Test your basic knowledge |

Hemeonc

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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 hemophilia B?
Low O2 in papilla; can also get microhematuria from medullary infarcts
Nl PT - elevated PTT - intrinsic pathway defect
ATIII def
Def in factor IX

2. What is the characteristic histologic finding in Hodgkin Lymphoma
Reed - sternberg cells
Ticlopidine/clopidogrel
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Uroporphyrinogen decarboxylase

3. Megakaryocytosis
Kids= exposure to lead paint - adults = battery - ammunition factory
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Essential thrombocytosis
Hereditary spherocytosis - G6PD - sickle cell

4. Serum iron - transferrin - ferritin lab values for iron def anemia
B12 in fatty acid pathways leads to subacute combined degeneration
Down - up - down
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
40 to 75

5. Adults present with cutaneous patches/nodules - indolent CD4+
Mycosis fundgoides/Sezary syndrome
Sideroblastic anemia
Burkitt lymphoma
Extravascular hemolysis

6. Sickle cell
Off center nuclues - clock face chromatin
Sickle cell anemia
Uroporphyrin (tea colored urine)
Varying sizes

7. Plasma cell neoplasm
5- FU - AZT - hydroxyurea
Multiple myeloma
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Antigen - antibody

8. What are the etiologies of B12 def
Factor V Leiden
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

9. What does ectopic EPO produce
Inappropriate absolute with inc RBCs and EPO
Megakaryocytes
Birbeck granules
Adult T cell lymphoma - presents with cutaneous lesions

10. Impaired synthesis of DAF leading to inc complement mediated desctruction of RBCs via the GPI ancho
Paroxysmal nocturnal hemoglobinuria
Alpha thal - asian and african american
Direct coombs - agglutinate if RBCs are coated with Ig
Glucose and heme - which inhibit ALA synthase

11. What is appropriate absolute polycythemia
EBV
Inc RBC - dec O2 sat - inc EPO
Essential thrombocytosis
Inc vasodiltion - inc perm - inc pain

12. What does LEAD stand for in lead poisoning?
Direct coombs - agglutinate if RBCs are coated with Ig
MAHA
Tissue
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 -

13. What do platelets interact with to form a hemostatic plug
Fibrinogen
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Hodgkin
Erythroblastosis fetalis - Rh or other blood antigen incompatibility

14. What is the tx for vWD
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Blod - tissue - MACS
Reed - sternberg cells
40 to 50

15. abnormal clone of hematopoetic stem cells are increasingly sensitive to growth factors - inc RBC - JAK2 mut
Off center nuclues - clock face chromatin
G6PD
Polycythemia vera
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT

16. Which drugs can cause macrocytic anemia?
5- FU - AZT - hydroxyurea
Protein C or S deficiency
Glycine and succinyl - coa
Splicing sites and promotor sequences

17. What is the treatment to prevent a woman from forming anti Rh antibody?
Intrinsic - all factors except - VII - XIII
Rhogam - Rh antigen immunoglobulin
G6PD
M3 AML (acute promyelocytic leukemia)

18. What are the likely exposures of kids and adults for lead poisoning
Indirect coombs - agglutinate if serum anti RBC surface Ig
Kids= exposure to lead paint - adults = battery - ammunition factory
Degrades fibrin mesh and converts C3 to C3a
Inc

19. Production of mutant factor V that cannot by degraded by protein C - most common cause of inherited hypercoaguability
HbSS
Factor V Leiden
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Sickle cell

20. inc HbF on electrophoresis
Both alpha and beta thal
CD15 and CD30 pos
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
CML

21. What is the characteristic spread of Hodgkin Lymphoma
Contiguous
Inc vasodiltion - inc perm - inc pain
Hereditary elloptocytosis
Diffuse Large b cell lymphoma

22. t(11;14)
Inducers of primary antibody response
Reed - sternberg cells
Mantle cell lymphoma
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis

23. What is the result of thrombocytopenia or platelet dysfunction?
Petechiae
Sheets of lymphocytes interspersed with macs
Fc
Exposed collagen upon endothelial damage

24. Is HS extravascular or intravascular?
Plummer - vinson syndrome
Direct coombs - agglutinate if RBCs are coated with Ig
Extravascular
Parvovirus

25. What is the characteristic lab finding on electrophoresis
PGI2 - NO inc blood flow - dec platelet aggregation
Factor V Leiden
Paraprotein spike - monoclonal protein
...

26. What is the ddx for aplastic anemia

27. What percentage if WBCs are polys?
Schistocytes and inc LDH
Mantle cell lymphoma
40 to 75
Paroxysmal nocturnal hemoglobinuria

28. What substance prevents mast cells degranulation?
Lead - and EtOH
Cromolyn sodium
TRAP (tartrate resistant acid phosphatase
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -

29. What do plasma cells do
Produce antibody - lots of RER and golgi
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Langerhans cells

30. What are the azuraphilic granules in PMNs
Lysosomes
Burkitt lymphoma
B6
Erythroblastosis fetalis - Rh or other blood antigen incompatibility

31. What is the philadelphia chromosome
DIC - TTP/HUS - traumatic hemolysis
Prothrombin gene mutation
Thrombotic thrombocytopenic purpura
T(9;22) bcr abl

32. What percentage of WBCs are monocytes?
Low O2 in papilla; can also get microhematuria from medullary infarcts
VWD
2 to 10
AB - no antibodies

33. Target cell

34. What converts plasminogen to plasm and What does plasmin do?
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
TPA - cleavage of fibrin mesh
AML
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

35. Back pain - hemoglobinuria
Common a few days after oxidative stress in a pt with G6PD
Hairy cell leukemia
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
5- FU - AZT - hydroxyurea

36. philadelphia chromosome - blood looks like marrow
IgG - Warm is GREAT
Down - up - down
Round densly staining nucleus with a small amount of pale cytoplasm
CML

37. Mutation in 3' untranslated region associated with venous clots
No
Inc vasodiltion - inc perm - inc pain
Howell - Jolly bodies - hypo/asplenia
Prothrombin gene mutation

38. anti - GpIIb/IIIa antibodies leading to peripheral platelet destruction
40 to 75
Inappropriate absolute with inc RBCs and EPO
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Idiopathic thrombocytopenia (ITP)

39. CD5+ - poor prognosis - t(11;14)
Kids= exposure to lead paint - adults = battery - ammunition factory
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Mantle cell - older males

40. How does vWD cause elevated PTT?
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Langerhans cells
VWF carries/protects factor VIII
Protoporphyrin (blood)

41. Blood type A
Petechiae
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Bite cells and Heinz bodies
A antigen and B antibodies

42. What finding you do you see in patients after splenectomy
Blistering cutaneous photosens - most common porphyria
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Howell Jolly bodies

43. Who has more severe disease - HbSS or HbSC
HbSS
Essential thrombocytosis
Reed - sternberg cells
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)

44. What the alpha granules contain in platelets?
Inc RBC - dec O2 sat - inc EPO
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
VWF and fibrinogen
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA

45. What is HbH
Howell - Jolly bodies - hypo/asplenia
Hb Barts - gamma4 in defect in all 4 alpha genes
Beta 4
Myelofibrosis (marow is crying being its fibrosed'

46. What percentage of WBCs are eosinophils?
TPA - cleavage of fibrin mesh
ADP and Ca
Anti Rh
1 to 6

47. Oxidation of iron - denatured hemoglobin preceipitation damage to RBC membrane - formation of bite cells
Heinz bodies - seen in alpha thal and G6PD
40 to 75
2 to 10
HbSS

48. mother's antibodies attack fetal RBCs
Abciximab
Bernard soulier
Alpha thal - asian and african american
Erythroblastosis fetalis - Rh or other blood antigen incompatibility

49. What percentage of WBCs are basophils - and What is found in their basophilic granules?
Ringed sideronblasts with iron laden mitochondria
Ticlopidine/clopidogrel
Blood
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

50. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Hereditary spherocytosis
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Nl - up - nl
MAHA