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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 cell is primarily involved in non Hod lymph
B12 def
Histamine - heparin - and eosinohil chemotactic factors
B cells
Bone marrow infiltration - myelofibrosis

2. Teardrop cell
Up - down - nl
G6PD
Easy gas exchange
Bone marrow infiltration - myelofibrosis

3. Bite cell
Protoporphyrin (blood)
Complications of sickle cell anemia
G6PD
No platelet clumping

4. What is appropriate absolyte polycythemia associated with
Lung disease - congenital heart diseaes - and high altitude
Degrades fibrin mesh and converts C3 to C3a
Inc
B12 def

5. What is the characteristic spread of Hodgkin Lymphoma
Intravascular
Low in CML
Contiguous
Lysosomes

6. hypersegmented PMNs - glossitis - dec B12 - inc homocysteine - inc methymalonic acid
Inactivates it
Intravascular hemolysis
Blod - tissue - MACS
B12 def

7. What does plasmin do?
A antigen and B antibodies
Degrades fibrin mesh and converts C3 to C3a
Petechiae
Inhibits thrombin - ixa - xa - xiia - and activated by heparin

8. How are plasma cells characterized?
Inc HbF and dec HbS
Extravascular
Off center nuclues - clock face chromatin
Bimodal - men>women - except for nodular sclerosing type

9. What activates the intrinsic pathway?
B6
Protein S - cleaves and invactivates Va and VIIIa
Collagen - BM - activated platelets
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 -

10. What is the difference of presentation of Burkitt in Africa vs the United States
Africa = Jaw lesion - US = pelvis or abdomen
Inc HbA2 on electrophoresis
Birbeck granules
Multiple myeloma

11. Oxidation of iron - denatured hemoglobin preceipitation damage to RBC membrane - formation of bite cells
Heinz bodies - seen in alpha thal and G6PD
Histaminase and arylsulfatase
Leukemoid reaction
All trans retinoic acid

12. normal RBCs added to patient's serum
Indirect coombs - agglutinate if serum anti RBC surface Ig
CD15 and CD30 pos
Inc large vWF multimers - inc platelet aggregation and thrombosis
Aplastic anemia - pancytopenia

13. How do platelet disorders present?
Beta chain underproduced - asymptomatic - heterozygote
Uroporphyrin (tea colored urine)
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Antigen - antibody

14. Impaired synthesis of DAF leading to inc complement mediated desctruction of RBCs via the GPI ancho
Decrease EPO
MGUS - monoclonal gammopathy of undetermined significance
Langerhans cell histiocytosis
Paroxysmal nocturnal hemoglobinuria

15. What do the platelets bind? What is the step called
Helminth infections major basic protein
They bind vWF via GpIb
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Petechiae

16. bcl -2 t(14;18) adults
Heinz bodies - seen in alpha thal and G6PD
Beta 4
Signs and sx of aplastic anemia
Follicular lymphoma - indolent course

17. X linked defect in delta aminolevulinic acid synthase gene causes a defect in hemesynthesis
Inc UCB
Helps platelts adhere to endothelium
Howell Jolly bodies
Sideroblastic anemia

18. What are some causes of warm agglutinin autoimmune hemolytic anemia?
Inc UCB
SLE - CLL - alpha methyldopa
Extravascular
Lysine for glutamate at position 6

19. What do you see on peripheral smear with sideroblastic anemia
Ringed sideronblasts with iron laden mitochondria
Degrades fibrin mesh and converts C3 to C3a
Ferrocheletase and ALA dehydrogenase
Schistocytes and inc LDH

20. What is the are the presenting symptoms of lead poisoning in kids and adults
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Inc RBC - dec O2 sat - inc EPO
Dec synthesis of factors 1972 - protein C/S
Spleen

21. What do labs show in DIC?
Beta thal
Extravascular hemolysis
A antigen and B antibodies
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII

22. What is the receptor for vWF
Gp1b
Reed - sternberg cells
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
T(9;22) bcr abl

23. What percentage of WBCs are basophils - and What is found in their basophilic granules?
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Up - down - up
Hydroxyurea - bone marrow transplant
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

24. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
Up - down - nl
Hereditary spherocytosis
Porphobilinogen - delta ALA - uroporphyrin
Nl - up - nl

25. lymphoid neoplasms with widespread involvement of bone marrow - tumor cells usually foind in peripheral blood
PGI2 - NO inc blood flow - dec platelet aggregation
Leukemia
Hereditary spherocytosis
Bernard soulier

26. Can B cells function as APCs?
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Yes - via MHC II
40 to 75
Protoporphyrin

27. What does LEAD stand for in lead poisoning?
Bite cells and Heinz bodies
All
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 -
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT

28. What is the purpose of the fibrin mesh
Multiple myeloma
Acts to stabilize platelet plug
All trans retinoic acid
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60

29. discrete tumor masses arising from lymph nodes
Lymphoma
Beta thal
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
B6

30. Which infections can cause MAHA?
Intravascular hemolysis
Extrinsic - I - II - V - VII and X
Malaria - Babesia
Erythroblastosis fetalis - Rh or other blood antigen incompatibility

31. What is the main source of energy in RBCs
TRAP (tartrate resistant acid phosphatase
90% anearobically from glucose to lactate - 10% from HMP shunt
Myelofibrosis (marow is crying being its fibrosed'
Easy gas exchange

32. universal donor
Inc HbF and dec HbS
Protein C or S deficiency
No antigen - both antibodies
VWF and fibrinogen

33. What do you see in vit K def
Eleveated PT - PTT
Decrease EPO
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
B12/folate def

34. What does the blood smear show in glanzmann's?
CML to AML or All
Nl - up - nl
Collagen - BM - activated platelets
No platelet clumping

35. What is the coombs test results in AIHA?
B cells
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Produce antibody - lots of RER and golgi
Pos

36. What is the pathogenesis of sickle cell
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
Acts to stabilize platelet plug
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Orotic aciduria

37. Which pathway and factors are tested in the PTT test
Intrinsic - all factors except - VII - XIII
SLE - CLL - alpha methyldopa
Paroxysmal nocturnal hemoglobinuria
...

38. universal recipient
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Paraprotein spike - monoclonal protein
AB - no antibodies
Blod - tissue - MACS

39. What is makes a leukemia acute
Blasts > 5%
Up - down - up
Histaminase and arylsulfatase
B cells

40. Who has more severe disease - HbSS or HbSC
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Up - down - nl
HbSS

41. What is the aggregation phase of ppf?
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Lysosomes
AB - no antibodies
Fibrinogen bind GpIIb/IIIa and links platelts

42. Upregulated growth of leukocytes in bone marro
Leukemia
B12 in fatty acid pathways leads to subacute combined degeneration
No lytic bone lesions in WM
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs

43. Elderly - mature b cell tumor with filamentous - hairlike projections
Uroporphyrinogen decarboxylase
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Hairy cell leukemia
Def in factor IX

44. What are the two substances produced by eosinophils help limit the reaction following mast cell degranulation?
Up - down - nl
Sheets of lymphocytes interspersed with macs
Histaminase and arylsulfatase
TXA2 - dec blood flow - inc platelet aggregation

45. In a Rh - mother who has developed anti Rh antibodies - who is at risk of hemolytic disease?
Anti Rh
T(12;21)
Her next Rh+ fetus
Helps platelts adhere to endothelium

46. What is the therapy for the M3 variant?
ADP and Ca
All trans retinoic acid
Inc
Dec synthesis of factors 1972 - protein C/S

47. Which cell is neoplastic in multiple myeloma
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Ankryin - band 4.1 or spectrin
Polycythemia vera
Plasma cell

48. abnormal clone of hematopoetic stem cells are increasingly sensitive to growth factors - inc RBC - JAK2 mut
B symptoms - fever night sweats - weight loss
Schistocytes - helmet cells
Polycythemia vera
Ticlopidine/clopidogrel

49. Which substrates begin the heme synthesis pathway
Lung disease - congenital heart diseaes - and high altitude
Paraprotein spike - monoclonal protein
M3 AML (acute promyelocytic leukemia)
Glycine and succinyl - coa

50. When is the peak incidence for nonHod lymphoma
Collagen - BM - activated platelets
Pos
20 to 40
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)