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Heme-Onc 2
First Aid Q&A: Hematology & Oncology 2
| Question | Answer |
|---|---|
| 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
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