Hosam Mohamed-
c
Hematopoiesis occurs in the ________ pathway.
a) lymphoid
b) myeloid
c) both
-
c
Cell contains a bilobed nucleus; stains orange-red or bright red.
a) neutrophils
b) basophils
c) eosinophils
-
b
Cell contains a nucleus with two distinct lobes; stained blue-purple.
a) neutrophils
b) basophils
c) eosinophils
-
a
Cell contains a nucleus with 2-4 lobes connected by thin filaments; light pink or reddish purple.
a) neutrophils
b) basophils
c) eosinophils
-
neutrophils, lymphocytes, monocytes, eosinophils, basophils
Order the Leukocytes in order from Most abundant to least abundant.
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antigen A; antibody-B
What antigens and antibodies are present in a person with A blood type?
-
antigen A & B; no antibodies
What antigens and antibodies are present in a person with AB blood type?
-
no antigens; Anti A- & Anti-B antibodies
What antigens and antibodies are present in a person with O blood type?
-
o-
Who is our universal donor?
-
AB +
Who is our universal recipient?
-
apheresis
the removal of blood plasma from the body by the withdrawal of blood, its separation into plasma and cells, and the reintroduction of the cells, used especially to remove antibodies in treating autoimmune diseases.
-
EPO
- is a glycoprotein that regulates the daily production of 200 red blood cells every day.
-
binds and promotes survival, proliferation, and differentiation to mature erythorocytes
How does EPO interact with erythroid progenitor cells?
-
interstitial cells in kidney; hypoxia
EPO production occurs in ________ & occurs because of _______.
-
hepcidin
Increased levels of ______ block intestinal iron absorption.
-
HIV, chemotherapy, renal failure, CKD, iron deficiency
What conditions are indicated for ESA's?
-
ESA and IV iron supplementation
What is the current standard of care in CKD patients with anemia?
-
Hb < 10g/dl
At what Hb levels do we support partial treatment with ESA's?
-
>11g/dl
At what Hb levels do ESA's begin to become dangerous?
-
lowest
The ________ ESA dose is sufficient to reduce the need for transfusions.
-
Mircera
-continuous erythropoietin receptor activator
-long half-life
-
d
How is Mircera administered? And how often?
a) IV; once a month
b) SQ; every other month
c) IV; twice a month
d) SQ; once a month
-
c
Which drug is a synthetic peptide-based ESA that was recalled due to causing anaphylaxis?
A) Mircera
B) EXONDYS
C) OMONTYS
D) Daprodustat
-
d
Which drug is a hypoxia-inducible factor propyl hydroxylase inhibitor (HIF-PHI)?
A) Mircera
B) EXONDYS
C) OMONTYS
D) Daprodustat
-
folate & vitamin B12
Besides iron, what else do RBC's require to develop?
-
PEG modification
What makes MICERA more stable?
-
a
Daprodustat is ______ compared to ESA in regards to hemoglobin levels & MACE.
a) non-inferior
b) inferior
c) superior
-
avoid strong CYP2C8 inhibitors
What is the contraindication associated with Daprodustat?
-
inhibits PHD2 & activates the expression of EPO
Explain Daprodustat MOA.
-
HIF2a is hydroxylated and ubiquitinated by E3 ligase; it is then destroyed by the proteasome which results in no EPO produced.
What happens if PHD2 is active?
-
an enzyme; catalyzes hydroxlation of proline residue on HIF2a
What is PHD2? What is its function?
-
EGLN1 missense
What type of mutation allows Tibetans to avoid altitude sickness?
-
polycythemia
-a disease state in which the proportion of blood volume that is occupied by red blood cells increases; usually occurs at high altitudes.
-
exhibits a lower Km value; increased oxygen affinity; increased HIF degradation
How does the EGLN mutation work in hypoxic conditions?
-
immature; mature
Band neutrophils are considered _______ while segmented are ______.
-
febrile neutropenia
-neutropenia accompanied with a fever > 101
-
Granulocyte colony stimulating factors
-stimulates production of neutrophil precursors, enhances differentiation & maturation of neutrophil precursors, activates & enhances mature neutrophils
-
cancer patients receiving myelosuppressive chemo or bone marrow transplant; patients with myeloid leukemia; patients with severe neutropenia
What are the indications for Filgrastim & Pegfilgrastim?
-
b
Which medication is a covalently linked analog recombinant of filgrastim with a longer half life?
A) Mircera
B) Pegfilgrastim
C) Filgrastim
D) Daprodustat
-
a
Which chemotherapy cycle has the greatest risk of CIN?
a) 1st
b)2nd
c)3rd
4)4th
-
CIN
-major dose-limiting toxicity of systemic cancer chemotherapy–Increases risk of infection, prompts dose delays/reductions, impacts effectiveness and impairs quality of life
-
d
When trying to prevent CIN in cancer patients, when do we administer Filgrastim & Pegfilgrastim?
a) 24-72 hours before chemotherapy
b) during chemotherapy
c) 2 hours after chemotherapy
d) 24-72 hours after chemotherapy
-
fluroquinolone antibiotics
In patients at high risk for infection-related morbidity and mortality, ______ use is recommended with CSF agents.
-
c
Which plays a critical role in eosinophil differentiation, maturation, recruitment, and activation in tissues?
a) IL-3
b) IL-4
c) IL-5
d) IL-6
-
IL-5 blockers
-are indicated as an add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype.
-
patients with severe asthma age 6 & up
Mepolizumab indication?
-
selectively inhibits eosinophilic airway inflammation and significantly reduces asthma exacerbations regardless of IgE levels in blood
Mepolizumab MOA?
-
false
Patients should stop their inhaled glucocorticoid steroid therapy while taking Mepolizumab (NUCALA). True or false?
