pseudomembranous colitis due to Clostridium difficile overgrowth | Clindamycin
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| Macrolide antibiotic associated with cholestatic hepatitis | Erythromycin
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| Fluoroquinolone antibiotic associated with tendinitis | Gatifloxacin
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| Chemotherapeutic that has side effects of weight gain, foot ulcers, vision problems, elevated blood sugar, oral candidiasis, wild swinging mood changes. What is the etiologic agent? | Prednisone. Cushing-like symptoms (weight gain, moon facies, thin skin, brittle bones), cataracts, HTN, elevated blood sugar, mood changes (glucocorticoid psychosis)
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| Life threatening side effect of Bleomycin? | Pulmonary fibrosis
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| Adverse side effects of Vincristine | Peripheral neuritis, areflexia and paralytic ileus (neurotoxic)
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| 41 yro pregnant woman with vaginal bleeding; 4 months pregnant but uterus is 6 month size; elevated hCG 5x upper limit of normal. Diagnosis? | Hydatidiform mole
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| Causes of eosinophilia? | NAACP; Neoplasm, asthma, allergies, collagen vascular disease (Polyarteritis nodosa, Churg-Strauss), Parasites
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| Diffuse interstitial fibrosis and increased risk of mesothelioma and bronchogenic carcinoma. Diagnosis? | Asbestos exposure
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| Parainfluenza virus infection leading to laryngotracheobronchitis characterized by "seal-like" barking cough. Diagnosis? | Croup
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| Condition characterized by pulmonary infections, chronic bronchitis, and pancreatic insufficiency. | Cystic fibrosis
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| A marker for hepatomas and germ cell (yolk sac tumors) | alpha-fetoprotein
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| Marker for colorectal, pancreatic, gastric, and breast carcinoma | carcinoembryonic antigen
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| Marker for melanoma, neural tumors and astrocytomas | S-100
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| Marker for neuroblastoma, lung and gastric cancers | bombesin
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| Marker for prostatic carcinoma | PSA
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| What type of neoplastic cell is most common in non-Hodgkin's lymphoma? | B-cell; notable exception is lymphoblastic lymphoma which is T-cell
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| What type of neoplastic cells is associated with multiple myeloma? | Plasma cells, often with a "fried egg" appearance
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| What is the site of nodal metastasis of testicular cancer? | Testes began life way up in the abdomen, lymphatic drainage is thus retroperitoneal
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| Tumors of the scrotum, but not of the testes may spread to these lymph nodes. | Superficial inguinal lymph nodes (remember, testes go to retroperitoneal lymph nodes)
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| What enzyme catalyzes the rate-limiting and committed step in heme synthesis? | delta-Aminolevulinic acid synthase (ALA synthase)
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| What is the mechanism of vincristine? | Microtuble formation inhibitor
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| What is the mechanism of Doxorubicin? | Free radical generation and DNA intercalation producing DNA strand breaks
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| Which abnormalities on peripheral blood smear would you expect to find in a patient with a history of splenectomy? | Immature and irregular erythrocytes, Heinz bodies and target cells
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| 20 yro african american female develops anemia post UTI treated with sulfonamides. Blood smear shows RBC lysis and precipitates of hemoglobin in RBCs. Diagnosis? | G6PD, high incidence in AA's, heinz bodies, precipitated by sulfonamides
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| Drug that binds IIb/IIIa on activated platelets preventing platelet aggregation | Abciximab
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| Drug that inhibits ADP pathway involved in binding of fibrinogen to platelets during platelet aggregation | Clopidogrel and ticlopidine
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| Patient with jaundice and a palpable, enlarged, nontender gallbladder. Diagnosis? | Courvoisier's sign; Pancreatic cancer obstructing the gallbladder from emptying
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| 8 yro boy with severe hemolytic anemia, hepatosplenomegaly, and maxillary overgrowth. Transfusions since birth but hasn't had one in 4 months. Diagnosis? | Beta-thalassemia major
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| Brain tumor often localized to cranial nerve VIII, slow growing and easily resected. | Schwannoma
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