Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
92 Cards in this Set
- Front
- Back
cornerstone of treatment for SCLC (limited-stage and extensive-stage)
|
Combination chemotherapy
|
|
define limited-stage disease SCLC
|
disease limited to one hemithorax, with hilar and mediastinal LAD that can be encompassed within one radiotherapy portal
|
|
thalassemia that presents with normal hemoglobin electrophoresis results
|
α-thalassemia trait
|
|
pentad of findings in TTP
|
fever, neurologic deficits, thrombocytopenia, microangiopathic hemolytic anemia, kidney impairment
|
|
how is mantle cell lymphoma diagnosis confirmed?
|
presence of overexpression of cyclin D1 and a t(11;14) translocation in the malignant lymphoid cells
|
|
CD4-positive T-cell leukemia characterized by major skin involvement
|
mycosis fungoides
|
|
what is Sézary syndrome?
|
cutaneous lymphoma with prominent leukemic phase; sometimes considered a late stage of mycosis fungoides with lymphadenopathy
|
|
provides independent prognostic information in CLL
|
β2-microglobuin level, heavy gene mutational status, and cytogenetics
|
|
test to establish diagnosis of CML
|
fluorescence in situ hybridization (FISH) assay for t(9;22)
|
|
conditions where JAK 2 is positive
|
polycythemia vera (95%) and essential thrombocythemia and primary myelofibrosis (50-60%)
|
|
heterophile antibody test
|
infectous mononucleosis
|
|
useful in the management of the hormonal symptoms of neuroendocrine tumors when they are present and may slow progression of metastatic carcinoid tumors
|
octreotide, a somatostatin analogue
|
|
when is R hemicolectomy indicated in carcinoid tumors of ileocecal area
|
large carcinoid tumors (≥2 cm) of appendix or tumors of appendix of any size with aggressive histology (high-grade neuroendocrine tumors or adenocarcinomas)
|
|
treatment of locally advanced anal cancer
|
RT + 5FU and mitomycin
|
|
is surgery indicated in anal cancer?
|
stages I, II, and III potentially cured with RT + chemo, without disfiguring operation
|
|
how to confurm adherence to hydroxyurea therapy in sickle patients
|
check MCV (should show macrocytosis)
|
|
treatment of acute chest syndrome
|
(ABx, O2, pain meds, don't overhydrate, transfusion) empiric broad-spectrum antibiotics, supplemental oxygen, pain meds (diminish chest splinting), and avoid overhydration; transfusion if hypoxic despite o2
|
|
appropriate breast cancer follow-up
|
H&P + mammography
|
|
causes of PRCA (4)
|
parvovirus B19 infection, myelodysplasia, large granular lymphocytosis, thymoma
|
|
??diagnostic of large granular lymphocytosis
|
Flow cytometry revealing CD57+ T cells and clonality on T-cell receptor gene rearrangement studies
|
|
lab findings in PRCA caused by parvovirus infection
|
giant pronormoblasts in bone marrow biopsy, and no large granular lymphocytes on PBS
|
|
poor prognostic features of melanoma (3)
|
thickness greater than 0.75 mm, a positive deep margin, or lymphovascular invasion
|
|
most common complication of sickle cell trait
|
hematuria due to papillary necrosis
|
|
purpose of γ-irradiation of erythrocytes
|
eradicates lymphocytes (minimizes GVHD)
|
|
advantages of leukoreduction of blood product
|
less febrile nonhemolytic transfusion reactions, CMV transmission, and alloimmunization (but not anaphylaxis)
|
|
Young men with a predominant tumor location in the mediastinum and retroperitoneum
|
extragonadal germ cell cancer syndrome, (check HCG and AFP)
|
|
monoclonal antibody against vascular endothelial growth factor
|
Bevacizumab
|
|
a monoclonal antibody that interferes with the HER2/neu receptor
|
trastuzumab or Herceptin
|
|
side effects of traztuzumab
|
Heart failure (esp when used with anthracycline)
|
|
side effects of tamoxifen
|
increased risk for thromboembolic disease and endometrial cancer
|
|
agent used for ER-positive breast cancer
|
tamoxifen
|
|
mutation in severe congenital neutropenia
|
neutrophil elastase gene
|
|
work up for autoimmune neutropenia
|
antineutrophil antibody assay
|
|
Diagnosis of APS
|
venous or arterial thromboembolism or pregnancy morbidity (3 or + first-trimester miscarriages or one fetal death) and positive laboratory results ([dRVVT], ACL Ab, β2 GPI) on two occasions 12 weeks apart
|
|
mutations associated with mild to moderate hyperhomocysteinemia
|
Methylene tetrahydrofolate reductase mutations
|
|
how to minimize risk of alloimmnization in patients with SCD
|
phenotypically matched for the C, E, and K antigens
|
|
who should undergo yearly mammography and breast MRI
|
patients who received mantle radiation, carriers of the BRCA1 or BRCA2 mutation
|
|
side effect of bevacizumab
|
disrupt normal vasculature, resulting in POOR WOUND HEALING and vascular catastrophes, including bleeding or thromboses
|
|
diagnostic of hairy cell leukemia
|
dry aspirate on bone marrow sampling and finding of lymphoid cells with hair-like projections
|
|
treatment of hairy cell leukemia
|
cladribine, highly curable
|
|
describe headache of brain mets
|
maximum intensity on waking up, severe and persistent despite analgesia
|
|
How to manage pregnant with SCD in a painful crisis
|
Fluids, O2, morphine (not teratogenic)
|
|
low risk prostate cancer
|
T1 or T2 cancer with Gleason score <8 and PSA <20
|
|
when is antiandrogen therapy considered in prostate cancer?
|
newly diagnosed + high-risk + received radiation therapy OR hormone-sensitive metastatic cancercancer
|
|
when is radical prostatectomy indicated in prostate cancer?
|
younger patients with organ-confined disease and a life expectancy greater than 10 years
|
|
treatment of diffuse large B cell lymphoma
|
R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone) x six cycles, high-dose chemotherapy and autologous HSCT for recurrent
|
|
Treatment of newly diagnosed acute lymphoblastic leukemia.
|
induction chemo with daunorubicin, vincristine, L-asparaginase, prednisone
|
|
BCR-ABL inhibitor used for the treatment of chronic myeloid leukemia
|
imatinib
|
|
Anticoagulants approved for the treatment of HIT
|
argatroban + lepirudin (direct thrombin inhibitors) and danaparoid (heparinoid)
|
|
Pulmo nodule vs lung mass
|
pulmo NODULE = nodule up to 3 cm diameter surrounded by normal lung and no LAD vs. MASS = >3 cm
|
|
when should lung nodules be followed?
|
low risk </=4mm, follow-up not required; highi risk <4mm, follow up in 1 year. low-risk (never smokers, no first-degree relative with lung cancer, or significant radon or asbestos exposure); high-risk (smoking history, environmental exposure)
|
|
treatment of CUPS in woman with axillary LAD
|
axillary LAD without other findings = treat as stage II breast cancer
|
|
the only malignancy in which removing the primary tumor in the setting of metastatic disease can improve overall outcome rather than just reduce local symptoms.
|
Kidney cancer
|
|
diagnosis of multiple myeloma
|
bone marrow biopsy showing 10% or more clonal plasma cells
|
|
diagnosis of symptomatic myeloma
|
requires evidence of end-organ damage (hypercalcemia, kidney dysfunction, anemia, and/or bone disease) related to myeloma
|
|
greatest reduction in cancer risk for patients who are (+) for BRCA
|
bilateral salphingo-oophorectomy and bilateral mastectomy
|
|
chronic myeloproliferative disorder characterized by overproduction of megakaryocytes and bone marrow stromal cell-mediated collagen deposition
|
primary myelofibrosis
|
|
high risk features of primary myelofibrosis
|
age >65; fever, night sweats, and weight loss >/=10%; Hb <10 g/dL (100 g/L);WBC > 25,000/µL (25 × 109/L); and circulating blasts of >/=1%
|
|
what is SEVERE aplastic anemia?
|
>/=2 of: ANC 200 to 500/µL, Plt <20,000/µL, and retic <0.2%
|
|
VERY SEVERE aplastic anemia
|
ANC <200/µL
|
|
aplastic anemia in young man occurs after viral infection. which viral infections can cause this?
|
EBV, CMV
|
|
define limited stage SCLC
|
disease limited to one hemithorax, with hilar and mediastinal LAD that can be encompassed within one radiotherapy portal.
|
|
treatment of SCLC
|
limited stage - RT and chemo; extensive - chemo only
|
|
patient on tamoxifen develops menopausal symptoms - what is your treatment?
|
venlafaxine
|
|
What is retinoic acid syndrome?
|
In APL patients who receive ATRA, 25% develope syndrome of fever, hypotension, dyspnea, peripheral edema, weight gain, AKI due to ATRA-induced differentiation; MECHANISM is due to release of cytokines from promyelocytes leading to capillary leak
|
|
manifestations of tumor lysis syndrome
|
hyperkalemia, hyperuricemia, hyperphosphatemia, hypocalcemia, AKI, DIC
|
|
how to treat a pregnant patient with DVT?
|
LMWH throughout pregnancy + 6 weeks after delivery
|
|
4 side effects of Tamoxifen
|
VTE, endometrial cancer, hot flushes, cataracts.
|
|
warfarin reversal for life-threatening bleeding (2)
|
vitamin K, 10 mg IV over 1 hour, plus prothrombin complex concentrate (PCC)
|
|
what is prothrombin complex concentrate (PCC)?
|
lyophilized plasma products that contain each of the vitamin K-dependent coagulation factors
|
|
associated with increased RDW
|
iron, folate, or vitamin B12 deficienty
|
|
treatment of head and neck cancer in general
|
locoregionally advanced (stages III and IVA and IVB without mets) combination of radiation, chemo and surgery. early-stage (stages I and II) head and neck cancer receive surgery or radiation with curative intent
|
|
when is iron chelation indicated in beta thalassemia?
|
high ferritin and transferrin saturation, even without SSx of iron overload
|
|
what are bite cells?
|
cells with eccentrically located hemoglobin confined to one side of the cell seen in g6pd
|
|
differentiate WAIHA from cold agglutinin disease
|
direct Coombs (antiglobulin) test is frequently strongly positive for IgG and negative or weakly positive for complement in WAIHA,
|
|
diagnostic test to establish PNH
|
cytometric analysis for CD55 and CD59
|
|
how to prevent DVT in pregnant?
|
LMWH
|
|
how to prevent DVT in pregnant with APAS?
|
LMWH or UFH + ASA
|
|
rare NMJ transmission disorder caused by antibodies directed against presynaptic voltage-gated P/Q-type calcium channels
|
Lambert-Eaton myasthenic syndrome
|
|
how to diagnose Lambert-Eaton myasthenic syndrome
|
EMG and assays for P/Q-type calcium channel antibodies
|
|
differentiate cobalamin from folate deficiency
|
cobalamin deficiency presents with neuro symptoms + elevated MMA and homocysteine; folate does not have neuro symptoms
|
|
findings in smear of MDS
|
leukoerythroblastic picture, nucleated RBCs and a left shift in WBC; megathrombocytes, teardrop cells
|
|
treatment for acquired hemophilia with severe bleeding
|
rFVIIa
|
|
treatment for DIC with severe bleeding
|
FFP and CP
|
|
what is the pathophysiology of TRALI?
|
caused by antileukocyte antibodies in the donor blood product directed against recipient leukocytes, which then sequester in the lungs, usually during or within 6 hours of a transfusion
|
|
etiology of acute hemolytic transfusion reaction
|
most commonly caused by a clerical error leading to ABO incompatibility. hypotension and DIC develop very early in the transfusion
|
|
surveillance for stage III colon cancer, post op and adjuvant chemo
|
PE + CEA q 3-6m; CT chest, abd, pelv q1y for 3-5y; colonoscopy 1y after resection the q3-5y
|
|
when is exchange transfusion or RBC transfusion indicated in sickle cell disease?
|
acute management of stroke and acute chest syndrome.
|
|
most common forms of cutaneous T-cell non-Hodgkin lymphoma.
|
Mycosis fungoides (affects skin) and Sézary syndrome (affects skin and blood)
|
|
treatment for progressing mycosis fungoides/Sézary syndrome.
|
alemtuzumab (anti-CD52)
|
|
What is the Mentzer index?
|
MCV/RBC; <13 = β-thalassemia.
|
|
treatment of High-risk, early-stage lesions bladder cancer
|
BCG immunotherapy (intravesicular)
|