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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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1. Serum iron - transferrin - ferritin lab values for lead poisoning anemia
Nl PT - elevated PTT - intrinsic pathway defect
Lysine for glutamate at position 6
Up - down - nl
2 to 10

2. What is the therapy for CML (philly chrom)
Round densly staining nucleus with a small amount of pale cytoplasm
Paroxysmal nocturnal hemoglobinuria
Imatinib - anti bcr abl
IFN gama

3. What indicated a good prognosis in Hodgkin lymphoma?
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Inc lymphoctes - and less RS cells
HbSS
Howell Jolly bodies

4. What is the characteristic finding for MAHA on peripheral smear?
Paroxysmal nocturnal hemoglobinuria
Schistocytes - helmet cells
GpIIb/IIIa
Spleen

5. What do auer rods stain with
DIC
Inc HbA2 on electrophoresis
Adult T cell lymphoma - presents with cutaneous lesions
Peroxidase

6. What is the receptor for vWF
B12/folate def
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Gp1b
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

7. Blood type B
Acts to stabilize platelet plug
Induces differentiation of myeloblasts
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
B antigena and A antibodes

8. What percentage of WBCs are basophils - and What is found in their basophilic granules?
90% anearobically from glucose to lactate - 10% from HMP shunt
Nodular sclerosing
Lysine for glutamate at position 6
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

9. What is the Ddx for for a macrocytic anemia
Howell Jolly bodies
Inc HbA2 on electrophoresis
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Up - down - nl

10. hypersegmented PMNs - glossitis - dec B12 - inc homocysteine - inc methymalonic acid
AML
SLE - CLL - alpha methyldopa
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
B12 def

11. Megakaryocytosis
Paroxysmal nocturnal hemoglobinuria
Birbeck granules
Fc
Essential thrombocytosis

12. adults - auer rods - inc circulating myeblasts on peripheral smear
B antigena and A antibodes
B12 def
AML
Multiple myeloma

13. What causes the jaundice in extravascular hemolysis
Leukemia
Beta thal
Inc UCB
Intravascular hemolysis

14. dec haptoglobin - inc LDH - hemoglobin in urine (paroxysmal nocturnal hemoglobinuria - mechanical destruction as in aortic stenosis or a prosthetic valve
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Orotic aciduria
Intravascular hemolysis
Multiple myeloma

15. What are the presenting symptoms of porphyria cutanea tarda
Langerhans cells
Mantle cell - older males
ADP and Ca
Blistering cutaneous photosens - most common porphyria

16. What do they express on their surface?
MHC II and Fc receptors
Schistocytes - helmet cells
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
Protoporphyrin (blood)

17. hypocellular bone marrown tih fatty infiltration
Von Willebrand's disease
Cromolyn sodium
Aplastic anemia - pancytopenia
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm

18. Is HS extravascular or intravascular?
Sideroblastic anemia
CLL (SLL without the peripheral lymphocytosis
Plummer - vinson syndrome
Extravascular

19. What is the effected enzyme in acute intermittment porphyria?
Factor V Leiden
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Folate def

20. What CD molecules are on RS cells
EBV
Exposed collagen upon endothelial damage
Contiguous
CD15 and CD30 pos

21. Where do B cells arise from - mature - and migrate to...
Langerhans cell histiocytosis
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Parvovirus

22. universal recipient
No lytic bone lesions in WM
ATIII def
AB - no antibodies
Blasts > 5%

23. t(8;14) c - myc gene
Burkitt lymphoma
Alpha thal - asian and african american
Lead - and EtOH
Decrease EPO

24. Back pain - hemoglobinuria
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
Beta thal
Blod - tissue - MACS
Common a few days after oxidative stress in a pt with G6PD

25. What do the dense granules contain in platelets
CML to AML or All
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
...
ADP and Ca

26. Which enzyme converts vit k to activated vit k - and what substance inhibits this enzyme
Epoxide reductase - warfarin inhibits
ATIII def
1 to 6
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium

27. inhibition of ferrochelatase and ALA dehydrogenase leading to dec heme synthesis - also inhibition of rRNA degradation
VIII
Signs and sx of aplastic anemia
ADP and Ca
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling

28. What is monoclonal expansion without symptoms associated with multiple myeloma?
B antigena and A antibodes
MGUS - monoclonal gammopathy of undetermined significance
Mantle cell - older males
Plasma cell

29. What do the platelets bind? What is the step called
Abciximab
Uroporphyrin (tea colored urine)
Hereditary spherocytosis - autoimmune hemolysis
They bind vWF via GpIb

30. Ddx for microcytic anemia
Fe def - thal - pb poison - sideroblastic anemia
Degrades fibrin mesh and converts C3 to C3a
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Cromolyn sodium

31. philadelphia chromosome - blood looks like marrow
Indirect coombs - agglutinate if serum anti RBC surface Ig
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Up - down - nl
CML

32. Tdt+ - CAllA+ - kids in the marrow - adolescent males with mediastinal mass
B6 therapy (pyrodixine)
Intrinsic - all factors except - VII - XIII
ATIII def
All

33. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Decrease EPO
Peroxidase
Hereditary spherocytosis
Extravascular hemolysis

34. Deficiency in GpIIb/IIIa

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35. What is relative polycythemia
Glycine and succinyl - coa
Liver disease - abetalipoproteinemia - acntho = spiny
Dec plasma volume
Nl - up - nl

36. How is beta thal minor dx
Lysine for glutamate at position 6
Inc HbA2 on electrophoresis
CML to AML or All
Hereditary spherocytosis - autoimmune hemolysis

37. What finding you do you see in patients after splenectomy
Cromolyn sodium
They bind vWF via GpIb
ATIII def
Howell Jolly bodies

38. When do you see MAHA?
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Thrombotic thrombocytopenic purpura
B12/folate def
No antigen - both antibodies

39. Where to T cells arise and mature - and migrate to...
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 -
Parvovirus
B12/folate def
Bone marrow - thymus - blood (80% of circulating lymphos are T)

40. What is the general pathology of a macrocytic anemia?
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Leukemia
Alpha thal - asian and african american
Thrombotic thrombocytopenic purpura

41. In a Rh - mother who has developed anti Rh antibodies - who is at risk of hemolytic disease?
Her next Rh+ fetus
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Myelofibrosis (marow is crying being its fibrosed'
CML to AML or All

42. What is the age group most commonly affected by multiple myeloma
B antigena and A antibodes
Inappropriate absolute with inc RBCs and EPO
Ferrocheletase and ALA dehydrogenase
40 to 50

43. What does 'Neutrophils Like Making Everything Better' stand for?
G6PD
Factor V Leiden
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Nodular sclerosing

44. Causes of iron def?
Bleeding - malnutrition/absorption - inc demand pregs
120 days
Inc serum iron - normal TIBC - inc ferratin
Dec plasma volume

45. What do labs show in ITP?
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
TXA2 - dec blood flow - inc platelet aggregation
Malaria - Babesia
Pos

46. What substance accumulates in porphyria cutanea
Uroporphyrin (tea colored urine)
Nl PT - elevated PTT - intrinsic pathway defect
Fibrinogen bind GpIIb/IIIa and links platelts
Inc lymphoctes - and less RS cells

47. After an injury - What does vWF bind to begin platelet plug formation?
Reed - sternberg cells
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
5- FU - AZT - hydroxyurea
Exposed collagen upon endothelial damage

48. Which factor does vWF carry/protect
All trans retinoic acid
Hodgkin
Porphyrias
VIII

49. What activates protein C and What does activated protein C do?
Protein S - cleaves and invactivates Va and VIIIa
Pyruvate kinase def - extravascular
Ticlopidine/clopidogrel
Off center nuclues - clock face chromatin

50. What is the coombs test results in AIHA?
Liver disease - abetalipoproteinemia - acntho = spiny
Lung disease - congenital heart diseaes - and high altitude
Pos
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT