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88 Cards in this Set

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Rate-limiting enzymes:
Glucose
Phosphofructokinase
Rate-limiting enzymes:
Gluconeogenesis
Fructose-1,6-bisphosphatase
Rate-limiting enzymes:
TCA cycle
Isocirtate dehydrogenase
Rate-limiting enzymes:
Glycogen synthesis
Glycogen synthease
Rate-limiting enzymes:
Glycogenolysis
Glycogen phosphorylase
Characteristics of Type II DM medications:
Lactic acidosis is a rare but worrisome SE
Metformin
Characteristics of Type II DM medications:
Most common SE is hypoglycemia
Sulfonylureas
Characteristics of Type II DM medications:
MOA: closes K+ channel on Beta cells → depolarization → Ca2+ influx → insulin release
Sulfonylureas
Characteristics of Type II DM medications:
MOA: inhibit a-glucosidease at intestinal brush border
a-glucosidase inhibitors
Characteristics of Type II DM medications:
MOA: agonist at PPAR-gamma receptors
Thiazolidinediones (TZDs)
3 mineral compounds to tx esophageal reflux:
-Aluminum hydroxide
-Magnesium hydroxide
-Calcium carbonate
What coag factor is deficient in Hemophilia A
Factor VIII
What coag factor is deficient in Hemophilia B
Factor IX
Clinical deficiency in protein C or protein S?
both anticoagulants, deficiency in anticoagulant → hypercoagulable state, makes too many blood clots
Overdose for Heparin
Protamine Sulfate
Overdose for Warfarin
Fresh frozen plasma and Vitamin K
What do you do with a pt who has HIT (heparin induced thrombocytopenia)?
-Stop heparin
-Anticoagulate c. Lepirudin or Argatroban
Vitamin K dependent clotting factors
Factors II, VII, IX, X, Protein C, and Protein S
Substances eliminated by Zero-order kinetics
“PEA” – Phenytoin, Ethanol, ASA
What enzymes are used to metabolize EtOH
-Ethanol – alcohol dehydrogenase → Acetaldehyde
-Acetaldehyde – Acetaldehyde dehydrogenase → Acetate
What allows RBCs to change shape while passing through vessels
Spectrin
Where does fetal erythropoiesis take place and what bones in adult?
-Fetal: Yolk sac, Liver, Spleen, Bones
-Adult: Vertebrae, Ribs, Pelvis, Sternum, Tibia & femur
Name of immature erythrocytes
Reticulocytes
What enzymes for heme synthesis are inhibited by lead toxicity?
Ferrochelatase and ALA Dehydratase
In addition to colon cancer, what is one of the most common causes of GI bleeding in the elderly?
Angiodysplasia
What is a likely scenario that would lead to a pt being exposed to arsenic?
Living in an arsenic-rich region and ingesting ground water c. arsenic
What test is used to diagnose beta thalassemia minor?
Hemoglobin electrophoresis
Lab values to tell the difference between iron deficiency and thalassemia
Iron deficiency: low serum iron, increased TIBC, low ferritin
Thalassemia: NL iron, NL TIBC, NL ferritin, target cells on blood smear
What diagnosis do you need to r/o in a male >50yrs with new onset iron deficiency anemia?
colon cancer
Microcytic anemia c. swallowing difficulty and glossitis
Plummer-Vinson syndrome
Microcytic anemia and >3.5% HbA2
Beta thalassemia minor
Megaloblastic anemia not correctable by B12 or Folate supplementation
Orotic aciduria
Megaloblastic anemia along c. peripheral neuropathy
B12 deficiency
Microcytic anemia and basophilic stippling
lead poisoning
Microcytic anemia reversible c. B6
Sideroblastic anemia
HIV (+) pt c. macrocytic anemia
Zidovudine
Normocytic anemia + red urine in the morning
paroxysmal nocturnal hemoglobinuria
Normocytic anemia and elevated Creatinine
Chronic kidney disease
What are the causes of Aplastic anemia
Radiation, Benzene, Chloramphenicol, alkylating agent, Anti-metabolites, viruses, fanconi anemia
3 mechanisms that cells use to breakdown proteins
Ubiquitin protein ligase
Lysosomes
Calcium-dependent enzymes
Which HIV medication is known to cause bone marrow suppression?
Zidovudine
What is the treatment for lead poisoning?
Adults: EDTA and succimer
Children: EDTA, succimer, and dimercaprol
A child, anemic since birth, has now been cured with splenectomy. What is the disease?
Hereditary spherocytosis
Finding associated c. hereditary spherocytosis
Anemia and jaundice, pigmented gallstones, splenomegaly, spherocytes on peripheral smear, (+) osmotic fragility test, Coombs’ test (-) (b/c antibodies are not causing the hemolysis)
What 2 protozal diseases that can cause hemolytic anemia
Malaria and Babesiosis
What conditions are associated c. Target Cells?
“HALT”
HbC disease, Asplenia, Liver disease, and Thalassemia
Name given to anemia due to mechanical destruction of erythrocytes due to aortic stenosis or prosthetic heart valve
Macroangiopathic anemia
What is the cause of ITP
Anti-glycoprotein IIb/IIIa antibodies on platelets
What is the defect in Bernard-Soulier disease?
Deficiency in glycoprotein Ib
What is the lifespan of a platelet?
8-10days
What molecule is expressed on the surface of an activated platelet?
Glycoprotein IIb/IIIa
What lab values do you expect to see in DIC?
Increased bleeding time, increased PT and PTT, decreased platelets, increased D-Dimer
MOA Streptokinase
convert plasminogen to plasmin
MOA ASA
Irreversibly inhibits COX-1 and COX-2
MOA Clopidogrel
Blocks ADP receptors
MOA Abciximab
Gp IIb/IIIa inhibitor
MOA Tirofiban
Gp IIB/IIIa inhibitor
MOA Ticlopidine
Blocks ADP receptors
MOA Enoxaparin
LMWH; inhibits factor Xa
MOA Eptifibatide
Gp IIb/IIIa inhibitor
What neoplasms are associated c. AIDS?
Kapossi Sarcoma (HHV-8)
Invasive squamous cell cancer
CNS lymphoma
Non-Hodgkin lymphoma
What is the most common inherited bleed disorder?
von Willebrand Disease
What cancer is associated c. Hashimotot thyroiditis?
Marginal cell lymphoma
-arises outside of lymph nodes and in chronically inflamed tissues
Most common lymphoma in US (and among adults)
Diffuse large B-cell
Reed-Sternberg cells
Hodgkin’s Lymphoma
Particularly associated c. EBV
Burkitt and maybe Hodgkin’s Lymphoma
Associated c. long-term celiac disease
Intestinal T-cell Lymphoma
Lymphoma equivalent of CLL
Small lymphocytic lymphoma
“Starry-sky pattern”
due to phagocytosis of apoptotic tumor cells → Burkitt’s Lymphoma
Associated c. Sjogren’s syndrome, Hashimoto thyroiditis, and H. pylori
Marginal Cell MALToma
Age distribution of Hodgkin’s Lymphoma
Bimodal distribution, ages 20 and 65
Age distribution of Non-Hodgkin’s Lymphoma
Widely variable
Most common type of Non-Hodgkin lymphoma in adults?
Diffuse Large B-Cell
Most common type of Non-Hodgkin lymphoma in children?
Lymphoblastic lymphoma
Pt present c. anemia, bone pain, and hypercalcemia. Bone marrow biopsy demonstrates plasma cells. What is the diagnosis and what will be seen in the urine?
Diagnosis: Multiple Myeloma
Urinalysis: nothing
Urine protein electrophoresis (UPEP): Monoclonal antibody spike
Most common leukemia in children
ALL
Most common leukemia in adults (in US)
CLL
Characteristic Auer Rods
AML (M2 and M3)
More than 20% blasts in marrow
Acute leukemia
Leukemia c. more mature cells and less than 5% blasts
Chronic leukemia
PAS (+) acute leukemia
ALL
Commonly presents c. bone pain
ALL
Numerous basophils, splenomegaly, and negative for LAP
CML
Always positive for the Philadelphia chromosome t(9;22)
CML
Acute leukemia positive for peroxidase
AML
Solid sheets of lymphoblasts in marrow
ALL
PAS (-) acute leukemia
AML
Always associated c. the BCR-ABL genes
CML