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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 does ADP do?
Dendritic cells?
A antigen and B antibodies
Up - down - nl
Helps platelts adhere to endothelium

2. Elderly - mature b cell tumor with filamentous - hairlike projections
They bind vWF via GpIb
Birbeck granules
Hairy cell leukemia
B cells

3. What substances are released in mast cell degranulation
Histamine - heparin - and eosinohil chemotactic factors
ATIII def
AML
Diffuse Large b cell lymphoma

4. What do you see in peripheral smear in a pt with G6PD?
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Burkitt lymphoma
Dec synthesis of factors 1972 - protein C/S
Bite cells and Heinz bodies

5. adults - auer rods - inc circulating myeblasts on peripheral smear
SLE - CLL - alpha methyldopa
Essential thrombocytosis
AML
Ewing sarcoma

6. Serum iron - transferrin - ferritin lab values for hemochromatosis
All
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
Up - down - up
Inducers of primary antibody response

7. RBCs damagaed from passing through obstructed - narrowed vessel lumina
MAHA
Varying shapes
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Inducers of primary antibody response

8. Oxidation of iron - denatured hemoglobin preceipitation damage to RBC membrane - formation of bite cells
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
All
Heinz bodies - seen in alpha thal and G6PD
20 to 40

9. Serum iron - transferrin - ferritin lab values for pregs - OCP use
VWF and fibrinogen
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
Nl - up - nl
Indirect coombs - agglutinate if serum anti RBC surface Ig

10. Serum iron - transferrin - ferritin lab values for anemia of chronic disease
Histaminase and arylsulfatase
Bite cells and Heinz bodies
Up - down - nl
Down - down - up

11. In a Rh - mother who has developed anti Rh antibodies - who is at risk of hemolytic disease?
Pos
Her next Rh+ fetus
Bimodal - men>women - except for nodular sclerosing type
B12 def

12. What is contained within the azurophilic granules of PMNs
Varying shapes
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Blood
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin

13. What is the Ddx for a normocytic - normochromic anemia?
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis
Inc HbF and dec HbS
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion

14. Serum iron - transferrin - ferritin lab values for lead poisoning anemia
40 to 75
Up - down - nl
VWF carries/protects factor VIII
CML to AML or All

15. Megakaryocytosis
Bite cells and Heinz bodies
Decrease EPO
Essential thrombocytosis
Deoxygenated HbS polymerizes - low O2 or dehydration precipiates sickling - anemia and veno - occlusive disease

16. Spherocyte
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Glycine and succinyl - coa
Hereditary spherocytosis - autoimmune hemolysis
Glanzmann's throbmasthenia - GpIIb/IIIa - nl platelets - inc BT

17. What is the ddx for aplastic anemia

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18. anti - GpIIb/IIIa antibodies leading to peripheral platelet destruction
A antigen and B antibodies
Idiopathic thrombocytopenia (ITP)
Inappropriate absolute with inc RBCs and EPO
Ferrocheletase and ALA dehydrogenase

19. Who are the professional APCs?
Sickle cell anemia
Dendritic cells?
Histamine - heparin - and eosinohil chemotactic factors
Beta chain absent - homozgote - severe anemia requiring blood transfusion - secondary hemochromatosis

20. What is the general pathology of a macrocytic anemia?
40 to 75
Lysine for glutamate at position 6
DNA synth impaired - maturation of nucleus delayed relative to maturation of cytoplasm
PGI2 - NO inc blood flow - dec platelet aggregation

21. What does plasmin do?
Degrades fibrin mesh and converts C3 to C3a
Varying shapes
Inhibits thrombin - ixa - xa - xiia - and activated by heparin
Hodgkin

22. hemolytic in a newborn - dec ATP and rigid RBCs
Kidney - Gi - microcytic anemai in both - kids = mental retardation and adults = headache - memory loss - demyelination
Fibrinogen bind GpIIb/IIIa and links platelts
Hb Barts - gamma4 in defect in all 4 alpha genes
Pyruvate kinase def - extravascular

23. What is the presenting scenario for TTP?
Signs and sx of aplastic anemia
PENTAD: neurologic sx - renal sx - fever - thrombocytopenia - MAHA
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
Positive osmootic fragility test and splenectomy

24. Blood type A
Polycythemia vera with inc plasma volume - inc RBCs - inc EPO
EBV
A antigen and B antibodies
MHC II and Fc receptors

25. What symptoms are associated with Hodgkin lymphoma
ADP and Ca
Blasts > 5%
B symptoms - fever night sweats - weight loss
VWD

26. What finding you do you see in patients after splenectomy
Howell Jolly bodies
Glanzmann's throbmasthenia
Induces differentiation of myeloblasts
Reed - sternberg cells

27. How does the therapy for M3 vairant work?
ADP and Ca
Induces differentiation of myeloblasts
...
Valine for glutamate

28. What is the mutation in HbS
Dec plasma volume
Sideroblastic anemia
Valine for glutamate
Inc vasodiltion - inc perm - inc pain

29. What is the life span of a normal RBC
Hairy cell leukemia
Langerhans cell histiocytosis
120 days
Anti Rh

30. Plasma cell neoplasm
Nl - up - nl
M3 AML (acute promyelocytic leukemia)
Multiple myeloma
All < 15 - AML = median onset around 60 - CML = 30 to 60 - and CLL > 60

31. What are the two substances produced by eosinophils help limit the reaction following mast cell degranulation?
Inc RBC - dec O2 sat - inc EPO
Histaminase and arylsulfatase
VWF and fibrinogen
PGI2 - NO inc blood flow - dec platelet aggregation

32. What are the pro aggregation factors?
TXA2 - dec blood flow - inc platelet aggregation
Extrinsic - I - II - V - VII and X
Low O2 in papilla; can also get microhematuria from medullary infarcts
Burkitt lymphoma

33. What is the most common nonhodgkin lymphoma
WBC diff highest to lowest: neutrophils - lymphocytes - monocytes - eosinophils - basophils
AML
Diffuse Large b cell lymphoma
Signs and sx of aplastic anemia

34. What is the treatment for sideroblastic anemia
CD15 and CD30 pos
Peripheral neuropathy - posterior columns (vibration/proprioception) - lateral corticospinal (spasticity) - dementia
Fibrinogen bind GpIIb/IIIa and links platelts
B6 therapy (pyrodixine)

35. What do labs show in DIC?
Antigen - antibody
Hydroxyurea - bone marrow transplant
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII
Extrinsic - I - II - V - VII and X

36. What does the large SA:volume ratio in RBCs help facilitate?
Macrohemorrhage - hemarthroses - easy bruising
Her next Rh+ fetus
Easy gas exchange
M3 AML (acute promyelocytic leukemia)

37. What distinguishes multiple myeloma fromk Waldenstroms macroglobulinemia?
Hereditary spherocytosis
No lytic bone lesions in WM
Marrow - marrow - follicles of lymph nodes - white pulp of spleen (unencapsulated lymphoid tissue)
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion

38. iron deficiency anemia - esophageal web - atrophic glossitis
Neoplastic - asthma - allergic processes - collagen vacsular disease - parasites
Africa = Jaw lesion - US = pelvis or abdomen
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
Plummer - vinson syndrome

39. Drug that inhbits the GpIIb/IIIa directly
Abciximab
ADP and Ca
B12 in fatty acid pathways leads to subacute combined degeneration
Inc serum iron - normal TIBC - inc ferratin

40. What cell is primarily involved in non Hod lymph
Off center nuclues - clock face chromatin
B cells
Varying shapes
Lung disease - congenital heart diseaes - and high altitude

41. Conditions of defective heme synthesis leading to accumulation of heme precurors
Inc vasodiltion - inc perm - inc pain
120 days
Porphyrias
Off center nuclues - clock face chromatin

42. What activates protein C and What does activated protein C do?
Protein S - cleaves and invactivates Va and VIIIa
Follicular lymphoma - indolent course
TRAP (tartrate resistant acid phosphatase
Down - down - up

43. Basophilica stippling
Chloride bicarb antiport system - - allows transport of C02 from periph to lungs
CLL (SLL without the peripheral lymphocytosis
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning
Heinz bodies - seen in alpha thal and G6PD

44. What is relative polycythemia
Essential thrombocytosis
Uroporphyrinogen decarboxylase
Def in factor IX
Dec plasma volume

45. What causes the jaundice in extravascular hemolysis
All trans retinoic acid
Inc UCB
Direct coombs - agglutinate if RBCs are coated with Ig
Nl - up - nl

46. What is the tx for sickle cell
Gp1b - bernard - soulier - dec platelets (giant platelets not counted) - inc BT
M3 AML (acute promyelocytic leukemia)
Hydroxyurea - bone marrow transplant
Incactivates II - VII - IX - X - XI - XII

47. What is the Ddx for for a macrocytic anemia
Yes - via MHC II
Leukemia
Folate/B12 - nonmegaoblastic anemias - liver dz - EtOH (non folate/B12) reticulocytosis - metabolic disorder - drugs
EBV

48. t(15;17)
Induces differentiation of myeloblasts
M3 AML (acute promyelocytic leukemia)
Imatinib - anti bcr abl
Extravascular hemolysis

49. What is makes a leukemia acute
ADP and Ca
Blasts > 5%
MAHA
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion

50. Basophilic nuclear remnants fonud in RBCs
Malnutrition - malabsoprtion - impaired metabolism - inc requirement as in an hemolytic anemia or pregnancy
Lung disease - congenital heart diseaes - and high altitude
Howell - Jolly bodies - hypo/asplenia
HbC disease - Asplenia - Liver disease - thalassemia - 'HALT the hunter said to his target'