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Difference between IgG and IgM reponse
IgG- Secondary response. Creates larger titers, is faster and more effective than primary.
IgM: Primary reponse, low titers, slow response and short lasting.
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What is an ELISA test?
An enzyme-linked immunosorbent assay, also called ELISA or EIA, is a test that detects and measures antibodies in your blood. This test can be used to determine if you have antibodies related to certain infectious conditions.
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For management of HIT, what class of drugs should be substituted as alternative forms of anticoagulation?
Direct thrombin inhibitors
- Danaparoid
- Argatroban 2mcg/kg/min (PTT 1.5-3)
- Bivalirudin (Angiomax)
- Fondaparinus
- Transition to warfarin when:
- overlap with warfarin for INR goal
- Plt is over 150
- start 5 mg and target 2.0-3.0 INR
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Main cause of DIC?
Infection - 10-20% Gram negative sepsis
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What is the most sensitive lab test for DIC?
- D- dimer
- sensitivity: is the ability of a test to correctly identify those with the disease (true positive rate)
- i.e. the percentage of sick people who are correctly identified as having the condition
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Which leukemia is known for pancytopenia with circulating blasts? Constitutes 80% of child leukemias
Acute lymphocytic leukemia
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The hallmark of this leukemia is pancytopenia with circulating blasts but granules are visible and there is the presensce of Auer rods. Bone tenderness to sternum and tibia.
Acute myeloid leukemia
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Abnormal B lymphocyte and generalized lymphadenopathy characterize this leukemia. It is the most common in older adults.
Chronic lymphocytic leukemia
- *lymphocytosis
- *hypogammaglobulinemia
- *watchful waiting
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This leukemia is characterized by myeloid cell overproduction and distiguished by the presnce of Philadelphia chromosome and fusion gene BCR/ABL protein.
Chronic myelogenous leukemia
- *ionizing radiation exposure risk
- *WBC elevation
- *increased LDH and uric acid
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What class is imatinib in?
What toxicities does it have?
tyrosine kinase inhibitor
increased lfts, fluid retention, muscle cramping, skin rash, prolong QT, pulmonary HTN, or diarrhea
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This is classified from 90% of cases having painless, nontender cervical lymphadenopathy.
Hodgkin Lymphoma
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Anergic skin reactions such as one being + TB test no - can happen with this disease
Hodgkin lymph
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What are the most important prognostic factors in Hodgkin lymphoma?
tumor bulk and stage
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What are the signs of superior vena caval obstruction/syndrome?
- cyanosis
- engorgement of neck veins
- lack of lulsations
- enlarged neck circumference
- pericardial disease
- tamponade
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Squamous cell carcinoma lesions of the lung is found:
- Central lesions
- cavitation
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Small cell carcinoma (SCC) lesions of the lung only are found
central
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Peripheral lung cancer lesions are from:
- adenocarcinoma
- large cell carcinoma
- bronchoalveolar cell carcinoma
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Chemo agents used for small cell carcinoma (SCC) of the lungs in limited stage.
Extensive stage?
cisplatin or carboplatin regimen with etoposide or irinotecan
carboplatin or cisplatin and etoposide
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Screening tests beginning at age 50 for colorectal cancer:
- Fecal occult blood testing (FOBT)
- digital rectal examination (DRE)
- flexible sigmoidoscopy
- colonoscopy
- double contrast barium enema
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Genetic mutations associated with breast CA are?
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Which herbs or medications can alter prostate-specific antigen, making it lower and giving false neg?
- finasteride (Proscar)
- androgen-receptor blocker
- saw palmetto
- PC-SPES
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What is the age specific ranges for normal PSA?
- 40s- <2.5 ng/ml
- 50s- <3.5
- 60s- <4.5
- 70s- <6.5
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What is the first line therapy for regional or metastatic prostate cancer?
- Chemo- docetaxel
- abiraterone acetate with prednisone or enzalutamid
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Reduced levels of serum carotene and serume retional are seen in patients with what form of cancer?
Bladder
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common opportunistic infections with AIDS
- Pneumocystis jiroveci
- cryptosporidium parvum
- candida albicans
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After exposure to the HIV virus, how long will it take before it is detected in an ELISA test?
3 weeks to 6 months
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If ELISA is positive for HIV, what is the next confirmatory test?
- Western blot
- screens for antibodies against HIV
HIV DNA may be checked by polymerase chair reaction
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What is the combination regimen for PrEP and who should take it?
Tenofovir 300mg and Emtricitabine 200 mg/day
sexually active men, adult injection drug users, partners of HIV
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Prophylaxis against Pneumocystis jiroveci with CD4 counts <200 with HIV?
- Trimethobrim-sulfamethoxazole Bactrim DS
- or
- aerosolized pentamidine 200 neb
- >300 Cd4 counts for over 3 months you can stop ppx
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Fo mycobacterium avium prophylaxis in HIV with CD4 counts <50 give
azithromycin 1200 mg weekly
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