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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 do labs show in DIC?
ADP and Ca
ADP and Ca
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Inducers of primary antibody response

2. What are the labs and tx for HS?
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Sheets of lymphocytes interspersed with macs
Positive osmootic fragility test and splenectomy
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils

3. Which immunoglobulin is involved in warm agglutination?
Lung disease - congenital heart diseaes - and high altitude
Cromolyn sodium
TPA - cleavage of fibrin mesh
IgG - Warm is GREAT

4. What does STOP Making New Thrombi stand for
Def in factor IX
B6 therapy (pyrodixine)
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Fe def - thal - pb poison - sideroblastic anemia

5. what proteins can be defective in HS?
Ankryin - band 4.1 or spectrin
Def in factor IX
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Histamine - heparin - and eosinohil chemotactic factors

6. What happens in beta thal major?
8-10 days
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Fc

7. adults - auer rods - inc circulating myeblasts on peripheral smear
Inc
AML
Ticlopidine/clopidogrel
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT

8. What is the characteristic spread of Hodgkin Lymphoma
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
Ewing sarcoma
Contiguous
Inactivates it

9. What does LEAD stand for in lead poisoning?
Idiopathic thrombocytopenia (ITP)
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 -
Fibrinogen bind GpIIb/IIIa and links platelts
Liver disease - abetalipoproteinemia - acntho = spiny

10. Upregulated growth of leukocytes in bone marro
Protoporphyrin
Leukemia
Alpha thal - asian and african american
Inc serum iron - normal TIBC - inc ferratin

11. Acanthocyte (spur cell)
B cells
Leukemia
Easy gas exchange
Liver disease - abetalipoproteinemia - acntho = spiny

12. What is the age breakdown for hodgkins
Liver disease - abetalipoproteinemia - acntho = spiny
Von Willebrand's disease
Bimodal - men>women - except for nodular sclerosing type
Up - down - nl

13. What condition can result from treating AML M3 from the release of the Auer rods
DIC
Nodular sclerosing
Pos
Intrinsic - all factors except - VII - XIII

14. bcl -2 t(14;18) adults
Aplastic anemia - pancytopenia
Indirect coombs - agglutinate if serum anti RBC surface Ig
Inc RBC - dec O2 sat - inc EPO
Follicular lymphoma - indolent course

15. hypersegmented PMNs - glossitis - dec folate - inc homocysteine - nl methylmalonic acid
Nodular sclerosing
Folate def
Low in CML
Pos

16. Why does B12 def cause neuro sx?
Paraprotein spike - monoclonal protein
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
B12 in fatty acid pathways leads to subacute combined degeneration
Langerhans cell histiocytosis

17. What finding you do you see in patients after splenectomy
Howell Jolly bodies
Burkitt lymphoma
TRAP (tartrate resistant acid phosphatase
Plasma cell

18. Which pathway and factorrs are tested by the PT coag test
Both alpha and beta thal
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Extrinsic - I - II - V - VII and X

19. What is the accumulated substance in lead poisoning
Liver disease - abetalipoproteinemia - acntho = spiny
Protoporphyrin (blood)
Paroxysmal nocturnal hemoglobinuria
Incactivates II - VII - IX - X - XI - XII

20. What is the defect in beta thal?
Varying sizes
Splicing sites and promotor sequences
PGI2 - NO inc blood flow - dec platelet aggregation
AML

21. What do platelets release necessary for coagulation cascaed?
Beta 4
ADP and Ca
Howell - Jolly bodies - hypo/asplenia
Cromolyn sodium

22. What are dendritic cells called in the skin?
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Blistering cutaneous photosens - most common porphyria
Langerhans cells
Peroxidase

23. Where to T cells arise and mature - and migrate to...
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Lysine for glutamate at position 6
A antigen and B antibodies
ADP and Ca

24. What are the azuraphilic granules in PMNs
B12 in fatty acid pathways leads to subacute combined degeneration
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis
Lysosomes
Antigen - antibody

25. What is the purpose of the fibrin mesh
Sickle cell
Acts to stabilize platelet plug
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
AB - no antibodies

26. Serum iron - transferrin - ferritin lab values for anemia of chronic disease
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Down - down - up
IFN gama

27. Which pathway and factors are tested in the PTT test
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Intrinsic - all factors except - VII - XIII
Folate def
Def in factor IX

28. What the alpha granules contain in platelets?
VWF and fibrinogen
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Beta thal
Hodgkin

29. X linked defect in delta aminolevulinic acid synthase gene causes a defect in hemesynthesis
Adult T cell lymphoma - presents with cutaneous lesions
Sideroblastic anemia
Incactivates II - VII - IX - X - XI - XII
Sickle cell anemia

30. What virus is associated with 50% of Hodgkin lymphoma
EBV
Contiguous
Hydroxyurea - bone marrow transplant
AML

31. What is the general pathology of a macrocytic anemia?
Glycine and succinyl - coa
Parvovirus
Plasma cell
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm

32. What do you see on peripheral smear with sideroblastic anemia
They bind vWF via GpIb
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Ringed sideronblasts with iron laden mitochondria
20 to 40

33. iron deficiency anemia - esophageal web - atrophic glossitis
Induces differentiation of myeloblasts
Paraprotein spike - monoclonal protein
Plummer - vinson syndrome
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin

34. Does CML have a JAK2 mut
Heinz bodies - seen in alpha thal and G6PD
Up - down - nl
Direct coombs - agglutinate if RBCs are coated with Ig
No

35. What percentage of WBCs are eosinophils?
Inc suscept to infxn - primary amyloidosis - punched out lytic bone lesions - M spike - Ig light chains in urine - Rouleaud formations (stacked RBCs)
CD15 and CD30 pos
1 to 6
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis

36. What percentage of WBCs are basophils - and What is found in their basophilic granules?
Porphobilinogen deaminase aka uroporphyrinogen I synthase
Bite cells and Heinz bodies
Incactivates II - VII - IX - X - XI - XII
< 1% - heparin - histamine - LTD-4 - other vasoactive amines

37. What are some causes of warm agglutinin autoimmune hemolytic anemia?
SLE - CLL - alpha methyldopa
Helps platelts adhere to endothelium
Protoporphyrin (blood)
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'

38. What is the age group most commonly affected by multiple myeloma
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
40 to 50
Common a few days after oxidative stress in a pt with G6PD

39. Defect in platelet to platelet adhesion - receptor - disorder - platelet count and bleeding time

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40. How does vWD cause elevated PTT?
Both alpha and beta thal
Howell - Jolly bodies - hypo/asplenia
VWF carries/protects factor VIII
Africa = Jaw lesion - US = pelvis or abdomen

41. Defect in proteins interacting with RBC membrane skeleton and plasma membrane
DIC
Hereditary spherocytosis
VIII
Erythroblastosis fetalis - Rh or other blood antigen incompatibility

42. What substances are released in mast cell degranulation
90% anearobically from glucose to lactate - 10% from HMP shunt
Histamine - heparin - and eosinohil chemotactic factors
VWF and fibrinogen
DIC

43. What does ADP do?
Uroporphyrin (tea colored urine)
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Helps platelts adhere to endothelium
T(12;21)

44. What is the therapy for the M3 variant?
All trans retinoic acid
Varying shapes
Incactivates II - VII - IX - X - XI - XII
Beta 4

45. What is the tx for sickle cell
Rhogam - Rh antigen immunoglobulin
No
Hydroxyurea - bone marrow transplant
Low O2 in papilla; can also get microhematuria from medullary infarcts

46. What does NAACP stand for - in regards to the causes of eosinophiia?
No
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
DIC - TTP/HUS - traumatic hemolysis
VWF and fibrinogen

47. t(15;17)
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Inc UCB
M3 AML (acute promyelocytic leukemia)
Bone marrow infiltration - myelofibrosis

48. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Hodgkin
TPA - cleavage of fibrin mesh
Protoporphyrin
Splicing sites and promotor sequences

49. philadelphia chromosome - blood looks like marrow
Paroxysmal nocturnal hemoglobinuria
CML
Inflammation leads to inc hepcidin causing a dec in release from iron from macs: dec serum fe - dec TIBC - inc ferritin
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs

50. What percentage of WBCs are monocytes?
Helminth infections major basic protein
2 to 10
Up - down - nl
Blood