Heme-Onc (TQ)

buxapine's version from 2018-02-08 04:34

Leukemic Translocations

Question Answer
t(9;22)CML (bcr-abl hybrid) (Philadelphia CreaML cheese)
ALL - worse prognosis
t(8;14)Burkitt lymphoma (c-myc activation) (8 looks like a B)
- c-myc = Transcription factor
t(11;14)Mantle cell lymphoma (cyclin D1 activation) (Three 1's = D1)
t(14;18)Follicular lymphomas (bcl-2 activation) (Four-licular)
t(15;17)APML (M3 type of AML) = responsive to all-trans retinoic acid
- both are ODD numbers
tdt+ALL (only on lymphoblasts)
- a DNA polymerase (marker of pre-T and pre-B cells)
CD5+CLL (co-express with CD20)
- CD5 is normally a marker for T cells
MPO+AML (Auer Rods)
Jak2KMyeloproliferative disorders
- JAK2 is a non-receptor tyrosine kinase
Down SyndromeAML (<5y), ALL (>5y)
CD15+/CD30+RS Cells in Hodgkins's

Leukemia Associations

Question Answer
Exisional biopsyLymphomas
Rituximabanti-CD20 (B cells) for NHL, CLL
Marked leukocytosisCML
Auer Rods, DICM3 AML
Teardrop RBCsMyelofibrosis
RashAdult TLL
Smudge cellsCLL
CRABMultiple myeloma
Tennis racketLangerhan's histiocytes
Cerebriform nucleiMycosis fungoides (Sezary) (malignant T cells)
Clock face nuclei, RoleauxMultiple Myeloma
Bence Jones proteinMultiple Myeloma
TRAP+Hair cell leukemia (mature B cells)
Chronic inflammatory stateMarginal zne
Starry skyBurkitt
Hyperviscosity, CNS and visionWaldenstrom's
Owl eye nucleiRS cells in HL
Lacunar cellsRS cells in Nodular HL
Increased ESRHL bad prognosis
Increased LDHNHL bad prognosis
can progress to DLBCLCLL (Richter)
cladribineHairy cell leukemia (an adenosine analog, resistant to adenosine deaminase degradation)

Vascular HY

Question Answer
Assc with eosinophiliaChurg Strauss
DDX kawasakiviral ifxn
Kawasaki mnemonicImagine a patient riding a Kawasaki motorcycle (rash on their palm and soles) and increased heart rate due to excitement (involvement of coronary)
Associated with *serum HBsAgPolyarteritis Nodosa
Arteriogram: Innumerable microaneurysms and spasm on arteriogram.Polyarteritis Nodosa
"String of pearls" appearance on imagingPolyarteritis Nodosa
- due to varying stages of lesions w/ fibrosis
elevated ESRTakayasu and Temporal arteritis
Assc with polymyalgia rheumatica.Temporal (Giant Cell) Arteritis
Can lead to blindness without txTemporal arteritis
“Pulseless disease”Takayasu
Spares lungsPolyarteritis nodosa
Transmural inflammation of the arterial wall
with fibrinoid necrosis
Polyarteritis nodosa
May present with asthma and peripheral neuropathyChurg-Strauss syndrome
Forms granulomas (4)Temporal (giant cell) arteritis
Takayasu arteritis
Wegener Granulomatosis
Churg-Strauss Syndrome
Necrotizing (4)Wegener Granulomatosis
Churg-Strauss Syndrome
Polyarteritis Nodosa
Buerger Disease (thromboangiitis obliterans)
Affects only carotidsTemporal Giant Cell arteritis
Affects aortic archTakayasu Arteritis
Asian females < 40 years oldTakayasu Arteritis (asians have asian naming vasculitis)
Has it all (necrotizing, granuloma, and eosinophilia)Churg Strauss

Vascular tumors

Question Answer
Strawberry hemangioma Benign capillary hemangioma of infancy. Appears in first few weeks of life (1/200 births); grows rapidly and regresses spontaneously at 5–8 years old.
Cherry hemangiomaBenign capillary hemangioma of the elderly . Does not regress. Frequency ↑  with age.
Pyogenic granulomaPolypoid capillary hemangioma that can ulcerate and bleed. Associated with trauma and pregnancy.
Cystic hygromaCavernous lymphangioma of the neck. Associated with Turner syndrome.
Glomus tumorBenign, painful, red-blue tumor under fingernails. Arises from modified smooth muscle cells of glomus body.
Bacillary angiomatosisBenign capillary skin papules found in AIDS patients. Caused by Bartonella henselae infections. Frequently mistaken for Kaposi sarcoma.
AngiosarcomaRare blood vessel malignancy typically occurring in the head, neck, and breast areas. Usually in elderly, on sun-exposed areas. Associated with radiation therapy and arsenic exposure. Very aggressive and difficult to resect due to delay in diagnosis.
LymphangiosarcomaLymphatic malignancy associated with persistent lymphedema (e.g., post–radical mastectomy).
Kaposi sarcomaEndothelial malignancy most commonly of the skin, but also mouth, GI tract, and respiratory tract. Associated with HHV-8 and HIV. Frequently mistaken for bacillary angiomatosis

Vascular Tumor HY

Question Answer
Hemangioma of adult vs kids. Which one regress?kids = strawberry --. will regress
elderly = cherry
Associated with trauma and pregnancy.Pyogenic granuloma
Assc w/ turnerCystic hygroma
Arises from modified smooth muscle cellsGlomus tumor
- from glomus body (underneath finger nails)
Bartonella henselae infectionsBacillary angiomatosis
Associated with radiation therapy and arsenic exposure and vinyl chloride.Angiosarcoma
- usually hepatic
persistent lymphedema (e.g., post–radical mastectomy).Lymphangiosarcoma
DDX Kapsi sarcomaBacillary angiomatosis (from Bartonella)
Frequency ↑  with agecherry hemangioma
Assc w/ AIDS patients (2)Bacillary angiomatosis and Kaposi sarcoma


Question Answer
Main tox of C perfrigensLecithinase
- breaks down phospholipids
Streptokinase? What organismtPA (activates plasminogen)
- S. pyogenes
Vascular response to intimal injury?Intimal thickening and fibrosis
- Migration of medial smooth muscle cells into intima, followed by SMC proliferation and collagen synthesis (reactive intimal hyperplasia)
CK indicates?membrane daage
Clue cellsBacterial vaginosis
- most commonly gardnerella
Type 1 hypersensitivity mediators (3)IgE on presensitized mast cells and basophils
nitroprusside tox?cyanide
- treat with sulfur (thiolsulfate)
Seronegative spondylarthropatiesHLA-B27 association (gene that codes MHC Class 1)
-INCLUDES Reactive arthritis
Antiphospholipid syndrome
stains nuclear basic proteinsanti-ANA
Medial inflammation of a large vessel is?Arteritis
Intimal tear associated withAortic dissection
AAA assc withAtherosclerosis
TNF-alpha therapy may cause?TB latent reactivation
- ieinfliximab, etanercept, adalimumab
What must be done between using TNF-alpha therapy?PPD to screen laten TB
niacin SE?hyperuricemia
cystic medial degeneration can cause?aortic dissection/aneurysm
- assc with marfan's
Congenital hypothyrodismFeed poorly
Muscle hypotonia
pale, cool dry skin
coarse facial features/umbilical hernia
Osler-Weber-Rendu syndrome aka
Flushing associated with niacin mediated by? Tx?mediated by prostaglandins
Vancomycin induced redman syndrome via?Histamine release (NOT prostaglandins)
MOA capsaicinDecreasing Substance P in PNS
Uremia effect on platelet- BOTH platelet adhesion and aggregation are impaired.
definitive diagnosis for EBVDefinitive diagnosis is made by serologic testing for the EBV viral capsid antigen.
Produces platelet-derived growth factor (PDGF)Myelofibrosis (from megakaryocytes)