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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. Which pathway and factorrs are tested by the PT coag test
Extrinsic - I - II - V - VII and X
CML
B antigena and A antibodes
Direct coombs - agglutinate if RBCs are coated with Ig

2. What do platelets release necessary for coagulation cascaed?
ADP and Ca
Yes - via MHC II
Positive osmootic fragility test and splenectomy
Off center nuclues - clock face chromatin

3. Where do you see hypersegmented polys?
Histamine - heparin - and eosinohil chemotactic factors
B12/folate def
Glanzmann's throbmasthenia
Spleen

4. What causes the physiologic chloride shift and What does the chloride shift do?
Bleeding - malnutrition/absorption - inc demand pregs
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
CNS and testis
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

5. What activates the intrinsic pathway?
Collagen - BM - activated platelets
Fe def - thal - pb poison - sideroblastic anemia
MHC II and Fc receptors
Direct coombs - agglutinate if RBCs are coated with Ig

6. What do eosinophils defend against and What do they use to do it?
Fc
Helminth infections major basic protein
...
Sideroblastic anemia

7. Ddx for microcytic anemia
Indirect coombs - agglutinate if serum anti RBC surface Ig
Fe def - thal - pb poison - sideroblastic anemia
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
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 -

8. What indicated a good prognosis in Hodgkin lymphoma?
Reed - sternberg cells
Inc lymphoctes - and less RS cells
Burkitt lymphoma
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils

9. What do labs show in ITP?
Indirect coombs - agglutinate if serum anti RBC surface Ig
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Mantle cell lymphoma
Histaminase and arylsulfatase

10. t(15;17)
Protein C or S deficiency
B antigena and A antibodes
DIC
M3 AML (acute promyelocytic leukemia)

11. What is the tx for vWD
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Fc
Intrinsic - all factors except - VII - XIII
Uroporphyrin (tea colored urine)

12. What do the platelets bind? What is the step called
DIC
Protoporphyrin (blood)
CLL (SLL without the peripheral lymphocytosis
They bind vWF via GpIb

13. What is makes a leukemia acute
Acts to stabilize platelet plug
Epoxide reductase - warfarin inhibits
No
Blasts > 5%

14. What is contained within the azurophilic granules of PMNs
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Plummer - vinson syndrome
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
CLL (SLL without the peripheral lymphocytosis

15. What portion of IgE can mast cells bind
Blod - tissue - MACS
Intrinsic - all factors except - VII - XIII
Round densly staining nucleus with a small amount of pale cytoplasm
Fc

16. What are dendritic cells called in the skin?
PGI2 - NO inc blood flow - dec platelet aggregation
Ankryin - band 4.1 or spectrin
Langerhans cells
Blasts > 5%

17. Is HS extravascular or intravascular?
90% anearobically from glucose to lactate - 10% from HMP shunt
Extravascular
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Induces differentiation of myeloblasts

18. What does LEAD stand for in lead poisoning?
Inc lymphoctes - and less RS cells
Malaria - Babesia
T(12;21)
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 -

19. What is the affected enzyme in lead poisoning
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
AML
Ferrocheletase and ALA dehydrogenase
Diffuse Large b cell lymphoma

20. What substance is Fe added to to yield heme
Inducers of primary antibody response
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Protoporphyrin
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis

21. inc LDH - jaundice
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
Factor V Leiden
Extravascular hemolysis
Beta 4

22. What does Vit K deficiency cause?
Positive osmootic fragility test and splenectomy
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Produce antibody - lots of RER and golgi
Dec synthesis of factors 1972 - protein C/S

23. universal recipient
AB - no antibodies
Factor V resistant to activated protein C's inhibition
No platelet clumping
Hodgkin

24. What are the azuraphilic granules in PMNs
Birbeck granules
Lysosomes
Bernard soulier
Examples of oxidative stress

25. What is the treatment for sideroblastic anemia
Inc serum iron - normal TIBC - inc ferratin
Protoporphyrin
Splicing sites and promotor sequences
B6 therapy (pyrodixine)

26. Drug that inhbits the GpIIb/IIIa directly
Epoxide reductase - warfarin inhibits
Abciximab
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
CD15 and CD30 pos

27. Which immunoglobulin is involved in warm agglutination?
IgG - Warm is GREAT
Sideroblastic anemia
They bind vWF via GpIb
Intrinsic - all factors except - VII - XIII

28. anti - Ig antibody added to patients RBCs;
Paraprotein spike - monoclonal protein
DIC
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Direct coombs - agglutinate if RBCs are coated with Ig

29. t(11;14)
B12 def
Mantle cell lymphoma
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 -
No

30. What is the life spance of a platelet?
8-10 days
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Fe def - thal - pb poison - sideroblastic anemia
B antigena and A antibodes

31. What percentage of WBCs are eosinophils?
Ferrocheletase and ALA dehydrogenase
Histaminase and arylsulfatase
Inc HbA2 on electrophoresis
1 to 6

32. What is hemophilia B?
Def in factor IX
AB - no antibodies
Inducers of primary antibody response
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin

33. What does antithrombin do and What activates it?
Inappropriate absolute with inc RBCs and EPO
Epoxide reductase - warfarin inhibits
M3 AML (acute promyelocytic leukemia)
Inhibits thrombin - ixa - xa - xiia - and activated by heparin

34. Where does All spread
Sheets of lymphocytes interspersed with macs
Ewing sarcoma
Pyruvate kinase def - extravascular
CNS and testis

35. How does vWD cause elevated PTT?
Aplastic anemia - pancytopenia
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
VWF carries/protects factor VIII
Up - down - up

36. Marrow expansion - 'crew cut' on skull x ray - skeletal deformaties - and chipmunk faces
Sheets of lymphocytes interspersed with macs
Lung disease - congenital heart diseaes - and high altitude
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Beta thal

37. What virus can cause an aplastic crisis in pts with HS?
VWF carries/protects factor VIII
CNS and testis
Up - down - up
Parvovirus

38. What is the characteristic spread of Hodgkin Lymphoma
Hereditary elloptocytosis
B cells
Dendritic cells?
Contiguous

39. anisocytosis
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Contiguous
...
Varying sizes

40. What does bradykinin do?
Examples of oxidative stress
Indirect coombs - agglutinate if serum anti RBC surface Ig
Hodgkin
Inc vasodiltion - inc perm - inc pain

41. What happens in betal thal minor?
Fibrinogen bind GpIIb/IIIa and links platelts
Both alpha and beta thal
Liver disease - abetalipoproteinemia - acntho = spiny
Beta chain underproduced - asymptomatic - heterozygote

42. Conditions of defective heme synthesis leading to accumulation of heme precurors
Porphyrias
Prothrombin gene mutation
HbSS
Extrinsic - I - II - V - VII and X

43. What does STOP Making New Thrombi stand for
Parvovirus
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Cromolyn sodium
DDAVP (desmopressin) which releases stored vWF stored in endothelium

44. What does decreasing heme do to ALA synthase activity?
2 to 10
Inc
Fc
Valine for glutamate

45. What is the receptor for fibrinogen?
HIV or immunosupression
Hereditary spherocytosis
GpIIb/IIIa
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

46. What is the Ddx for nonhemolytic normocytic anemia
Degrades fibrin mesh and converts C3 to C3a
Hereditary elloptocytosis
Anemia of chronic disease - Aplastic anemia - kidney disease
Induces differentiation of myeloblasts

47. Mutation in 3' untranslated region associated with venous clots
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Malaria - Babesia
Prothrombin gene mutation
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy

48. What does the large SA:volume ratio in RBCs help facilitate?
No antigen - both antibodies
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
40 to 50
Easy gas exchange

49. What does NAACP stand for - in regards to the causes of eosinophiia?
Orotic aciduria
Intravascular
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Inc HbA2 on electrophoresis

50. What do labs show in DIC?
Inc RBC - dec O2 sat - inc EPO
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Hereditary spherocytosis - G6PD - sickle cell
Extravascular