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Hemeonc

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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. tennis rackets on EM
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Extravascular
Birbeck granules
Eleveated PT - PTT

2. Which drugs can cause macrocytic anemia?
Nodular sclerosing
Tissue
5- FU - AZT - hydroxyurea
EBV

3. What does NAACP stand for - in regards to the causes of eosinophiia?
Leukemia
Birbeck granules
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
B6

4. Serum iron - transferrin - ferritin lab values for pregs - OCP use
Dec
B cells
Nl - up - nl
Hereditary spherocytosis - autoimmune hemolysis

5. In hemophilia A or B What do you see in the coag tests
Eleveated PT - PTT
Blasts > 5%
Nl PT - elevated PTT - intrinsic pathway defect
Sheets of lymphocytes interspersed with macs

6. What reveresible things can a sideroblastic anemia
AB - no antibodies
Examples of oxidative stress
Lead - and EtOH
Signs and sx of aplastic anemia

7. Serum iron - transferrin - ferritin lab values for anemia of chronic disease
A antigen and B antibodies
Inc lymphoctes - and less RS cells
Produce antibody - lots of RER and golgi
Down - down - up

8. When is the peak incidence for nonHod lymphoma
CD15 and CD30 pos
GpIIb/IIIa
Inc large vWF multimers - inc platelet aggregation and thrombosis
20 to 40

9. What finding you do you see in patients after splenectomy
Direct coombs - agglutinate if RBCs are coated with Ig
Cromolyn sodium
Howell Jolly bodies
Acts to stabilize platelet plug

10. drug that inhibits ADP induced expression of GpIIb/IIIa
G6PD
Intravascular
Extravascular
Ticlopidine/clopidogrel

11. CD5+ - poor prognosis - t(11;14)
20 to 40
Kids= exposure to lead paint - adults = battery - ammunition factory
Langerhans cell histiocytosis
Mantle cell - older males

12. Drug that inhibits COX and therefore TXA2 synthesis
Helps platelts adhere to endothelium
Contiguous
Aspirin
Positive osmootic fragility test and splenectomy

13. What is the life spance of a platelet?
Hairy cell leukemia
Abciximab
8-10 days
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin

14. What is the therapy for the M3 variant?
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
VIII
Multiple myeloma
All trans retinoic acid

15. What are dendritic cells called in the skin?
Varying shapes
Langerhans cells
Signs and sx of aplastic anemia
No antigen - both antibodies

16. Drug that inhbits the GpIIb/IIIa directly
Abciximab
Inc lymphoctes - and less RS cells
40 to 75
Eleveated PT - PTT

17. abnormal clone of hematopoetic stem cells are increasingly sensitive to growth factors - inc RBC - JAK2 mut
Anti Rh
Polycythemia vera
Lead - and EtOH
Langerhans cells

18. What are the presenting symptoms of porphyria cutanea tarda
Langerhans cell histiocytosis
Kids= exposure to lead paint - adults = battery - ammunition factory
Rhogam - Rh antigen immunoglobulin
Blistering cutaneous photosens - most common porphyria

19. What is the mutation in HbC
Varying sizes
Bone marrow infiltration - myelofibrosis
Lysine for glutamate at position 6
AML

20. What is the life span of a normal RBC
Aplastic anemia - pancytopenia
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
120 days
VWF carries/protects factor VIII

21. Back pain - hemoglobinuria
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Inc HbA2 on electrophoresis
Round densly staining nucleus with a small amount of pale cytoplasm
Common a few days after oxidative stress in a pt with G6PD

22. What is the most common nonhodgkin lymphoma
Essential thrombocytosis
Sideroblastic anemia
Diffuse Large b cell lymphoma
Bite cells and Heinz bodies

23. What substance is Fe added to to yield heme
Dec synthesis of factors 1972 - protein C/S
Yes - via MHC II
IFN gama
Protoporphyrin

24. Schisotcyte - helmet cell
DIC - TTP/HUS - traumatic hemolysis
20 to 40
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 -
Off center nuclues - clock face chromatin

25. What are the etiologies of B12 def
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
TXA2 - dec blood flow - inc platelet aggregation
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
Down - down - up

26. What do you see in peripheral smear in a pt with G6PD?
Pyruvate kinase def - extravascular
Bite cells and Heinz bodies
T(9;22) bcr abl
Howell Jolly bodies

27. What is the Ddx for nonhemolytic normocytic anemia
Examples of oxidative stress
Anemia of chronic disease - Aplastic anemia - kidney disease
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Leukemoid reaction

28. What is hemophilia B?
Langerhans cells
Lacunar in nodular sclerosing variant
Def in factor IX
Nodular sclerosing

29. Megakaryocytosis
Essential thrombocytosis
Helps platelts adhere to endothelium
Fibrinogen bind GpIIb/IIIa and links platelts
Hereditary spherocytosis - autoimmune hemolysis

30. What is appropriate absolute polycythemia
Intravascular
Inc RBC - dec O2 sat - inc EPO
B6 therapy (pyrodixine)
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)

31. What is the purpose of the fibrin mesh
Sickle cell
Direct coombs - agglutinate if RBCs are coated with Ig
Acts to stabilize platelet plug
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin

32. What is the pattern of involvement and spread for nonHod lympho
Inc large vWF multimers - inc platelet aggregation and thrombosis
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Decrease EPO
Dendritic cells?

33. What do you see on peripheral smear with sideroblastic anemia
Ringed sideronblasts with iron laden mitochondria
Acts to stabilize platelet plug
40 to 50
Aplastic anemia - pancytopenia

34. What do the labs show for TTP?
Liver disease - abetalipoproteinemia - acntho = spiny
Fibrinogen bind GpIIb/IIIa and links platelts
Schistocytes and inc LDH
Paraprotein spike - monoclonal protein

35. What are the presenting symptoms of acute intermittent porphyria
Dec
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Varying sizes
Blod - tissue - MACS

36. fatigue - malaise - pallor - purpura - mucosal bleeding - petechiae - infection
Dec
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Signs and sx of aplastic anemia
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

37. Ddx for microcytic anemia
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Fe def - thal - pb poison - sideroblastic anemia
Sickle cell
Gp1b

38. What converts plasminogen to plasm and What does plasmin do?
Blod - tissue - MACS
Aspirin
TPA - cleavage of fibrin mesh
Extravascular

39. adults - auer rods - inc circulating myeblasts on peripheral smear
Indirect coombs - agglutinate if serum anti RBC surface Ig
AML
Factor V resistant to activated protein C's inhibition
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

40. inc LDH - jaundice
No lytic bone lesions in WM
M3 AML (acute promyelocytic leukemia)
Extravascular hemolysis
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60

41. Which pathway and factors are tested in the PTT test
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Plasma cell
Uroporphyrin (tea colored urine)
Intrinsic - all factors except - VII - XIII

42. What are the anti aggregation factors?
Direct coombs - agglutinate if RBCs are coated with Ig
Indirect coombs - agglutinate if serum anti RBC surface Ig
PGI2 - NO inc blood flow - dec platelet aggregation
Kids= exposure to lead paint - adults = battery - ammunition factory

43. What do the dense granules contain in platelets
Complications of sickle cell anemia
Tissue
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
ADP and Ca

44. 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
Sickle cell
Multiple myeloma
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Pyruvate kinase def - extravascular

45. What virus can cause an aplastic crisis in pts with HS?
Parvovirus
Von Willebrand's disease
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
Inc

46. t(11;14)
Mantle cell lymphoma
PGI2 - NO inc blood flow - dec platelet aggregation
Glycine and succinyl - coa
VWF and fibrinogen

47. What do labs show in ITP?
A antigen and B antibodies
Intravascular hemolysis
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Bite cells and Heinz bodies

48. Acanthocyte (spur cell)
No lytic bone lesions in WM
Valine for glutamate
Intrinsic - all factors except - VII - XIII
Liver disease - abetalipoproteinemia - acntho = spiny

49. What activates the fibrinolytic pathway?
DDAVP (desmopressin) which releases stored vWF stored in endothelium
All trans retinoic acid
Hydroxyurea - bone marrow transplant
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin

50. Production of mutant factor V that cannot by degraded by protein C - most common cause of inherited hypercoaguability
Megakaryocytes
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Factor V Leiden
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)