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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. Wilm's tumor - RCC - HCC - hydronephrosis
Bernard soulier
Lung disease - congenital heart diseaes - and high altitude
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Rhogam - Rh antigen immunoglobulin

2. What is the purpose of the fibrin mesh
Burkitt lymphoma
Prothrombin gene mutation
Acts to stabilize platelet plug
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia

3. What is relative polycythemia
Dec plasma volume
Mantle cell - older males
Anemia of chronic disease - Aplastic anemia - kidney disease
VWD

4. normal RBCs added to patient's serum
Yes - via MHC II
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Indirect coombs - agglutinate if serum anti RBC surface Ig
Plasma cell

5. What percentage of WBCs are monocytes?
Fibrinogen bind GpIIb/IIIa and links platelts
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Round densly staining nucleus with a small amount of pale cytoplasm
2 to 10

6. X linked - dec glutathione inc RBC susceptibility to oxidative stress
Helps platelts adhere to endothelium
TPA - cleavage of fibrin mesh
G6PD
Paroxysmal nocturnal hemoglobinuria

7. CD5+ - poor prognosis - t(11;14)
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Mantle cell - older males
CML

8. What is the ddx for aplastic anemia

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9. Where are monocytes typically found - where do they go - and What do the differentiate into?
MAHA
Follicular lymphoma - indolent course
Blod - tissue - MACS
HIV or immunosupression

10. Inherited deficiency of antithrombin; reduced inc in PTT after administration of heparin
Helminth infections major basic protein
ATIII def
B cells
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60

11. What is HbH
Beta 4
Degrades fibrin mesh and converts C3 to C3a
Varying shapes
B6

12. Bone pain plus anemia
Multiple myeloma
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Hereditary spherocytosis - G6PD - sickle cell
Rhogam - Rh antigen immunoglobulin

13. t(15;17)
M3 AML (acute promyelocytic leukemia)
PGI2 - NO inc blood flow - dec platelet aggregation
Fc
Howell - Jolly bodies - hypo/asplenia

14. defect in alpha globin gene - dec alpha globin synth - disease and populations?
CML
Alpha thal - asian and african american
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Sideroblastic anemia

15. Impaired synthesis of DAF leading to inc complement mediated desctruction of RBCs via the GPI ancho
Paroxysmal nocturnal hemoglobinuria
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Hereditary spherocytosis

16. Target cell

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17. Back pain - hemoglobinuria
Common a few days after oxidative stress in a pt with G6PD
Folate def
Kids= exposure to lead paint - adults = battery - ammunition factory
B antigena and A antibodes

18. What is a metabolic disorder tht can cause macrocytic anemia?
Orotic aciduria
ADP and Ca
Africa = Jaw lesion - US = pelvis or abdomen
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease

19. What vitamin is a cofactor for the first step of heme synthesis
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Plummer - vinson syndrome
Contiguous
B6

20. What are some causes of cold agglutinin anemia
PGI2 - NO inc blood flow - dec platelet aggregation
Acts to stabilize platelet plug
Schistocytes - helmet cells
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

21. What are the extrinsic hemolytic normocytic anemias?
Common a few days after oxidative stress in a pt with G6PD
Def in factor IX
Complications of sickle cell anemia
...

22. Where to T cells arise and mature - and migrate to...
Decrease EPO
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
Multiple myeloma

23. Fibrotic obliteration of bone marow with teardrop cells

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24. dec ability to activate factors V and VIII - inc risk of thrombotic skin necrosis with hemorrhage following administration of warfarin
PGI2 - NO inc blood flow - dec platelet aggregation
Protein C or S deficiency
Glucose and heme - which inhibit ALA synthase
Abciximab

25. What is the result of thrombocytopenia or platelet dysfunction?
B cells
Nl PT - elevated PTT - intrinsic pathway defect
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Petechiae

26. What are the azuraphilic granules in PMNs
Def in factor IX
Lysosomes
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Inactivates it

27. What is hemophiliia A
Deficiency in factor VIII
No lytic bone lesions in WM
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Off center nuclues - clock face chromatin

28. What signal activates MACS
SLE - CLL - alpha methyldopa
CML
IFN gama
Inhibits thrombin - ixa - xa - xiia - and activated by heparin

29. Blood type A
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
A antigen and B antibodies
Burkitt lymphoma
No platelet clumping

30. What is the characteristic finding for MAHA on peripheral smear?
Alpha thal - asian and african american
Schistocytes - helmet cells
Folate def
B6

31. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
...
Intrinsic - all factors except - VII - XIII
Hereditary spherocytosis
Fc

32. What does 'Neutrophils Like Making Everything Better' stand for?
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Sheets of lymphocytes interspersed with macs

33. inc WBC count with left shift - inc leukocyte alkaline phosphatase - often due to infection
Leukemoid reaction
Her next Rh+ fetus
Signs and sx of aplastic anemia
Howell - Jolly bodies - hypo/asplenia

34. Can B cells function as APCs?
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Lead lines on gingivae and epiphyses of long bones on xray - Encephalopathy and Erythrocyte basophilic stippling - Abdominal colic and Anemia - Drops - wrist and foot drop -
Yes - via MHC II
Leukemoid reaction

35. What do the iron studies show in sideroblastic anemia
Glucose and heme - which inhibit ALA synthase
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Collagen - BM - activated platelets
Inc serum iron - normal TIBC - inc ferratin

36. Deficiency in GpIIb/IIIa

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37. What does ectopic EPO produce
Dec synthesis of factors 1972 - protein C/S
TXA2 - dec blood flow - inc platelet aggregation
All
Inappropriate absolute with inc RBCs and EPO

38. Conditions of defective heme synthesis leading to accumulation of heme precurors
Heinz bodies - seen in alpha thal and G6PD
Blasts > 5%
Porphyrias
They bind vWF via GpIb

39. What does hairy cell leukemia stain with
TRAP (tartrate resistant acid phosphatase
Alpha thal - asian and african american
Sideroblastic anemia
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease

40. How are plasma cells characterized?
Off center nuclues - clock face chromatin
A antigen and B antibodies
Folate def
Low O2 in papilla; can also get microhematuria from medullary infarcts

41. What are dendritic cells called in the skin?
Adult T cell lymphoma - presents with cutaneous lesions
Schistocytes - helmet cells
40 to 75
Langerhans cells

42. Ringed sideroblasts
Low O2 in papilla; can also get microhematuria from medullary infarcts
Sideroblastic anemia
Intravascular hemolysis
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

43. What cell is primarily involved in non Hod lymph
Sheets of lymphocytes interspersed with macs
Nl PT - elevated PTT - intrinsic pathway defect
Yes - via MHC II
B cells

44. Causes of iron def?
Beta thal
Leukemia
Von Willebrand's disease
Bleeding - malnutrition/absorption - inc demand pregs

45. What does NAACP stand for - in regards to the causes of eosinophiia?
Dec synthesis of factors 1972 - protein C/S
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
DIC
MHC II and Fc receptors

46. What CD molecules are on RS cells
B12/folate def
CD15 and CD30 pos
Hereditary elloptocytosis
Fe def - thal - pb poison - sideroblastic anemia

47. mother's antibodies attack fetal RBCs
Nl - up - nl
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
AML
Africa = Jaw lesion - US = pelvis or abdomen

48. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Hodgkin
Hereditary spherocytosis - G6PD - sickle cell
Antigen - antibody

49. What is the most common nonhodgkin lymphoma
Leukemia
Bite cells and Heinz bodies
Diffuse Large b cell lymphoma
No lytic bone lesions in WM

50. HTLV-1
Protoporphyrin
Adult T cell lymphoma - presents with cutaneous lesions
Gp1b
Mantle cell lymphoma