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Heme-Onc 2

First Aid Q&A: Hematology & Oncology 2

QuestionAnswer
Chemotherapeutic agent shown to cause nephrotoxicity and acoustic nerve damage. Cisplatin
Chemotherapeutic agent toxicities include life threatening pulmonary fibrosis and minimal myelosuppression. Bleomycin
Chemotherapeutic agent that is cardiotoxic Doxorubicin (Trastuzumab is also cardiotoxic)
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
Patient with small-cell lung carcinoma is associated with ectopic production of what two hormones? ADH and ACTH
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
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
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
Chemotherapeutic agents known for generating megaloblastic anemia. (Hint: one is an antibiotic) Dihydrofolate reductase inhibitors. Trimethoprim (the antibiotic) and methotrexate
Broad spectrum antibiotic effective against bacterial meningitis; associated with aplastic anemia and gray baby syndrome Chloramphenicol
Antibiotic associated with pseudomembranous colitis due to Clostridium difficile overgrowth Clindamycin
Macrolide antibiotic associated with cholestatic hepatitis Erythromycin
Fluoroquinolone antibiotic associated with tendinitis Gatifloxacin
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)
Life threatening side effect of Bleomycin? Pulmonary fibrosis
Adverse side effects of Vincristine Peripheral neuritis, areflexia and paralytic ileus (neurotoxic)
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
Causes of eosinophilia? NAACP; Neoplasm, asthma, allergies, collagen vascular disease (Polyarteritis nodosa, Churg-Strauss), Parasites
Diffuse interstitial fibrosis and increased risk of mesothelioma and bronchogenic carcinoma. Diagnosis? Asbestos exposure
Parainfluenza virus infection leading to laryngotracheobronchitis characterized by "seal-like" barking cough. Diagnosis? Croup
Condition characterized by pulmonary infections, chronic bronchitis, and pancreatic insufficiency. Cystic fibrosis
A marker for hepatomas and germ cell (yolk sac tumors) alpha-fetoprotein
Marker for colorectal, pancreatic, gastric, and breast carcinoma carcinoembryonic antigen
Marker for melanoma, neural tumors and astrocytomas S-100
Marker for neuroblastoma, lung and gastric cancers bombesin
Marker for prostatic carcinoma PSA
What type of neoplastic cell is most common in non-Hodgkin's lymphoma? B-cell; notable exception is lymphoblastic lymphoma which is T-cell
What type of neoplastic cells is associated with multiple myeloma? Plasma cells, often with a "fried egg" appearance
What is the site of nodal metastasis of testicular cancer? Testes began life way up in the abdomen, lymphatic drainage is thus retroperitoneal
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)
What enzyme catalyzes the rate-limiting and committed step in heme synthesis? delta-Aminolevulinic acid synthase (ALA synthase)
What is the mechanism of vincristine? Microtuble formation inhibitor
What is the mechanism of Doxorubicin? Free radical generation and DNA intercalation producing DNA strand breaks
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
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
Drug that binds IIb/IIIa on activated platelets preventing platelet aggregation Abciximab
Drug that inhibits ADP pathway involved in binding of fibrinogen to platelets during platelet aggregation Clopidogrel and ticlopidine
Patient with jaundice and a palpable, enlarged, nontender gallbladder. Diagnosis? Courvoisier's sign; Pancreatic cancer obstructing the gallbladder from emptying
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
Brain tumor often localized to cranial nerve VIII, slow growing and easily resected. Schwannoma
Created by: rahjohnson