Clin Med Iii-Hematology/oncology

Front 1

t/f

splenomegaly is never benign

Back 1

true

Front 2

Massive splenomegaly is caused by all of the following except?

-myeloproliferative disease
-cirrhosis
-malaria
-myelofibrosis
-gaucher's
-kalazar

Back 2

cirrhosis; massive is caused by the 3 M's along with gaucher's and kalazar

Front 3

What does the splenomegaly mneumonic CHINA stand for?

Back 3

c-congestion (portal)
h-hematological
i-infection
n-neoplasia
a-autoimmune

Front 4

t/f

the normal spleen is not palpable

Back 4

true

Front 5

what are the 4 RBC components?

Back 5

cell membrane
hgb
iron
enzymes

Front 6

a common cell membrane disorder could be?

-Iron deficiency anemia
-sickle cell disease
-spherocytosis
-G6PD deficiency

Back 6

hereditary spherocytosis

Front 7

what is the best 1st test to diagnose hereditary spherocytosis?

-peripheral blood smear
-ELISA
-osmotic fragility test

Back 7

osmotic fragility test

Front 8

variations in cell size is referred to as?

Back 8

anisocytosis

Front 9

a pt with Fe def. anemia will have a _ RDW on CBC.

Back 9

increased

Front 10

a pt with Thalassmia will have _ RDW on CBC.

Back 10

normal

Front 11

_ is a quantitative measure of the degree of anisocytosis.

-MCH
-MCHC
-RDW
-retic. count

Back 11

RDW

Front 12

the RDW is useful in the diagnosis of _ anemia.

-microcytic
-normocytic
-macrocytic

Back 12

microcytic

Front 13

Enumerating reticulocytes therefore gives a measure of marrow _ _ production.

-hemoglobin
-white blood cell
-red blood cell

Back 13

red blood cell

Front 14

t/f

the lower the retic count the more hemolysis there is.

Back 14

false; the higher the retic count the more hemolysis there is.

Front 15

increased production of RBC's in the marrow can be caused by all of the following except?

-high elevation
-bleeding
-some anemias
-spherocytosis

Back 15

not spherocytosis

Front 16

the retic count usually _ after successful treatment for pernicious anemia, iron deficiency anemia or folic acid deficiency anemia.

-lowers
-raises
-normalizes

Back 16

raises

Front 17

where is iron stored?

-ferritin
-transferrin
-hemoglobin
-liver

Back 17

ferritin

Front 18

what is the first best test to order in a pt you think is anemic?

-cmp
-cbc
-iron
-ferritin

Back 18

cbc-to check hgb/hct

Front 19

what is the most accurate test to diagnose iron def. anemia?

-cbc
-h & h
-bone marrow
-ferritin

Back 19

bone marrow

Front 20

An anemic pt with a normal ferritin level = ?

-iron deficiency
-folate deficiency
-thalassemia

Back 20

thalassemia

Front 21

If an anemic pt has a normal MCV, but an elevated retic count what do you have?

-iron deficiency
-renal disease
-hemolysis

Back 21

hemolysis-get B12 and folate

Front 22

Hearsay exceptions declarant must be unavailable.

Back 22

1. Former testimony
2. Statement against interest
3. Dying declaration
4. Forfeiture (D caused the witness to be unavailable)

Front 23

Any pt over 40 y.o. with iron deficiency anemia is _ cancer until proven otherwise.

-colon
-breast
-stomach
-pancreatic

Back 23

colon

Front 24

in what type of deficit will a pt c/o neuropathy?

-folate
-iron
-B12
-ferritin

Back 24

B 12 deficiency

Front 25

A pt has B 12 and folate deficiency, what social habit must you ask about?

-smoking
-diet
-alcohol

Back 25

alcoholism

Front 26

What is the age of reticulocytes?

-<24 hours
-<48 hours
-<3 days
-<7 days

Back 26

< 48 hours

Front 27

what do CRP, ESR, platelets, and ferritin all have in common?

Back 27

acute phase reactants

Front 28

A 60 y.o. male pt has a hgb of 10, MCV 69, ferritin 6 (low). He also admits to occasional blood in the stool, with alternating diarrhea and constipation. What is your diagnosis, and what is your plan?

Back 28

Iron deficiency anemia, he needs a rectal exam with a follow up colonoscopy

Front 29

A 22 y.o. female from Italy, is admitted to you for syncope, on routine lab work she has a hgb 10.2, MCV 66, plts 270, the pt's iron and ferritin levels are normal, HbA2 is 5.5% (high). What does she have?

-B12/folate deficiency
-thalassemia
-iron deficiency
-spherocytosis

Back 29

thalassemia-beta

Front 30

a 61 y.o. female is admitted for SOB on excertion x2 months with ambulation unsteadiness. Her labs show WBC 3.1, Hgb 6.1, MCV 136, plts 110. She denies smoking, alcohol, and eats a regular diet. Her folate is nml 39, B12 is low. What do you have?

Back 30

macrocytic anemia with pancytopenia.

Pernicious anemia

Front 31

t/f

ferritin is the transport protein for iron, not for storage

Back 31

false; ferritin IS the tissue storage protein for iron, NOT a transport protein

Front 32

A 32 y.o. man comes in c/o bruising and generally not feeling well for 2 weeks. His WBC 11.5, hgb 8.3, MCV 95, Plt 20, Blasts 112.7. What do you suspect?

-viral infection
-lymphoma
-leukemia
-multiple myeloma

Back 32

leukemia

Front 33

if you suspect leukemia, what is the most important test?

Back 33

bone marrow biopsy

Front 34

a pt presents with abdominal discomfort, you find moderate splenomegaly, elevated retic count, low haptoglobin, elevated indirect bilirubin, and a + osmotic fragility test. What does your pt have?

Back 34

hereditary spherocytosis

Front 35

All of the following are true about sickle cell anemia except?

-will see nucleated RBC's
-Howell-Jolly bodies
-schilling test is diagnostic
-usually autosplenectomy by age 10
-hydroxyurea can reduce # of flareups

Back 35

schilling test is not even available

hemoglobin electrophoresis confirms diagnosis

Front 36

A 63 y.o. woman admitted for tx of severe/active RA. WBC 2.8, hgb 8.9, MCV 69, plts 91. spleen is enlarged, iron low, ferritin is low normal. What type of anemia does she have? What else do you know?

Back 36

microcytic anemia with moderate pancytopenia

Felty's syndrome=pancytopenia, splenomegaly and hypersplenism

Front 37

heavy plasma cell infiltrate on a bone marrow biopsy indicates?

-leukemia
-lymphoma
-multiple myeloma

Back 37

multiple myeloma

Front 38

heavy plasma cell infiltrate on a bone marrow biopsy indicates?

-leukemia
-lymphoma
-multiple myeloma

Back 38

multiple myeloma

Front 39

heavy plasma cell infiltrate on a bone marrow biopsy indicates?

-leukemia
-lymphoma
-multiple myeloma

Back 39

multiple myeloma

Front 40

for hemoglobinapathies the most accurate diagnostic test is ?

-blood smear
-hgb electrophoresis
-serial cbc's

Back 40

hgb electrophoresis

Front 41

for hemoglobinapathies the most accurate diagnostic test is ?

-blood smear
-hgb electrophoresis
-serial cbc's

Back 41

hgb electrophoresis

Front 42

for hemoglobinapathies the most accurate diagnostic test is ?

-blood smear
-hgb electrophoresis
-serial cbc's

Back 42

hgb electrophoresis

Front 43

Iron deficiency anemia is most often secondary to ____.

-gi bleed
-multiple myeloma
-malabsorption

Back 43

gi bleed

Front 44

Iron deficiency anemia is most often secondary to ____.

-gi bleed
-multiple myeloma
-malabsorption

Back 44

gi bleed

Front 45

pallor, glossitis, angular cheliosis, koilonychia, Plummer Vinson syndrome are all indicative of?

-Folate deficiency
-B12 deficiency
-iron deficiency

Back 45

iron deficiency

Front 46

pallor, glossitis, angular cheliosis, koilonychia, Plummer Vinson syndrome are all indicative of?

-Folate deficiency
-B12 deficiency
-iron deficiency

Back 46

iron deficiency

Front 47

Iron deficiency anemia is most often secondary to ____.

-gi bleed
-multiple myeloma
-malabsorption

Back 47

gi bleed

Front 48

pallor, glossitis, angular cheliosis, koilonychia, Plummer Vinson syndrome are all indicative of?

-Folate deficiency
-B12 deficiency
-iron deficiency

Back 48

iron deficiency

Front 49

Plummer-Vinson syndrome =?

-colon skip lesions
-esophageal string bean
-esophageal webbin

Back 49

eso. web

Front 50

Plummer-Vinson syndrome =?

-colon skip lesions
-esophageal string bean
-esophageal webbin

Back 50

eso. web

Front 51

Plummer-Vinson syndrome =?

-colon skip lesions
-esophageal string bean
-esophageal webbin

Back 51

eso. web