Test your basic knowledge |

Hemeonc

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. bcl -2 t(14;18) adults
Ankryin - band 4.1 or spectrin
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Follicular lymphoma - indolent course
VIII

2. What the alpha granules contain in platelets?
Mantle cell lymphoma
VWF and fibrinogen
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Epoxide reductase - warfarin inhibits

3. Where do B cells arise from - mature - and migrate to...
Pos
Induces differentiation of myeloblasts
Common a few days after oxidative stress in a pt with G6PD
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)

4. normal RBCs added to patient's serum
AML
Cromolyn sodium
Inducers of primary antibody response
Indirect coombs - agglutinate if serum anti RBC surface Ig

5. What do plasma cells do
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Produce antibody - lots of RER and golgi
Varying sizes
HIV or immunosupression

6. What is the are the presenting symptoms of lead poisoning in kids and adults
Yes - via MHC II
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
HbSS
Howell - Jolly bodies - hypo/asplenia

7. What role does antithrombin play?
AML
Birbeck granules
MAHA
Incactivates II - VII - IX - X - XI - XII

8. Spherocyte
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Glanzmann's throbmasthenia
Hereditary spherocytosis - autoimmune hemolysis
Myelofibrosis (marow is crying being its fibrosed'

9. What is the Ddx for for a macrocytic anemia
Intravascular
Hodgkin
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
B cells

10. What state is commonly associated with nonHod lymphoma
Inc large vWF multimers - inc platelet aggregation and thrombosis
IgG - Warm is GREAT
HIV or immunosupression
Langerhans cell histiocytosis

11. Where are basophils found?
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
MGUS - monoclonal gammopathy of undetermined significance
Blood
VWF carries/protects factor VIII

12. How does vWD cause elevated PTT?
Sheets of lymphocytes interspersed with macs
Lymphoma
VWF carries/protects factor VIII
PGI2 - NO inc blood flow - dec platelet aggregation

13. What do the iron studies show in sideroblastic anemia
Inc serum iron - normal TIBC - inc ferratin
Epoxide reductase - warfarin inhibits
Macrohemorrhage - hemarthroses - easy bruising
B12 def

14. What distinguishes multiple myeloma fromk Waldenstroms macroglobulinemia?
Dec
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
No lytic bone lesions in WM
Bite cells and Heinz bodies

15. Why can newborns with sickle cell be asymptomatic
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Glycine and succinyl - coa
Her next Rh+ fetus
Inc HbF and dec HbS

16. What is the affected enzyme in acute intermittment porphyria
Intravascular
Extravascular hemolysis
Porphobilinogen - delta ALA - uroporphyrin
Mantle cell lymphoma

17. What is the characteristic finding for MAHA on peripheral smear?
Inappropriate absolute with inc RBCs and EPO
Schistocytes - helmet cells
5- FU - AZT - hydroxyurea
CNS and testis

18. What is the mutation in HbC
Lysine for glutamate at position 6
Epoxide reductase - warfarin inhibits
Imatinib - anti bcr abl
VWF carries/protects factor VIII

19. S-100 and CD1a with birbeck granules
Langerhans cell histiocytosis
Burkitt lymphoma
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Fibrinogen bind GpIIb/IIIa and links platelts

20. Serum iron - transferrin - ferritin lab values for pregs - OCP use
Nl - up - nl
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Her next Rh+ fetus
Porphobilinogen - delta ALA - uroporphyrin

21. What do the dense granules contain in platelets
ADP and Ca
Essential thrombocytosis
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Sickle cell

22. What activates the fibrinolytic pathway?
G6PD
ADP and Ca
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Ankryin - band 4.1 or spectrin

23. What is the tx for vWD
Inc vasodiltion - inc perm - inc pain
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Exposed collagen upon endothelial damage
IgG - Warm is GREAT

24. What does antithrombin do and What activates it?
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
AML
Nl PT - elevated PTT - intrinsic pathway defect
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion

25. Tdt+ - CAllA+ - kids in the marrow - adolescent males with mediastinal mass
Myelofibrosis (marow is crying being its fibrosed'
B12/folate def
All
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead

26. What are dendritic cells called in the skin?
ADP and Ca
G6PD
Langerhans cells
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis

27. What substance is Fe added to to yield heme
Blistering cutaneous photosens - most common porphyria
Her next Rh+ fetus
Mantle cell lymphoma
Protoporphyrin

28. Is HS extravascular or intravascular?
Extravascular
Mantle cell lymphoma
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Varying shapes

29. RBCs damagaed from passing through obstructed - narrowed vessel lumina
MAHA
Langerhans cell histiocytosis
T(12;21)
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia

30. What causes the jaundice in extravascular hemolysis
Intravascular hemolysis
PGI2 - NO inc blood flow - dec platelet aggregation
Inc UCB
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

31. What is the characteristic spread of Hodgkin Lymphoma
5- FU - AZT - hydroxyurea
Deficiency in factor VIII
Inc vasodiltion - inc perm - inc pain
Contiguous

32. Basophilica stippling
Mycosis fundgoides/Sezary syndrome
Bernard soulier
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

33. What is the mutation in HbS
Bite cells and Heinz bodies
Paroxysmal nocturnal hemoglobinuria
Essential thrombocytosis
Valine for glutamate

34. Does CML have a JAK2 mut
No
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
Reed - sternberg cells
Beta 4

35. What do you see a starry sky appearance in Burkitt
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
CD15 and CD30 pos
Incactivates II - VII - IX - X - XI - XII
Sheets of lymphocytes interspersed with macs

36. What is relative polycythemia
Dec plasma volume
Down - down - up
Pyruvate kinase def - extravascular
Pos

37. How are the nucleus and the cytoplasm characterized for lymphocytes
Round densly staining nucleus with a small amount of pale cytoplasm
Lysine for glutamate at position 6
Rhogam - Rh antigen immunoglobulin
Off center nuclues - clock face chromatin

38. Drug that inhibits COX and therefore TXA2 synthesis
Off center nuclues - clock face chromatin
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Induces differentiation of myeloblasts
Aspirin

39. After an injury - What does vWF bind to begin platelet plug formation?
Inducers of primary antibody response
Exposed collagen upon endothelial damage
Hairy cell leukemia
Low O2 in papilla; can also get microhematuria from medullary infarcts

40. What is the difference of presentation of Burkitt in Africa vs the United States
Lacunar in nodular sclerosing variant
Africa = Jaw lesion - US = pelvis or abdomen
Bite cells and Heinz bodies
Varying sizes

41. Serum iron - transferrin - ferritin lab values for iron def anemia
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
SLE - CLL - alpha methyldopa
Down - up - down
Blood

42. What activates the intrinsic pathway?
Collagen - BM - activated platelets
Inc large vWF multimers - inc platelet aggregation and thrombosis
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 -
Signs and sx of aplastic anemia

43. Serum iron - transferrin - ferritin lab values for anemia of chronic disease
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Down - down - up
Blistering cutaneous photosens - most common porphyria
ATIII def

44. hypocellular bone marrown tih fatty infiltration
Howell - Jolly bodies - hypo/asplenia
Anemia of chronic disease - Aplastic anemia - kidney disease
Aplastic anemia - pancytopenia
Prothrombin gene mutation

45. What does bradykinin do?
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Essential thrombocytosis
Langerhans cells
Inc vasodiltion - inc perm - inc pain

46. What is the clinical picture of hemophilia A or B
Ringed sideronblasts with iron laden mitochondria
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease
Macrohemorrhage - hemarthroses - easy bruising
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 -

47. What do you see on peripheral smear with sideroblastic anemia
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
Ringed sideronblasts with iron laden mitochondria
Howell Jolly bodies
They bind vWF via GpIb

48. What is hemophiliia A
ATIII def
Deficiency in factor VIII
Langerhans cells
Paraprotein spike - monoclonal protein

49. 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
Fibrinogen
B12 def
Inc RBC - dec O2 sat - inc EPO

50. What is the accumulated substance in lead poisoning
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
Protoporphyrin (blood)
Deficiency in factor VIII
Antigen - antibody