HYPERSENSITIVITY
MULTIPLE MYELOMA
LYMPHOMA
ANAEMIA
ANATOMY
100
What is the basic mechanism behind type I hypersensitivity?
Production of IgE and degranulation of mast cells
100
What does CRAB stand for?
Calcium elevation, Renal insufficiency, Anaemia, Bone lesions
100
What is Rituximab?
Monoclonal antibody against CD20 used for treatment of B cell lymphoma
100
What are some signs/symptoms of iron deficiency anaemia?
General symptoms of anaemia (fatigue, shortness of breath, palpitations, pallor, tachycardia) + glossitis, angular stomatitis, koilonychias, dysphagia, pica.
100
Name the bones of the face.
- Inferior nasal concha (2) - Lacrimal bones (2) - Mandible - Maxilla (2) - Nasal bones (2) - Palatine bones (2) - Vomer - Zygomatic bones (2)
200
Solar keratosis is a precursor to which malignancy?
Squamous Cell Carcinoma
200
What are Bence-Jones proteins?
A monoclonal globulin protein or immunoglobulin light chain found in the urine – suggestive of MM
200
In Burkitts Lymphoma, what are the 'stars' and what makes up the 'sky' on a bone marrow sample?
Sky = Tumour cells - B cells Stars = macrophages
200
Name 3 causes of hereditary haemolytic anaemia.
Inherited RBC defects = Hereditary spherocytosis, elliptocytosis, pyropoikilocytosis Enzyme deficiencies = G6PD deficiency, PK deficiency Abnormal Hb production = Sickle cell anaemia, thalassaemia
200
What are the red pulp and white pulp of the spleen?
White pulp is lymphatic tissue that mainly consists of B-lymphocytes and T-lymphocytes that surround arteries. Red pulp consists of venous sinuses and splenic cords.
300
What mediates type IV hypersensitivity and how long after contact does the reaction occur?
Mediated by T cells and macrophages (antibody independent), and occurs hours to days after contact with antigen.
300
What is an ‘M-spike’?
On serum protein electrophoresis you get a large spike in the gamma region. It represents a high concentration of monoclonal immunoglobulin.
300
What are the four stages in the Ann Arbor staging system?
Stage I = one lymph node site (group) Stage II = more than one group of lymph nodes, but on the same side of the diaphragm Stage III = Lymph node groups on both sides of the diaphragm Stage IV = Extra-nodal involvement (organs etc.)
300
What is the difference between absolute and relative polycythemia? What are some causes of each?
Absolute = increased number of red cells with a normal total plasma volume. E.g. polycythemia vera, high altitude living, cyanotic heart disease Relative = decreased total plasma volume and normal total red cell volume. E.g. prolonged vomiting or diarrhea, excessive use of diuretics, deprivation of water.
300
What are the two parts of the orbicularis oculi, and what is the function of each part?
Palpebral = closes the eye gently Orbital = closes more forcefully - scrunches up the eye
400
How does adrenaline help in anaphylactic shock?
Tightens junctions between endothelial cells, relaxes bronchial smooth muscle and stimulates the heart.
400
What causes renal failure in MM patients?
Renal impairment is caused by the accumulation and precipitation of light chains – obstruction of tubules and toxic to proximal tubules
400
Reed Sternberg cells are CD15+, CD30+ and CD45-. True or false?
True
400
What is the pathophysiology of anaemia of chronic disease?
Increased cytokine release (IL-6) → increased hepcidin →decreased serum iron → decreased RBC production. [Could also be kidney disease, bone marrow infiltration or increased erythrophagocytosis]
400
What bones make up the pterion, and what artery runs behind it?
The frontal, temporal, parietal and greater wing of sphenoid make up the pterion. The middle meningeal artery runs behind it.
500
Name two common bacterial and two common viral infections of the skin?
Bacterial = Impetigo, Erysipelas, Cellulitis Viral = Molluscum contagiosum, Human papillomavirus, Herpes simplex virus
500
What is the mechanism behind bone destruction in MM?
Plasma cells increase production of RANK-L; TNF-B, IL-6 → up-regulation of osteoclasts and these produce factors that promote plasma cell development.
500
What are the main translocations involved in Burkitts and Follicular Lymphoma?
Burkitts = t(8:14) Follicular = t(14:18)
500
What are 2 causes of non-megaloblastic anaemia?
Alcoholism, liver disease, congenital bone marrow failure, reticulocytosis, MDS
500
How many foramina are within the sphenoid bone?
5: Optic canal, superior orbital fissure, foramen ovale, foramen rotundum and foramen spinosum.