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Test your basic knowledge |
Hemeonc
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
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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 are some causes of cold agglutinin anemia
Sheets of lymphocytes interspersed with macs
Peroxidase
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Helps platelts adhere to endothelium
2. What is the aggregation phase of ppf?
Lymphoma
Fibrinogen bind GpIIb/IIIa and links platelts
Nodular sclerosing
Anemia of chronic disease - Aplastic anemia - kidney disease
3. What indicated a good prognosis in Hodgkin lymphoma?
40 to 50
Aspirin
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Inc lymphoctes - and less RS cells
4. Drug that inhbits the GpIIb/IIIa directly
Inc lymphoctes - and less RS cells
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Abciximab
Intrinsic - all factors except - VII - XIII
5. What is the pathogenesis of TTP?
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Inc large vWF multimers - inc platelet aggregation and thrombosis
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Nl PT - elevated PTT - intrinsic pathway defect
6. What is the treatment to prevent a woman from forming anti Rh antibody?
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Indirect coombs - agglutinate if serum anti RBC surface Ig
Rhogam - Rh antigen immunoglobulin
Multiple myeloma
7. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Protein C or S deficiency
Extravascular hemolysis
Hereditary spherocytosis
Mycosis fundgoides/Sezary syndrome
8. When is the peak incidence for nonHod lymphoma
20 to 40
Hairy cell leukemia
Ankryin - band 4.1 or spectrin
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
9. fatigue - malaise - pallor - purpura - mucosal bleeding - petechiae - infection
Varying sizes
Fibrinogen
Common a few days after oxidative stress in a pt with G6PD
Signs and sx of aplastic anemia
10. What is the Ddx for a normocytic - normochromic anemia?
Paroxysmal nocturnal hemoglobinuria
Alpha thal - asian and african american
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
11. What does the large SA:volume ratio in RBCs help facilitate?
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Easy gas exchange
Plummer - vinson syndrome
Diffuse Large b cell lymphoma
12. What is relative polycythemia
Dec plasma volume
DIC
Varying shapes
CLL (SLL without the peripheral lymphocytosis
13. Marrow expansion - 'crew cut' on skull x ray - skeletal deformaties - and chipmunk faces
Beta thal
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Lead - and EtOH
VWD
14. What are the pro aggregation factors?
Leukemoid reaction
TXA2 - dec blood flow - inc platelet aggregation
TPA - cleavage of fibrin mesh
Acts to stabilize platelet plug
15. What causes the physiologic chloride shift and What does the chloride shift do?
5- FU - AZT - hydroxyurea
120 days
Low O2 in papilla; can also get microhematuria from medullary infarcts
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
16. What is the enzyme defect in Porphyria cutanea tarda
A antigen and B antibodies
Valine for glutamate
TRAP (tartrate resistant acid phosphatase
Uroporphyrinogen decarboxylase
17. Where are monocytes typically found - where do they go - and What do the differentiate into?
Malaria - Babesia
Macrohemorrhage - hemarthroses - easy bruising
Adult T cell lymphoma - presents with cutaneous lesions
Blod - tissue - MACS
18. What reveresible things can a sideroblastic anemia
Lead - and EtOH
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
HbSS
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 -
19. What do plasma cells do
Adult T cell lymphoma - presents with cutaneous lesions
Lymphoma
GpIIb/IIIa
Produce antibody - lots of RER and golgi
20. Which substrates begin the heme synthesis pathway
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Protein C or S deficiency
DIC - TTP/HUS - traumatic hemolysis
Glycine and succinyl - coa
21. What is a metabolic disorder tht can cause macrocytic anemia?
Orotic aciduria
Inappropriate absolute with inc RBCs and EPO
Inc lymphoctes - and less RS cells
Bone marrow - thymus - blood (80% of circulating lymphos are T)
22. What is makes a leukemia acute
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Blasts > 5%
DIC - TTP/HUS - traumatic hemolysis
23. What is monoclonal expansion without symptoms associated with multiple myeloma?
Collagen - BM - activated platelets
Glanzmann's throbmasthenia
MGUS - monoclonal gammopathy of undetermined significance
Howell - Jolly bodies - hypo/asplenia
24. Mutation in 3' untranslated region associated with venous clots
Ringed sideronblasts with iron laden mitochondria
Prothrombin gene mutation
Antigen - antibody
B12 def
25. What is the most common hodgkin lymphoma
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Nodular sclerosing
Howell - Jolly bodies - hypo/asplenia
Splicing sites and promotor sequences
26. Conditions of defective heme synthesis leading to accumulation of heme precurors
Lacunar in nodular sclerosing variant
Follicular lymphoma - indolent course
Porphyrias
Ferrocheletase and ALA dehydrogenase
27. Eosinophils are highly phagocytic For what kind of complex?
Howell Jolly bodies
Paroxysmal nocturnal hemoglobinuria
Antigen - antibody
8-10 days
28. What does hairy cell leukemia stain with
A antigen and B antibodies
Adult T cell lymphoma - presents with cutaneous lesions
Bone marrow infiltration - myelofibrosis
TRAP (tartrate resistant acid phosphatase
29. Inherited deficiency of antithrombin; reduced inc in PTT after administration of heparin
ATIII def
Protoporphyrin
MGUS - monoclonal gammopathy of undetermined significance
CNS and testis
30. Production of mutant factor V that cannot by degraded by protein C - most common cause of inherited hypercoaguability
Intravascular
B6 therapy (pyrodixine)
TRAP (tartrate resistant acid phosphatase
Factor V Leiden
31. What is their role?
Bimodal - men>women - except for nodular sclerosing type
Inducers of primary antibody response
Sideroblastic anemia
AML
32. What do platelets interact with to form a hemostatic plug
Fibrinogen
Easy gas exchange
Contiguous
EBV
33. Deficiency in vWF
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34. What is the presenting scenario for TTP?
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA
Lung disease - congenital heart diseaes - and high altitude
A antigen and B antibodies
Beta thal
35. What are the four levels of alpha thal?
Imatinib - anti bcr abl
Inc vasodiltion - inc perm - inc pain
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
36. What activates the fibrinolytic pathway?
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Schistocytes and inc LDH
Burkitt lymphoma
DIC
37. Why can newborns with sickle cell be asymptomatic
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Inc HbF and dec HbS
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
38. Widespread activation of clotting to a deficiency in clotting factors which causes a bleeding states
Up - down - nl
ATIII def
DIC
Bone marrow - thymus - blood (80% of circulating lymphos are T)
39. What cell is primarily involved in non Hod lymph
Hb Barts - gamma4 in defect in all 4 alpha genes
B cells
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
B antigena and A antibodes
40. What causes renal papillary necrosis in sickle cell
Low O2 in papilla; can also get microhematuria from medullary infarcts
G6PD
Incactivates II - VII - IX - X - XI - XII
Nodular sclerosing
41. What does bradykinin do?
TXA2 - dec blood flow - inc platelet aggregation
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Inc vasodiltion - inc perm - inc pain
Mantle cell - older males
42. What is the tx for aplastic anemia
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Incactivates II - VII - IX - X - XI - XII
Up - down - up
43. hypocellular bone marrown tih fatty infiltration
Sickle cell anemia
Inc
B6
Aplastic anemia - pancytopenia
44. What is hemophilia B?
Def in factor IX
Inc UCB
No platelet clumping
Dec plasma volume
45. Defect in platelet to platelet adhesion - receptor - disorder - platelet count and bleeding time
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46. t(11:22)
Ewing sarcoma
Sideroblastic anemia
DIC - TTP/HUS - traumatic hemolysis
Megakaryocytes
47. Causes of iron def?
Liver disease - abetalipoproteinemia - acntho = spiny
Down - down - up
A antigen and B antibodies
Bleeding - malnutrition/absorption - inc demand pregs
48. Ringed sideroblasts
Sideroblastic anemia
Lymphoma
CD15 and CD30 pos
Nodular sclerosing
49. What are the main associations with multiple myeloma?
Dendritic cells?
Deficiency in factor VIII
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Blood
50. X linked - dec glutathione inc RBC susceptibility to oxidative stress
Myelofibrosis (marow is crying being its fibrosed'
G6PD
Parvovirus
Alpha thal - asian and african american