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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 symptoms are associated with Hodgkin lymphoma
Follicular lymphoma - indolent course
ATIII def
Histamine - heparin - and eosinohil chemotactic factors
B symptoms - fever night sweats - weight loss

2. What are the anti aggregation factors?
Parvovirus
All
Beta chain underproduced - asymptomatic - heterozygote
PGI2 - NO inc blood flow - dec platelet aggregation

3. What are the etiologies of B12 def
Inc serum iron - normal TIBC - inc ferratin
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
Blistering cutaneous photosens - most common porphyria

4. Teardrop cell
Sheets of lymphocytes interspersed with macs
Inc UCB
Bone marrow infiltration - myelofibrosis
Hodgkin

5. Crew cut on skull xray due to marrow supression - 8% of AA population - single amino acid replacement in beta chain at position 6 - after a DNA point mutation
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Examples of oxidative stress
Sickle cell
Produce antibody - lots of RER and golgi

6. What are the age ranges for the various leukemias
Dec
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
Easy gas exchange
Beta thal

7. What does increasing heme do to ALA synthase activity
Dec
Degrades fibrin mesh and converts C3 to C3a
Hereditary spherocytosis
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

8. Why can newborns with sickle cell be asymptomatic
Nl - up - nl
Direct coombs - agglutinate if RBCs are coated with Ig
TRAP (tartrate resistant acid phosphatase
Inc HbF and dec HbS

9. What is contained within the azurophilic granules of PMNs
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
CLL (SLL without the peripheral lymphocytosis
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)

10. Does CML have a JAK2 mut
DIC - TTP/HUS - traumatic hemolysis
No
Uroporphyrinogen decarboxylase
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

11. What are the pro aggregation factors?
TXA2 - dec blood flow - inc platelet aggregation
T(12;21)
Glucose and heme - which inhibit ALA synthase
Yes - via MHC II

12. Where are mast cells found
Tissue
Fc
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
B6 therapy (pyrodixine)

13. What is the pathogenesis of TTP?
Glanzmann's throbmasthenia
All trans retinoic acid
MAHA
Inc large vWF multimers - inc platelet aggregation and thrombosis

14. What CD molecules are on RS cells
CD15 and CD30 pos
Megakaryocytes
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin

15. What is the life spance of a platelet?
G6PD
Paroxysmal nocturnal hemoglobinuria
Beta 4
8-10 days

16. What indicated a good prognosis in Hodgkin lymphoma?
Low O2 in papilla; can also get microhematuria from medullary infarcts
Intrinsic - all factors except - VII - XIII
Inc lymphoctes - and less RS cells
40 to 75

17. What are the likely exposures of kids and adults for lead poisoning
Inappropriate absolute with inc RBCs and EPO
Kids= exposure to lead paint - adults = battery - ammunition factory
Inc lymphoctes - and less RS cells
SLE - CLL - alpha methyldopa

18. After an injury - What does vWF bind to begin platelet plug formation?
B6
Inc vasodiltion - inc perm - inc pain
Exposed collagen upon endothelial damage
ATIII def

19. What is the pathogenesis of sickle cell
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
Yes - via MHC II
TXA2 - dec blood flow - inc platelet aggregation
MGUS - monoclonal gammopathy of undetermined significance

20. Plasma cell neoplasm
Inc
VWF carries/protects factor VIII
Her next Rh+ fetus
Multiple myeloma

21. What does STOP Making New Thrombi stand for
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Fc
Megakaryocytes

22. What does the large SA:volume ratio in RBCs help facilitate?
Easy gas exchange
CML
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Peroxidase

23. What is the ddx for aplastic anemia

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24. What is factor V leidin?

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25. Elliptocyte
Hereditary elloptocytosis
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Plummer - vinson syndrome
Schistocytes and inc LDH

26. universal recipient
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
B12/folate def
AB - no antibodies

27. t(11:22)
Ewing sarcoma
Beta chain underproduced - asymptomatic - heterozygote
Lysine for glutamate at position 6
DDAVP (desmopressin) which releases stored vWF stored in endothelium

28. What is appropriate absolyte polycythemia associated with
5- FU - AZT - hydroxyurea
120 days
VWF carries/protects factor VIII
Lung disease - congenital heart diseaes - and high altitude

29. bcl -2 t(14;18) adults
Follicular lymphoma - indolent course
Polycythemia vera
120 days
Megakaryocytes

30. What is the treatment for acute intermittent porphyria
ATIII def
Glucose and heme - which inhibit ALA synthase
TPA - cleavage of fibrin mesh
HIV or immunosupression

31. Which maternal antibodies cross the placenta - anti A/B or anti Rh
Blistering cutaneous photosens - most common porphyria
Anti Rh
Intravascular hemolysis
Varying sizes

32. What is the characteristic lab finding on electrophoresis
Protoporphyrin
Plummer - vinson syndrome
Paraprotein spike - monoclonal protein
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling

33. What is the effect of ACE on bradykinin
Bone marrow infiltration - myelofibrosis
Inactivates it
All
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin

34. inhibition of ferrochelatase and ALA dehydrogenase leading to dec heme synthesis - also inhibition of rRNA degradation
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Megakaryocytes
Valine for glutamate
2 to 10

35. What does antithrombin do and What activates it?
Glycine and succinyl - coa
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Howell Jolly bodies
Extravascular hemolysis

36. Where does All spread
CNS and testis
Complications of sickle cell anemia
Myelofibrosis (marow is crying being its fibrosed'
Inc large vWF multimers - inc platelet aggregation and thrombosis

37. What happens in betal thal minor?
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Beta chain underproduced - asymptomatic - heterozygote
Peroxidase
Fibrinogen bind GpIIb/IIIa and links platelts

38. What causes the physiologic chloride shift and What does the chloride shift do?
GpIIb/IIIa
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Down - down - up

39. What is the age breakdown for hodgkins
Extravascular hemolysis
EBV
Bimodal - men>women - except for nodular sclerosing type
Bernard soulier

40. Where are 1/3 of platelets stored
Spleen
VIII
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Produce antibody - lots of RER and golgi

41. Bite cell
SLE - CLL - alpha methyldopa
G6PD
CML
Histaminase and arylsulfatase

42. Where do B cells arise from - mature - and migrate to...
Protoporphyrin (blood)
Africa = Jaw lesion - US = pelvis or abdomen
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)

43. Bone pain plus anemia
Helminth infections major basic protein
Both alpha and beta thal
Direct coombs - agglutinate if RBCs are coated with Ig
Multiple myeloma

44. hypocellular bone marrown tih fatty infiltration
Petechiae
Aplastic anemia - pancytopenia
B6 therapy (pyrodixine)
Howell - Jolly bodies - hypo/asplenia

45. mother's antibodies attack fetal RBCs
B antigena and A antibodes
Leukemia
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
All

46. What does the blood smear show in glanzmann's?
PGI2 - NO inc blood flow - dec platelet aggregation
No platelet clumping
Liver disease - abetalipoproteinemia - acntho = spiny
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

47. What do the dense granules contain in platelets
IFN gama
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
No antigen - both antibodies
ADP and Ca

48. What does CRAB stand for in multiple myeloma
Indirect coombs - agglutinate if serum anti RBC surface Ig
B symptoms - fever night sweats - weight loss
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Kids= exposure to lead paint - adults = battery - ammunition factory

49. What is the Ddx for for a macrocytic anemia
Fe def - thal - pb poison - sideroblastic anemia
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
TPA - cleavage of fibrin mesh
Nodular sclerosing

50. What are the labs and tx for HS?
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Glanzmann's throbmasthenia
No
Positive osmootic fragility test and splenectomy