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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. Blood type B
Inc serum iron - normal TIBC - inc ferratin
Fe def - thal - pb poison - sideroblastic anemia
B antigena and A antibodes
Inc

2. What are some causes of warm agglutinin autoimmune hemolytic anemia?
Down - up - down
Nl - up - nl
SLE - CLL - alpha methyldopa
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning

3. What signal activates MACS
IFN gama
Factor V Leiden
Abciximab
All

4. t(15;17)
Positive osmootic fragility test and splenectomy
CML
Inactivates it
M3 AML (acute promyelocytic leukemia)

5. What virus is associated with 50% of Hodgkin lymphoma
Antigen - antibody
Inc HbA2 on electrophoresis
EBV
Africa = Jaw lesion - US = pelvis or abdomen

6. What happens in beta thal major?
B6
Helminth infections major basic protein
HbSS
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

7. What is HbH
Porphyrias
Myelofibrosis (marow is crying being its fibrosed'
Beta 4
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT

8. iron deficiency anemia - esophageal web - atrophic glossitis
Plummer - vinson syndrome
2 to 10
Lead - and EtOH
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

9. What condition can result from treating AML M3 from the release of the Auer rods
Plummer - vinson syndrome
CD15 and CD30 pos
Tissue
DIC

10. What is the receptor for fibrinogen?
5- FU - AZT - hydroxyurea
Hereditary spherocytosis - autoimmune hemolysis
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 -
GpIIb/IIIa

11. Which pathway and factors are tested in the PTT test
Sickle cell anemia
Multiple myeloma
Dec synthesis of factors 1972 - protein C/S
Intrinsic - all factors except - VII - XIII

12. What is the presenting scenario for TTP?
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA
They bind vWF via GpIb
No lytic bone lesions in WM
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling

13. Inherited deficiency of antithrombin; reduced inc in PTT after administration of heparin
Hereditary spherocytosis - autoimmune hemolysis
ATIII def
Bleeding - malnutrition/absorption - inc demand pregs
Plasma cell

14. abnormal clone of hematopoetic stem cells are increasingly sensitive to growth factors - inc RBC - JAK2 mut
Easy gas exchange
Polycythemia vera
Petechiae
Essential thrombocytosis

15. Impaired synthesis of DAF leading to inc complement mediated desctruction of RBCs via the GPI ancho
Peroxidase
Diffuse Large b cell lymphoma
MHC II and Fc receptors
Paroxysmal nocturnal hemoglobinuria

16. What are the labs and tx for HS?
Sideroblastic anemia
Def in factor IX
Positive osmootic fragility test and splenectomy
Rhogam - Rh antigen immunoglobulin

17. poikilocytosis
Varying shapes
TRAP (tartrate resistant acid phosphatase
Ewing sarcoma
Nl PT - elevated PTT - intrinsic pathway defect

18. Aplastic crisis after parvovirus - autosplenectomy - salmonella osteomyelitis - painful crisis - renal papillary necrosis - splenic sequestration
Inc lymphoctes - and less RS cells
Gp1b
Complications of sickle cell anemia
Kids= exposure to lead paint - adults = battery - ammunition factory

19. Which infections can cause MAHA?
Malaria - Babesia
B12 def
VWF carries/protects factor VIII
Protein C or S deficiency

20. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
No antigen - both antibodies
Hodgkin
Intrinsic - all factors except - VII - XIII
Up - down - nl

21. Marrow expansion - 'crew cut' on skull x ray - skeletal deformaties - and chipmunk faces
Plummer - vinson syndrome
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Beta thal
Def in factor IX

22. Where are monocytes typically found - where do they go - and What do the differentiate into?
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
All trans retinoic acid
Dec synthesis of factors 1972 - protein C/S
Blod - tissue - MACS

23. What is the difference of presentation of Burkitt in Africa vs the United States
Acts to stabilize platelet plug
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Def in factor IX
Africa = Jaw lesion - US = pelvis or abdomen

24. When do you see MAHA?
Blistering cutaneous photosens - most common porphyria
Down - down - up
Bleeding - malnutrition/absorption - inc demand pregs
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis

25. What is the tx for aplastic anemia
Lysine for glutamate at position 6
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
40 to 75
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF

26. What indicated a good prognosis in Hodgkin lymphoma?
No platelet clumping
Inc lymphoctes - and less RS cells
Plummer - vinson syndrome
Antigen - antibody

27. What is the life spance of a platelet?
Hereditary spherocytosis - G6PD - sickle cell
Anti Rh
Varying shapes
8-10 days

28. How does vWD cause elevated PTT?
Sickle cell
EBV
VWF carries/protects factor VIII
Anti Rh

29. What do you see in vit K def
CNS and testis
GpIIb/IIIa
Eleveated PT - PTT
Spleen

30. What does decreasing heme do to ALA synthase activity?
Thrombotic thrombocytopenic purpura
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Von Willebrand's disease
Inc

31. Acanthocyte (spur cell)
Prothrombin gene mutation
Inc lymphoctes - and less RS cells
Liver disease - abetalipoproteinemia - acntho = spiny
Sickle cell

32. Sickle cell
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Beta thal
Inc serum iron - normal TIBC - inc ferratin
Sickle cell anemia

33. Wilm's tumor - RCC - HCC - hydronephrosis
Inc
Paraprotein spike - monoclonal protein
No
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO

34. What is their role?
GpIIb/IIIa
B antigena and A antibodes
Inducers of primary antibody response
Beta chain underproduced - asymptomatic - heterozygote

35. What is the defect in beta thal?
Splicing sites and promotor sequences
AB - no antibodies
Blood
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread

36. Which immunoglobulin is involved in warm agglutination?
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Mantle cell lymphoma
IgG - Warm is GREAT
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils

37. anti - GpIIb/IIIa antibodies leading to peripheral platelet destruction
B antigena and A antibodes
AML
Idiopathic thrombocytopenia (ITP)
Helps platelts adhere to endothelium

38. What percentage of WBCs are monocytes?
Lung disease - congenital heart diseaes - and high altitude
SLE - CLL - alpha methyldopa
Glycine and succinyl - coa
2 to 10

39. What is the therapy for CML (philly chrom)
Peroxidase
Valine for glutamate
Imatinib - anti bcr abl
Her next Rh+ fetus

40. Back pain - hemoglobinuria
Heinz bodies - seen in alpha thal and G6PD
Common a few days after oxidative stress in a pt with G6PD
Lymphoma
Protoporphyrin

41. Which factor does vWF carry/protect
Off center nuclues - clock face chromatin
Mycosis fundgoides/Sezary syndrome
Decrease EPO
VIII

42. What is the activation stage of platelet plug formation?
MGUS - monoclonal gammopathy of undetermined significance
Yes - via MHC II
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Histaminase and arylsulfatase

43. Upregulated growth of leukocytes in bone marro
Leukemia
Hereditary spherocytosis
CNS and testis
Thrombotic thrombocytopenic purpura

44. What do the platelets bind? What is the step called
Thrombotic thrombocytopenic purpura
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
They bind vWF via GpIb
Plummer - vinson syndrome

45. What is hemophiliia A
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Dec plasma volume
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Deficiency in factor VIII

46. Basophilica stippling
Common a few days after oxidative stress in a pt with G6PD
Protein C or S deficiency
EBV
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning

47. What is appropriate absolyte polycythemia associated with
Hereditary elloptocytosis
Yes - via MHC II
Lung disease - congenital heart diseaes - and high altitude
Pos

48. What is the affected enzyme in acute intermittment porphyria
Induces differentiation of myeloblasts
DIC
T(12;21)
Porphobilinogen - delta ALA - uroporphyrin

49. Blood type A
Leukemoid reaction
A antigen and B antibodies
Indirect coombs - agglutinate if serum anti RBC surface Ig
Erythroblastosis fetalis - Rh or other blood antigen incompatibility

50. philadelphia chromosome - blood looks like marrow
CML
Aspirin
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
DIC - TTP/HUS - traumatic hemolysis