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ThePath
Acute Lymphoblastic Leukemia (ALL)
Ages < 15
May Present with Bone Marrow Involvement in Children
Mediastinal Mass in Adolescents
TdT Positive
CALLA Positive
t(12;21) Better Prognosis
Spread to CNS and Testes
Most Responsive to Chemotherapy
2 mins
Acute Myelogenous Leukemia (AML)
Myeloblasts Increase on Peripheral Smear
Median Onset 60 Years
T 15;17 M3 Subtype
Auer Rods
Disseminated Intravascular Coagulation (DIC) is a Common Presentation
M5 Gum Infiltration
Responds to Vitamin A
3 mins
Adult T Cell Lymphoma
Caused by HTLV 1
Japan, West Africa, Caribbean
Present with cutaneous lesions
Aggressive
1 min
Aortic Regurgitation
Auscultation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Considerations
Can Cause Austin Flint Murmur
1 min
Aortic Stenosis
Characteristics
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Syncope
Helmet Cells
2 mins
Bacterial Endocarditis
Signs and Symptoms
Fever
New murmur
Janeway Lesions
Splinter Hemorrhages
Roth spots/round white spots on retina
Osler nodes/tender lesions on finger or toe pads
Anemia
2 mins
Bleomycin
Indications
Testicular Cancer
Hodgkin's Lymphoma
Mechanism of Action
Induces Free Radical Formation
Breaks in DNA Strands
Side Effects
Pulmonary Fibrosis
Skin Changes
Mucositis
1 min
Bronchiectasis
Obstructive Lung Disease
Chronic Necrotizing Infection
Permanent Airway Dilation
Poor Ciliary Motility
Kartagener's Syndrome
Cystic Fibrosis
Allergic Bronchopulmonary Aspergillosis
Hemoptysis
Increased Sputum
2 mins
Burkitt's Lymphoma
Adolescents or young adults
C-myc gene moves next to heavy chain Ig gene
T 8;14
Starry sky appearance
Sheets of lymphocytes with interspersed macrophages
Jaw lesion in endemic (African) form
Pelvis or abdomen in non endemic form (American form)
Associated with EBV
2 mins
Candida Albicans
Fungi
Yeast with Pseudohyphae at 20 Degrees C
Germ Tube Formation at 37 Degrees C
Pruritic Vaginitis
White Cottage Cheese Discharge
Fiery Red Mucosa
Diabetics
Antibiotic Use
Esophageal Thrush in Immunocompromised
Diaper Rash
Endocarditis in IV Drug Users
2 mins
Cardiac Tamponade
Mechanism
Fluid in the Pericardial Sac
Pericarditis
Decreased Cardiac Output
Signs/Symptoms
Beck's Triad
Hypotension
Jugular Venous Distention (JVD)
Distant Heart Sounds
Pulsus Paradoxus
Electrical Alternans
Treatment
Pericardiocentesis
1 min
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
2 mins
Chronic Bronchitis
Pathophysiology
Chronic Inflammation of Bronchi
Signs and Symptoms
Early-Onset Cyanosis
Blue Bloaters
Productive Cough
Wheezing
Chronic Obstructive Pulmonary Disease (COPD)
Late-Onset Dyspnea
Crackles
Diagnosis
Reid Index > 50%
2 mins
Chronic Lymphocytic Leukemia (CLL)
Signs and Symptoms
Age > 60 Years
B Cell Neoplasm
Smudge Cells
Often Asymptomatic
Cold IgM Autoimmune Hemolytic Anemia
Warm IgG Autoimmune Hemolytic Anemia
Richter's Transformation
3 mins
Chronic Myelogenous Leukemia (CML)
Pathophysiology
BCR-ABL
9;22 Translocation
Philadelphia Chromosome
Signs & Symptoms
Tyrosine Kinase
Low Alkaline Phosphatase
Splenomegaly
Considerations
Blast Crisis
Age 30 to 90 Years
Responds to Imatinib
3 mins
Class I Antiarrhythmics (Na+ Channel Blockers) Overview
Indications
Arrhythmias
Local Anesthesia
Mechanism of Action
Block or Slow Conduction
Block Na+ Channels
Raise Threshold
State Dependent
Contraindication
Hyperkalemia
1 min
Class IA Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP, ERP, and QT interval.
Drugs
Disopyramide
Procainamide
Drug-induced Lupus
Quinidine
Cinchonism
Shared Side Effects
Thrombocytopenia
Torsades de Pointes
1 min
Class IB Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
After Myocardial Infarction
Mechanism of Action
Affect Ischemic Tissue
Decrease AP duration
Drugs
Mexiletine
GI Upset
Lidocaine
CNS Depression
Tocainide
Phenytoin
Hirsutism
2 mins
Class IC Antiarrhythmics (Na+ Channel Blockers)
Indications
Used as Last Resort
V-Tach
Mechanism of Action
No Effect on AP Duration
Drugs
Propafenone
Flecainide
Contraindications
Post-Myocardial Infarction
56 secs
Class III Antiarrhythmics (K+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP Duration, ERP, and QT Interval
Drug Names
Amiodarone
Check Function Tests
Dirty Drug
Ibutilide
Dofetilide
Sotalol
Beta-Blocker
2 mins
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