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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. What percentage of WBCs are eosinophils?
Alpha thal - asian and african american
1 to 6
Sickle cell anemia
Blood

2. What is the affected enzyme in lead poisoning
Inc UCB
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Ferrocheletase and ALA dehydrogenase
Acts to stabilize platelet plug

3. What percentage if WBCs are polys?
Macrohemorrhage - hemarthroses - easy bruising
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
VIII
40 to 75

4. What CD molecules are on RS cells
HIV or immunosupression
Down - down - up
Megakaryocytes
CD15 and CD30 pos

5. What activates protein C and What does activated protein C do?
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Mycosis fundgoides/Sezary syndrome
Protein S - cleaves and invactivates Va and VIIIa
SLE - CLL - alpha methyldopa

6. What is the age group most commonly affected by multiple myeloma
Exposed collagen upon endothelial damage
Lung disease - congenital heart diseaes - and high altitude
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
40 to 50

7. What is the Ddx for nonhemolytic normocytic anemia
Ringed sideronblasts with iron laden mitochondria
Anemia of chronic disease - Aplastic anemia - kidney disease
Beta 4
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT

8. What is the presenting scenario for TTP?
Inc HbA2 on electrophoresis
Mantle cell lymphoma
VIII
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA

9. What do you see in vit K def
Lung disease - congenital heart diseaes - and high altitude
Eleveated PT - PTT
VWF carries/protects factor VIII
Inc lymphoctes - and less RS cells

10. From what cells are platelets derived from
Pyruvate kinase def - extravascular
Protein S - cleaves and invactivates Va and VIIIa
Malaria - Babesia
Megakaryocytes

11. What symptoms are associated with Hodgkin lymphoma
CLL (SLL without the peripheral lymphocytosis
Histamine - heparin - and eosinohil chemotactic factors
B symptoms - fever night sweats - weight loss
Folate def

12. What is the philadelphia chromosome
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
B12 def
T(9;22) bcr abl
Beta thal

13. How is beta thal minor dx
Alpha thal - asian and african american
Inc lymphoctes - and less RS cells
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Inc HbA2 on electrophoresis

14. universal recipient
Produce antibody - lots of RER and golgi
AB - no antibodies
Plummer - vinson syndrome
120 days

15. Blood type B
VWD
B antigena and A antibodes
Africa = Jaw lesion - US = pelvis or abdomen
Incactivates II - VII - IX - X - XI - XII

16. Which immunoglobulin is involved in warm agglutination?
IgG - Warm is GREAT
G6PD
Peroxidase
Fc

17. inc WBC count with left shift - inc leukocyte alkaline phosphatase - often due to infection
Hairy cell leukemia
Uroporphyrin (tea colored urine)
Beta chain underproduced - asymptomatic - heterozygote
Leukemoid reaction

18. hypersegmented PMNs - glossitis - dec folate - inc homocysteine - nl methylmalonic acid
Plummer - vinson syndrome
Folate def
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
90% anearobically from glucose to lactate - 10% from HMP shunt

19. What is the defect in beta thal?
B cells
Splicing sites and promotor sequences
Glycine and succinyl - coa
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

20. What is the are the presenting symptoms of lead poisoning in kids and adults
Factor V resistant to activated protein C's inhibition
Histaminase and arylsulfatase
Fibrinogen
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination

21. universal donor
No antigen - both antibodies
Inc vasodiltion - inc perm - inc pain
Lysine for glutamate at position 6
Multiple myeloma

22. Drug that inhibits COX and therefore TXA2 synthesis
Aspirin
TPA - cleavage of fibrin mesh
Porphyrias
Easy gas exchange

23. What is the tx for sickle cell
Megakaryocytes
Indirect coombs - agglutinate if serum anti RBC surface Ig
Hydroxyurea - bone marrow transplant
Diffuse Large b cell lymphoma

24. What are some causes of cold agglutinin anemia
VWD
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Langerhans cells
Paraprotein spike - monoclonal protein

25. inc LDH - jaundice
5- FU - AZT - hydroxyurea
TRAP (tartrate resistant acid phosphatase
Extravascular hemolysis
DDAVP (desmopressin) which releases stored vWF stored in endothelium

26. What reveresible things can a sideroblastic anemia
VWD
Lead - and EtOH
EBV
B12/folate def

27. What is the clinical picture of hemophilia A or B
Heinz bodies - seen in alpha thal and G6PD
Macrohemorrhage - hemarthroses - easy bruising
ADP and Ca
Varying sizes

28. Deficiency in vWF

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29. What is the treatment to prevent a woman from forming anti Rh antibody?
Parvovirus
Rhogam - Rh antigen immunoglobulin
Mantle cell lymphoma
Hereditary spherocytosis - G6PD - sickle cell

30. What is the therapy for the M3 variant?
A antigen and B antibodies
5- FU - AZT - hydroxyurea
All trans retinoic acid
B symptoms - fever night sweats - weight loss

31. How does vWD cause elevated PTT?
Factor V resistant to activated protein C's inhibition
Myelofibrosis (marow is crying being its fibrosed'
VWF carries/protects factor VIII
B antigena and A antibodes

32. What is the treatment for acute intermittent porphyria
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Inc large vWF multimers - inc platelet aggregation and thrombosis
No lytic bone lesions in WM
Glucose and heme - which inhibit ALA synthase

33. abnormal clone of hematopoetic stem cells are increasingly sensitive to growth factors - inc RBC - JAK2 mut
Splicing sites and promotor sequences
G6PD
Polycythemia vera
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination

34. What does ADP do?
Follicular lymphoma - indolent course
Bernard soulier
Helps platelts adhere to endothelium
Valine for glutamate

35. What is the receptor for vWF
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Gp1b
Epoxide reductase - warfarin inhibits

36. Serum iron - transferrin - ferritin lab values for iron def anemia
Positive osmootic fragility test and splenectomy
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Leukemoid reaction
Down - up - down

37. Aplastic crisis after parvovirus - autosplenectomy - salmonella osteomyelitis - painful crisis - renal papillary necrosis - splenic sequestration
B12 in fatty acid pathways leads to subacute combined degeneration
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Helminth infections major basic protein
Complications of sickle cell anemia

38. Is G6PD intravascular or extravascular
VWD
Intravascular
Paraprotein spike - monoclonal protein
Hereditary spherocytosis - autoimmune hemolysis

39. Oxidation of iron - denatured hemoglobin preceipitation damage to RBC membrane - formation of bite cells
Beta chain underproduced - asymptomatic - heterozygote
Ankryin - band 4.1 or spectrin
Heinz bodies - seen in alpha thal and G6PD
Protein C or S deficiency

40. What does 'Neutrophils Like Making Everything Better' stand for?
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
G6PD
CML to AML or All
MHC II and Fc receptors

41. What do they express on their surface?
Leukemoid reaction
MHC II and Fc receptors
40 to 75
Extravascular hemolysis

42. Conditions of defective heme synthesis leading to accumulation of heme precurors
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Porphyrias
Fibrinogen bind GpIIb/IIIa and links platelts
Fibrinogen

43. When is the peak incidence for nonHod lymphoma
Helminth infections major basic protein
Hereditary spherocytosis - autoimmune hemolysis
20 to 40
Heinz bodies - seen in alpha thal and G6PD

44. hemolytic in a newborn - dec ATP and rigid RBCs
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Cromolyn sodium
Pyruvate kinase def - extravascular
ADP and Ca

45. Where are basophils found?
TRAP (tartrate resistant acid phosphatase
HIV or immunosupression
Blood
Uroporphyrin (tea colored urine)

46. discrete tumor masses arising from lymph nodes
Anemia of chronic disease - Aplastic anemia - kidney disease
Lymphoma
Myelofibrosis (marow is crying being its fibrosed'
AB - no antibodies

47. What is the effect of ACE on bradykinin
Multiple myeloma
B12 def
Inactivates it
Langerhans cells

48. What is monoclonal expansion without symptoms associated with multiple myeloma?
Helminth infections major basic protein
MGUS - monoclonal gammopathy of undetermined significance
G6PD
HIV or immunosupression

49. adults - auer rods - inc circulating myeblasts on peripheral smear
Macrohemorrhage - hemarthroses - easy bruising
ADP and Ca
AML
Thrombotic thrombocytopenic purpura

50. What is relative polycythemia
Hairy cell leukemia
Dec plasma volume
40 to 75
Sickle cell anemia