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Path IV-1
Neoplasia, WBC Disorders, Hemostasis Disorders, Immunohematology
| Question | Answer |
|---|---|
| Suffix that generally indicates a benign tumor | OMA |
| Benign tumors of epithelial origine arise form what layers? | Ectoderm and Endoderm. Examples: tubular adenoma arising from glands in the colon. |
| Benign tumors of conneticve tissue origin arise from | Mesoderm: lipoma |
| What is a mixed tumor? | Neoplastic cells have two different morphologic patterns but derive form the same germ cell layer. |
| Give an example of a mixed tumor? | pleomorphic adenoma of the parotid gland. |
| What does the following describe? tumor that derive from more than one germ cell layer. | Teratomas |
| Where would you find a teratoma? 4 places. What germ cell layers would they come from? | Ovaries, testes, anterior mediastinum, and pineal gland. They would come from ectoderm, mesoderm, and endoderm. |
| This type of cancer is derived from epithelial tissue and is malignant. | Carcinoma |
| What are the sites of Squamous cell carcinoma? | Oropharynx, larynx, upper/middle esophagus, lung, cervix, skin |
| What are the sites of adenocarcinoma? (glandular epithelium) | Lung, distal esophagus to rectum, pancreas, liver, breast, endometrium, ovaries, kidneys, prostate. |
| What are the sites of transitional cell carcinoma? | Urinary bladder, ureter, renal pelvis |
| This type of cancer is derived from connective tissue and is considered malignant. | Sarcoma. |
| What is an example of a sarcoma? | osteogenic sarcoma of the bone. |
| What kind of tumor is non-neoplastic overgrowth of disorganized tissue indigenous to a particular site? | Hamartoma |
| Give an example of hamartoma | bronchial hamartoma (contains cartilage), Peutz-Jeghers polyp |
| What is a Choristoma? | Non neoplastic normal tissue in a foreign location. |
| Give an example of a Choristoma | pancreatic tissue in the stomach wall; parietal cells in Meckel diverticulum. |
| T/F. Benign and malignant tumros derive from multiple cells (polyclonal). | F. They are monoclonal in orgin. Non-neoplastic proliferation would make this correct. |
| T/F. Benign tumors have normal telomerase activity while malignant tumors have upregulation of telomerase activity. | T |
| What is the sequence of invasion of a tumor? | (1) Loss of intercellular adherence. (E-cadherin not produced.) (2) Cell invasion (cell receptors attach to laminin, cells release type IV collagenase, cell receptors attach to fibronectin in the extracellular matrix, cells produce cytokines, angiogen. |
| What is the most common site of orgin for metastasis too the lymph nodes? | metastatic breast and lung cancer |
| What is the most common site of orgin for metastasis too the lungs? What is the most common primary cancer? | mETASTATIC breast cancer Adenocarcinoma |
| What is the most common site of orgin for metastasis too he liver? What is the most common primary? | metastatic lung cancer hepatocellular carcinoma |
| What is the most common site of orgin for metastasis too the bone? What is the most common primary cancer at this site? | metastatic breast cancer primary osteogenic sarcoma. |
| What is the most common site of orgin for metastasis too brain? What is the most common primary cancer here? | metastatic lung cancer glioblastoma multiforme, cerebellar astrocytoma. |
| What is the second most common cause of death in the united states? | Cancer |
| What are the causes of cancer | Tobacco, alcohol, chemicals, radiation, pathogens. |
| T/F Carcinoma of epithelial orgin spread through lymphatics and sarcoma through blood vessels. | T |
| T/F Women with a history of breast cancer in a first-degree relative have a 100 times greater risk for developing breast cancer. | F. It is 2 times greater and the Relative risk is 2. |
| T/F cancer is the most common cause of death in children in the US. | F. Accidents are. Cancer comes in at number 2. |
| What are the common tumors in children that are not common in adults? | Acute lymphoblastic leukemia, centralnervous system tumors, and neuroblastoma, and Wilm's tumor. |
| What are the most common cancers in men? | Prostate, Lung, and colorectal. |
| What are the most common cancers in women? | Breast, Lung, colorectal |
| What are the most common gynecologic cancers? | Endometrium, Ovarian, and cervical. |
| What are the most common cancer related deaths in men? | Lung, prostate, colorectal |
| What are the most common cancer related deaths in women? | Lung, breast, colorectal. |
| What are the most common cancer related deaths in gyntecological patients? | Ovary, endometrium, and cervicx. |
| What is the most common cause of death in adults? | Heart Disease |
| Which cancers are the following a precursor for? (1) Actinic keratosis (2) Atypical hyperplasia of ductal epithelium of breast. (3)Chronic irritation at sinus orifice, third degree burn scars? | (1) squamous Cell Carcinoma (2) Adenocarcinoma (3) Squamous Cell Carcionma |
| T/F Chronic ulcerative colitis is a precursor lesion for Choriocarcinoma. | F. It is a precursor for adenocarcinoma. The precurssor for choriocarcinoma is (1) complete hydatidiform mole |
| T/F A dysplastic nevus is a precursor lesion for adenocarcinoma. | F. It is a precursor for malignant melanoma. the precursor for adenocarcinoma is. Villous adenoma of rectum, vaginal adenosis, tubular adenoma of colon, scar tissue in lung, regenerative nodules in cirrhosis, endometrial hyperplasia, Barett's esophagus. |
| T/F Hepatitis B vaccination decreases the risk for hepatocellular carcinoma due to hepatitis B-induced postnecrotic cirrhosis. | T |
| Treatment of Helicobacter pylori infections will decrease the risk for developing which cancers? | Malignant lymphoma and adenocarcinoma of the stomach. |
| What are protooncogenes? | They are genes involved in normal growth and repair. |
| What do mutations in protooncogenes cause? | sustained activity of the genes. |
| What are suppressor genes? | (anti-oncogenes). the protect against unregulated cell growth. They control G1 to S phase of the cell cycle an dnuclear transcription. |
| Mutations in Suppressor genes cause? | unregulated cell proliferation |
| What are antiapoptosis genes? | BCL2 family. They are protein products that prevent cytochrome c from leaving the mitochondria. Mutations cause increased gene activity, which prevents apoptosis |
| What are Apoptosis genes? | they regulate programmed cell death. Examples are BAX apoptosis gene. |
| What are DNA repair genes? | Mismatch repair genes produce proteins that correct erros in nucleotide pairing, nucleotide excision repair pathway excises pyrimidine dimers in uv damaged skin. |
| What is the effect of mutations in repair genes? | allows cells with nonlethal damage to proliferate, which increases the risk for cancer. |
| What is the most common group of carcinogens in the united states? | polycyclic hydrocarbons in tobacco smoke. |
| T/F Direct-acting carcinogens are activated by the liver cytochrome P-450 system (polycyclic hydrocarbons) | F. Indirect-acting carcinogens makes the statement true. Direct-acting contain electron-deficient atoms that react wtih electron rich atoms in DNA. (alkylating agents) |
| What is the sequence of chemical carcinogensis? | (1) Initiation (irreversible mutation) (2) Promotion (stimulate mutated cells to enter the cell cycle). (3)Progression (development of tumor heterogeneity, production of cells that invade or metastasize) |
| What parasite causes or is related to squamous cell carcinoma of the urinary bladder? | Schistosoma hematobium |
| What parasite is related to cholangiocarcinoma of the bile ducts? | Clonorchis sinensis and Opisthorchis viverrini |
| What do the following chemicals cause (cancer)? (1) Aflatoxin (2)Alkylating Agents (3) Arsenic (4) Benzene (5)Nitrosamines (6) Polyvinyl Chloride | (1) HCC (2)Lymphoma (3)SCC (4) AML (5)Stomach Cancer (6) Liver Angiosarcoma |
| T/F CD8 T cells recognize altered class I antigens on neoplasticcells and destroy them | T |
| T/F NK cells direcly and indirectly kill through type II hypersensitivity | T |
| In tumor staging (TNM system) what do each of the letters stand for? What are significant findings? | T stands for tumor size. >2 cm correlates with metastatic ability. N refers to whether lymph nodes are involved. M refers to extranodal metastases (liver, lung) |
| What is and what causes Cachexia in cancer? | Wasting disease caused by TNF-a Anorexia, muscle wasting, loss of subcutaneous fat, and fatigue. |
| Which of the following anemias can be caused by cancer? ACD, ID, Macrocytic, Myelophthisic | All of them |
| What are some cancer effects? (general) | Cachexia, Anemia, Coagulation abnormalities, and Paraneoplastic syndromes. |
| What sign is the sudden appearance of numerous pigmented seborrheic keratoses called? What is it indicative of? | Leser-trelat sign and it is indicative of stomache carcinoma. |
| Sterile vegetations on the mitral valve can be a sign of what type of carcinoma? | Mucus-secreting pancreatic and colorectal carcinoma. Nonbacterial thrombotic endocarditis. |
| What is hypertrophic osteoarthropathy? | Periosteal reaction of distal phalanx often associated with clubbing of the nail and is indicative of bronchogenic carcinoma. |
| What is superficial migratory thrombophlebitis indicative of? | Pancreatic carcinoma. (Trousseau's sign |
| Eaton Lambert syndrome is characterized by myasthenia gravis-like symptoms; antibody directed against calcium channel. What kind of cancer does this indicate? | small cell carcinoma of the lung. |
| T/F Chediak-Higashi syndrome, Leukocyte Adhesion defect (selectins CD11a/CD18), Phagocytosis defect, Chronic granulomatous disease, and Myeloperoxidase deficiency are Qualitative disorders | T |
| T/F What are some of the clinical findings in qualitative disorders? | Unusual pathogens, frequent infections and growth failure, severe gingivitis, and lack of inflammatory response. |
| What syndrome is described by the following criteria? Autosomal Recessive, neutrophil disorder, abnormal chemotaxis, "cold" soft tissue abscesses, Red Hair, leonine face, chronic exzema, and increased IgE? | Job Syndrome |
| What is the defining leukocyte count for a leukemoid reaction? | >50,000 |
| Leukemoid reactions involve neutrophils, lymphocytes, or eosinophils. What is the etiology of each of these involved? | Perforated appendicitis (neutrophils) Whooping cough (lymphocytes) Cutaneous larva migrans (eosinophils) |
| What is the neutrophil count for neutrophilia? What are some of the causes? | >7000 /microliters; infections, sterile inflammations, drug's, and stress. |
| What is the nuetrophil count for neutropenia? | <1500/ microliters |
| Eosinophilia is described by an absolute eosinophil count of? | >700 cells/mm3 |
| T/F Hypercortisolism will cause Eosinophilia | F. It will cause Eosinopenia; examples of this would be Cushing syndrome, or corticosteroid use. Hypocorisolism would cause no sequestering of eosinophils in the lymph nodes and we would get a eosinophilia. |
| T/F Type I hypersensitivity, Parasitic infestation, Polyarteritis nodosa, Hodgkin's disease, and Addison's disease will cause Eosinophilia | T |
| What is the etiology of an absolute basophil count > 110 cells/mm (basophilia) | Chronic nyeloproliferative disorders such as polycythemia vera. |
| What is/are the cause(s) of atypical lymphocyte infectious mononucleosis? | EBV, Kissing diseasem, CD21 (CR2) receptor for C3d, infects epithelial cells via integrin a5/B1. |
| What are some of the clinical findings of infectious mononucleosis? | Extreme Fatigue, Fever, Sore throat, Exudative tonsillitis, Tender hepatosplenomegaly, Generalized tender lymphadenopathy, Ampicillin rash. |
| T/F Causes of lymphopenia include: HIV, primary immunodeficiency, autoimmune destruction, corticosteroids, and radiation | T |
| A heterophil antibody test is used for what? | It is the initial screening test for infectious mononucleosis. It detects IgM antibodies against horse (most common), sheep, and vovine RBCs. The sensitivity is 87% and specificity is 91%. |
| Of the following ages which is the most common leukemia? NB-14, 15-39, 40-60, >60 | NB-14: Acute Lymphoblastic Anemia 15-39: Acute myeloblastic leukemia 40-60: Acute myeloblastic leukemia ~60% and Chronic myelogenous leukemia ~40% of cases >60: Chronic Lymphocytic leukemia |
| What are the lab findings in acute leukemia? | Peripheral WBC <10K -- >100K Blast Cells usually present. Normocytic to macrocytic anemia Thrombocytopenia <100K cells Hypercellular bone marrow >20% blasts, often completely replaced w/blasts |
| What are the clinical findings in chronic leukemia | (1) Insideous onset (2) slightly more common than acute leukemia (3) Hepatosplenoegaly, and (4) Generalized painless lymphadenopathy. |
| What is the survival rate of ALL? | 87% 5 year survival |
| What is the 5 year survival rate of AML and CLL? | 21%, and 75% |
| What is the 5 year survival rate of CML? | 89% |
| T/F Increase in bone marrow production of RBCs will be found in absolute polycythemia | T |
| T/F Polycythemia vera's are mostly caused by a mutation of JAK2 gene on chromosome 9 | T |
| T/F A JAK2 gene mutation on Chromosome 9 can manifest as myelofirbrosis, myeloid metaplasia, or essential thrombocythemia. | T |
| What are the risk factors for developing CML? | Ionizing radiation and benzene exposure. |
| At what age do individuals typically get CML? | It typically occurs at age 40-60 and accounts for 15% of adult leukemias. |
| What is the only leukemia with Thrombocytosis? | CML |
| The treatment for CML is? How does it work? | Imatinib mesylate (Gleevec) It is an oral tyrosine kinase inhibitor which keeps the mutation from occuring. |
| What is the most common cause of splenomegally in patients older than 50? | Myelofibrosis and Myeloid metaplasia. |
| T/F Serum Leukocyte alkaline phosphatase score is normal to increased in MMM, decreased in CML, and increased in PV. | T |
| What is characterized by the following? Massive splenomegaly with infarcts, and left sided pleural effusion? | MMM |
| T/F CML, ET, and MMM have JAK2 mutations on chromosome 9 | T |
| What are the 4 classifications of Myelodysplastic Syndromes? | Refractory Anemia, Refractory anemia w/ringed sideroblasts, chronic myelomonocytic leukemia, and refractory anemia with excess blasts in transformation. |
| T/F Auer Rods are found in myeloblasts in CML | F. They are found in AML (M2 and M3) |
| T/F M2: AML w/maturation is th emost common type of AML and they have Auer Rods and occurs in the age bracke of 15-59 years of age | T |
| M3: Acute promyelocytic | Numerous Auer Rods, DIC is invariably present, t(15:17) translocation, abnormal retinoic acid metabolism |
| M5: Acute monocytic | No Auer rods, and gum infiltration |
| Lymphoid Leukemias include: | Acute lymphoblastic leukemia (ALL), Chronic lymphoytic leukemia, Adult T cell leukemia, and Hairy cell leukemia. |
| What is the most common cancer in children? | ALL early pre-B sub type is most common |
| T/F Pre-T Cell ALL is characterized by CD10 and TDT negative | F. CD10 neg and TdT pos |
| Adult T-cell leukemia is associated with HTLV-1, TAX gene inhibiting TP53 suppressor gene, and skin lesions, lytic bone lesions with hypercalcemia. | T |
| What are the vitamin K dependent factors that inactivate factors V and VIII and enhance fibrinolysis? | Protein C and s |
| What is responsible for binding platelets to exposed collage and is produced by Weibel-Palade bodies? | Von Willebrand factor |
| What activates factor VII in the extrinsic pathway? | Factor III released from injured tissue. |
| T/F the glycoprotein receptors for VwP ar designated GPIb | T |
| T/F the glycoprotein receptors for fibrinogen are designated GPIIb-IIIa | T |
| What are the functions of factor XIIa? | Activates factor XI, Activates plasminogen (produces plasmin), activates teh kininogen system (produces kallikrein and bradykinin) |
| T/F Factor XIa is the only activator of Factor IX to form IXa. | F. Factors XIa and VIIa activate factor IX to form IXa. |
| Vitamin K is activated in the liver by what? | Epoxide Reductaase |
| Where is the majority of viatmin K synthesized? | Colonic Bacteria |
| Certain coagulation factors are consumed in the formation of a fibrin clot. What are they? | Fibrinogen (I), factor V, factor VIII, and prothrombin (II) |
| What drug will competitively block plasminogen activation, thereby inhibiting fibrinolysis? | Aminocaproic acid |
| In the platelet phase of vascular injury the sequence is: | Platelet adhesion via gpIb:vWF, platelet release reaction (release of ADP), platelet synthesis and release of TXA2, and a Temporary platelet plut stopping bleading |
| T/F D-Dimer Assay's detect fibrinogen degradation products | F. They are not cross-linked. The corect anser would be that D-Dimer Assay's detect cross-linked insoluble fibrin monomers in a fibrin clot. |
| Acute Idiopathic thrombocytopenic Purpura (ITP) | most common cause thrombocytopenia in children 2-6. IgG antibodies against GpIIb-IIIa (TII reaction). Abrupt onset w/ epistaxis, easy bruising, and petechiae, no lymphadenopathy or splenomegaly. Responds to corticosteroids. |
| Chronic ITP | Most common cause of thrombocytopenia in adults, most common in women 20-40 years of age |
| What is the most common cause of thrombocytopenia in hospitalized patients? | Heparin-induced thrombocytopenia. Macrophage removal of platelets surfaced by IgG antibody directed against heparin attached to PF4 (T II), occurs 5-14 days after Rx; must stop heparin |
| Thrombotic thrombocytopenic purpura (TTP) | Adult females, increasein circulating multimers of vWF increases platelet adhesion to areas of endothelial injury at arteriole-capillary junctions. FEVER, Thrombocytopenia, renal failure, microangiopathic hemolytic anemia and schistocytes present. |
| T/F a deficiency of factor VIIIc is found in Hemophilia A | T |
| T/F Hemophilia B is an X-linked recessive disorder involving a deficiency of factor IX. Christmas factor. | T |
| What is the most common hereditary coagulation disorder? | vWD |
| vFD is associated with what 3 other conditions? | Mitral Valve prolapse, Marfan syndrome, and angiodysplasia. |
| T/F all of the following are lab findings found in liver disease. increased PT and PTT, increased FDPs and D dimers, increased bleeding time. | T |
| What is the most common hereditary thrombosis problem? | Factor V Leiden |
| There is an increased incidence of duodenal ulcers within which blood group? | O |
| Increased incidence of gastric carcinoma is within which blood group? | A |
| Increased incidence of gastric carcinoma is within which blood group? | A |
| What is the most and least common blood groups? | O, and AB |
| Forward Typeing | ID's blood group antigen by reacting anti A and anti B against RBC's |
| BAck Typeing | ID's natural antibodies in serum by reacting A type RBC and B type RBC against serum |
| Duffy antigens | ARe the antigen sight for P. Vivax infestation |
| T/F anti i hemolytic anemia is assoicated with infectious mononucleosis | T |
| Anti I hemolytic anemia is associated with mycoplasma pneumonia | T |
| What are the screening processes done on donar blood? | Group ABO and type Rh Antibody Screen (indirect coombs) Infectious disease screen (syphilis, hepatitis B and C, HIV 1 and 2, Human T-lymphotrophic virus. |
| What is the most common infectious agent transmitted by blood transfusion? | CMV |
| What is the most common transfusion reaction and what would be the clinical findings? | Type i allergic reaction, clinically we would see urticaria w/pruritus, fever, tachycardia, wheezing, potential for anaphylactic shock. Mild cases may be treated with antihistamines. |
| IgA deficient individuals with antibodies directed against IgA are more susceptible to anaphylactic reaction. | T |
| What are packed RBC's for? | increase O2 transport to tissues, they have less volume and a higher Hct whan whole blood. |
| What is the most common contaminent of stored blood? | Yersinia enterocolitica. A pathogen that thrives on iron, is the most common contaiminant of stored blood. |
| Platelet (blood product) contains and is used for? | used to stop medically significan bleeding related to thrombocytopenia or qualitative platelet defects. They have HLA antigens and ABO antigens on their surface; however, they lack Rh antigens. |
| What is Fresh Frozen Plasma used for? | treatment of multiple coagulation deficiencies (DIC, cirrhosis) or treatment of warfarin over-anticoagulation if bleeding is life-threatening. |
| What is cryoprecipitate? | Used for tretament of coagulation factor deficiencies involving fibrinogen and factor VIII (DIC) Desmopressin acetate is used instead of cryoprecipitate in treatingm mild hemophilia A and von Willebrand disease. |
Created by:
jpriddle01
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