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Hemeonc

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Macro - ovalocyte
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Howell Jolly bodies
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Lysine for glutamate at position 6

2. What is the treatment to prevent a woman from forming anti Rh antibody?
Protein C or S deficiency
Eleveated PT - PTT
Rhogam - Rh antigen immunoglobulin
B6 therapy (pyrodixine)

3. How do platelet disorders present?
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Induces differentiation of myeloblasts
Low in CML
Mantle cell - older males

4. What does ADP do?
Birbeck granules
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Helps platelts adhere to endothelium
Extravascular

5. Does CML have a JAK2 mut
Intravascular
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
No
Blasts > 5%

6. Where are monocytes typically found - where do they go - and What do the differentiate into?
Dec plasma volume
DIC
HIV or immunosupression
Blod - tissue - MACS

7. What is the characteristic lab finding on electrophoresis
Lacunar in nodular sclerosing variant
Direct coombs - agglutinate if RBCs are coated with Ig
ATIII def
Paraprotein spike - monoclonal protein

8. What is the purpose of the fibrin mesh
Hereditary spherocytosis
T(12;21)
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
Acts to stabilize platelet plug

9. What converts plasminogen to plasm and What does plasmin do?
Alpha thal - asian and african american
TPA - cleavage of fibrin mesh
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Pyruvate kinase def - extravascular

10. What is the characteristic spread of Hodgkin Lymphoma
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Contiguous
Up - down - up
Inc large vWF multimers - inc platelet aggregation and thrombosis

11. What is hemophilia B?
Def in factor IX
B antigena and A antibodes
B symptoms - fever night sweats - weight loss
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

12. Which cell is neoplastic in multiple myeloma
2 to 10
Dec plasma volume
Plasma cell
Nl PT - elevated PTT - intrinsic pathway defect

13. What do labs show in DIC?
Valine for glutamate
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Varying shapes
Sickle cell

14. What substance prevents mast cells degranulation?
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Porphyrias
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Cromolyn sodium

15. Wilm's tumor - RCC - HCC - hydronephrosis
Essential thrombocytosis
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
120 days
ADP and Ca

16. Widespread activation of clotting to a deficiency in clotting factors which causes a bleeding states
DIC
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
MHC II and Fc receptors
No

17. Blood type B
Plummer - vinson syndrome
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
B antigena and A antibodes
Yes - via MHC II

18. When is the peak incidence for nonHod lymphoma
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
90% anearobically from glucose to lactate - 10% from HMP shunt
VWF carries/protects factor VIII
20 to 40

19. What percentage of WBCs are monocytes?
2 to 10
Sideroblastic anemia
Her next Rh+ fetus
DIC - TTP/HUS - traumatic hemolysis

20. Drug that inhibits COX and therefore TXA2 synthesis
Dendritic cells?
Inc vasodiltion - inc perm - inc pain
Incactivates II - VII - IX - X - XI - XII
Aspirin

21. Sickle cell
DIC
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Lung disease - congenital heart diseaes - and high altitude
Sickle cell anemia

22. What does bradykinin do?
Uroporphyrinogen decarboxylase
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
Inc vasodiltion - inc perm - inc pain
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)

23. What is the pathogenesis of aplastic anemia with kidney disease
Common a few days after oxidative stress in a pt with G6PD
Decrease EPO
Plasma cell
Langerhans cell histiocytosis

24. What is the presenting scenario for TTP?
Lead - and EtOH
B cells
Examples of oxidative stress
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA

25. From what cells are platelets derived from
Megakaryocytes
Bone marrow infiltration - myelofibrosis
Dendritic cells?
G6PD

26. What cell is primarily involved in non Hod lymph
Indirect coombs - agglutinate if serum anti RBC surface Ig
B12 in fatty acid pathways leads to subacute combined degeneration
B cells
Fibrinogen bind GpIIb/IIIa and links platelts

27. What is makes a leukemia acute
G6PD
Blasts > 5%
8-10 days
Acts to stabilize platelet plug

28. What percentage of WBCs are basophils - and What is found in their basophilic granules?
Inactivates it
Helminth infections major basic protein
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Intravascular

29. What are the variants of the RS cells
Nodular sclerosing
G6PD
Lacunar in nodular sclerosing variant
Hydroxyurea - bone marrow transplant

30. t(8;14) c - myc gene
Blood
Burkitt lymphoma
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Alpha thal - asian and african american

31. What is relative polycythemia
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
T(12;21)
Inc HbF and dec HbS
Dec plasma volume

32. Adults present with cutaneous patches/nodules - indolent CD4+
Malaria - Babesia
Megakaryocytes
Gp1b
Mycosis fundgoides/Sezary syndrome

33. poikilocytosis
Inc UCB
Peroxidase
Varying shapes
Myelofibrosis (marow is crying being its fibrosed'

34. What are some causes of warm agglutinin autoimmune hemolytic anemia?
Varying sizes
Intravascular hemolysis
SLE - CLL - alpha methyldopa
Yes - via MHC II

35. What is the result of thrombocytopenia or platelet dysfunction?
Inducers of primary antibody response
Exposed collagen upon endothelial damage
Aplastic anemia - pancytopenia
Petechiae

36. Basophilic nuclear remnants fonud in RBCs
Plummer - vinson syndrome
TPA - cleavage of fibrin mesh
Howell - Jolly bodies - hypo/asplenia
G6PD

37. Eosinophils are highly phagocytic For what kind of complex?
Lysosomes
Orotic aciduria
Antigen - antibody
Degrades fibrin mesh and converts C3 to C3a

38. What is the tx for vWD
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Dec synthesis of factors 1972 - protein C/S
Extravascular
ATIII def

39. S-100 and CD1a with birbeck granules
Nodular sclerosing
B12 in fatty acid pathways leads to subacute combined degeneration
Langerhans cell histiocytosis
Mantle cell lymphoma

40. deficiency in ADAMTS13 leading to dec degradation of vWF
ATIII def
Thrombotic thrombocytopenic purpura
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Gp1b

41. What happens in betal thal minor?
Ticlopidine/clopidogrel
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Beta chain underproduced - asymptomatic - heterozygote
Howell - Jolly bodies - hypo/asplenia

42. What is the clinical picture of hemophilia A or B
Macrohemorrhage - hemarthroses - easy bruising
Inc serum iron - normal TIBC - inc ferratin
Epoxide reductase - warfarin inhibits
T(12;21)

43. inc LDH - jaundice
Bite cells and Heinz bodies
Extravascular hemolysis
Uroporphyrinogen decarboxylase
Histamine - heparin - and eosinohil chemotactic factors

44. What causes the jaundice in extravascular hemolysis
ADP and Ca
Inc UCB
Protoporphyrin
Birbeck granules

45. Target cell

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46. Plasma cell neoplasm
Alpha thal - asian and african american
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Multiple myeloma
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)

47. Acanthocyte (spur cell)
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
MAHA
Liver disease - abetalipoproteinemia - acntho = spiny
Prothrombin gene mutation

48. Blood type A
Inc large vWF multimers - inc platelet aggregation and thrombosis
A antigen and B antibodies
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Splicing sites and promotor sequences

49. What distinguishes multiple myeloma fromk Waldenstroms macroglobulinemia?
Protein S - cleaves and invactivates Va and VIIIa
Extrinsic - I - II - V - VII and X
No lytic bone lesions in WM
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

50. Schisotcyte - helmet cell
Pyruvate kinase def - extravascular
DIC - TTP/HUS - traumatic hemolysis
Blood
Degrades fibrin mesh and converts C3 to C3a