Boards Hem Onc

Front 1

Poikilocytosis means what?

Back 1

erythrocytes of varying shapes

Front 2

what is the life-span of a PLT?

Back 2

8-10 days

Front 3

what are 7 causes of eosinophilia?

Back 3

DNAAAACP
Neoplastic
Asthma, Atopy, Allergies, Addison's
Collagen Vasc Disorders
Parasites

Front 4

Which cells have "BIG HANDS" to capture Ag on MHC III -->
"BIG FEET" to run to lymph node and show to Th-cell (Ag presentation?

What are these called in the skin?

Back 4

Dendritic cell

Langerhan's cell

Front 5

Are PRO C and PRO S pro or anti-coagulants?

Back 5

ANTI-coagulants!!!

Front 6

Bleeding time checks integrity of what?

Back 6

PLTS only!

Front 7

PT / INR (Prothrombin Time) checks integrity of what?

Back 7

Extrinsic pathway --> Clot

VII
X V II I

Front 8

PTT (Partial thromboplastin time) checks the integrity of what?

Back 8

Intrinsic pathway --> Clot

XII, XI, IX, VIII
X, V, II, I

Front 9

PLT Count checks what?

Back 9

# PLTs

Front 10

PATHOLOGIC TYPES OF RBCS

Back 10

PATHOLOGIC TYPES OF RBCS

Front 11

What pathology(ies) does this RBC indicate:

Acanthocyte (spur cell)

Back 11

Liver dz
AbetalipoPROemia

Front 12

Basophilic Stippling

Back 12

Baste the ox TAIL

Thalassemia
Anemia of chronic dz
Iron defic
Lead poisoning

Front 13

Bite cell

Back 13

G6PD defic

"Kondagunta took a BITE out of my back after checking for G6PD defic"

G6PD defic --> Heinz bodies that are bit by spleen --> Bite cells

Front 14

Elliptocyte

Back 14

Hereditary Elliptocytosis

Front 15

Macro-ovalocyte

Back 15

Megaloblastic Anemia ( BTW, will also have hyper-seg PMNS)

Marrow failure

Front 16

Ringed sideroblasts

Back 16

Sideroblastic anemia

Front 17

Schistoycte, Helmet cell

Back 17

DIC
TTP / HUS
Traumatic hemolysis (artificial heart valves)

Front 18

Sickle cell

Back 18

sickle cell anemia

Front 19

Spherocyte

Back 19

Hereditary spherocytosis

Autoimmune hemolysis

Front 20

Teardrop cell

Back 20

Bone marrow infiltration
(ie: myelofibrosis)

Front 21

Target Cell

Back 21

"HALT" said the hunger to his Target

HbC dz
Asplenia
Liver dz
Thalassemia

Front 22

Heinz bodies

Back 22

Oxidation of Fe from ferrous to ferric -->
Denature HGB -->
Precipitationfo HGB and damage to RBC membranes

Go to spleen and become bit cells

Front 23

Howell-Jolly bodies

Back 23

Hyposplenia or asplenia
BC spleen should bit out the HJ body

Front 24

Rouleaux (stacks of RBCs)

Back 24

Multiple Myeloma

Front 25

ANEMIAS

Back 25

ANEMIAS

Front 26

What type of anemia does this describe:

-Microcytic and Hypochromic
-Assoc w/ chronic bleeding

Back 26

Fe Defic Anemia

Front 27

Fe defic anemia may be part of what syndrome w/ a classic triad?

Back 27

Plummer-Vinson Syndrome

(Fe defic anemia, Esophageal web, atrophic glossitis)

Front 28

What are the thalassemias?

Back 28

A group of disorders characterized by defective (not absent) synthesis of the GLOBIN chain (not the heme molecule itself)

Front 29

1) Which thalassemia --> microcytic anemia?

2) What's the defect in alpha-thal?

3) If you have alpha-thal w/ a 4 gene deletion what type of HGB will you have?

4) If you have alpha-thal w/ a 3 gene deletion what type of HGB will you have?

5) If someone has alpha-thal 1/ 1-2 gene deletions will he have a significant anemia?

Back 29

1) alpha-thalassemia AND beta-thalassemia

2) Defective alpha-globin synthesis

3) Hb Barts (4 gamma globins) --> Hydrops fetalis

4) HbH dz (4 beta globins)

5) No

Front 30

1) What is beta-thal?

2) If you have beta thal MINOR, you are heterozygous for the gene defect, and TF your beta chains are _____

3) If you have beta-thal MAJOR, you are homozygous for the gene defect, and TF you beta chains are ____

4) How to dx beta-thal minor?

5) Beta thal minor will have what similar finding on x-ray as sickle-cell?

6) Both beta-thal minor and major --> Inc amt of what in blood

Back 30

1) Defective beta-globin synthesis -->
microcytic anemia

2) Underproduced

3) ABSENT

4) Inc HbA2 on electrophoresis

5) "crew cut" on skull on x-ray

6) HbF (2 alphas, 2 gammas)

Front 31

BTW, give the MCV cut offs for the anemia:

MCV < 80 = microcytic
MCV 80-100 = normocytic
MCV > 100 = Macrocytic

Back 31

BTW, give the MCV cut offs for the anemia:

MCV < 80 = microcytic
MCV 80-100 = normocytic
MCV > 100 = Macrocytic

Front 32

1) Interestingly lead poisoning can lead to a microcytic anemia. What 2 enzymes does lead poisoning inhibit which are req'd for heme synthesis?

Back 32

1) Ferrochetalase
ALA-dehydratase

Front 33

What is everything you need to know about lead poisoning summed up in one mnemonic?

Back 33

LEAD

Lead Lines on gingiva and long bones on X-ray

Encephalopathy
Erythrocyte Basophilic stippling


ABD Colic
Anemia (sideroblastic)
hA

Drops
(foot and wrist)
Dimercaperol (1st line tx)
eDta (1st line tx)

Succimer (Tx for kids)

Front 34

MACROCYTIC ANEMIA

Back 34

MACROCYTIC ANEMIA

Front 35

Megaloblastic anemia caused by folate and b-12 deficiency will have what on PBS?

Back 35

Hypersegmented PMNs

Front 36

NORMOCYTIC ANEMIA

Back 36

NORMOCYTIC ANEMIA

Front 37

One cause of a normocytic anemia is what?

Back 37

Hemolysis (intravascular and extravascular)

Front 38

Intravascular hemolysis will have what 2 lab findings?

Back 38

Dec haptoglobin (binds the HGB that leaks out)

Inc LDH

Front 39

When you see pancytopenia, you should knee-jerk what type of anemia?

Back 39

Aplastic anemia (they are basically synonymous)

Front 40

1) Aplastic anemia results from destruction of the myeloid stem cells due to what 5 things?

Back 40

Radiation
Drugs
Viruses
Fanconi's Anemia
Idiopathic

Front 41

SOME MORE ON INTRAVASCULAR HEMOLYSIS
(A TYPE OF NORMOCYTIC ANEMIA)

Back 41

SOME MORE ON INTRAVASCULAR HEMOLYSIS
(A TYPE OF NORMOCYTIC ANEMIA)

Front 42

What type of Intravascular Hemolysis does this describe?:
1) Ankyrin or Spectrin defic -->
RBCs w/ no central pallor

2) What lab test is seen w/ this?

3) Why would this lead to intravascular hemolysis?

4) How to dx HS?

Back 42

1) Hereditary spherocytosis

2) Inc MCHC

3) BC these RBCs are removed by the spleen

4) Positive osmotic fragility test

Front 43

What type of Intravascular Hemolysis does this describe?:

1) -X-linked disorders
-Dec reduced glutathione production --> RBC susceptibility to osmotic stress from sulfa drugs, fava beans, infxns, etc... --> Hemolysis

2) 2 types pathologic RBCs found?

Back 43

1) G6PD deficiency

2) Heinz Bodies
Bite Cells

Front 44

What type of Intravascular Hemolysis does this describe?:

Dec ATP --> Rigid RBCs

Back 44

Pyruvate Kinase defic

Front 45

Inc Complement mediated RBC Lysis

Back 45

PNH (Paroxysmal Nocturnal Hemoglobinuria)

Front 46

ONE LAST CAUSE OF HEMOLYTIC ANEMIA: SICKLE CELL DZ

1) What type of HGB do ppl w/ Sickle cell have?

2) What's the amino acid substutution?

3) What's the process by which RBCs become sickled?

4) Heterozygotes for the SS gene will have what
Homozygotes?
A) Heterozygotes will be resistant to what?

5) Why are newborns w/ sickle cell dz initially asx-ic?

6) What will you see on x-ray?

Back 46

1) HbS

2) Glutamate --> Valine @ position 6

3) Low O2 or Dehydration -->
Polymerization of the HbS in the RBC -->
Sickling of the RBC

4) Sickle Cell Trait
Sickle Cell dz
A) Malaria

5) BC newborns have a higher amt of HbF

6) Crew-cut skull

Front 47

Complications of Sickle Cell

1) Aplastic crisis if infected w/ what?

2) What will happen to spleen?

3) No spleen = what?
A) What encapsulated organism will often cause osteomyelitis in SS pts?

Back 47

1) Parvovirus B-19

2) Infarcted --> Autosplenectomy

3) Inc risk infxn w/ encapsulated organisms
A) Salmonella

Front 48

Tx for sickle cell?

Back 48

Hydroxyurea (inc HbF and p-laxes sickling)

BM T-plant

Front 49

Autoimmune Hemolytiic Anemia:

1) Can be the result of what 2 types Ab?

2) An infxn w/ what -->
Cold agglutinins -->
AI Hemolytic Anemia?

3) What type CA --> Cold agglutinin formation?

Back 49

1) Warm Agglutinins (IgG)
"Warm Weather is GGGreat!"

Cold Agglutinins (IgM)
"mmmmm Cold ice cream"

2) Mycoplasma pneumonia
Infectious Mono

3) CLL

Front 50

1) what is 1 example of AI Hemolytic Anemia that can effect a fetus?

2) What lab test will usually be positive in AI hemolytic anemia?

3) What's the diff b/t direct and indirect coombs tests?

Back 50

1) Erythroblastosis fetalis

2) Direct & Indirect Coombs

3) Direct Coombs:
anti-Ig Ab is added to Pt's RBCs to see if pts RBCs are coated in a diff Ig (if so will cause agglutination)

Indirect Coombs:
Normal RBCs added to pts serum to see if serum has Ig against RBCs

Front 51

What type of hemolysis does this describe:

1) RBCs are damaged when passing through obstructed or narrowed lumens?

2) Seen in what 3 cond'ns?

3) What type of pathologic RBC?

Back 51

1) Microangiopathic Hemolytic Anemia

2) DIC, HUS / TTP, SLE

3) Schistocyte (Helmet cell)

Front 52

Prosthetic heart valves can also lead to what type of hemolytic anemia that will have schistocytes?

Back 52

Macroangiopathic hemolytic anemia

Front 53

2 infxous agents -->
Hemolysis and TF anemia?

Back 53

Malaria
Babesia

Front 54

SEE YOUR NOTES FOR THE EXPLANATION OF TIBC, FERRITIN, ETC..

THEN LOOK 2 THE CHART ON BOTTOM OF P 385

Back 54

SEE YOUR NOTES FOR THE EXPLANATION OF TIBC, FERRITIN, ETC..

THEN LOOK 2 THE CHART ON BOTTOM OF P 385

Front 55

HEME SYNTHESIS PROBS

Back 55

HEME SYNTHESIS PROBS

Front 56

We already said that lead poisoning can lead to probs in heme synthesis. What 2 enz that are necesarry for heme synthesis does lead inhibit?

Back 56

Ferrochetalase
ALA dehydratase

Front 57

What is the RLS of heme synth?

Defic leads to what?

Back 57

delta-aminolevulinic acid synthetase

Sideroblastic anemia

Front 58

What heme synthesis disorder does this describe:
1) ABD Pain
Red - wine colored urine
Polyneuropathy
Psych probs
Precipitated by drugs

2) Result of defect in what enz?

3) Tx?

Back 58

1) Acute Intermittent Porphyria

2) Porphobilinogen Deaminase

3) Glucose and Heme which inhibit ALA syntase

Front 59

What heme synthesis disorder does this describe?:
1) Blistering, cutaneous photosensitivity
Inc Hair Growth (Hypertrichosis)

2) What enz is dec?

3) How common?

Back 59

1) Porphyria Cutanea Tarda

2) Uroporphyrinogen Decarboxylase

3) MC porphyria

Front 60

COAGULATION DISORDERS

Back 60

COAGULATION DISORDERS

Front 61

1) Hemophilia A is a deficiency in what?

2) Hemophilia B?

3) BC factors IX and VIII are effected, what clotting test will be elevated?

Back 61

1) Clotting Factor VIII
(A sounds like 8)

2) Clotting Factor IX
(B-9)

3) PTT

Front 62

Vit K defic will -->
Deficiency of what clotting factors

Deficiency of what anti-coags?


What clotting tests will be elevated?

Back 62

2, 7, 9, 10

PRO C & PRO S

PT and PTT

Front 63

PLT DISORDERS
See FA pic p. 377

Back 63

PLT DISORDERS

Front 64

Bernard Soulier =

Back 64

Dec GpIb

Front 65

Glanzmann's Thrombasthenia =

Back 65

Dec GpIIb / IIIa

Front 66

ITP
(Idiopathic Thrombocytopenic Purpura)

=

Back 66

anti-Gp IIb / IIIa Ab

Front 67

TTP =

Back 67

dec ADAMTS13 -->
Dec PLT survival

Front 68

von Willebrand's Dz =

Tx?

Back 68

Dec vW Factor -->
PLTs can't adhere to subendothelial collagen

Desmopressin releases stored vWF from endothelium

Front 69

What can kick off DIC?

Insert Rhyme AND Pic Here from POM Notes!!!

Back 69

STOP Making New Thrombi

Sepsis (gram neg)
Trauma
OB complications
Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion


Insert Rhyme AND Pic Here from POM Notes!!!

Front 70

What is the MC cause of an inherited HYPERcoagulability?

Back 70

Factor V Leiden

Front 71

Is the following Leukemia or Lymphoma:

1) Lympoid neoplasms (neoplasms composed of lymphocytes), often in the BM, w/ tumor cells usually found in peripheral blood.

2) Discrete (obvious) Tumor Masses arising from lymph nodes

Back 71

1) Leukemia

2) Lymphoma
(A tumor of lymph nodes that can really be anywhere)

Front 72

What is this:

Inc WBC count w/ a left shift. Often due to infxn

Back 72

Leukemoid RXN

Front 73

Let's Play Hodgkin's or Non-Hodgkin's Lymphoma:

1) Reed-Sternberg "Buttcheek" Cells

2) Seen in HIV and I/C

3) "B-Sx": Fever, Night Sweats, Wt Loss

4) Assoc w/ EBV

5) Age is usually: 20-40

6) Bimodal age distribution?

7) Majority (although not all) involve B-Cells

Back 73

1) HL

2) NHL

3) HL

4) HL

5) NHL

6) HL

7) NHL

Front 74

Is a lot of RS cells a good or bad prognosis for HL?

Back 74

Bad!!

Front 75

How can you remember that RS Cells = HL?

Back 75

"A Hodge Podge of RS Cells"

Front 76

Is an a high or low Lymphocyte:RS cell ratio a good thing?

Back 76

a HIGH ratio. You want LESS RS cells

Front 77

4 DIFF TYPES NHL:

Burkitt's Lymphoma
Diffuse Large B-Cell Lymphoma
Mantle Cell Lymphoma
Follicular Lymphoma

Back 77

4 DIFF TYPES NHL:

Burkitt's Lymphoma
Diffuse Large B-Cell Lymphoma
Mantle Cell Lymphoma
Follicular Lymphoma

Front 78

Which type of HL do he following describe:

1) t (8;14)

2) MC type NHL

3) t(11;14)

4) t(14;18)

5) EBV?

6) Cyclin D is deactivated?

7) bcl-2 is expressed?

8) "Starry Sky" appearance?

9) c-myc oncogene?

Back 78

1) Burkitt's

2) Diffuse large B-cell

3) Mantle Cell

4) Follicular lymphoma

5) Burkitt's

6) Mantle Cell

7) Follicular

8) Burkitt's

9) Burkitt's

Front 79

What type of lymphoma can be caused by HTLV-1

Back 79

Adult T-cell lymphoma
(one of the few T-cell lymphomas)

Front 80

1) What pathology does this describe?:
-Punched-out lytic bone lesiosn on x-ray
-M-spike on PRO electrophoresis
-Bence Jones PRO
-Rouleaux

2) Multiple myeloma is a CA composed of what cell type?

3) The spike in the gamma band on PRO electrophoresis is from what?

4) 4 Major features you should remember about MM?

Back 80

1) Multiple Myeloma

2) Plasma cells all derived from a single plasma cell (monoclonal plasma cell)

3) Excessive IgG and IgA being produced by these plasma cells

4) CRAB
hyperCalcemia
Renal insuffic
Anemia
Bone lytic lesions and Back pain

Front 81

What pathology may mimic MM but will NOT have lytic bone lesions?

What type Ig will be Inc in WM?

Back 81

Waldenstrom's Macroglobulinemia

IgM

Front 82

What cond'n is a monoclonal gammopathy w/out the sx of multiple myeloma?

Back 82

MGUS

(Monoclonal Gammopathy of Unknown Significance)

Front 83

TRAP positive makes you think of what type Leukemia?

Back 83

Hairy Cell Leukemia

Front 84

1) What type of leukemia does this describe:
Auer Rods

2) What's the translocation?

3) 1 specific type AML --> DIC?

Back 84

1) AML

2) t(15;17)

3) Acute M3 PL

Acute M3 PL w/ t(15;17) -->
Granules Empty -->
DIC and you tx w/ ALL T and ID
&
Don't forget about all THE Auer Rods

Front 85

1) What leukemia:
t(9;22)

2) the t(9;22) --> formation of what gene on what chromosome?

Back 85

1) CML

2) bcr-abl gene; Philadelphia Chromosome

Front 86

What pathology is this:

-Cells express S-100 and CD1a
-Tennis racket shaped birbeck granules on EM

Back 86

Langerhans Cell Histiocytosis
(Excessive prolif of Lang Cells which are dendritic cells)

Front 87

Will CML have a Jak-2 mutation?

3 myeloprolif disorders that do have JAK2 mutations and that might (check on this) also be able to be tx'ed w/ imatanib?

Back 87

NO, it has the philly chromosome

Polycythemia Vera
Essential thrombocytosis
Myelofibrosis

Front 88

How to Tx CML?

Back 88

Imatinib