hematology + oncology review and explanations

which medication has a contraindication of intrathecal administration?

vincristine (vinca alkaloids)

which medication acts on integration...?

-integra-

which medication acts on TPO receptors?

-trombopag

which medication increases fetal hemoglobin?

Hydroxyurea

which disease can myelodysplastic anemia progress to?

AML

which medication regimen is used for PrEP?

Emtricitabine/Tenofovir DISOPROXIL fumarate

who should get education about HIV PrEP prophylaxis?

all sexually active adults and adolescents or people who have a partner that is HIV +

which medication can cause pulmonary fibrosis?

bleomycin

which medication can cause cardiotoxicity?

doxorubicin

who needs to get HIV screening?

one-time screening for ages 13-64

which medication is an antimetabolite that works in the S phase?

5-Fluorouracil

Patient has TCP after heparin use (HIT). What is their treatment?

Discontinue heparin and start argatroban

What CD4 count should you start treatment for pneumocytitis?

200

Which of the following starts the extrinsic pathway?

Tissue factor

Patient has swelling in face/neck (sx of SVCS). What is the condition that could be causing this?

Small cell lung cancer

Patient has back pain, worse laying down, what should be given prior?

IV steroids

Patient has elevated hypercalcemia 14.5, what is the management?

Bisphosphonates

Patient has hyperuricemia, hyperphosphatemia hyperkalemia, hypocalcemia?

Tumor lysis syndrome

What is the testing for dx HIV?

antigen/antibody (4th gen)

Patient has bone lytic lesions (MM), what is the confirmatory test?

SPEP + IFE

Patient has follicular lymphoma, what is the tx?

Observation

What is the confirmatory test for pt w/ painless neck mass and gets worse drinking etoh?

Excisional lymph node biopsy

Patient gets itchy after taking shower, what is the dx?

Polycythemia vera

Patient has trali, what is the cause?

Caused by anti-HLA or antigranulocyte antibodies

Patient has TACO, how to prevent something?

Transfuse by 4 hours

Patient has dyspnea, fever, chills, facial flushing, lumbar area pain)?

Acute hemolytic transfusion reaction

Patient has sx of sickle cell crisis, whats the next best step?

CT of head

Patient has elevated methylmalonic acid, what is tx?

IM B12 injections

Patient has nail spooning and lip swelling, what would you expect to see on labs?

Decreased ferritin

Patient has low hemoglobin, RBCs, WBCs, and platelets. What is most likely the diagnosis?

Aplastic anemia

Labs are shown with microcytic, hyperchromic RBCs. What would you see on a blood smear?

Spherocytes

Patient has bite cells shown on their smear (G6PD deficiency). They are taking dapsone and a med that starts with a R for leprosy. What do you do?

Discontinue dapsone

patient has a rapid growing mass and histology shows "starry sky", what genetic mutation is associated with this?

MYC gene

What patient education would you give someone with hemophilia A?

Avoid NSAIDs

Patient is having dark urine only in the mornings?

Paroxysmal nocturnal hemoglobinuria

Pt is having hemolytic anemia sx and coombs test is positive for IgG and C3. What is it?

Warm autoimmune hemolytic anemia

Pt is also having sx and coombs test is positive. What education would you give?

Avoid cold temps

Patho of MAHA?

Microthrombi causing small vessel damage/stress to RBCs (schistocytes)

Patient has an isolated DVT (leg swelling) and states this has happened before and has family hx of clotting. What is diagnosis?

Factor V lieden

Patient has hodgkin symptoms. What do you see on smear?

Reed sternberg

Patient has spikes of F and A2?

Beta-thalassemia

Patient has bronze skin, basophilic stippling?

Chelation therapy

What factor could the patient be deficient in?

Factor 9

Patient has thrombocytosis, what mutation? Didn't he get itchy in the shower?

JAK2

Patient has prolonged bleeding? What condition?

Von willebrand disease

Patient takes warfarin and gets skin necrosis. What deficiency would they have?

Protein C

A 5 year old is having diffuse purpura that has black eschar in some locations. Prolonged PT and aPTT. Decreased fibronegen. What do they have?

Congenital protein c deficiency

What lab value measures anisocytosis?

RDW

Patient's platelets are low but have no symptoms. Smear present with platelet clumping. What is diagnosis?

EDTA pseudothrombopenia

Patient has had a recent viral infection and labs only show thrombocytopenia?

Immune thrombocytopenia

Patient presents with fever, abnormal creatinine, TCP, anemia, and confusion.

What does she have? TTP

Picture of livedo riticularis (blue colored on legs). What is associated with it?

Cold agglutination

What is associated with mutation of chromosome 9 and 22?

CML (philadelphia chromosome)

*pic of blood smear* Question describing what it does/patho of it:

I think this a reticulocyte: increased red blood cells

Patient with HIT and then determining how long the treatment of DTI will help bring the platelets back?

4-10 days

What is present on a blood smear of AML?

Auer rods

which medication should you be cautious for with sulfa allergy?

darunivir

what is a side effect of epoetin to monitor for?

Thromboembolism

Patient is having bleeding sx and labs show an increase in lymphocytes?

CLL

Peripheral smear of AML?

Myeloblasts >20

How often should a patient be on PrEP?

28 days

What stimulates neutrophil proliferation and differentiation?

Filgastrim

Best iron supplement for vegan, and less GI discomfort?

ascorbic acid + carbonyl

Patient received prednisone and something else and had not gotten better and they had no active bleeding plt <30k and it was asking for what would be the next step?

rituximab

Patient has hereditary spherocytosis. What is definitive tx?

Splenectomy

Patient has bloody diarrhea and is + for E.coli (HUS). What is tx?

Supportive care and fluids

Patient is having fever, chills, 5 days after a blood transfusion. What would you do?

observe

Pathology of cold agglutination?

Bacteria not visible on gram stain Virus of B-cell lymphocytes

Patient is having spooning of the nails and lip sx. What would you expect on their smear?

Microcytic, hypochromic cells

What test monitors intrinsic factors?

aPTT

What is tested with PT?

(VII, V, II, X)

Patient experiencing hyperleukocytosis (200000 WBC) with suspected AML or ALL, what do you give them?

Hydroxyurea