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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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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 does hairy cell leukemia stain with
CD15 and CD30 pos
TRAP (tartrate resistant acid phosphatase
HIV or immunosupression
CML

2. What is the therapy for the M3 variant?
TXA2 - dec blood flow - inc platelet aggregation
Nl - up - nl
All trans retinoic acid
Prothrombin gene mutation

3. Back pain - hemoglobinuria
Intravascular hemolysis
Common a few days after oxidative stress in a pt with G6PD
40 to 75
All trans retinoic acid

4. inc HbF on electrophoresis
Both alpha and beta thal
Inc RBC - dec O2 sat - inc EPO
5- FU - AZT - hydroxyurea
Inc lymphoctes - and less RS cells

5. defect in alpha globin gene - dec alpha globin synth - disease and populations?
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
No lytic bone lesions in WM
Alpha thal - asian and african american
Plasma cell

6. What is the Ddx for a normocytic - normochromic anemia?
Incactivates II - VII - IX - X - XI - XII
TRAP (tartrate resistant acid phosphatase
Malaria - Babesia
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis

7. discrete tumor masses arising from lymph nodes
Hb Barts - gamma4 in defect in all 4 alpha genes
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
No antigen - both antibodies
Lymphoma

8. Which pathway and factors are tested in the PTT test
Complications of sickle cell anemia
Intrinsic - all factors except - VII - XIII
Blistering cutaneous photosens - most common porphyria
Helps platelts adhere to endothelium

9. What do you see in peripheral smear in a pt with G6PD?
Bite cells and Heinz bodies
Birbeck granules
AML
Kids= exposure to lead paint - adults = battery - ammunition factory

10. mother's antibodies attack fetal RBCs
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
MGUS - monoclonal gammopathy of undetermined significance
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Inhibits thrombin - ixa - xa - xiia - and activated by heparin

11. What is the age breakdown for hodgkins
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Ferrocheletase and ALA dehydrogenase
Aplastic anemia - pancytopenia
Bimodal - men>women - except for nodular sclerosing type

12. Can B cells function as APCs?
Yes - via MHC II
Antigen - antibody
Howell Jolly bodies
Porphobilinogen - delta ALA - uroporphyrin

13. What is a metabolic disorder tht can cause macrocytic anemia?
Porphobilinogen - delta ALA - uroporphyrin
Orotic aciduria
IgG - Warm is GREAT
AML

14. What does ADP do?
Helps platelts adhere to endothelium
B antigena and A antibodes
MAHA
Howell Jolly bodies

15. What do auer rods stain with
Epoxide reductase - warfarin inhibits
Peroxidase
DIC
Hereditary spherocytosis - G6PD - sickle cell

16. Megakaryocytosis
MHC II and Fc receptors
Inactivates it
Essential thrombocytosis
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -

17. Which maternal antibodies cross the placenta - anti A/B or anti Rh
Liver disease - abetalipoproteinemia - acntho = spiny
B antigena and A antibodes
Polycythemia vera
Anti Rh

18. What percentage of WBCs are eosinophils?
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Yes - via MHC II
Prothrombin gene mutation
1 to 6

19. What is the main source of energy in RBCs
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
90% anearobically from glucose to lactate - 10% from HMP shunt
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
B symptoms - fever night sweats - weight loss

20. What causes the physiologic chloride shift and What does the chloride shift do?
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Fibrinogen
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Inappropriate absolute with inc RBCs and EPO

21. What is the treatment for sideroblastic anemia
Paroxysmal nocturnal hemoglobinuria
8-10 days
B6 therapy (pyrodixine)
Ankryin - band 4.1 or spectrin

22. What are the four levels of alpha thal?
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Hereditary spherocytosis - G6PD - sickle cell
Multiple myeloma
Nl PT - elevated PTT - intrinsic pathway defect

23. What does Vit K deficiency cause?
Dec synthesis of factors 1972 - protein C/S
Protein C or S deficiency
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
40 to 75

24. What do they express on their surface?
Orotic aciduria
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
MHC II and Fc receptors
Glycine and succinyl - coa

25. What does the large SA:volume ratio in RBCs help facilitate?
Easy gas exchange
Sheets of lymphocytes interspersed with macs
Paraprotein spike - monoclonal protein
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

26. Conditions of defective heme synthesis leading to accumulation of heme precurors
Prothrombin gene mutation
Nl - up - nl
Schistocytes and inc LDH
Porphyrias

27. What do the labs show for TTP?
EBV
Blistering cutaneous photosens - most common porphyria
Schistocytes and inc LDH
Inhibits thrombin - ixa - xa - xiia - and activated by heparin

28. Which drugs can cause macrocytic anemia?
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
5- FU - AZT - hydroxyurea
20 to 40
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs

29. What do eosinophils defend against and What do they use to do it?
Fibrinogen bind GpIIb/IIIa and links platelts
Helminth infections major basic protein
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Inducers of primary antibody response

30. Basophilic nuclear remnants fonud in RBCs
Tissue
Folate def
Aspirin
Howell - Jolly bodies - hypo/asplenia

31. What do the dense granules contain in platelets
ADP and Ca
Inc HbA2 on electrophoresis
Common a few days after oxidative stress in a pt with G6PD
Valine for glutamate

32. What is relative polycythemia
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Heinz bodies - seen in alpha thal and G6PD
Dec plasma volume

33. can be asymptomatic - often in older adults - peripheral blood lymphcytosis with smudge cells and warm antibody autoimmune hemolytic anemia
1 to 6
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
CLL (SLL without the peripheral lymphocytosis
Sheets of lymphocytes interspersed with macs

34. What does 'Neutrophils Like Making Everything Better' stand for?
EBV
Anti Rh
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

35. Drug that inhbits the GpIIb/IIIa directly
Abciximab
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
EBV

36. What is the difference of presentation of Burkitt in Africa vs the United States
Dendritic cells?
Hereditary spherocytosis - G6PD - sickle cell
No lytic bone lesions in WM
Africa = Jaw lesion - US = pelvis or abdomen

37. What does STOP Making New Thrombi stand for
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Protein C or S deficiency
Histamine - heparin - and eosinohil chemotactic factors
Inc UCB

38. What begins the extrinsic pathway?
Pos
Protein S - cleaves and invactivates Va and VIIIa
Tissue factor converst the VII and VIIa
Megakaryocytes

39. What are the azuraphilic granules in PMNs
Inc HbA2 on electrophoresis
Lysosomes
Malaria - Babesia
...

40. t(15;17)
M3 AML (acute promyelocytic leukemia)
B12/folate def
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
120 days

41. Where does All spread
Def in factor IX
CNS and testis
IFN gama
EBV

42. anti - GpIIb/IIIa antibodies leading to peripheral platelet destruction
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
VIII
40 to 50
Idiopathic thrombocytopenia (ITP)

43. What are dendritic cells called in the skin?
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Langerhans cells
M3 AML (acute promyelocytic leukemia)
20 to 40

44. Is G6PD intravascular or extravascular
EBV
Aplastic anemia - pancytopenia
Intravascular
Extrinsic - I - II - V - VII and X

45. Which pathway and factorrs are tested by the PT coag test
Diffuse Large b cell lymphoma
Extrinsic - I - II - V - VII and X
VIII
Inappropriate absolute with inc RBCs and EPO

46. abnormal clone of hematopoetic stem cells are increasingly sensitive to growth factors - inc RBC - JAK2 mut
Epoxide reductase - warfarin inhibits
Macrohemorrhage - hemarthroses - easy bruising
All trans retinoic acid
Polycythemia vera

47. Where do B cells arise from - mature - and migrate to...
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
B antigena and A antibodes
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Glucose and heme - which inhibit ALA synthase

48. anisocytosis
Histamine - heparin - and eosinohil chemotactic factors
Inc UCB
Varying sizes
40 to 50

49. What are the variants of the RS cells
Mycosis fundgoides/Sezary syndrome
Lacunar in nodular sclerosing variant
Myelofibrosis (marow is crying being its fibrosed'
120 days

50. Macro - ovalocyte
They bind vWF via GpIb
Up - down - up
CML to AML or All
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)