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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 do platelets interact with to form a hemostatic plug
...
Fibrinogen
Sheets of lymphocytes interspersed with macs
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

2. What finding you do you see in patients after splenectomy
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Hb Barts - gamma4 in defect in all 4 alpha genes
Howell Jolly bodies
EBV

3. What substance prevents mast cells degranulation?
Cromolyn sodium
Acts to stabilize platelet plug
Low O2 in papilla; can also get microhematuria from medullary infarcts
2 to 10

4. Blood type B
CLL (SLL without the peripheral lymphocytosis
Round densly staining nucleus with a small amount of pale cytoplasm
Epoxide reductase - warfarin inhibits
B antigena and A antibodes

5. What virus is associated with 50% of Hodgkin lymphoma
No antigen - both antibodies
EBV
Down - up - down
B12 in fatty acid pathways leads to subacute combined degeneration

6. RBCs damagaed from passing through obstructed - narrowed vessel lumina
MAHA
Acts to stabilize platelet plug
CLL (SLL without the peripheral lymphocytosis
Alpha thal - asian and african american

7. What is the difference of presentation of Burkitt in Africa vs the United States
Sideroblastic anemia
Inc
Helps platelts adhere to endothelium
Africa = Jaw lesion - US = pelvis or abdomen

8. What is the pathogenesis of aplastic anemia with kidney disease
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
Deficiency in factor VIII
Decrease EPO

9. What is the aggregation phase of ppf?
TRAP (tartrate resistant acid phosphatase
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Howell - Jolly bodies - hypo/asplenia
Fibrinogen bind GpIIb/IIIa and links platelts

10. What is the age group most commonly affected by multiple myeloma
40 to 50
T(12;21)
Dec plasma volume
Sheets of lymphocytes interspersed with macs

11. What level of leukocyte alkaline phosphatase is expected in CML versus leukemoid reaction
Low in CML
CD15 and CD30 pos
Alpha thal - asian and african american
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT

12. What is the receptor for fibrinogen?
Von Willebrand's disease
Abciximab
GpIIb/IIIa
Uroporphyrinogen decarboxylase

13. What is the effected enzyme in acute intermittment porphyria?
Up - down - nl
Ringed sideronblasts with iron laden mitochondria
Inc HbF and dec HbS
Porphobilinogen deaminase aka uroporphyrinogen I synthase

14. What percentage if WBCs are polys?
XIIa activates kallikrein - which activates plasmin (and converts HMWK to bradykinin
Helminth infections major basic protein
Tissue
40 to 75

15. What does the large SA:volume ratio in RBCs help facilitate?
Easy gas exchange
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Antigen - antibody
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites

16. What portion of IgE can mast cells bind
Histamine - heparin - and eosinohil chemotactic factors
Fc
Mycosis fundgoides/Sezary syndrome
ADP and Ca

17. Which infections can cause MAHA?
Malaria - Babesia
Exposed collagen upon endothelial damage
Africa = Jaw lesion - US = pelvis or abdomen
Splicing sites and promotor sequences

18. X linked - dec glutathione inc RBC susceptibility to oxidative stress
G6PD
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT
Langerhans cells
Lung disease - congenital heart diseaes - and high altitude

19. Plasma cell neoplasm
Easy gas exchange
VWF carries/protects factor VIII
Multiple myeloma
Histamine - heparin - and eosinohil chemotactic factors

20. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Hodgkin
Deficiency in factor VIII
Eleveated PT - PTT
TRAP (tartrate resistant acid phosphatase

21. What does LEAD stand for in lead poisoning?
Direct coombs - agglutinate if RBCs are coated with Ig
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 -
ADP and Ca
Produce antibody - lots of RER and golgi

22. What are the pro aggregation factors?
SLE - CLL - alpha methyldopa
Langerhans cells
Inc UCB
TXA2 - dec blood flow - inc platelet aggregation

23. Where do you see hypersegmented polys?
Up - down - nl
Inc serum iron - normal TIBC - inc ferratin
B12/folate def
Idiopathic thrombocytopenia (ITP)

24. inhibition of ferrochelatase and ALA dehydrogenase leading to dec heme synthesis - also inhibition of rRNA degradation
No lytic bone lesions in WM
Bernard soulier
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII

25. Which cell is neoplastic in multiple myeloma
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Ewing sarcoma
Plasma cell
Multiple myeloma

26. What is the main source of energy in RBCs
90% anearobically from glucose to lactate - 10% from HMP shunt
CML
Valine for glutamate
Extravascular hemolysis

27. Fava beans - sufla drugs - infectinos
Aspirin
Examples of oxidative stress
Helminth infections major basic protein
Inc

28. What do the iron studies show in sideroblastic anemia
Sickle cell
Spleen
Inc serum iron - normal TIBC - inc ferratin
Paraprotein spike - monoclonal protein

29. What are the presenting symptoms of porphyria cutanea tarda
Blistering cutaneous photosens - most common porphyria
Polycythemia vera
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Splicing sites and promotor sequences

30. What are some causes of cold agglutinin anemia
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Pos
Valine for glutamate

31. What cell is primarily involved in non Hod lymph
Helps platelts adhere to endothelium
Ankryin - band 4.1 or spectrin
B cells
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII

32. What does Vit K deficiency cause?
Glanzmann's throbmasthenia
Dec synthesis of factors 1972 - protein C/S
Bleeding - malnutrition/absorption - inc demand pregs
Leukemoid reaction

33. What reveresible things can a sideroblastic anemia
All trans retinoic acid
ADP binding to receptors causes upregulation of GpIIb/IIIa expression at platelet surface
< 1% - heparin - histamine - LTD-4 - other vasoactive amines
Lead - and EtOH

34. What are the azuraphilic granules in PMNs
Reed - sternberg cells
Multiple myeloma
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Lysosomes

35. What activates the intrinsic pathway?
Collagen - BM - activated platelets
Antigen - antibody
Pos
Adult T cell lymphoma - presents with cutaneous lesions

36. What do the platelets bind? What is the step called
Fibrinogen
T(12;21)
They bind vWF via GpIb
ATIII def

37. t(15;17)
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 -
M3 AML (acute promyelocytic leukemia)
CML to AML or All
Ferrocheletase and ALA dehydrogenase

38. What virus is associated with Burkitt lymphoma
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Essential thrombocytosis
EBV

39. HTLV-1
Adult T cell lymphoma - presents with cutaneous lesions
Indirect coombs - agglutinate if serum anti RBC surface Ig
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO

40. Serum iron - transferrin - ferritin lab values for lead poisoning anemia
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'
Up - down - nl
Varying shapes
Cold - seen in CLL - mycoplasma pneumoniae infections or infectious mononucleosis

41. What symptoms are associated with Hodgkin lymphoma
ADP and Ca
Helps platelts adhere to endothelium
B symptoms - fever night sweats - weight loss
Plummer - vinson syndrome

42. What chromosomal translocation is associated with a better prognosis in All
Burkitt lymphoma
T(12;21)
Inc large vWF multimers - inc platelet aggregation and thrombosis
Indirect coombs - agglutinate if serum anti RBC surface Ig

43. What is the treatment for lead poising?
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Common a few days after oxidative stress in a pt with G6PD
Adult T cell lymphoma - presents with cutaneous lesions
Hb Barts - gamma4 in defect in all 4 alpha genes

44. What does CRAB stand for in multiple myeloma
Lysine for glutamate at position 6
HyperCalcemia - Renal insuff - Anemia - Bone lytic lesions/Back pain
Factor V resistant to activated protein C's inhibition
Dec plasma volume

45. When do you see MAHA?
Up - down - up
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
8-10 days
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis

46. Serum iron - transferrin - ferritin lab values for pregs - OCP use
ADP and Ca
Nl - up - nl
EBV
Hereditary spherocytosis

47. What does ADP do?
Polycythemia vera
B antigena and A antibodes
Decrease EPO
Helps platelts adhere to endothelium

48. What activates protein C and What does activated protein C do?
20 to 40
2 to 10
Inc serum iron - normal TIBC - inc ferratin
Protein S - cleaves and invactivates Va and VIIIa

49. What is the defect in beta thal?
Sheets of lymphocytes interspersed with macs
Splicing sites and promotor sequences
Dimercaprol and EDTA 1st line of treatment - succimer for kids - it sucks to be a kid who eats lead
Glanzmann's throbmasthenia

50. What do auer rods stain with
Peroxidase
DIC
Porphyrias
Lung disease - congenital heart diseaes - and high altitude