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Hemeonc
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Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
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. What is the coombs test results in AIHA?
Pos
Def in factor IX
Adult T cell lymphoma - presents with cutaneous lesions
Ferrocheletase and ALA dehydrogenase
2. CD5+ - poor prognosis - t(11;14)
Intravascular
Porphobilinogen deaminase aka uroporphyrinogen I synthase
They bind vWF via GpIb
Mantle cell - older males
3. What are the likely exposures of kids and adults for lead poisoning
Kids= exposure to lead paint - adults = battery - ammunition factory
Plasma cell
Glanzmann's throbmasthenia
DDAVP (desmopressin) which releases stored vWF stored in endothelium
4. Is HS extravascular or intravascular?
Thrombotic thrombocytopenic purpura
G6PD
Extravascular
Mycosis fundgoides/Sezary syndrome
5. What do labs show in DIC?
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Aplastic anemia - pancytopenia
Bite cells and Heinz bodies
GpIIb/IIIa
6. Bite cell
Ticlopidine/clopidogrel
B cells
Megakaryocytes
G6PD
7. What activates the intrinsic pathway?
Howell Jolly bodies
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Collagen - BM - activated platelets
Folate def
8. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Dec
Hodgkin
PGI2 - NO inc blood flow - dec platelet aggregation
Aplastic anemia - pancytopenia
9. What is the affected enzyme in lead poisoning
Degrades fibrin mesh and converts C3 to C3a
Acts to stabilize platelet plug
Ferrocheletase and ALA dehydrogenase
Contiguous
10. What substance is Fe added to to yield heme
Protoporphyrin
HIV or immunosupression
Inc lymphoctes - and less RS cells
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
11. What is appropriate absolyte polycythemia associated with
Paraprotein spike - monoclonal protein
Lung disease - congenital heart diseaes - and high altitude
Ferrocheletase and ALA dehydrogenase
Uroporphyrin (tea colored urine)
12. fatigue - malaise - pallor - purpura - mucosal bleeding - petechiae - infection
VWD
Lacunar in nodular sclerosing variant
Low in CML
Signs and sx of aplastic anemia
13. What is the effect of ACE on bradykinin
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
G6PD
Inactivates it
Factor V Leiden
14. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Hereditary spherocytosis
Paraprotein spike - monoclonal protein
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
15. Who has more severe disease - HbSS or HbSC
Hereditary spherocytosis
G6PD
HbSS
CML
16. What is the age group most commonly affected by multiple myeloma
Round densly staining nucleus with a small amount of pale cytoplasm
PGI2 - NO inc blood flow - dec platelet aggregation
40 to 50
All
17. Aplastic crisis after parvovirus - autosplenectomy - salmonella osteomyelitis - painful crisis - renal papillary necrosis - splenic sequestration
Lead - and EtOH
B antigena and A antibodes
Decrease EPO
Complications of sickle cell anemia
18. How does vWD cause elevated PTT?
VWF carries/protects factor VIII
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
DIC - TTP/HUS - traumatic hemolysis
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
19. What do platelets release necessary for coagulation cascaed?
ADP and Ca
Yes - via MHC II
Abciximab
Paraprotein spike - monoclonal protein
20. Crew cut on skull xray due to marrow supression - 8% of AA population - single amino acid replacement in beta chain at position 6 - after a DNA point mutation
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Tissue
Sickle cell
Induces differentiation of myeloblasts
21. dec haptoglobin - inc LDH - hemoglobin in urine (paroxysmal nocturnal hemoglobinuria - mechanical destruction as in aortic stenosis or a prosthetic valve
Common a few days after oxidative stress in a pt with G6PD
B6
Intravascular hemolysis
Multiple myeloma
22. What begins the extrinsic pathway?
Adult T cell lymphoma - presents with cutaneous lesions
EBV
IgG - Warm is GREAT
Tissue factor converst the VII and VIIa
23. Why does B12 def cause neuro sx?
B12 in fatty acid pathways leads to subacute combined degeneration
ADP and Ca
Blood
VWF carries/protects factor VIII
24. What cell is primarily involved in non Hod lymph
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Myelofibrosis (marow is crying being its fibrosed'
Mantle cell lymphoma
B cells
25. What are the presenting symptoms of porphyria cutanea tarda
G6PD
Glanzmann's throbmasthenia
Blistering cutaneous photosens - most common porphyria
Intravascular hemolysis
26. Mutation in 3' untranslated region associated with venous clots
Extravascular hemolysis
Prothrombin gene mutation
Lacunar in nodular sclerosing variant
Blasts > 5%
27. What is the activation stage of platelet plug formation?
Collagen - BM - activated platelets
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Her next Rh+ fetus
B cells
28. What is the pathogenesis of ACD?
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Plummer - vinson syndrome
Hereditary spherocytosis - autoimmune hemolysis
Intravascular hemolysis
29. What causes the physiologic chloride shift and What does the chloride shift do?
Idiopathic thrombocytopenia (ITP)
Easy gas exchange
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Thrombotic thrombocytopenic purpura
30. Where do B cells arise from - mature - and migrate to...
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
...
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
TPA - cleavage of fibrin mesh
31. What are the main associations with multiple myeloma?
No antigen - both antibodies
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Hereditary spherocytosis
Hodgkin
32. What is the accumulated substance in lead poisoning
Inducers of primary antibody response
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Inc
Protoporphyrin (blood)
33. What signal activates MACS
Decrease EPO
Uroporphyrin (tea colored urine)
IFN gama
Lysosomes
34. What indicated a good prognosis in Hodgkin lymphoma?
Glucose and heme - which inhibit ALA synthase
Inc lymphoctes - and less RS cells
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Prothrombin gene mutation
35. Eosinophils are highly phagocytic For what kind of complex?
Fe def - thal - pb poison - sideroblastic anemia
Antigen - antibody
Inc HbA2 on electrophoresis
Multiple myeloma
36. Elderly - mature b cell tumor with filamentous - hairlike projections
Intrinsic - all factors except - VII - XIII
Hairy cell leukemia
No lytic bone lesions in WM
Positive osmootic fragility test and splenectomy
37. What is the general pathology of a macrocytic anemia?
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
B cells
Both alpha and beta thal
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
38. drug that inhibits ADP induced expression of GpIIb/IIIa
GpIIb/IIIa
Contiguous
Diffuse Large b cell lymphoma
Ticlopidine/clopidogrel
39. What symptoms are associated with Hodgkin lymphoma
B symptoms - fever night sweats - weight loss
Diffuse Large b cell lymphoma
Lead - and EtOH
Complications of sickle cell anemia
40. What do labs show in ITP?
Histaminase and arylsulfatase
Fc
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Malaria - Babesia
41. What is the mutation in HbC
No
Imatinib - anti bcr abl
Lysine for glutamate at position 6
Idiopathic thrombocytopenia (ITP)
42. What causes the jaundice in extravascular hemolysis
Langerhans cell histiocytosis
Varying shapes
Inc UCB
G6PD
43. When do you see MAHA?
Sheets of lymphocytes interspersed with macs
B cells
No lytic bone lesions in WM
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
44. Bone pain plus anemia
Howell Jolly bodies
Kids= exposure to lead paint - adults = battery - ammunition factory
Multiple myeloma
VWF carries/protects factor VIII
45. Megakaryocytosis
Rhogam - Rh antigen immunoglobulin
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Aplastic anemia - pancytopenia
Essential thrombocytosis
46. What substances are released in mast cell degranulation
Malaria - Babesia
Histamine - heparin - and eosinohil chemotactic factors
DIC
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
47. What percentage if WBCs are polys?
ADP and Ca
Round densly staining nucleus with a small amount of pale cytoplasm
40 to 75
90% anearobically from glucose to lactate - 10% from HMP shunt
48. What do you see on peripheral smear with sideroblastic anemia
Protein S - cleaves and invactivates Va and VIIIa
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Lymphoma
Ringed sideronblasts with iron laden mitochondria
49. What do platelets interact with to form a hemostatic plug
Burkitt lymphoma
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
DIC - TTP/HUS - traumatic hemolysis
Fibrinogen
50. What is the enzyme defect in Porphyria cutanea tarda
Up - down - nl
Ferrocheletase and ALA dehydrogenase
Fc
Uroporphyrinogen decarboxylase
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