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Hematology
New set 2023 UWORLD only
| Question | Answer |
|---|---|
| What are the most common associations with Pure Red Cell Aplasia? | Thymoma, lymphocytic leukemia, and parvovirus B19 infection. |
| How is Pure Red cell aplasia characterized clinically? | Severe anemia w/ reticulocytopenia and morphologically NORMAL platelets and leukocytes. |
| What cancers are associated with BRCA gene germline mutation? | Breast and Ovarian cancer |
| What leads to cancer in a BRCA gene mutation? | Inability to repair ds-DNA breaks |
| To which anticancer medications are BRCA gene mutated cancers more susceptible? | Platinum compounds |
| BRCA gene is responsible for: | Repair ds-DNA breaks |
| How is the relationship of P50 in a Hb with HIGH affinity to oxygen? | ↓↓ P-50 |
| How is ↓P50 represented graphically in the oxygen-dissociation curve? | Leftward shift |
| What are the results of ↓ability to release O2 w/in peripheral tissues? | 1. Renal hypoxia 2. ↑ EPO synthesis 3. Compensatory erythrocytosis |
| MC Direct factor Xa inhibitor? | Apixaban |
| What conversion is reduced by Direct factor Xa inhibitors? | ↓↓ Prothrombin -----> Thrombin |
| Drug that actively blocks active site of factor Xa? | Apixaban |
| ↓↓ prothrombin ---> thrombin is caused by the use of what type of anticoagulants? | Direct factor Xa inhibitors |
| What are the effects of aging in respect to new blood vessel synthesis? | 1. ↑ Bone Marrow Fat 2. ↓ Bone Marrow mass 3. ↑ BM fat + ↓ BM mass ====> ↓↓ BM reserve |
| What type of anticoagulant is Enoxaparin? | LMWH |
| What is a common LMWH? | Enoxaparin |
| LMWH binds and activates which protein? | Antithrombin III |
| Activated AT-III binds to what in order to initiate anticoagulation? | Binds cofactor Xa ---> ↓ prothrombin to thrombin conversion |
| Do LMWHs act on factor Xa or thrombin? | Factor Xa |
| Heparin acts directly on factor Xa or thrombin? | Thrombin |
| What are 2 examples of Direct Oral factor Xa inhibitors? | Rivaroxaban and Apixaban |
| What is an example of an Indirect factor Xa inhibitor? | Fondaparinux |
| What is the main reason for preferred use of DOACs over Vitamin K antagonists (Warfarin)? | Less variability in therapeutic drug effect |
| List of benefits of DOACs over VKAs: | 1. Less variability in therapeutic drug effect with meds and diet 2. Do not require lab monitoring |
| What is the MC VKA? | Warfarin |
| What is a common example of how cancer cells avoid immune recognition, leading to survival? | Overexpression of PD-L1 on cancer cell |
| What is the role of PD-L1? | Binding to PD-1 receptor on cytotoxic T cell --> inhibition of T cell response |
| What is "T-cell exhaustion"? | Inability of cytotoxic T cell to respond to antigen due to overexpression of PD-L1 --PD-1 binding. |
| Why are monoclonal antibodies against PD-L1 and PD-1 effective against some particular cancers? | Express elevated levels of NEOANTIGENS on its surface |
| The individual subunits of Hb molecule are structurally analogous (similar) to: | Myoglobin |
| What labs are affected in the Early stage of Iron deficiency anemia? | Loss of iron in storage = ↓↓ serum Ferritin |
| What labs are affected in the intermediate stage of iron deficiency anemia? | ↓ serum Fe and transferrin saturation, due to Fe2+-limited erythropoiesis |
| What labs are added in decrement in the late stage of iron deficiency anemia? | ↓↓ MCV, MCHC, Reticulocyte count |
| What are the 4 Ts (masses) associated with anterior mediastinum mass? | 1. Thymoma 2. Teratoma (& germ cell tumors) 3. "terrible" lymphoma 4. Thyroid neoplasm |
| Which of the 4 Ts in anterior mediastinum masses is associated with elevated α-fetoprotein and ß-hCG levels? | Non-seminomatous germ cell tumor |
| Amyloidosis is associated with which hematologic malignancy? | Multiple Myeloma |
| What percentage level/range in a bone marrow sample of plasma cells is indicative of Multiple Myeloma? | >10% |
| What causes Cyclic neutropenia? | Mutation in the gene encoding NEUTROPHIL ELASTASE |
| What is the approximate time cycle of cyclic neutropenia? | Every 3 weeks |
| What are common Bone Marrow findings of Cyclic neutropenia? | Nuclear fragmentations and membrane blebbing |
Created by:
rakomi
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