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[h] Hematology & Oncology System Flashcards

[i] Master this session in just 5 minutes.

[q] …… inhibits epoxide reductase which interferes with γ-carboxylation of vitamin K-dependent clotting factors II, VII, IX, and X, and proteins C and S.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFdhcmZhcmluLg==[Qq]

[q] – The target INR for therapeutic warfarin anticoagulation is ….

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDItMy4=[Qq]

[q] What is the most likely diagnosis?

45 years old patient on warfarin as anticoagulant for treatment of DVT presenting with intracranial hemorrhage, he was using omeprazole for treatment of GERD for along time.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERydWctZHJ1ZyBpbnRlcmFjdGlvbiBiZXR3ZWVuIHdhcmZhcmluIGFuZCBvbWVwcmF6b2xlIChDWVAgNDUwIGluaGliaXRvciku

[q] For reversal of warfarin, we give ……..

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHZpdGFtaW4gSyBhbmQgRm9yIHJhcGlkIHJldmVyc2FsLCB3ZSBnaXZlIGZyZXNoIGZyb3plbiBwbGFzbWEgdW50aWwgdml0YW1pbiBrIHN0YXJ0IHRvIHdvcmtzLg==[Qq]

[q] ……. enhances the activity of antithrombin → Lowers the activity of thrombin and factor Xa.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhlcGFyaW4u[Qq]

[q] …….. has equal activity against Factor Xa and thrombin, while ….. has greater activity against Factor Xa than thrombin.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFVuZnJhY3Rpb25hdGVkIGhlcGFyaW4sIExNV0gu

JiM4MjExOyBPbmx5IHVuZnJhY3Rpb25hdGVkIGhlcGFyaW4gKG5vdCBMTVdIKSBoYXMgYSBwZW50YXNhY2NoYXJpZGUgY2hhaW4gbG9uZyBlbm91Z2ggKCZndDsxOCBzYWNjaGFyaWRlIHVuaXRzKSB0byBiaW5kIHRvIGJvdGggYW50aXRocm9tYmluIGFuZCB0aHJvbWJpbi4gQXMgYSByZXN1bHQsIHVuZnJhY3Rpb25hdGVkIGhlcGFyaW4gaGFzIGVxdWFsIGFjdGl2aXR5IGFnYWluc3QgRmFjdG9yIFhhIGFuZCB0aHJvbWJpbiwgd2hpbGUgTE1XSCBoYXMgZ3JlYXRlciBhY3Rpdml0eSBhZ2FpbnN0IEZhY3RvciBYYSB0aGFuIHRocm9tYmluLg==

[q] What is the most likely diagnosis?

Patient who was on heparin as anticoagulant for long time present with thrombosis although low platelet count?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhlcGFyaW4taW5kdWNlZCB0aHJvbWJvY3l0b3BlbmlhIChISVQpLg==

RGV2ZWxvcG1lbnQgb2YgSWdHIGFudGlib2RpZXMgYWdhaW5zdCBoZXBhcmluLWJvdW5kIHBsYXRlbGV0IGZhY3RvciA0IChQRjQpLiBBbnRpYm9keS1oZXBhcmluLVBGNCBjb21wbGV4IGFjdGl2YXRlcyBwbGF0ZWxldHMgJiM4MjExOyZndDsgdGhyb21ib3NpcyBhbmQgdGhyb21ib2N5dG9wZW5pYS4=

[Qq]

[q] Antidote of heparin is ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByb3RhbWluZSBzdWxmYXRlIGlzIGEgcGVwdGlkZSB0aGF0IGJpbmRzIHRvIGhlcGFyaW4gZm9ybWluZyBhIGNvbXBsZXggdGhhdCBoYXMgbm8gYW50aWNvYWd1bGFudCBhY3Rpdml0eSAoY2hlbWljYWwgaW5hY3RpdmF0aW9uKS4=

[q] ….. is a form of low molecular weight heparin that, like heparin, functions by binding and activating antithrombin III.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEVub3hhcGFyaW4sIGRhbHRlcGFyaW4u[Qq]

[q] Low molecular weight heparin is more widely used than unfractionated heparin. Why?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

TE1XSCBoYXZlIGJldHRlciBiaW9hdmFpbGFiaWxpdHksIGFuZCAyLTQgdGltZXMgbG9uZ2VyIGhhbGYtbGlmZTsgY2FuIGJlIGFkbWluaXN0ZXJlZCBzdWJjdXRhbmVvdXNseSBhbmQgd2l0aG91dCBsYWJvcmF0b3J5IG1vbml0b3Jpbmcu

74KnIE9jY3VycmVuY2Ugb2YgaGVwYXJpbi0gaW5kdWNlZCB0aHJvbWJvY3l0b3BlbmlhIChISVQpIGlzIG11Y2ggbW9yZSBjb21tb24gd2l0aCB0aGUgdXNlIG9mIHVuZnJhY3Rpb25hdGVkIGhlcGFyaW4gY29tcGFyZWQgdG8gbG93IG1vbGVjdWxhciB3ZWlnaHQgaGVwYXJpbi4=

Enoxaparin has been shown to cause a statistically significant reduction in death and recurrent myocardial infarction when used in the acute treatment of myocardial infarction as compared with unfractionated heparin (ESSENCE, TIMM 1 trials).

[q] Upon clinical suspicion of HIT, the most important initial step in treatment is to stop ……. and give ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN0b3AgYWxsIGZvcm1zIG9mIGhlcGFyaW4sIERpcmVjdCB0aHJvbWJpbiBpbmhpYml0b3JzIChoaXJ1ZGluLCBsZXBpcnVkaW4gYW5kIGFyZ2F0cm9iYW4sIGRhYmlnYXRyYW4pIGRvIG5vdCByZXF1aXJlIGFudGl0aHJvbWJpbi1sbGwgZm9yIHRoZWlyIGFjdGlvbiBhbmQgYXJlIGRydWdzIG9mIGNob2ljZSBpbiB0aGUgdHJlYXRtZW50IG9mIEhJVC4=[Qq]

[q] The mainstay of DVT treatment in pregnancy is ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGhlcGFyaW4gKENvdW1hZGluIGlzIG5vdCB1c2VkIGJlY2F1c2UgaXQgaXMgdGVyYXRvZ2VuaWMpLg==[Qq]

[q] …… directly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots. ↑ PT, ↑ PTT, no change in platelet count.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRocm9tYm9seXRpY3MgKEFsdGVwbGFzZSAodFBBKSwgcmV0ZXBsYXNlIChyUEEpLCB0ZW5lY3RlcGxhc2UgKFROSy10UEEpLCBzdHJlcHRva2luYXNlKS4=[Qq]

[q] We treat Thrombolytics toxicity with ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGFtaW5vY2Fwcm9pYyBhY2lkIGFuZCB0cmFuZXhlbWljIGFjaWQgKGFudGktZmlicmlub2x5dGljcyku

[q] ….. inhibit platelet aggregation by blocking P2Y12 receptors → Prevent expression of glycoproteins IIb/IIIa on platelet surface?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFEUCByZWNlcHRvciBpbmhpYml0b3JzLiBDbG9waWRvZ3JlbCwgcHJhc3VncmVsLCB0aWNhZ3JlbG9yIChyZXZlcnNpYmxlKSwgdGljbG9waWRpbmUgKGlycmV2ZXJzaWJsZSku[Qq]

[q] In patients with an aspirin allergy, aspirin can cause bronchoconstriction with shortness of breath and wheezing. In such patients, the best alternative antiplatelet agent is ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENsb3BpZG9ncmVsLg==[Qq]

[q] – Ticlopidine is rarely used due to the occurrence of serious side effects. ……. is seen in about 1 percent of patients on ticlopidine and typically presents with fever and mouth ulcers

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE5ldXRyb3BlbmlhLiBUaG91Z2ggdGhpcyBpcyByYXJlLCBpdCBpcyBhIHNlcmlvdXMgY29tcGxpY2F0aW9uIGFuZCBjb21wbGV0ZSBibG9vZCBjb3VudCBzaG91bGQgYmUgbW9uaXRvcmVkIGJpd2Vla2x5IGZvciB0aGUgZmlyc3QgdGhyZWUgbW9udGhzLg==[Qq]

[q] ……. bind to the glycoprotein receptor IIb/IIIa (fibrinogen receptor) on activated platelets, preventing aggregation.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdseWNvcHJvdGVpbiBJSWIvSUlJYSBpbmhpYml0b3JzIChBYmNpeGltYWIsIGVwdGlmaWJhdGlkZSwgdGlyb2ZpYmFuKS4=[Qq]

[q] …….. is a Phosphodiesterase III inhibitor → ↑ cAMP in platelets → resulting in inhibition of platelet aggregation; vasodilators.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENpbG9zdGF6b2wsIGRpcHlyaWRhbW9sZS4=[Qq]

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