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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 the clinical picture of hemophilia A or B
Follicular lymphoma - indolent course
DDAVP (desmopressin) which releases stored vWF stored in endothelium
B12/folate def
Macrohemorrhage - hemarthroses - easy bruising
2. Oxidation of iron - denatured hemoglobin preceipitation damage to RBC membrane - formation of bite cells
Liver disease - abetalipoproteinemia - acntho = spiny
Blood
Heinz bodies - seen in alpha thal and G6PD
Cromolyn sodium
3. Macro - ovalocyte
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Imatinib - anti bcr abl
Beta thal
4. What causes the jaundice in extravascular hemolysis
Inc UCB
Inappropriate absolute with inc RBCs and EPO
Splicing sites and promotor sequences
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
5. Back pain - hemoglobinuria
Blod - tissue - MACS
Rhogam - Rh antigen immunoglobulin
Common a few days after oxidative stress in a pt with G6PD
Collagen - BM - activated platelets
6. What are the labs and tx for HS?
40 to 50
Positive osmootic fragility test and splenectomy
Fibrinogen bind GpIIb/IIIa and links platelts
Pyruvate kinase def - extravascular
7. Adults present with cutaneous patches/nodules - indolent CD4+
Inc UCB
Mycosis fundgoides/Sezary syndrome
90% anearobically from glucose to lactate - 10% from HMP shunt
Porphyrias
8. How are plasma cells characterized?
Glanzmann's throbmasthenia
Off center nuclues - clock face chromatin
Plummer - vinson syndrome
Blistering cutaneous photosens - most common porphyria
9. What is the accumulated substance in lead poisoning
Protoporphyrin (blood)
Pyruvate kinase def - extravascular
Eleveated PT - PTT
B6 therapy (pyrodixine)
10. What is the treatment for sideroblastic anemia
Intrinsic - all factors except - VII - XIII
B symptoms - fever night sweats - weight loss
B6 therapy (pyrodixine)
Intravascular
11. Where are basophils found?
Blood
MGUS - monoclonal gammopathy of undetermined significance
Nl PT - elevated PTT - intrinsic pathway defect
VWF and fibrinogen
12. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Porphyrias
120 days
Lacunar in nodular sclerosing variant
Hodgkin
13. What does 'Neutrophils Like Making Everything Better' stand for?
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Produce antibody - lots of RER and golgi
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
MHC II and Fc receptors
14. What do the dense granules contain in platelets
ADP and Ca
Gp1b
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Exposed collagen upon endothelial damage
15. Causes of iron def?
They bind vWF via GpIb
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Bleeding - malnutrition/absorption - inc demand pregs
Blood
16. What do the iron studies show in sideroblastic anemia
Inc serum iron - normal TIBC - inc ferratin
Bone marrow infiltration - myelofibrosis
Valine for glutamate
Eleveated PT - PTT
17. What substance accumulates in porphyria cutanea
HbSS
Gp1b
Peroxidase
Uroporphyrin (tea colored urine)
18. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Hereditary spherocytosis
Protoporphyrin
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
19. What are dendritic cells called in the skin?
Inc HbA2 on electrophoresis
Anemia of chronic disease - Aplastic anemia - kidney disease
Nl PT - elevated PTT - intrinsic pathway defect
Langerhans cells
20. What percentage of WBCs are eosinophils?
1 to 6
Leukemia
Prothrombin gene mutation
DIC
21. Which immunoglobulin is involved in warm agglutination?
Varying sizes
Alpha thal - asian and african american
IgG - Warm is GREAT
Down - up - down
22. Which enzyme converts vit k to activated vit k - and what substance inhibits this enzyme
Epoxide reductase - warfarin inhibits
Imatinib - anti bcr abl
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Ringed sideronblasts with iron laden mitochondria
23. What cell is primarily involved in non Hod lymph
B cells
DDAVP (desmopressin) which releases stored vWF stored in endothelium
B12 def
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
24. Drug that inhbits the GpIIb/IIIa directly
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Abciximab
B6
Incactivates II - VII - IX - X - XI - XII
25. Where are monocytes typically found - where do they go - and What do the differentiate into?
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Inc RBC - dec O2 sat - inc EPO
Blod - tissue - MACS
Langerhans cells
26. can be asymptomatic - often in older adults - peripheral blood lymphcytosis with smudge cells and warm antibody autoimmune hemolytic anemia
Hereditary spherocytosis - autoimmune hemolysis
CLL (SLL without the peripheral lymphocytosis
Peroxidase
Von Willebrand's disease
27. Wilm's tumor - RCC - HCC - hydronephrosis
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Bernard soulier
Fe def - thal - pb poison - sideroblastic anemia
28. hypersegmented PMNs - glossitis - dec B12 - inc homocysteine - inc methymalonic acid
Extrinsic - I - II - V - VII and X
B12 def
Plummer - vinson syndrome
MAHA
29. hemolytic in a newborn - dec ATP and rigid RBCs
Alpha thal - asian and african american
Pyruvate kinase def - extravascular
Sheets of lymphocytes interspersed with macs
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
30. Plasma cell neoplasm
Multiple myeloma
Lead - and EtOH
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
IgG - Warm is GREAT
31. How does the therapy for M3 vairant work?
Malaria - Babesia
Induces differentiation of myeloblasts
Alpha thal - asian and african american
DIC
32. What causes the physiologic chloride shift and What does the chloride shift do?
Inc vasodiltion - inc perm - inc pain
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
33. Marrow expansion - 'crew cut' on skull x ray - skeletal deformaties - and chipmunk faces
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Beta thal
Nl PT - elevated PTT - intrinsic pathway defect
34. What do platelets interact with to form a hemostatic plug
Macrohemorrhage - hemarthroses - easy bruising
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Fibrinogen
Orotic aciduria
35. Serum iron - transferrin - ferritin lab values for pregs - OCP use
Factor V Leiden
Nl - up - nl
Acts to stabilize platelet plug
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
36. What condition can result from treating AML M3 from the release of the Auer rods
DIC
TPA - cleavage of fibrin mesh
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Prothrombin gene mutation
37. Which cell is neoplastic in multiple myeloma
Protein C or S deficiency
ATIII def
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Plasma cell
38. lymphoid neoplasms with widespread involvement of bone marrow - tumor cells usually foind in peripheral blood
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 -
Leukemia
Ringed sideronblasts with iron laden mitochondria
Varying shapes
39. What does bradykinin do?
Inc vasodiltion - inc perm - inc pain
Hairy cell leukemia
1 to 6
Contiguous
40. What is the purpose of the fibrin mesh
Acts to stabilize platelet plug
Kids= exposure to lead paint - adults = battery - ammunition factory
GpIIb/IIIa
VWF carries/protects factor VIII
41. What do you see on peripheral smear with sideroblastic anemia
Kids= exposure to lead paint - adults = battery - ammunition factory
Ringed sideronblasts with iron laden mitochondria
Helps platelts adhere to endothelium
Follicular lymphoma - indolent course
42. How are the nucleus and the cytoplasm characterized for lymphocytes
Round densly staining nucleus with a small amount of pale cytoplasm
EBV
40 to 75
B12/folate def
43. inc LDH - jaundice
Extravascular hemolysis
Off center nuclues - clock face chromatin
VWF and fibrinogen
Rhogam - Rh antigen immunoglobulin
44. drug that inhibits ADP induced expression of GpIIb/IIIa
Helminth infections major basic protein
Inc vasodiltion - inc perm - inc pain
Indirect coombs - agglutinate if serum anti RBC surface Ig
Ticlopidine/clopidogrel
45. What is contained within the azurophilic granules of PMNs
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
Fc
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
46. anti - Ig antibody added to patients RBCs;
Glucose and heme - which inhibit ALA synthase
Plummer - vinson syndrome
T(9;22) bcr abl
Direct coombs - agglutinate if RBCs are coated with Ig
47. philadelphia chromosome - blood looks like marrow
Low in CML
Epoxide reductase - warfarin inhibits
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
CML
48. What do labs show in DIC?
B cells
Hereditary spherocytosis - G6PD - sickle cell
1 to 6
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
49. What portion of IgE can mast cells bind
Lung disease - congenital heart diseaes - and high altitude
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
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 -
Fc
50. What substance is Fe added to to yield heme
Howell Jolly bodies
Lysine for glutamate at position 6
Leukemoid reaction
Protoporphyrin
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