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. deficiency in ADAMTS13 leading to dec degradation of vWF
Bimodal - men>women - except for nodular sclerosing type
All
Thrombotic thrombocytopenic purpura
Nl - up - nl

2. How does the therapy for M3 vairant work?
No antigen - both antibodies
Induces differentiation of myeloblasts
Pos
2 to 10

3. Adults present with cutaneous patches/nodules - indolent CD4+
Mycosis fundgoides/Sezary syndrome
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
They bind vWF via GpIb
2 to 10

4. What level of leukocyte alkaline phosphatase is expected in CML versus leukemoid reaction
Incactivates II - VII - IX - X - XI - XII
Low in CML
No platelet clumping
Alpha thal - asian and african american

5. Upregulated growth of leukocytes in bone marro
Megakaryocytes
Intravascular hemolysis
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Leukemia

6. 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
Sickle cell
Inc HbA2 on electrophoresis
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
CLL (SLL without the peripheral lymphocytosis

7. Production of mutant factor V that cannot by degraded by protein C - most common cause of inherited hypercoaguability
MGUS - monoclonal gammopathy of undetermined significance
Mantle cell - older males
No antigen - both antibodies
Factor V Leiden

8. What is the presenting scenario for TTP?
Off center nuclues - clock face chromatin
Acts to stabilize platelet plug
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA
SLE - CLL - alpha methyldopa

9. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Peroxidase
Africa = Jaw lesion - US = pelvis or abdomen
Hodgkin
No lytic bone lesions in WM

10. What do you see on peripheral smear with sideroblastic anemia
Hereditary spherocytosis - autoimmune hemolysis
Inc serum iron - normal TIBC - inc ferratin
Ringed sideronblasts with iron laden mitochondria
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF

11. What is the result of thrombocytopenia or platelet dysfunction?
T(9;22) bcr abl
Petechiae
Lacunar in nodular sclerosing variant
DIC

12. X linked - dec glutathione inc RBC susceptibility to oxidative stress
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
G6PD
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Inc lymphoctes - and less RS cells

13. What virus is associated with 50% of Hodgkin lymphoma
Beta chain underproduced - asymptomatic - heterozygote
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 -
Kids= exposure to lead paint - adults = battery - ammunition factory
EBV

14. What are the neuro sx of B12 def?
Sickle cell anemia
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Direct coombs - agglutinate if RBCs are coated with Ig
Cromolyn sodium

15. What happens in betal thal minor?
Inc RBC - dec O2 sat - inc EPO
MAHA
Hereditary spherocytosis
Beta chain underproduced - asymptomatic - heterozygote

16. What virus can cause an aplastic crisis in pts with HS?
Parvovirus
Up - down - nl
Off center nuclues - clock face chromatin
Uroporphyrin (tea colored urine)

17. Teardrop cell
Complications of sickle cell anemia
Histamine - heparin - and eosinohil chemotactic factors
Bone marrow infiltration - myelofibrosis
Africa = Jaw lesion - US = pelvis or abdomen

18. What are the main associations with multiple myeloma?
Blasts > 5%
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
EBV
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

19. hypersegmented PMNs - glossitis - dec folate - inc homocysteine - nl methylmalonic acid
Tissue
Megakaryocytes
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Folate def

20. Marrow expansion - 'crew cut' on skull x ray - skeletal deformaties - and chipmunk faces
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Beta thal
Sickle cell anemia
G6PD

21. What are some classic examples of extravascular hemolysis
Antigen - antibody
Langerhans cells
No antigen - both antibodies
Hereditary spherocytosis - G6PD - sickle cell

22. what proteins can be defective in HS?
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Ankryin - band 4.1 or spectrin
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Plasma cell

23. What do eosinophils defend against and What do they use to do it?
Intrinsic - all factors except - VII - XIII
Follicular lymphoma - indolent course
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60
Helminth infections major basic protein

24. What is the pathogenesis of TTP?
TXA2 - dec blood flow - inc platelet aggregation
Liver disease - abetalipoproteinemia - acntho = spiny
Dec
Inc large vWF multimers - inc platelet aggregation and thrombosis

25. What is the therapy for CML (philly chrom)
Lead - and EtOH
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Gp1b
Imatinib - anti bcr abl

26. What portion of IgE can mast cells bind
Protoporphyrin
Beta thal
Fc
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis

27. What does increasing heme do to ALA synthase activity
Aspirin
Schistocytes - helmet cells
Dec
DIC

28. t(11:22)
Inc
TXA2 - dec blood flow - inc platelet aggregation
Ewing sarcoma
Inc lymphoctes - and less RS cells

29. What does decreasing heme do to ALA synthase activity?
Abciximab
Positive osmootic fragility test and splenectomy
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Inc

30. Which infections can cause MAHA?
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Malaria - Babesia
Macrohemorrhage - hemarthroses - easy bruising
GpIIb/IIIa

31. philadelphia chromosome - blood looks like marrow
HIV or immunosupression
Def in factor IX
CLL (SLL without the peripheral lymphocytosis
CML

32. Inherited deficiency of antithrombin; reduced inc in PTT after administration of heparin
Sideroblastic anemia
Acts to stabilize platelet plug
ATIII def
Indirect coombs - agglutinate if serum anti RBC surface Ig

33. What are dendritic cells called in the skin?
SLE - CLL - alpha methyldopa
Essential thrombocytosis
Def in factor IX
Langerhans cells

34. anti - GpIIb/IIIa antibodies leading to peripheral platelet destruction
Lacunar in nodular sclerosing variant
Idiopathic thrombocytopenia (ITP)
No platelet clumping
Antigen - antibody

35. RBCs damagaed from passing through obstructed - narrowed vessel lumina
Idiopathic thrombocytopenia (ITP)
Bone marrow - thymus - blood (80% of circulating lymphos are T)
ATIII def
MAHA

36. Where are 1/3 of platelets stored
20 to 40
...
Spleen
CML

37. Deficiency in GpIIb/IIIa

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

38. Sickle cell
Plummer - vinson syndrome
Mantle cell lymphoma
Sickle cell anemia
Reed - sternberg cells

39. What does STOP Making New Thrombi stand for
Extrinsic - I - II - V - VII and X
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Complications of sickle cell anemia
Hereditary spherocytosis - autoimmune hemolysis

40. What is the age breakdown for hodgkins
Bimodal - men>women - except for nodular sclerosing type
MHC II and Fc receptors
Complications of sickle cell anemia
ATIII def

41. What are some causes of cold agglutinin anemia
Dec plasma volume
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
ATIII def
Schistocytes and inc LDH

42. Which substrates begin the heme synthesis pathway
Blod - tissue - MACS
Epoxide reductase - warfarin inhibits
Glycine and succinyl - coa
Hereditary spherocytosis - autoimmune hemolysis

43. What is the clinical picture of hemophilia A or B
90% anearobically from glucose to lactate - 10% from HMP shunt
Tissue factor converst the VII and VIIa
Macrohemorrhage - hemarthroses - easy bruising
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease

44. hypersegmented PMNs - glossitis - dec B12 - inc homocysteine - inc methymalonic acid
B12 def
Degrades fibrin mesh and converts C3 to C3a
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Inc vasodiltion - inc perm - inc pain

45. What is the effect of ACE on bradykinin
Ringed sideronblasts with iron laden mitochondria
Inactivates it
Bone marrow infiltration - myelofibrosis
Incactivates II - VII - IX - X - XI - XII

46. What percentage of WBCs are eosinophils?
1 to 6
Cromolyn sodium
Plasma cell
ATIII def

47. Why can newborns with sickle cell be asymptomatic
IgG - Warm is GREAT
Inc HbF and dec HbS
TPA - cleavage of fibrin mesh
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

48. Serum iron - transferrin - ferritin lab values for hemochromatosis
Up - down - up
Examples of oxidative stress
VWD
Low in CML

49. What is the ddx for aplastic anemia

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

50. When do you see MAHA?
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Cromolyn sodium
Mantle cell - older males
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis