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Test your basic knowledge |
Hemeonc
Start Test
Study First
Subject
:
health-sciences
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. What activates the intrinsic pathway?
Anemia of chronic disease - Aplastic anemia - kidney disease
IFN gama
Collagen - BM - activated platelets
Extravascular hemolysis
2. Serum iron - transferrin - ferritin lab values for hemochromatosis
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
Heinz bodies - seen in alpha thal and G6PD
Up - down - up
Malaria - Babesia
3. Which cell is neoplastic in multiple myeloma
Plasma cell
Anemia of chronic disease - Aplastic anemia - kidney disease
Factor V Leiden
No platelet clumping
4. What are the four levels of alpha thal?
Positive osmootic fragility test and splenectomy
IgG - Warm is GREAT
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Mantle cell - older males
5. t(15;17)
Tissue factor converst the VII and VIIa
M3 AML (acute promyelocytic leukemia)
Diffuse Large b cell lymphoma
Inc RBC - dec O2 sat - inc EPO
6. Macro - ovalocyte
Inc HbA2 on electrophoresis
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Paroxysmal nocturnal hemoglobinuria
Dendritic cells?
7. Serum iron - transferrin - ferritin lab values for anemia of chronic disease
Anemia of chronic disease - Aplastic anemia - kidney disease
Down - down - up
Bone marrow infiltration - myelofibrosis
Hairy cell leukemia
8. What is hemophiliia A
Langerhans cell histiocytosis
Inc large vWF multimers - inc platelet aggregation and thrombosis
Deficiency in factor VIII
Contiguous
9. S-100 and CD1a with birbeck granules
Hereditary spherocytosis - G6PD - sickle cell
Aplastic anemia - pancytopenia
MAHA
Langerhans cell histiocytosis
10. What substances are released in mast cell degranulation
Burkitt lymphoma
Histamine - heparin - and eosinohil chemotactic factors
Tissue factor converst the VII and VIIa
Indirect coombs - agglutinate if serum anti RBC surface Ig
11. Drug that inhbits the GpIIb/IIIa directly
Blood
Abciximab
Mantle cell lymphoma
Ankryin - band 4.1 or spectrin
12. What is the receptor for vWF
Gp1b
Tissue factor converst the VII and VIIa
Exposed collagen upon endothelial damage
Splicing sites and promotor sequences
13. What virus is associated with 50% of Hodgkin lymphoma
Leukemia
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
EBV
40 to 50
14. What is monoclonal expansion without symptoms associated with multiple myeloma?
MGUS - monoclonal gammopathy of undetermined significance
Alpha thal - asian and african american
Liver disease - abetalipoproteinemia - acntho = spiny
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
15. How are the nucleus and the cytoplasm characterized for lymphocytes
Uroporphyrinogen decarboxylase
Howell - Jolly bodies - hypo/asplenia
Round densly staining nucleus with a small amount of pale cytoplasm
Inc UCB
16. What is the general pathology of a macrocytic anemia?
B6 therapy (pyrodixine)
Mantle cell lymphoma
Diffuse Large b cell lymphoma
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
17. Which maternal antibodies cross the placenta - anti A/B or anti Rh
Anti Rh
Ewing sarcoma
Decrease EPO
Adult T cell lymphoma - presents with cutaneous lesions
18. What is contained within the azurophilic granules of PMNs
Follicular lymphoma - indolent course
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Tissue
19. Defect in platelet to collagen adhesion - receptor - disorder - platelet count and BT
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Fe def - thal - pb poison - sideroblastic anemia
Rhogam - Rh antigen immunoglobulin
20. Is HS extravascular or intravascular?
Ringed sideronblasts with iron laden mitochondria
PGI2 - NO inc blood flow - dec platelet aggregation
Extravascular
Blod - tissue - MACS
21. What is the characteristic histologic finding in Hodgkin Lymphoma
Sideroblastic anemia
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Reed - sternberg cells
ADP and Ca
22. What are the etiologies of folate def
5- FU - AZT - hydroxyurea
Orotic aciduria
90% anearobically from glucose to lactate - 10% from HMP shunt
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
23. Conditions of defective heme synthesis leading to accumulation of heme precurors
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Macrohemorrhage - hemarthroses - easy bruising
Porphyrias
B symptoms - fever night sweats - weight loss
24. What substance accumulates in porphyria cutanea
Uroporphyrin (tea colored urine)
40 to 50
MGUS - monoclonal gammopathy of undetermined significance
1 to 6
25. Basophilic nuclear remnants fonud in RBCs
2 to 10
Howell - Jolly bodies - hypo/asplenia
G6PD
Africa = Jaw lesion - US = pelvis or abdomen
26. What is the Ddx for for a macrocytic anemia
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Africa = Jaw lesion - US = pelvis or abdomen
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Multiple myeloma
27. Intrinsic pathway coagulation defect and defect in platelet plug formation - most common inherited bleeding disorder - AD
All
Histamine - heparin - and eosinohil chemotactic factors
IgG - Warm is GREAT
VWD
28. What cell is primarily involved in non Hod lymph
Lung disease - congenital heart diseaes - and high altitude
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
B cells
AB - no antibodies
29. What percentage of WBCs are basophils - and What is found in their basophilic granules?
40 to 75
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Positive osmootic fragility test and splenectomy
Splicing sites and promotor sequences
30. Aplastic crisis after parvovirus - autosplenectomy - salmonella osteomyelitis - painful crisis - renal papillary necrosis - splenic sequestration
90% anearobically from glucose to lactate - 10% from HMP shunt
Positive osmootic fragility test and splenectomy
Schistocytes and inc LDH
Complications of sickle cell anemia
31. What is the affected enzyme in acute intermittment porphyria
Myelofibrosis (marow is crying being its fibrosed'
Cromolyn sodium
Porphobilinogen - delta ALA - uroporphyrin
Splicing sites and promotor sequences
32. What percentage if WBCs are polys?
Sickle cell
40 to 75
Inactivates it
Birbeck granules
33. Where to T cells arise and mature - and migrate to...
Decrease EPO
Thrombotic thrombocytopenic purpura
40 to 75
Bone marrow - thymus - blood (80% of circulating lymphos are T)
34. What substance is Fe added to to yield heme
1 to 6
90% anearobically from glucose to lactate - 10% from HMP shunt
Protoporphyrin
Idiopathic thrombocytopenia (ITP)
35. What causes renal papillary necrosis in sickle cell
EBV
Degrades fibrin mesh and converts C3 to C3a
Pyruvate kinase def - extravascular
Low O2 in papilla; can also get microhematuria from medullary infarcts
36. anisocytosis
Schistocytes - helmet cells
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Varying sizes
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
37. Eosinophils are highly phagocytic For what kind of complex?
Antigen - antibody
Epoxide reductase - warfarin inhibits
Hairy cell leukemia
Inappropriate absolute with inc RBCs and EPO
38. Where are mast cells found
Hydroxyurea - bone marrow transplant
Direct coombs - agglutinate if RBCs are coated with Ig
Alpha thal - asian and african american
Tissue
39. Where are basophils found?
Blood
Up - down - up
Mycosis fundgoides/Sezary syndrome
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
40. What does decreasing heme do to ALA synthase activity?
Collagen - BM - activated platelets
Lysosomes
Inc
Signs and sx of aplastic anemia
41. What role does antithrombin play?
HbSS
Incactivates II - VII - IX - X - XI - XII
B12 def
DIC - TTP/HUS - traumatic hemolysis
42. What condition can result from treating AML M3 from the release of the Auer rods
DIC
G6PD
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Malaria - Babesia
43. How does the therapy for M3 vairant work?
Valine for glutamate
Bimodal - men>women - except for nodular sclerosing type
Induces differentiation of myeloblasts
VIII
44. can be asymptomatic - often in older adults - peripheral blood lymphcytosis with smudge cells and warm antibody autoimmune hemolytic anemia
VWF and fibrinogen
CLL (SLL without the peripheral lymphocytosis
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
Valine for glutamate
45. adults - auer rods - inc circulating myeblasts on peripheral smear
Extravascular hemolysis
Plummer - vinson syndrome
AML
All trans retinoic acid
46. What signal activates MACS
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
Fe def - thal - pb poison - sideroblastic anemia
IFN gama
Inappropriate absolute with inc RBCs and EPO
47. philadelphia chromosome - blood looks like marrow
CML
Inc
Nl PT - elevated PTT - intrinsic pathway defect
Uroporphyrin (tea colored urine)
48. What are the pro aggregation factors?
Mantle cell lymphoma
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
TXA2 - dec blood flow - inc platelet aggregation
40 to 75
49. Fava beans - sufla drugs - infectinos
Bleeding - malnutrition/absorption - inc demand pregs
Dec synthesis of factors 1972 - protein C/S
Examples of oxidative stress
Cromolyn sodium
50. Upregulated growth of leukocytes in bone marro
Orotic aciduria
120 days
Common a few days after oxidative stress in a pt with G6PD
Leukemia