Anemias
On peripheral blood smear, a patient's RBCs appear hypochromic, with the presence of elliptocytes, likely indicative of this condition.
What is iron deficiency anemia?
TTP is the result of a deficiency in an enzyme coded by this gene.
What is ADAMTS13?
Turning MacConkey agar this color means the bug ferments the lactose.
What is pink?
A patient with multiple myeloma should be immunized against the following organism.
A. Streptococcus pneumonia
B. Hepatic C virus
C. Listeria mon cytogenetic
D. Epstein Barr virus
What is A. Streptococcus pneumonia?
This type of Anticoagulant drug is indicated for pregnant patients.
A. Warfarin
B. Unfractionated heparin
C. Low Molecular weight heparin
D. Dabigitran
What is C. LMWH?
A 7-year-old boy is brought to the physician for a follow-up examination after the removal of a tooth. During the procedure, he had prolonged bleeding that did not resolve with pressure and gauze packing and eventually required suture placement. His older brother had a similar episode a year ago, but his parents and two sisters have never had problems with prolonged bleeding. Physical examination shows no abnormalities. Genetic analysis confirms an X-linked recessive disorder. The patient is likely deficient in this factor.
What is Factor VIII?
Hemarthroses are generally a dead giveaway for these inherited coagulation disorders.
What are Hemophilias A & B?
This is the #1 reason why Hedgehogs will kill you.
What is the "adorable factor"?
JK: What is non-typhoidal Salmonella enterica?
A 48 year old male complains of weakness and general malaise for 2 months. Pt denies any recent illness and does not take any meds. PE reveals pale looking male with no acute distress. HR 110 bpm, hepatosplenomegaly. CBC reveals WBC 62000 CML, Hgb 8.3 g/dl, Hct 24.6%. Diff reveals predominance of mono blasts and promyelocytes with Auer rods present. This is the dx.
A. ALL
B. AML
C. CML
D. CLL
What is B. AML?
This drug is used to treat CML (extra points if you can explain why).
What is TKI - imatinib? In CML there is a t(9:22) causing the formation of the “Philadelphia chromosome” and the mutant BCR-ABL1 fusion gene. This gene encodes a hybrid tyrosine kinase that allows for the increased enzymatic activity that leads to unregulated relief ration of hematopoietic cells.
A 55 year old non smoking male presents with a hemoglobin of 18.5 g/dl and a hematocrit of 56%. This physical examination finding is the most likely to be noted in this patient out of the following:
A. Splenomegaly
B. Cheilosis
C. Purpura
D. Decreased vibratory sense
What is A. splenomegaly?
A 46-year-old man is admitted to the hospital with a 3-day history of productive cough with purulent sputum and fever with chills. On the second day of admission, he develops bloody vomiting, altered mental status, and multiple red spots all over the body. He is oriented only to self. His temperature is 39.3°C (102.7°F), pulse is 110/min, respirations are 26/min, and blood pressure is 86/50 mm Hg. Physical examination shows ecchymoses on both lower extremities. Crackles are heard at the right lung base. Laboratory studies show a platelet count of 45,000/mm3, with a prothrombin time of 44 sec and partial thromboplastin time of 62 sec. D-dimer concentrations are elevated. This is the most likely cause of this patient's ecchymoses.
What is Disseminated Intravascular Coagulation (DIC)?
This bug causes fake appendicitis. (HINT: Her cousins cause bubonic and pneumonic plagues.)
Who is Yersinia enterocolitica?
A 60 year old presents with fatigue and splenomegaly. CBC reveals the following: WBC-24k/microliter, Hgb- 13.5 g/dl, Hct- 40%, MCV - 87 fL. MCHC - 34 g/dL, MCH-28 pg and platelets 380,000 Ml. The differential reveals neutrophils- 11%, lymphocytes-80%, monocytes 8% and basophils 1%. This is the most likely dx.
A. ALL
B. AML
C. CLL
D. CML
What is C. CLL?
This drug class' mechanism of action is to bind to the highly conserved A site of the 16s rRNA and lead to interrupted protein synthesis/death.
What are the aminoglycosides?
An 8 year old presents with splenomegaly. CBC results reveal the following: WBC- 6300/ml, Hgb-10.5 g/dl, Hct- 31%, MCV-31% MCV-87 fL, MCHC-29 g/dl, MCH-28 pg, and platelets - 317k mL. Examination of the RBC morphology reveals 80% spherocytosis. One of the following would be most helpful in confirming the diagnosis.
A. Direct Coombs test
B. Osmotic fragility
C. G-6-PD level
D. Serum ferritin
What is B. Osmotic fragility?
A 44-year-old woman is admitted with a severe nosebleed. She states no hx of trauma, and has never had nosebleeds before. She reports a history of upper respiratory symptoms 1 week ago. CBC comes back with a PLT of 10,000/mm3 and she is given this diagnosis, treated with steroids.
What is ITP?
These three GNRs always cause disease.
Who are Salmonella typhi, Shigella, and Yersinia pestis?
A 29-year-old man comes to the physician because of a 3-month history of fatigue, weight loss, and multiple painless swellings on his neck and axilla. He reports that his swellings become painful after he drinks alcohol. Physical examination shows nontender cervical and axillary lymphadenopathy. A lymph node biopsy specimen shows giant binucleate cells. This is the most likely diagnosis.
A. Hodgkin lymphoma
B. ALL
C. Non-Hodgkins lymphoma
D. CML
What is A. Hodgkin lymphoma?
This antimicrobial quinolone drug has only gram negative activity.
What is cipro?
A 2-year-old boy is brought to the physician for evaluation of pallor and increasing lethargy for 2 days. One week ago, he experienced abdominal pain, vomiting, and bloody diarrhea that have since subsided. The patient's father states that they returned early from a 6-week roadtrip in Mexico because of these symptoms. His parents have been giving him oral rehydration solution. His immunizations are up-to-date. He appears pale. His temperature is 37.4°C (99.3°F), pulse is 105/min, respirations are 30/min, and blood pressure is 95/50 mm Hg. Examination shows scleral icterus. The abdomen is soft and nontender; there is no rebound or guarding. The remainder of the examination shows no abnormalities. Laboratory studies show:
Hgb 8.5 g/dL, MCV 94, Leukocyte 18,000, PLT 45,000, Creatinine 1.9 mg/dL, Indirect Bilirubin 2.4 mg/dL LDH 1658 U/L.
Blood smear shows schistocytes. This is the most likely diagnosis.
What is hemolytic uremic syndrome? (HUS)
Seven days after undergoing bilateral total knee arthroplasty, a 65-year-old man comes to the physician with a dark discoloration and blisters on his abdomen. Current medications include simvastatin, aspirin, and low molecular weight heparin. His vital signs are within normal limits. Examination of the skin shows multiple coalescing blisters with areas of necrosis around the umbilicus. Laboratory studies show a platelet count of 32,000/mm3. This complex is the most likely underlying cause of this patient's symptoms.
What is Heparin-PF4 complex?
2 parter: THIS is the most common STEC bug in North America, infamous for causing THIS terrible triad of acute renal injury (AKI), microangiopathic hemolytic anemia (MAHA), and thrombocytopenia (low PLTs) with bloody diarrhea (also, ADAMTS13 level normal).
Who is E. coli O157:H7 and what is hemolytic uremic syndrome (HUS)?
No Bloody diarrhea? ADAMTS13 <10%? TTP
65-year-old man comes to the physician because of a 6-month history of muscle weakness. During this period, the patient has had low energy, intermittent nosebleeds, and a 5-kg (11-lb) weight loss. He also reports progressive hearing and vision problems. He has a history of pins-and-needles sensation, numbness, and pain in his feet. Vital signs are within normal limits. Physical examination shows a palpable liver tip 2–3 cm below the right costal margin. There is nontender lympadenopathy in the groin, axillae, and neck. A serum protein electrophoresis exhibits a sharp, narrow spike of monoclonal IgM immunoglobulin. Which of the following is the most likely diagnosis?
A. CLL
B. Multiple Myeloma
C. Waldenstrom
D. Mantle Cell lymphoma
What is C. Waldenstrom?
This macrolide has the side effect of peripheral neuropathy.
What is linezolid?