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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 labs show in DIC?
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 -
Adult T cell lymphoma - presents with cutaneous lesions
B cells
Schistocytes - inc fibrin split products (D- dimers) - dec fibrinogen - dec factors V and VIII

2. How is beta thal minor dx
Von Willebrand's disease
ADP and Ca
Inc HbA2 on electrophoresis
Blasts > 5%

3. What condition can result from treating AML M3 from the release of the Auer rods
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Blistering cutaneous photosens - most common porphyria
DIC
Inc large vWF multimers - inc platelet aggregation and thrombosis

4. Upregulated growth of leukocytes in bone marro
Antigen - antibody
Histaminase and arylsulfatase
GpIIb/IIIa
Leukemia

5. Elderly - mature b cell tumor with filamentous - hairlike projections
Cromolyn sodium
Decrease EPO
Hairy cell leukemia
B12 def

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
Erythroblastosis fetalis - Rh or other blood antigen incompatibility
VIII
Splicing sites and promotor sequences
Sickle cell

7. bcl -2 t(14;18) adults
Idiopathic thrombocytopenia (ITP)
Signs and sx of aplastic anemia
Follicular lymphoma - indolent course
Lead poisoning - rRNA causes aggregration of ribosomes and basophilic stippling

8. Why does B12 def cause neuro sx?
Dec
Macrohemorrhage - hemarthroses - easy bruising
B12 in fatty acid pathways leads to subacute combined degeneration
Von Willebrand's disease

9. Which infections can cause MAHA?
Malaria - Babesia
Histamine - heparin - and eosinohil chemotactic factors
IFN gama
Extravascular

10. Target cell

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11. What is the mutation in HbS
T(9;22) bcr abl
Easy gas exchange
Sideroblastic anemia
Valine for glutamate

12. What is the Ddx for a normocytic - normochromic anemia?
Extrinsic - I - II - V - VII and X
B12/folate def
Ewing sarcoma
Hemolytic or non hemolytic - and then for the hemolytiuc - intravascular hemolysis or extravascular hemolysis

13. What is the pattern of involvement and spread for nonHod lympho
Hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
1 to 6
Extravascular
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread

14. What is the tx for vWD
DDAVP (desmopressin) which releases stored vWF stored in endothelium
Fc
TPA - cleavage of fibrin mesh
Hereditary spherocytosis - G6PD - sickle cell

15. How are plasma cells characterized?
VWD
Off center nuclues - clock face chromatin
Spleen
Radiation/drugs - viral agents - fanconi's anemia - idiopathic may follow acute hepatitis

16. Which lymphoma is characterized by localized involvement with a single group of nodes and mediastinal lymphadenopathy
Yes - via MHC II
Myelofibrosis (marow is crying being its fibrosed'
Hodgkin
Hereditary elloptocytosis

17. What does the blood smear show in glanzmann's?
Protoporphyrin (blood)
Leukemoid reaction
Indirect coombs - agglutinate if serum anti RBC surface Ig
No platelet clumping

18. Drug that inhbits the GpIIb/IIIa directly
Down - down - up
5- FU - AZT - hydroxyurea
90% anearobically from glucose to lactate - 10% from HMP shunt
Abciximab

19. anisocytosis
MGUS - monoclonal gammopathy of undetermined significance
Nl PT - elevated PTT - intrinsic pathway defect
Varying sizes
B6

20. What is the receptor for fibrinogen?
Myelofibrosis (marow is crying being its fibrosed'
Lacunar in nodular sclerosing variant
Alpha thal - asian and african american
GpIIb/IIIa

21. What substances are released in mast cell degranulation
M3 AML (acute promyelocytic leukemia)
Protein S - cleaves and invactivates Va and VIIIa
B6 therapy (pyrodixine)
Histamine - heparin - and eosinohil chemotactic factors

22. lymphoid neoplasms with widespread involvement of bone marrow - tumor cells usually foind in peripheral blood
Blistering cutaneous photosens - most common porphyria
HbSS
Leukemia
TAIL - thalassemias - anemia of chronic disease - iron def - lead poisoning

23. inc WBC count with left shift - inc leukocyte alkaline phosphatase - often due to infection
Off center nuclues - clock face chromatin
Leukemoid reaction
Induces differentiation of myeloblasts
Rhogam - Rh antigen immunoglobulin

24. fatigue - malaise - pallor - purpura - mucosal bleeding - petechiae - infection
Factor V Leiden
Signs and sx of aplastic anemia
DIC
Dec synthesis of factors 1972 - protein C/S

25. What does decreasing heme do to ALA synthase activity?
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Ankryin - band 4.1 or spectrin
Inc
MHC II and Fc receptors

26. What is the tx for aplastic anemia
ADP and Ca
Allogenic bone marrow transplant - RBC/platelet transfusion - C- GSF - or GM- CSF
Eleveated PT - PTT
B12 def

27. What do labs show in ITP?
Petechiae
B12 in fatty acid pathways leads to subacute combined degeneration
Factor V Leiden
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT

28. What is the age breakdown for hodgkins
Bimodal - men>women - except for nodular sclerosing type
Hydroxyurea - bone marrow transplant
Paroxysmal nocturnal hemoglobinuria
Anti Rh

29. Deficiency in vWF

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30. Fibrotic obliteration of bone marow with teardrop cells

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31. Basophilic nuclear remnants fonud in RBCs
Positive osmootic fragility test and splenectomy
Varying shapes
Defect in 4 - not compatible with life - defect in 3 - HbH disease - defect in 1/2 not associated with sig anemia
Howell - Jolly bodies - hypo/asplenia

32. What does hairy cell leukemia stain with
MAHA
Burkitt lymphoma
TRAP (tartrate resistant acid phosphatase
Schistocytes - helmet cells

33. What does Vit K deficiency cause?
Bone marrow - thymus - blood (80% of circulating lymphos are T)
Gp1b
DIC - TTP- HUS - SLE malignant HTN - prostethic heart valves - aortic stenosis
Dec synthesis of factors 1972 - protein C/S

34. What are the variants of the RS cells
Hodgkin
Lacunar in nodular sclerosing variant
Protoporphyrin
Bone marrow infiltration - myelofibrosis

35. Where are basophils found?
120 days
Blood
Pyruvate kinase def - extravascular
Common a few days after oxidative stress in a pt with G6PD

36. What is the receptor for vWF
Anemia of chronic disease - Aplastic anemia - kidney disease
Megakaryocytes
Gp1b
Intravascular hemolysis

37. What are the presenting symptoms of acute intermittent porphyria
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Her next Rh+ fetus
Heinz bodies - seen in alpha thal and G6PD
Beta 4

38. Macro - ovalocyte
VWF carries/protects factor VIII
Megaloblastic anemia (also hypersegmented PMNs - marrow failure)
Plasma cell
Low O2 in papilla; can also get microhematuria from medullary infarcts

39. What is the treatment for sideroblastic anemia
Peroxidase
B6 therapy (pyrodixine)
Folate def
B12/folate def

40. After an injury - What does vWF bind to begin platelet plug formation?
Multiple - peripheral nodes - extranodal involvement - noncontiguous spread
Beta thal
Exposed collagen upon endothelial damage
Tissue factor converst the VII and VIIa

41. What is appropriate absolyte polycythemia associated with
Off center nuclues - clock face chromatin
Lung disease - congenital heart diseaes - and high altitude
Rhogam - Rh antigen immunoglobulin
VWD

42. What does STOP Making New Thrombi stand for
Causes of DIC: Sepsis (gram neg) - Trauma - Obstetric complications - acute Pancreatitis - Malignancy - Nephrotic syndrome - Tranfusion
Inc bleeding time - microhemorrhage: mucuous membrane bleeding - epitaxis - petechiae - purpura - possible thrombocytopenia
Dec platelet survival and inc megakaryocytes - thrombocytopenia and inc BT
Examples of oxidative stress

43. Eosinophils are highly phagocytic For what kind of complex?
Inc
Macrohemorrhage - hemarthroses - easy bruising
IFN gama
Antigen - antibody

44. t(11;14)
Aplastic anemia - pancytopenia
Mantle cell lymphoma
Hydroxyurea - bone marrow transplant
Inhibits thrombin - ixa - xa - xiia - and activated by heparin

45. What is factor V leidin?

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46. How does vWD cause elevated PTT?
Hodgkin
Pyruvate kinase def - extravascular
VWF carries/protects factor VIII
Multiple myeloma

47. Elliptocyte
AB - no antibodies
IgG - Warm is GREAT
2 to 10
Hereditary elloptocytosis

48. Ringed sideroblasts
Sideroblastic anemia
Insufficient intake as with strict vegans - malabsorption as in crohns - pernicious anemia - diphyllobothrium
Imatinib - anti bcr abl
IgG - Warm is GREAT

49. Where are 1/3 of platelets stored
Factor V resistant to activated protein C's inhibition
Painful abdomen (also in lead poisoning) - red wine colored urine - polyneuropathy - psychological distrubances - precipated by drugs -
Spleen
Peroxidase

50. Ddx for microcytic anemia
Lead - and EtOH
Paraprotein spike - monoclonal protein
Fe def - thal - pb poison - sideroblastic anemia
CLL (SLL without the peripheral lymphocytosis