Pediatric Hematology and Oncology Quiz

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Questions and Answers

Which condition is primarily associated with problems in the initial stages of coagulation?

  • Anemia
  • Disorders of Primary Hemostasis (correct)
  • Leukemia
  • Disorders of Secondary Hemostasis

What is a key focus of pediatrics in the context of hematology?

  • Managing chronic diseases in adults
  • Understanding blood disorders in children (correct)
  • Combating viral infections in newborns
  • Developing surgical procedures for elders

Which topic would likely cover transformative health policy changes?

  • Quality of Health
  • Immunology
  • Conflict & Change in Health Care (correct)
  • Anemia

Which of the following is NOT typically addressed in the study of Social Medicine?

<p>Pathophysiology of Diseases (A)</p> Signup and view all the answers

In the context of pediatric oncology, what is a critical aspect to consider?

<p>Treatment protocols for childhood cancers (B)</p> Signup and view all the answers

What is indicated for prophylaxis when CD4 lymphocyte percentage is below 14%?

<p>Bronchoscopy (A)</p> Signup and view all the answers

Which of the following is a symptom associated with Candida albicans infection?

<p>Painless creamy-white plaques (B)</p> Signup and view all the answers

What is the first-line treatment for disseminated Mycobacterium avium complex (MAC)?

<p>Daily clarithromycin and ethambutol (D)</p> Signup and view all the answers

What laboratory finding is commonly associated with Mycobacterium avium complex infection?

<p>Elevated alkaline phosphatase (B)</p> Signup and view all the answers

Which condition is characterized by asymptomatic hyperkeratotic lesions linked with EBV due to underlying HIV?

<p>Oral Hairy Leukoplakia (D)</p> Signup and view all the answers

What indicates a peripheral destruction of red blood cells in an anemic condition?

<p>Reticulocyte count &gt; 3% (C)</p> Signup and view all the answers

Which condition is characterized by hyperbilirubinemia, jaundice, and splenomegaly?

<p>Sickle cell anemia (D)</p> Signup and view all the answers

In acute myeloid leukemia (AML), what finding is typically observed?

<p>Auer rods (B)</p> Signup and view all the answers

What is a common trait of chronic lymphocytic leukemia (CLL)?

<p>Presence of smudge cells (C)</p> Signup and view all the answers

Which type of leukemia can be associated with the Philadelphia chromosome?

<p>Chronic myeloid leukemia (CML) (B)</p> Signup and view all the answers

What type of hemolysis is characterized by the presence of bilirubin-rich gallstones?

<p>Extravascular hemolysis (C)</p> Signup and view all the answers

Which immunophenotyping markers are positive in Adult T-Cell Leukemia/Lymphoma (ATLL)?

<p>CD4 and CD8 (B)</p> Signup and view all the answers

What is the typical prognosis for acute promyelocytic leukemia (APL) associated with the M3 classification?

<p>Good with ATRA treatment (B)</p> Signup and view all the answers

What condition is often confused with a leukemoid reaction due to high white blood cell count?

<p>Chronic myeloid leukemia (A)</p> Signup and view all the answers

What is a significant characteristic of hairy cell leukemia?

<p>Pancytopenia with splenomegaly (B)</p> Signup and view all the answers

What is the mechanism of action of Pegasparaginase?

<p>Hydrolyzes asparagine to aspartic acid and ammonia (D)</p> Signup and view all the answers

Which side effect is associated with the use of Imatinib?

<p>Arterial thrombosis (D)</p> Signup and view all the answers

What common mechanism is shared by Olaparib, Niraparib, and Rucaparib?

<p>They are PARP inhibitors used for BRCA mutations (A)</p> Signup and view all the answers

What is the main role of Bevacizumab in cancer therapy?

<p>Inhibiting VEGF to prevent neovascularization (C)</p> Signup and view all the answers

Which of the following therapies is associated with non-specific symptoms like diarrhea and hepatotoxicity?

<p>Sunitinib (C)</p> Signup and view all the answers

What is the mechanism by which Erlotinib and Gefitinib work?

<p>Inhibition of EGFR to reduce cell proliferation (D)</p> Signup and view all the answers

What is a known side effect of using Alemtuzumab?

<p>Fatal infusion reactions (C)</p> Signup and view all the answers

Which targeted therapy is specifically a Bruton’s tyrosine kinase inhibitor?

<p>Ibrutinib (A)</p> Signup and view all the answers

What is a common lab error that may cause a false low platelet count?

<p>EDTA causing platelet clumping (A)</p> Signup and view all the answers

Which blood disorder is characterized by low platelets and microcytopenia?

<p>Wiskott-Aldrich Syndrome (C)</p> Signup and view all the answers

What type of bleeding is indicated by petechiae?

<p>Superficial bleeding (D)</p> Signup and view all the answers

Which disorder is associated with giant platelets?

<p>ITP (D)</p> Signup and view all the answers

What is the primary function of the PFA-100 test?

<p>Evaluate platelet aggregation (C)</p> Signup and view all the answers

In which condition would you likely see tear drop cells?

<p>Myelophthisic Disease (A)</p> Signup and view all the answers

What complication may arise from low platelet production?

<p>Spontaneous bleeding (B)</p> Signup and view all the answers

Which inherited bleeding disorder is most common?

<p>von Willebrand Disease (D)</p> Signup and view all the answers

What is a common autoimmune disorder characterized by fever, weakness, and malar rash?

<p>Systemic Lupus Erythematosus (B)</p> Signup and view all the answers

Which factor is NOT associated with an increased risk of developing Multiple Sclerosis?

<p>Physical inactivity (C)</p> Signup and view all the answers

Which of the following is a therapy option for Rheumatoid Arthritis?

<p>Anti-TNF agents (C)</p> Signup and view all the answers

What type of hypersensitivity is primarily involved in the pathology of Systemic Lupus Erythematosus?

<p>Type III hypersensitivity (B)</p> Signup and view all the answers

Which abnormal blood cell morphology is characterized by a small and spherical shape?

<p>Spherocytes (C)</p> Signup and view all the answers

What is the normal ratio of lymphocytes to red blood cells in the bloodstream?

<p>1:3 (C)</p> Signup and view all the answers

Which of the following is a correct statement about platelets?

<p>They are derived from megakaryocytes. (A)</p> Signup and view all the answers

What is the primary vector responsible for spreading Lymphatic Filariasis?

<p>Mosquitoes (D)</p> Signup and view all the answers

Which of the following describes the presence of Howell-Jolly bodies?

<p>Nuclear remnants in mature red blood cells (A)</p> Signup and view all the answers

What is the role of IL-2 in T cell biology?

<p>Supports T cell survival and proliferation (A)</p> Signup and view all the answers

Which type of red blood cell abnormality is characterized by the shape resembling a crescent?

<p>Sickle Cell (C)</p> Signup and view all the answers

Which condition is characterized by demyelination due to autoreactive T cells?

<p>Multiple Sclerosis (A)</p> Signup and view all the answers

What pathology is primarily caused by Wuchereria bancrofti?

<p>Filariasis (A)</p> Signup and view all the answers

What is a characteristic feature of neutrophils when mature?

<p>Multi-lobed nucleus (C)</p> Signup and view all the answers

Flashcards

What is Anemia?

Anemia is a condition characterized by a deficiency in red blood cells, hemoglobin, or both, resulting in reduced oxygen-carrying capacity of the blood.

What is 'Primary Hemostasis'?

Primary hemostasis refers to the initial response to vessel injury, involving the formation of a platelet plug to stop bleeding. Disorders in this stage can lead to prolonged bleeding.

What is 'Secondary Hemostasis'?

Secondary hemostasis involves the coagulation cascade, a complex series of reactions leading to the formation of a stable fibrin clot. Disorders of this stage can also lead to prolonged bleeding.

What are 'Leukemia' and 'Lymphoma'?

Leukemia is a cancer of the blood cells characterized by uncontrolled proliferation of abnormal white blood cells. Lymphoma involves the lymphatic system and affects lymphocytes.

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What is 'Access to Health Care'?

Access to healthcare refers to the ability of individuals to access healthcare services without facing barriers like cost, distance, or lack of insurance.

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What is Pneumocystis jirovecii pneumonia (PCP)?

A lung infection caused by a fungus called Pneumocystis jirovecii, often seen in individuals with weakened immune systems like those with HIV/AIDS. It can manifest with shortness of breath, rapid breathing, and a characteristic butterfly-shaped pattern on chest x-ray.

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What is Candida albicans infection?

A yeast infection that can affect the mouth (oral thrush) and esophagus in people with weakened immune systems, particularly those with HIV/AIDS. Oral thrush presents as painless, creamy-white plaques in the mouth, easily scraped off, while esophageal candidiasis causes retrosternal pain and difficulty swallowing.

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What is Mycobacterium avium complex (MAC) infection?

A rare type of opportunistic bacterial infection that can affect people with weakened immune systems, particularly those with advanced HIV/AIDS. It typically causes a range of symptoms including fatigue, fever, diarrhea, abdominal pain, and enlarged liver and spleen.

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What is Cryptococcus neoformans infection?

A fungal infection often seen in individuals with HIV/AIDS, commonly affecting the brain and causing meningitis. It presents with symptoms such as headache, fever, light sensitivity, neck stiffness, confusion, and vomiting.

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What is Oral Hairy Leukoplakia?

A type of oral lesion that can occur in people with HIV/AIDS, appearing as asymptomatic, white, hyperkeratotic lesions on the tongue. These lesions are often associated with Epstein-Barr Virus and usually resolve with antiretroviral therapy.

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Thrombocytopenia

A deficiency in the number of platelets in the blood, which can lead to increased bleeding risk.

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Qualitative Platelet Defect

A condition where platelets are present in normal numbers but don't function properly, leading to bleeding problems.

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Low Platelet Production

A condition where platelets are produced at a lower rate than normal, leading to thrombocytopenia.

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Platelet Destruction

A condition where platelets are destroyed faster than they're produced, leading to thrombocytopenia.

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Platelet Sequestration

A condition where platelets are sequestered in the spleen, leading to thrombocytopenia.

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Prothrombin Time (PT)

A test to evaluate the extrinsic pathway of coagulation, used to assess how long it takes blood to clot.

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Partial Thromboplastin Time (aPTT)

A test to evaluate the intrinsic pathway of coagulation, used to assess how long it takes blood to clot.

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Platelet Count

A laboratory test that measures the number of platelets in a sample of blood.

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Pegaspargase

A chemotherapy drug used for acute lymphoblastic leukemia (ALL). It acts by hydrolyzing asparagine into aspartic acid and ammonia, which disrupts the cell cycle and prevents tumor cell growth.

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PARP Inhibitors (Olaparib, Niraparib, Rucaparib)

Inhibitors of poly ADP-ribose polymerase (PARP). PARP is involved in DNA repair, and its inhibition can lead to DNA damage and cell death. These drugs are particularly effective in tumors with BRCA mutations, as these mutations disrupt homologous recombination repair, making tumor cells reliant on PARP for DNA repair.

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Imatinib

Targets the tyrosine kinase (TK) of the BCR-ABL fusion protein. This fusion protein is often found in chronic myeloid leukemia (CML) and is a key driver of the disease. Imatinib blocks the activation of the TK, leading to inhibition of cell growth and proliferation.

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Lapatinib

Targets the tyrosine kinase (TK) of the HER-2 receptor, which is often overexpressed in breast cancer. Lapatinib inhibits the autophosphorylation of HER-2, leading to the suppression of downstream signaling pathways and decreased cell proliferation.

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Erlotinib

Targets the tyrosine kinase (TK) of the EGFR receptor, which is often overexpressed in various cancer types, including lung cancer. Erlotinib inhibits the activation of the TK, leading to the suppression of the EGFR pathway and decreased cell proliferation.

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Sunitinib

Targets the tyrosine kinase (TK) of vascular endothelial growth factor (VEGF), which plays a key role in angiogenesis (blood vessel formation). Sunitinib inhibits the TK of VEGF, leading to the suppression of new blood vessel formation and the inhibition of tumor growth and metastasis.

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Trastuzumab

A monoclonal antibody (mAb) that targets the extracellular domain of the HER-2 receptor. It inhibits the overexpression of HER-2, which is often implicated in breast cancer, by blocking its signaling and preventing its interaction with other receptors.

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Bevacizumab

A monoclonal antibody (mAb) that binds to vascular endothelial growth factor (VEGF). VEGF is a key driver of angiogenesis, the process of blood vessel formation, which is essential for tumor growth and metastasis. Bevacizumab inhibits VEGF by blocking its interaction with its receptors, leading to the suppression of angiogenesis and the inhibition of tumor growth and metastasis.

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Normocytic Anemia

A type of anemia characterized by decreased RBC production or survival. A low reticulocyte count suggests a production defect, while a high count indicates increased destruction.

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Extravascular Hemolysis

A type of hemolytic anemia where RBCs are destroyed prematurely outside the bloodstream, leading to hyperbilirubinemia, jaundice, splenomegaly, and increased risk of gallstones.

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Hereditary Spherocytosis

A genetic disorder characterized by RBCs with a sphere-like shape, leading to premature destruction. It can cause aplastic crisis, especially with parvovirus B19 infection.

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Sickle Cell Anemia

A genetic disorder caused by a mutation in the hemoglobin gene. It results in sickle-shaped RBCs, leading to vaso-occlusive crises and various complications.

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Leukemoid Reaction

A condition characterized by an overproduction of white blood cells, usually due to an infection or inflammation. It is often associated with a left shift in the differential white blood cell count.

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Chronic Lymphoid Leukemia (CLL)

A type of leukemia characterized by a proliferation of mature lymphocytes, often in older adults. It is usually associated with a high white blood cell count.

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Hairy Cell Leukemia

A rare, slow-growing type of leukemia characterized by the presence of hairy cells in the bone marrow. It typically affects middle-aged males and is characterized by splenomegaly without significant lymph node enlargement.

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Adult T-Cell Leukemia/Lymphoma (ATLL)

A type of leukemia caused by the HTLV-1 virus. It is associated with a proliferation of CD4+ cells and is characterized by skin rash, lymphadenopathy, hepatosplenomegaly, and lytic bone lesions.

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Mycosis Fungoides

A type of cutaneous lymphoma characterized by a proliferation of CD4+ cells in the skin. It often manifests as a rash that progresses to plaques and, in some cases, can spread to the blood.

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Lymphadenopathy (LAD)

A type of lymphoma that primarily affects the lymph nodes, causing painless enlargement. It can be caused by chronic inflammation, metastatic cancer, or infection.

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Type III Hypersensitivity

A type of immune response where immune complexes are formed and deposited in tissues, leading to inflammation and damage. It involves the activation of complement and the recruitment of neutrophils.

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Multiple Sclerosis (MS)

An autoimmune disease characterized by the production of autoreactive T cells that attack the myelin sheath surrounding nerve fibers in the central nervous system, leading to inflammation and demyelination.

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Rheumatoid Arthritis (RA)

An autoimmune disease where the immune system attacks the joints, causing inflammation, pain, and stiffness. It often affects the hands, wrists, and feet.

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Rheumatoid Factor (RF)

A common finding in Rheumatoid Arthritis (RA) where IgM antibodies bind to the Fc region of IgG, forming immune complexes that trigger inflammation.

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Anti-Cyclic Citrullinated Peptide (CCP)

An antibody that specifically targets citrullinated peptides, which are proteins modified by the addition of citrulline. This antibody is highly specific for rheumatoid arthritis.

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Anti-Cyclic Citrullinated Peptide (CCP)

An antibody that specifically targets citrullinated peptides, which are proteins modified by the addition of citrulline. This antibody is highly specific for rheumatoid arthritis.

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Anti-TNF Therapy

A type of therapy for rheumatoid arthritis that aims to block the activity of tumor necrosis factor (TNF), a pro-inflammatory cytokine.

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Anti-TNF Therapy

A type of therapy for rheumatoid arthritis that aims to block the activity of tumor necrosis factor (TNF), a pro-inflammatory cytokine.

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CTLA4-Ig Therapy

A type of therapy for rheumatoid arthritis that utilizes a protein called CTLA4-Ig to block the interaction between T cells and antigen-presenting cells, preventing T cell activation.

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CTLA4-Ig Therapy

A type of therapy for rheumatoid arthritis that utilizes a protein called CTLA4-Ig to block the interaction between T cells and antigen-presenting cells, preventing T cell activation.

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Anti-CD3 Therapy

A type of therapy for rheumatoid arthritis that involves the depletion of T cells using an antibody that binds to the CD3 molecule on the surface of T cells.

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Anti-CD20 Therapy (Rituximab)

A type of therapy for rheumatoid arthritis that involves the depletion of B cells using an antibody called Rituximab that binds to the CD20 molecule on the surface of B cells.

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Anti-CD20 Therapy (Rituximab)

A type of therapy for rheumatoid arthritis that involves the depletion of B cells using an antibody called Rituximab that binds to the CD20 molecule on the surface of B cells.

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Anti-CD20 Therapy (Rituximab)

A type of therapy for rheumatoid arthritis that involves the depletion of B cells using an antibody called Rituximab that binds to the CD20 molecule on the surface of B cells.

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Immune System Ablation Therapy

A type of therapy for rheumatoid arthritis that involves the use of chemotherapy to deplete the entire immune system, followed by a transplant of the patient's own stem cells to repopulate the immune system.

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Immune System Ablation Therapy

A type of therapy for rheumatoid arthritis that involves the use of chemotherapy to deplete the entire immune system, followed by a transplant of the patient's own stem cells to repopulate the immune system.

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TReg Therapy

A type of therapy for rheumatoid arthritis that aims to enhance the function of regulatory T cells (Tregs), which help suppress the immune response.

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Study Notes

Biochemistry - Week 1

  • Cancer Genetics: Cell division, DNA loss, metastasis, and clonal origin are discussed.
  • Driver and passenger mutations.
  • Proto-oncogenes and tumor suppressor genes.
  • Genetic alterations from errors in cell cycle, exposure to mutagens, viral infections, or carcinogens.
  • Epigenetics plays a role in cancer development.
  • Hereditary cancer syndromes vs sporadic cancer.

Immunology - Week 1

  • Cancer: Heterogeneity, tumor-specific & associated antigens, and immunosurveillance.
  • B-cells, macrophages, dendritic cells, and T cells are crucial components of the immune response to cancer.
  • Tumor detection, NK cells, and ADCC mechanisms.
  • Immunotherapy, monoclonal antibodies, and adoptive cell transfers (a & b).

Immunology - Week 1 (continued)

  • Autoimmunity: Self-tolerance, central & peripheral tolerance & factors influencing autoimmunity.
  • Organ-specific & non-specific autoimmunity.
  • Genetic & environmental factors/ other factors (infection), organs involved (Hasimotos, Type I Diabetes, SLE).
  • Type I, II, & III hypersensitivity reactions.

Histology - Week 1

  • Blood Cells: Review of RBCs, WBCs, and Platelets.
  • Maturation and variations in cells.
  • Include features of abnormal inclusions and defects.

Microbiology - Week 1 (part 1)

  • Blood Parasites:
  • African Trypanosomiasis & Filarial Worms overview of diseases, distribution, cycles, and clinical features. Dx & Tx for diseases.
  • Malaria, including clinical features and vector.

Microbiology - Week 1 (part 2)

  • Malaria (continued):
  • Species, vector, and life cycle of this infectious disease.
  • Including relapse, complications, and diagnostics.

Pathology - Week 1

  • Blood Cells:
  • RBCs, anemia, and coagulation disorders.
  • Blood Parasites: relevant pathology.
  • Hemostasis and Coagulopathies (anemias & disorders)
  • Leukemia/Lymphoma (and know markers).

Pharmacology - Week 1

  • Anti-anemia medication.
  • Anti-cancer treatment.
  • HIV/AIDS medications and treatment.

Biochemistry, Immunology, Pathology, and Pharmacology - Week 2

  • Anemia: Pathophysiology of various anemias.
  • Disorders of Primary/Secondary Hemostasis.

Pediatrics - Week 2

  • Hematology & Hematopoietic aspects
  • Immunology & infectious aspects
  • Oncology - review of relevant questions

Pathophysiology - Week 2

  • Anemia
  • Disorders of Primary/Secondary Hemostasis.
  • Leukemia, Lymphoma
  • Basic overview of infectious diseases.

Pathophysiology, Pathology, and Pharmacology - Week 3 & 4

  • Rheumatoid arthritis, Sjogren's syndrome, seronegative spondyloarthropathies, and fibromyalgia.
  • Disorders of Secondary Hemostasis (DIC).
  • Leukemia and lymphoma (classifications, diagnosis, and treatment).
  • Immunodeficiency disorders (1° and 2°).
  • Transplantation, immunology, and related treatment
  • HIV, AIDS, ART overview.
  • Geriatrics: fall assessment & prevention (risk factors)
  • Pediatric Oncology

Other

  • Geriatrics: fall assessment and prevention
  • Social Medicine: Ethical Considerations
  • Medical ethics
  • Week 4: Fall Assessment and Prevention.
  • Pediatrics: MSK Oncology

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