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. Back pain - hemoglobinuria
VWD
Degrades fibrin mesh and converts C3 to C3a
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Common a few days after oxidative stress in a pt with G6PD

2. Megakaryocytosis
Peroxidase
Essential thrombocytosis
Ringed sideronblasts with iron laden mitochondria
Complications of sickle cell anemia

3. What do platelets interact with to form a hemostatic plug
Fibrinogen
Inc large vWF multimers - inc platelet aggregation and thrombosis
Varying sizes
CLL (SLL without the peripheral lymphocytosis

4. Inherited deficiency of antithrombin; reduced inc in PTT after administration of heparin
ATIII def
Glucose and heme - which inhibit ALA synthase
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Bernard soulier

5. What is the therapy for CML (philly chrom)
Imatinib - anti bcr abl
Ticlopidine/clopidogrel
Both alpha and beta thal
Sickle cell

6. tennis rackets on EM
ADP and Ca
Birbeck granules
No lytic bone lesions in WM
Varying shapes

7. Is HS extravascular or intravascular?
Extravascular
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Lysine for glutamate at position 6
Blood

8. What happens in beta thal major?
Tissue factor converst the VII and VIIa
Fibrinogen bind GpIIb/IIIa and links platelts
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

9. What is the coombs test results in AIHA?
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 -
2 to 10
DIC - TTP/HUS - traumatic hemolysis
Pos

10. Conditions of defective heme synthesis leading to accumulation of heme precurors
Burkitt lymphoma
DIC
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Porphyrias

11. CD5+ - poor prognosis - t(11;14)
B cells
Mantle cell - older males
HIV or immunosupression
All

12. Fava beans - sufla drugs - infectinos
EBV
Inc HbF and dec HbS
They bind vWF via GpIb
Examples of oxidative stress

13. What activates the fibrinolytic pathway?
Ringed sideronblasts with iron laden mitochondria
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Helps platelts adhere to endothelium

14. What is the main source of energy in RBCs
B6
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
90% anearobically from glucose to lactate - 10% from HMP shunt
All trans retinoic acid

15. What is the clinical picture of hemophilia A or B
Macrohemorrhage - hemarthroses - easy bruising
Hereditary spherocytosis - autoimmune hemolysis
Def in factor IX
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

16. What role does antithrombin play?
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
40 to 50
Protein C or S deficiency
Incactivates II - VII - IX - X - XI - XII

17. What is the mutation in HbS
5- FU - AZT - hydroxyurea
TRAP (tartrate resistant acid phosphatase
Valine for glutamate
CNS and testis

18. Blood type A
EBV
A antigen and B antibodies
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Intravascular hemolysis

19. dec ability to activate factors V and VIII - inc risk of thrombotic skin necrosis with hemorrhage following administration of warfarin
Protein C or S deficiency
MHC II and Fc receptors
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Ringed sideronblasts with iron laden mitochondria

20. What does STOP Making New Thrombi stand for
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
TXA2 - dec blood flow - inc platelet aggregation
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Hodgkin

21. What percentage if WBCs are polys?
40 to 75
Antigen - antibody
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Sheets of lymphocytes interspersed with macs

22. What is the receptor for vWF
2 to 10
Gp1b
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Mantle cell - older males

23. What causes renal papillary necrosis in sickle cell
Myelofibrosis (marow is crying being its fibrosed'
Low O2 in papilla; can also get microhematuria from medullary infarcts
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin

24. What do platelets release necessary for coagulation cascaed?
Intrinsic - all factors except - VII - XIII
ADP and Ca
Macrohemorrhage - hemarthroses - easy bruising
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium

25. inc LDH - jaundice
Extravascular hemolysis
ATIII def
Histamine - heparin - and eosinohil chemotactic factors
DDAVP (desmopressin) which releases stored vWF stored in endothelium

26. Elderly - mature b cell tumor with filamentous - hairlike projections
Hairy cell leukemia
Decrease EPO
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Extrinsic - I - II - V - VII and X

27. What do you see on peripheral smear with sideroblastic anemia
TXA2 - dec blood flow - inc platelet aggregation
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Ringed sideronblasts with iron laden mitochondria
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 -

28. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Tissue factor converst the VII and VIIa
MAHA
Ringed sideronblasts with iron laden mitochondria
Hodgkin

29. deficiency in ADAMTS13 leading to dec degradation of vWF
Macrohemorrhage - hemarthroses - easy bruising
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Thrombotic thrombocytopenic purpura
Aspirin

30. What do auer rods stain with
Induces differentiation of myeloblasts
Peroxidase
Parvovirus
Varying shapes

31. What is the difference of presentation of Burkitt in Africa vs the United States
Ankryin - band 4.1 or spectrin
Africa = Jaw lesion - US = pelvis or abdomen
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
G6PD

32. What is the affected enzyme in lead poisoning
Aplastic anemia - pancytopenia
2 to 10
Folate def
Ferrocheletase and ALA dehydrogenase

33. What converts plasminogen to plasm and What does plasmin do?
TPA - cleavage of fibrin mesh
Examples of oxidative stress
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
SLE - CLL - alpha methyldopa

34. What is a metabolic disorder tht can cause macrocytic anemia?
Orotic aciduria
B cells
SLE - CLL - alpha methyldopa
Valine for glutamate

35. What is the age breakdown for hodgkins
CML
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Bimodal - men>women - except for nodular sclerosing type
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin

36. What is the Ddx for a normocytic - normochromic anemia?
Blasts > 5%
Uroporphyrin (tea colored urine)
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread

37. What percentage of WBCs are monocytes?
Mycosis fundgoides/Sezary syndrome
GpIIb/IIIa
Follicular lymphoma - indolent course
2 to 10

38. What is a blast crisis
CML to AML or All
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Mantle cell lymphoma
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 -

39. RBCs damagaed from passing through obstructed - narrowed vessel lumina
MAHA
Protoporphyrin
EBV
Myelofibrosis (marow is crying being its fibrosed'

40. Where are basophils found?
Deficiency in factor VIII
Varying sizes
Blood
Lacunar in nodular sclerosing variant

41. Target cell

42. Elliptocyte
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Hereditary elloptocytosis
Signs and sx of aplastic anemia
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia

43. Oxidation of iron - denatured hemoglobin preceipitation damage to RBC membrane - formation of bite cells
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Heinz bodies - seen in alpha thal and G6PD
ATIII def
Beta thal

44. What are the anti aggregation factors?
Inc vasodiltion - inc perm - inc pain
PGI2 - NO inc blood flow - dec platelet aggregation
Examples of oxidative stress
Collagen - BM - activated platelets

45. What are the pro aggregation factors?
Inc HbF and dec HbS
TXA2 - dec blood flow - inc platelet aggregation
Tissue factor converst the VII and VIIa
Multiple myeloma

46. What is the pathogenesis of TTP?
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
B6 therapy (pyrodixine)
Varying sizes
Inc large vWF multimers - inc platelet aggregation and thrombosis

47. What does Vit K deficiency cause?
Inc large vWF multimers - inc platelet aggregation and thrombosis
DIC - TTP/HUS - traumatic hemolysis
Dec synthesis of factors 1972 - protein C/S
Africa = Jaw lesion - US = pelvis or abdomen

48. What is the effected enzyme in acute intermittment porphyria?
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Rhogam - Rh antigen immunoglobulin
Sideroblastic anemia
Porphobilinogen deaminase aka uroporphyrinogen I synthase

49. Tdt+ - CAllA+ - kids in the marrow - adolescent males with mediastinal mass
All
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
Her next Rh+ fetus
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -

50. Which factor does vWF carry/protect
VIII
MGUS - monoclonal gammopathy of undetermined significance
Histamine - heparin - and eosinohil chemotactic factors
Signs and sx of aplastic anemia