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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. RBCs damagaed from passing through obstructed - narrowed vessel lumina
Low O2 in papilla; can also get microhematuria from medullary infarcts
90% anearobically from glucose to lactate - 10% from HMP shunt
MAHA
Heinz bodies - seen in alpha thal and G6PD

2. What does antithrombin do and What activates it?
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Inactivates it
Inc lymphoctes - and less RS cells
Liver disease - abetalipoproteinemia - acntho = spiny

3. What do the dense granules contain in platelets
ADP and Ca
Ewing sarcoma
Plasma cell
DIC - TTP/HUS - traumatic hemolysis

4. How does vWD cause elevated PTT?
Liver disease - abetalipoproteinemia - acntho = spiny
A antigen and B antibodies
ATIII def
VWF carries/protects factor VIII

5. What are the labs and tx for HS?
Bleeding - malnutrition/absorption - inc demand pregs
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
Inc large vWF multimers - inc platelet aggregation and thrombosis
Positive osmootic fragility test and splenectomy

6. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Round densly staining nucleus with a small amount of pale cytoplasm
Burkitt lymphoma
Tissue factor converst the VII and VIIa
Hereditary spherocytosis

7. What is their role?
Abciximab
Inducers of primary antibody response
Bleeding - malnutrition/absorption - inc demand pregs
Ferrocheletase and ALA dehydrogenase

8. What percentage of WBCs are monocytes?
2 to 10
Complications of sickle cell anemia
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
IgG - Warm is GREAT

9. What are the neuro sx of B12 def?
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Langerhans cells
B antigena and A antibodes
Inc serum iron - normal TIBC - inc ferratin

10. Is HS extravascular or intravascular?
Extravascular
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Produce antibody - lots of RER and golgi
Pyruvate kinase def - extravascular

11. What level of leukocyte alkaline phosphatase is expected in CML versus leukemoid reaction
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Polycythemia vera
Low in CML
Inc serum iron - normal TIBC - inc ferratin

12. What is the aggregation phase of ppf?
Indirect coombs - agglutinate if serum anti RBC surface Ig
Abciximab
Fibrinogen bind GpIIb/IIIa and links platelts
Blood

13. What are the age ranges for the various leukemias
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
All
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

14. What do the platelets bind? What is the step called
Dendritic cells?
B12 in fatty acid pathways leads to subacute combined degeneration
They bind vWF via GpIb
Lysine for glutamate at position 6

15. What begins the extrinsic pathway?
Histamine - heparin - and eosinohil chemotactic factors
Signs and sx of aplastic anemia
Low in CML
Tissue factor converst the VII and VIIa

16. What does the blood smear show in glanzmann's?
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Parvovirus
No platelet clumping
120 days

17. hemolytic in a newborn - dec ATP and rigid RBCs
B cells
Reed - sternberg cells
Pyruvate kinase def - extravascular
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)

18. What cell is primarily involved in non Hod lymph
B cells
Lysine for glutamate at position 6
Lung disease - congenital heart diseaes - and high altitude
Incactivates II - VII - IX - X - XI - XII

19. What state is commonly associated with nonHod lymphoma
B antigena and A antibodes
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
HIV or immunosupression
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs

20. From what cells are platelets derived from
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Diffuse Large b cell lymphoma
Heinz bodies - seen in alpha thal and G6PD
Megakaryocytes

21. t(11:22)
8-10 days
Howell - Jolly bodies - hypo/asplenia
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Ewing sarcoma

22. What virus is associated with Burkitt lymphoma
Glucose and heme - which inhibit ALA synthase
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
EBV
Orotic aciduria

23. dec haptoglobin - inc LDH - hemoglobin in urine (paroxysmal nocturnal hemoglobinuria - mechanical destruction as in aortic stenosis or a prosthetic valve
Contiguous
Intravascular hemolysis
Factor V Leiden
Lysine for glutamate at position 6

24. What is the pathogenesis of ACD?
No platelet clumping
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Dendritic cells?
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

25. What do the iron studies show in sideroblastic anemia
Inc serum iron - normal TIBC - inc ferratin
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Inc HbF and dec HbS
No antigen - both antibodies

26. What percentage if WBCs are polys?
Nl - up - nl
IgG - Warm is GREAT
40 to 75
Her next Rh+ fetus

27. what proteins can be defective in HS?
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
CML
Ankryin - band 4.1 or spectrin
Extrinsic - I - II - V - VII and X

28. Tdt+ - CAllA+ - kids in the marrow - adolescent males with mediastinal mass
Diffuse Large b cell lymphoma
Parvovirus
Leukemoid reaction
All

29. What are the anti aggregation factors?
Common a few days after oxidative stress in a pt with G6PD
Kids= exposure to lead paint - adults = battery - ammunition factory
PGI2 - NO inc blood flow - dec platelet aggregation
90% anearobically from glucose to lactate - 10% from HMP shunt

30. What are some causes of cold agglutinin anemia
Fe def - thal - pb poison - sideroblastic anemia
Sheets of lymphocytes interspersed with macs
Folate def
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

31. Serum iron - transferrin - ferritin lab values for hemochromatosis
Lacunar in nodular sclerosing variant
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Up - down - up
Megakaryocytes

32. What does STOP Making New Thrombi stand for
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Her next Rh+ fetus
Reed - sternberg cells

33. Blood type A
Epoxide reductase - warfarin inhibits
Diffuse Large b cell lymphoma
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
A antigen and B antibodies

34. What is the general pathology of a macrocytic anemia?
Degrades fibrin mesh and converts C3 to C3a
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Leukemia
Kids= exposure to lead paint - adults = battery - ammunition factory

35. What are the likely exposures of kids and adults for lead poisoning
Kids= exposure to lead paint - adults = battery - ammunition factory
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Common a few days after oxidative stress in a pt with G6PD
Protein C or S deficiency

36. Megakaryocytosis
AML
Essential thrombocytosis
Degrades fibrin mesh and converts C3 to C3a
Glucose and heme - which inhibit ALA synthase

37. What does NAACP stand for - in regards to the causes of eosinophiia?
Mantle cell lymphoma
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites

38. universal recipient
AB - no antibodies
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
G6PD
Mantle cell - older males

39. Where does All spread
Africa = Jaw lesion - US = pelvis or abdomen
Essential thrombocytosis
CNS and testis
Exposed collagen upon endothelial damage

40. What is the receptor for fibrinogen?
Parvovirus
Intravascular hemolysis
All trans retinoic acid
GpIIb/IIIa

41. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Spleen
IFN gama
B cells
Hodgkin

42. When is the peak incidence for nonHod lymphoma
Hb Barts - gamma4 in defect in all 4 alpha genes
20 to 40
CLL (SLL without the peripheral lymphocytosis
90% anearobically from glucose to lactate - 10% from HMP shunt

43. Drug that inhibits COX and therefore TXA2 synthesis
They bind vWF via GpIb
Intravascular hemolysis
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
Aspirin

44. What is the are the presenting symptoms of lead poisoning in kids and adults
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Varying shapes
Positive osmootic fragility test and splenectomy
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination

45. What reveresible things can a sideroblastic anemia
Lead - and EtOH
Induces differentiation of myeloblasts
Beta thal
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

46. defect in alpha globin gene - dec alpha globin synth - disease and populations?
Peroxidase
Alpha thal - asian and african american
DIC - TTP/HUS - traumatic hemolysis
Intravascular

47. What is the effected enzyme in acute intermittment porphyria?
Langerhans cells
Sickle cell
Direct coombs - agglutinate if RBCs are coated with Ig
Porphobilinogen deaminase aka uroporphyrinogen I synthase

48. Schisotcyte - helmet cell
DIC - TTP/HUS - traumatic hemolysis
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Contiguous
Paraprotein spike - monoclonal protein

49. Defect in platelet to platelet adhesion - receptor - disorder - platelet count and bleeding time

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50. inc WBC count with left shift - inc leukocyte alkaline phosphatase - often due to infection
Inducers of primary antibody response
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
VWD
Leukemoid reaction