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Hemeonc
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Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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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 is a blast crisis
A antigen and B antibodies
Protein S - cleaves and invactivates Va and VIIIa
...
CML to AML or All
2. Which pathway and factors are tested in the PTT test
Intrinsic - all factors except - VII - XIII
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Ferrocheletase and ALA dehydrogenase
M3 AML (acute promyelocytic leukemia)
3. X linked - dec glutathione inc RBC susceptibility to oxidative stress
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
G6PD
40 to 75
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
4. What is the tx for aplastic anemia
CD15 and CD30 pos
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Protoporphyrin
5. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Inc UCB
Hereditary spherocytosis
DIC
Paroxysmal nocturnal hemoglobinuria
6. What distinguishes multiple myeloma fromk Waldenstroms macroglobulinemia?
No lytic bone lesions in WM
Beta 4
Essential thrombocytosis
5- FU - AZT - hydroxyurea
7. What percentage of WBCs are monocytes?
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Antigen - antibody
2 to 10
Helps platelts adhere to endothelium
8. What is the life span of a normal RBC
Hb Barts - gamma4 in defect in all 4 alpha genes
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Hereditary spherocytosis
120 days
9. What does bradykinin do?
Inc vasodiltion - inc perm - inc pain
All trans retinoic acid
Africa = Jaw lesion - US = pelvis or abdomen
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
10. What is the most common nonhodgkin lymphoma
CNS and testis
Diffuse Large b cell lymphoma
Bite cells and Heinz bodies
DIC
11. What are the pro aggregation factors?
Hydroxyurea - bone marrow transplant
Protein S - cleaves and invactivates Va and VIIIa
TXA2 - dec blood flow - inc platelet aggregation
Lung disease - congenital heart diseaes - and high altitude
12. Causes of iron def?
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
Factor V resistant to activated protein C's inhibition
Bleeding - malnutrition/absorption - inc demand pregs
Paroxysmal nocturnal hemoglobinuria
13. What causes hydrops fetalis
T(12;21)
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
Hb Barts - gamma4 in defect in all 4 alpha genes
...
14. Where do you see hypersegmented polys?
Ticlopidine/clopidogrel
Blod - tissue - MACS
Fibrinogen
B12/folate def
15. Which enzyme converts vit k to activated vit k - and what substance inhibits this enzyme
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Epoxide reductase - warfarin inhibits
Pyruvate kinase def - extravascular
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
16. What virus is associated with 50% of Hodgkin lymphoma
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Dec
Antigen - antibody
EBV
17. What is the Ddx for for a macrocytic anemia
Protein S - cleaves and invactivates Va and VIIIa
CML
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
IgG - Warm is GREAT
18. Which drugs can cause macrocytic anemia?
IFN gama
5- FU - AZT - hydroxyurea
B12 def
T(12;21)
19. Which immunoglobulin is involved in warm agglutination?
8-10 days
Abciximab
Paroxysmal nocturnal hemoglobinuria
IgG - Warm is GREAT
20. What causes the physiologic chloride shift and What does the chloride shift do?
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Def in factor IX
Down - down - up
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
21. Which infections can cause MAHA?
Beta 4
Fe def - thal - pb poison - sideroblastic anemia
Malaria - Babesia
Diffuse Large b cell lymphoma
22. What do you see a starry sky appearance in Burkitt
All
IgG - Warm is GREAT
Sheets of lymphocytes interspersed with macs
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
23. What is the tx for sickle cell
Hydroxyurea - bone marrow transplant
Direct coombs - agglutinate if RBCs are coated with Ig
MHC II and Fc receptors
90% anearobically from glucose to lactate - 10% from HMP shunt
24. Where are 1/3 of platelets stored
Spleen
Yes - via MHC II
MAHA
Helminth infections major basic protein
25. What is the philadelphia chromosome
Fibrinogen
T(9;22) bcr abl
Her next Rh+ fetus
Intrinsic - all factors except - VII - XIII
26. What is the treatment for sideroblastic anemia
VWD
2 to 10
B6 therapy (pyrodixine)
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
27. What activates the fibrinolytic pathway?
Essential thrombocytosis
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Intravascular
CML
28. X linked defect in delta aminolevulinic acid synthase gene causes a defect in hemesynthesis
Anemia of chronic disease - Aplastic anemia - kidney disease
Mycosis fundgoides/Sezary syndrome
...
Sideroblastic anemia
29. From what cells are platelets derived from
Megakaryocytes
CD15 and CD30 pos
TPA - cleavage of fibrin mesh
Her next Rh+ fetus
30. Basophilic nuclear remnants fonud in RBCs
Malaria - Babesia
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA
Howell - Jolly bodies - hypo/asplenia
Gp1b
31. What signal activates MACS
Hereditary spherocytosis - G6PD - sickle cell
IFN gama
Glycine and succinyl - coa
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
32. What is HbH
HIV or immunosupression
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Beta 4
Howell - Jolly bodies - hypo/asplenia
33. Megakaryocytosis
Nodular sclerosing
Lead - and EtOH
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Essential thrombocytosis
34. t(15;17)
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Factor V Leiden
M3 AML (acute promyelocytic leukemia)
35. How does vWD cause elevated PTT?
Positive osmootic fragility test and splenectomy
Blasts > 5%
EBV
VWF carries/protects factor VIII
36. What condition can result from treating AML M3 from the release of the Auer rods
DIC
Prothrombin gene mutation
Thrombotic thrombocytopenic purpura
Bone marrow infiltration - myelofibrosis
37. What is the difference of presentation of Burkitt in Africa vs the United States
Valine for glutamate
Blistering cutaneous photosens - most common porphyria
Africa = Jaw lesion - US = pelvis or abdomen
Factor V resistant to activated protein C's inhibition
38. What is the treatment to prevent a woman from forming anti Rh antibody?
A antigen and B antibodies
Beta chain underproduced - asymptomatic - heterozygote
Plummer - vinson syndrome
Rhogam - Rh antigen immunoglobulin
39. What does hairy cell leukemia stain with
No antigen - both antibodies
Epoxide reductase - warfarin inhibits
TRAP (tartrate resistant acid phosphatase
Protoporphyrin
40. What is the treatment for acute intermittent porphyria
M3 AML (acute promyelocytic leukemia)
Glucose and heme - which inhibit ALA synthase
Porphyrias
Varying shapes
41. Who has more severe disease - HbSS or HbSC
Tissue
HbSS
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Epoxide reductase - warfarin inhibits
42. RBCs damagaed from passing through obstructed - narrowed vessel lumina
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
MAHA
Folate def
Beta chain underproduced - asymptomatic - heterozygote
43. What is the main source of energy in RBCs
Inappropriate absolute with inc RBCs and EPO
Africa = Jaw lesion - US = pelvis or abdomen
Peroxidase
90% anearobically from glucose to lactate - 10% from HMP shunt
44. Who are the professional APCs?
Dendritic cells?
Factor V Leiden
Factor V resistant to activated protein C's inhibition
No lytic bone lesions in WM
45. What do auer rods stain with
Burkitt lymphoma
Bernard soulier
Peroxidase
Inc serum iron - normal TIBC - inc ferratin
46. Deficiency in GpIIb/IIIa
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47. Blood type A
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
A antigen and B antibodies
G6PD
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
48. Which pathway and factorrs are tested by the PT coag test
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Inc serum iron - normal TIBC - inc ferratin
Extrinsic - I - II - V - VII and X
SLE - CLL - alpha methyldopa
49. What is the therapy for the M3 variant?
Helminth infections major basic protein
Factor V Leiden
All trans retinoic acid
Produce antibody - lots of RER and golgi
50. What activates protein C and What does activated protein C do?
Protein S - cleaves and invactivates Va and VIIIa
CML to AML or All
TXA2 - dec blood flow - inc platelet aggregation
Extravascular hemolysis
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