Leukemias, Lymphomas, Disorders Of The Blood/wbc/platlets

Front 1

what disease:
normal platlet
increased bleeding time
normal PT
increased PTT

Back 1

VWD

Front 2

what disease:
decreased platlet
increased bleeding time
normal PT
normal PTT

Back 2

thombocytopenia (ITP, TIP, HUS)

Front 3

what disease:
normal platlet
normal bleeding time
normal PT
increased PTT

Back 3

hemophilia A

Front 4

what disease:
decreased platlet
increased bleeding time
increased PT
increased PTT

Back 4

DIC

Front 5

what disease:
normal platlet
increased bleeding time
normal PT
normal PTT

Back 5

aspirin/NSAID therapy

Front 6

what disease:
normal platlet
normal bleeding time
increased PT
increased PTT

Back 6

warfarin/heparin use

Front 7

thrombohemorraghic disorder
increased PT and PTT
thrombocytopenia
increased bleeding time
d-dimers
normocyctic anemia with schistocytes and reticulocycitosis

Back 7

DIC

Front 8

txt of DIC

Back 8

treat disease
transfuse blood components
FFP, packed RBC, platlet concentrates

Front 9

DVT and pulmonary emboli at early age
most common

Back 9

factor V leiden

Front 10

no prolongation of PTT after standard dose of heparin -- what is deficient?

Back 10

antithrombin III

Front 11

hemorrhagic skin necrosis from warfarni therapy, def in what?

Back 11

protein C

Front 12

decreased factor VIII could be from what 2 diseases?

Back 12

Hemophilia A and VWD

Front 13

ristocetin cofactor assay is to detect what?

Back 13

to detect VWF antigen

Front 14

most common cause of childhood thrombocytopenia
after resp tract infection
NO lymphadenopathy or splenomegaly

Back 14

acute idiopathic thomrbocytopenic purpura (ITP)

Front 15

IgG Abs againsted GpIIb:IIIa receptor is what?

Back 15

thrombocytopenic purpura

Front 16

adult female
presents with:
fever, thrombocyopenia, renal failure, microangiopathic hemolytic anemia with schistocytes, and CNS defects

Back 16

TTP

Front 17

excess vWF is defect in what enzyme and what can it be treated with?

Back 17

metalloprotease in endotheilial cells
txt: plasmapheresis

Front 18

what does d-dimer assay detect, and what diseases?

Back 18

only cross linked insoluable fibrin monmers in fibrin clot (NOT fibrinogen)

screaning for pulm embolism
DIC
and coronary artery thrombosis

Front 19

causes of thrombocytopenia

Back 19

1. decreased production (aplastic anemia, leukemia)
2. Increased destruction (ITP, TTP, DIC)
3. sequestion in spleen

Front 20

causes of thrombocytosis

Back 20

1. increased platlet cuont -- essential thrombocythemia, PV
2. reactive - iron def, ifnection, splenectomy

Front 21

absent GpIb platlet receptor for vWF
platlet adhesion defect

Back 21

bernard'soulier syndrome
life long bleeding problem
auto recessive

Front 22

platlet aggregation defect
absent GPIIb-IIIa fribinogen receptor

Back 22

glanzmann's
auto recessive

Front 23

IgA mediated vasculitis
child
post acute infection

Back 23

henoch-schonlein syndrome

Front 24

drugs that cause immune thrombocytopenia

Back 24

1. quinine
2. quinidine
3. heparin

Front 25

women 15-50, children post vaccination
present with thrombocytopenia

Back 25

ITP

Front 26

thrombocytopenia with neurological Sx
helmet cells

Back 26

TTP
use FFP

Front 27

child post e.coli ifnection
increased splenic pooling
renal trouble

Back 27

HUS,

do NOT transfuse with platlets

Front 28

factor IX def

Back 28

hemo B

Front 29

txt of vWD

Back 29

vasopressin
factor VIII concentrates with vWF

Front 30

txt of DIC

Back 30

FFP, platlet concentrates, cryoprecipitate, ATIII and protein C concentrates

Front 31

contraindications of DIC

Back 31

NEVER give heparin or antiplatlet drugs, or fibrinolytic inhibitors

Front 32

young pt presents with DVT and prolonged PTT

Back 32

factor V leiden

Front 33

arterial thrombosis
recurrent venous thrombosis in early adult life

deficient in what?
hereditary?

Back 33

antithrombin def

auto dom

Front 34

increased thrombotic risk
increased plasma prothomrbin levels

is what?

Back 34

prothomrbin G20210

Front 35

increasd risk of both venous and arterial thrombosis

Back 35

hyperhomocystinemia

Front 36

venous and arterial thrombosis
lupus PT
lots of miscarriages
prolonged PTT that does NOT correct with mixture study (50:50 with normal plasma)

Back 36

antiphospholipid syndrome

Front 37

what blood type is the mother if there is HDN ABO?

Back 37

mother is type O

Front 38

HDN presents in 1st pregnancy, is it ABO or Rh related?

Back 38

ABO occurs in 1st preggo only

Front 39

clinical presentation of infant with HDN ABO

Back 39

mild jaundice, slight anemia -- correct with phototherapy

Front 40

RH (-) mother has what kind of Abs cross over placenta to the Rh (+) fetus?

Back 40

IgG anti-D

Front 41

what does the cord blood test show from an HDN?

Back 41

increased bilirubin
increased blasts
+ direct coombs
anemia
reticulocytosis

Front 42

what does the kleihauer betke test used for?

Back 42

to determine what dose of Rh Ig to give to the mother, based on + screening of resistance of fetal cells to acid hemolysis

Front 43

txt of srs HDN Rh

Back 43

exchange transfusion, remvoes Abs and bilirubin
replaces incompatable RBC with compatible ones
lowers bilirubin levels
corrects anemia
must be compatible with mother's blood

Front 44

what can cause thrombocytopenia in fetus?

Back 44

alloimmune neonatal thrombcytopenia

mother does not have HPA platlet Ab, IgG abs cross placenta and bleeding can result

Front 45

examples of malignant localized lymphadenopathy (2)

Back 45

1. HL
2. NHL

Front 46

examples of generalized malignancies (>3 non-contguous areas of enlargment)

Back 46

1. CLL/ALL
2. NHL/HL
3. WM

Front 47

ex of lymphocytosis

Back 47

1. CLL
2. ALL

Front 48

examples of lymphopenia

Back 48

1. HL:
2. chemo
3. HIV
4. SLE

Front 49

is CLL B or T cell?

Back 49

B cell

Front 50

elderly female presents with:
lymphadenopathy
recurrent infections
AIHA
thrombocytopenia
hypogamaglobinemia

Back 50

CLL

Front 51

small mature looking lymphocytes (can't distinguish from normal), found with smudge cells... what is it?

Back 51

CLL

Front 52

can transform to diffuse large cell lymphoma ... what is this syndrome called?

Back 52

richter's found in CLL

Front 53

when do you txt CLL?

Back 53

when there are signs of:
lympadenopathy or organomegaly
BM failure
constitution B sx

Front 54

SIg + (weak)
CD5 +
CD 23 +
CD 10 -
FMC7 -

what is this?

Back 54

CLL

Front 55

agents to txt CLL...

Back 55

1. cytotoxic: chlorambucil, cyclophosphamide, purine analogues
2. corticosteroids
3. monoclona Abs - CD20 and CD52

Front 56

CLL pt comes in with adenopathy and splenomgaly, what do you txt for?

Back 56

pallitive only

Front 57

CLL pt comes in thrombocytopenia and anemia, with organomegaly ... what do you txt for?

Back 57

start txt for chemo

Front 58

PLL is what kind of cell, B or T?

Back 58

B cell

Front 59

pt presents with:
massive splenomegaly
no lymphadenopathy
SIg + (bright)
CD5 -
CD23 -
FMC7 +

what does pt have?

Back 59

PLL

Front 60

hairy cell leukemia is what kind of cell? B or T?

Back 60

B cell

Front 61

older male with fatigue and infections presents with splenomegaly, what is it?

Back 61

hairy cell leukemia

Front 62

TRAP + is what?

Back 62

HCL

Front 63

what do you treat HCL with?

Back 63

2-CDA

Front 64

large granular lymhocytic leukemia is what kind, T or B cell?

Back 64

T cell

Front 65

50 yo pt presents with arthropathy and rheumatoid arthritis, anemia, neutropenia, increased WBC. BM has large cells with azurophilic granules.

Back 65

LGLL

Txt not normally needed

Front 66

CD 3+
CD 56 +
CD4 -
CD 8 +

what is it?

Back 66

LGLL

Front 67

adult t cell leukemia/lymphoma is ass'd with what virus? where is this virus common?

Back 67

HLTV, japan/caribbean

Front 68

pt comes in and presents with:
lymphadenopathy
hepatosplenomegaly
skin lesions
bone pain
hyper calcemia

what is it?

Back 68

ATLL

Front 69

clover-leaf nuclei with

CD3 +
CD4 +
CD8 -

what is it?

Back 69

ATLL

Front 70

what is the most common form of HL?

Back 70

nodular sclerosis

Front 71

reed sternberg cell = what?

Back 71

HL

Front 72

32 yo pt presents with painless cervical lymphadenopathy, weight loss, and night sweats... what does he have?

Back 72

HL

Front 73

survivors of HL are at increased risk for what kind of malignancies?

Back 73

AML, NHL, epitheliam tumors, malignant melanoma

Front 74

what is the prognosis of HL and txt?

Back 74

curable, use ABVD

sensitive to BOTH chemo and radiation

Front 75

CD 15 +
CD 30 +
LCA -
neutrophilia
eosinophilia
lymphopenia
increased ESR and C reactive protein
increased LDH

Back 75

NH, increased LDH = poor prognosis

Front 76

is LDH routine in NHL or NH?

Back 76

NHL

Front 77

pt presents with painless lymphadenopathy, SOB/DOE, fullness, jaundice, anemia, neutropenia, thrombocytopenia == what??

Back 77

NHL

Front 78

txt of NHL

Back 78

use CHOP and anti-CD20 (R-CHOP)

Front 79

follicular lymphoma is what grade of NHL? (high, intermediate or low) is it curable?

Back 79

Low grade, not curable

Front 80

older pt with destroyed lymph node and cleaved lymphocytes... what is it?

Back 80

NHL - FL

Front 81

t(14;18) is ass'd with?

Back 81

FL

Front 82

BLC2 overexpression is linked to what NHL?

Back 82

FL

Front 83

t(11;14) and overexpression of BCL1 and Cyclin D is ass'd with what?

Back 83

mantle cell lymphoma

Front 84

CD 19 +
CD5 +
CD23 -
FMC7 +
CD22 +

what disease?

Back 84

Mantle cell

Front 85

t(8;14) is add'd with what disease and overexpression of what>?

Back 85

C-myc overexpression

ass'd with burkitt's lymphonma

Front 86

for burkitt's fill in blank:

endemic is found in the ____ and is/is NOT ass'd with EBV

sporadic is found in the ___ and is/ISNOT ass'd with EBV

Back 86

endemic = jaw with EBV assosciation

sporadic = abdominal pain NOT EBV ass'd

Front 87

starry sky = what?

Back 87

burkitt's

Front 88

is burkitt's curable and if so, with what?

Back 88

yes, CHOP

Front 89

an intermediate NHL with large cells and diffuse growth is what?

Back 89

diffuse large cell lymphoma

Front 90

what NHL curability depends on age as a determination of prognosis?

Back 90

DLCL

also on LDH, performance status, stage, and # of extranodal sites

Front 91

pt comes in with pruitic, psorasis like plague... what is it?

Back 91

mycosis fungoides -- T cell, CD4+

Front 92

circulating lymphoma cells that look like folder cerebriform nuclei

Back 92

sezary syndrome

Front 93

73 yo pt presents with backache and frequent infections, what is it?

Back 93

MM

Front 94

bence jones proteins found = what?

Back 94

MM

Front 95

is MM curable?

Back 95

no, pallitve txt only

Front 96

plasma cell with an eccentric nuclei, deep blue cytoplasm and perinuclar halo is related to what??

Back 96

MM

Front 97

i say lytic bone lesions, you say...

Back 97

MM

Front 98

what chromosome deletion and gene is affected in MM?

Back 98

del 13, and Rb gene

Front 99

contraindication in MM

Back 99

IV contrast agents!!

Front 100

pt presents with:
huge tongue
CHF, cardiomegaly
neuropathy
renal failure
carpal tunnel...

what is it related to?

Back 100

amyloidosis

Front 101

amyloidosis is present in what?

Back 101

anything with increased proteins

MM
MGUS
WM

Front 102

pt comes in with:

changes in vision
lethargy
confusion
headache
nose bleed
and CHF

what is this syndrome?

Back 102

hypervisocity syndrome

Front 103

hyperviscocity syndrome is related can be caused by what?

Back 103

1. PV
2. acute leukemia
3. MM
4. WM
5. hyperfibrinogemia

Front 104

M protein <3mg/dl
normal: serum Ca, renal fxn
NO bone lesions
NO anemia... is what?

Back 104

MGUS.. can evolve into MM

Front 105

lymphoplasmacytoid cell found in what?

Back 105

WM

Front 106

pt presents with:
fatigue, bleeding, weight loss
hepatosplenomegaly
lymphadenopathy
hyperviscovisity

increased IgM
NO bone lesions

what is it?

Back 106

WM

Front 107

t(9;22) is related to what malignancy?

Back 107

ALL -- unfavorable prognosis

BCR/ABL

Front 108

a 4 year old presents with anemia, thrombocytiopenia, neutropenia

PAS is +
TdT is +

what is it?

Back 108

ALL, B cell

Front 109

child pt presents with mediastinal mass, anemia, neutropenia, thrombocytopenia..

PAS +
+ for CD4, 5, 8

what is it?

Back 109

ALL, T cell

Front 110

pt presents with spontaneous bleeding and easy bruising with dilated swellings that started in childhood. pt has frequent recurrent GI bleeds... what is it?

Back 110

hereditary hemorrhagic telangiectasia

Front 111

is HHT auto dom, recessive, or x-linked?

Back 111

auto dom

Front 112

↓ MCV
↓ serum Fe
↓ RBC count
↓ ferritin
↑ TIBC
↑ RDW

what is it?

Back 112

Fe defiency

Front 113

↓ MCV
↓ serum Fe
↓ RBC count
↑ ferritin
↓ TIBC
normal RDW

what is it?

Back 113

ACD

Front 114

↓ MCV
NORMAL serum Fe
↑ RBC count
normal ferritin
normal TIBC


what is it?

Back 114

alpha thal trait

Front 115

↓ MCV
↑ serum Fe
↓ RBC count
↓ ferritin
↓ TIBC
normal RDW
ringed sideorblasts present
basophilic stippling

what is it?

Back 115

lead poisoning

Front 116

↓ HbA
↓ HbA2
↓ HbF
↑ RBC count
normal electropherisis

what is it?

Back 116

alpha thal trait

Front 117

4 beta chains is called what and has how many gene deletions?

Back 117

HbH and has 3 genes deleted

Front 118

HbH presents as with?

Back 118

severe hemolytic anemia

Front 119

Four deletions is called?

Back 119

HbBart -- incompatible with life
4x gamma chains

Front 120

pt presents with:
microcytic anemia
decreased MCV, Hb, and Hct
INCREASED RBC
normal RDW and ferritin

Hb electrophersis shows:
↓ HbA
↑ HbA2, and HbF with RBC count

Back 120

beta thal minor

Front 121

pt has severe hemolytic anemia with extramedullary hematopoesis, with the following electropherisis:

NO HbA
↑ HbA2, and HbF
increased RBC and reticulocytes

what is ti?

Back 121

beta thal major

Front 122

causes of sideroblastic anemia

Back 122

1. chronic alcoholism
2. B6 defiency
3. lead posoning

Front 123

loss of vibration sense is seen in what?

Back 123

B12 def

Front 124

macrocytic anemia + neuro defects =?

Back 124

B12 def

Front 125

most common cause of ACD?

Back 125

pneumonia

Front 126

hemochromatosis can occur from frequent transufions, chronic hemolytic diseases or from a missense mutation in this gene?

Back 126

HFE gene

Front 127

PK deficiency pt comes in with bronze skin ... what do you think?

Back 127

hemocrhoamtosis, oh shiz we need to chelate her bitchass

Front 128

hypersegmented PMN == ?

Back 128

megaloblastic anemia

Front 129

hereditary spherocytosis is a..

extra or intravasclar?
intrinsic or extrinsic?

Back 129

extravasuclar intrinsic with auto domin and poor penetrance

Front 130

pt has a viral infection from a parvovirus, with gallstones... what do you suspect?

pt has osmotic fragility and spherocytes on smear

Back 130

hereditary spherocytosis

Front 131

defect in:

spectrin
ankyrin
band 4.2

is ass'd with what?

Back 131

hereditary spherocytosis

Front 132

you say heinz bodies and bite cell... i say...

Back 132

G6PD def

Front 133

pt has rapid drop in Hb after eating fava beans, pt has what?

Back 133

G6PD

Front 134

G6PD is... auto dom/recessive or xlinked?

Back 134

x-linked

Front 135

pt has splenomegaly and evan's syndrome.. what test do you order? and will it be + or - ?

what is the pt presenting with?

Back 135

+ direct Coombs

AIHA

Front 136

warm reactive is ass'd with idiopathic, complement specific... to what type of Ig?

Back 136

IgG

Front 137

cold reactive is ass'd with mycoplasma, mono, and lymphomas... what type of Ig?

Back 137

IgM

Front 138

you see helmet cells, you suspect what?? (3)

Back 138

1. DIC
2. HUS
3. TTP

Front 139

missing CD55 and CD59

Back 139

PNH

Front 140

acid ham test is done in what? what does it test for?

Back 140

PNH, suspectibility to sucrose soltuion

Front 141

pt presents with thrombosis, recurrent abdominal pain, and interrcurent infections... what do you suspect?

Back 141

PNH

Front 142

BM has hypoplasia
decreased LAP score
hemosideruria

what is it?

Back 142

PNH

Front 143

txt for PNH

Back 143

immunosuprresion, BMT, supportive care

Front 144

hbH can be demo'd with what stain?

Back 144

cresyle blue stain, looking for inclusions

Front 145

what thal presents with at birth??

Back 145

alpha

Front 146

severe anemia at 4-6 months
jaundice
hair on end appearance on xray
target cells
Howell Jolly bodies

Back 146

beta thal

Front 147

sickle cell is...

intra/extravascular
intrinsic or extrinsic

Back 147

extravascular, intrinsic defect

Front 148

what does the blood smear look like in a pt with sickle trait?

Back 148

TOTALLY NORMAL

Front 149

rhomboidal RBC
target cells
microsphercytes are common in what Hb subtype of sickle cell?

Back 149

HbC

Front 150

child with sickle cell presents with what hallmark?

Back 150

dactylitis

Front 151

adult with sickle cell presents with what hallmark?

Back 151

acute chest syndrome

Front 152

what prophylaxis do you give a sickle cell pt?

Back 152

penicillin

Front 153

pt has:
hemolytic anemia
heinz bodies
heat preciptation test
crisis after taking oxidative drugs

Back 153

unstable Hb

Front 154

HbEE = ?
HbE beta thal =?
HbAE = ??

Back 154

HbEE = mild hypochromia and microcytosis

HbE beta thal = SEVERE transfusion dept hemolytic disease like beta thal major

HbAE = mild thal phenotype with microcytosis and hypocrhomia

Front 155

Hb with high O2 affinity have an increase in what?

Back 155

erythopoeitin

Front 156

Hb with high O2 affinity is RIGHT or LEFT shift on dissosciation curve?

Back 156

LEFT shift

Front 157

pt has cyanosis and a R shift on diss curve, what do they have?

Back 157

Hb with LOW O2 affinity

Front 158

pt has cyanosis and you draw blood -- it's brown, what do they have?

Back 158

HbM

Front 159

what Hb phenotype has mild target cells but no anemia?

Back 159

HbAC

Front 160

what Hb phenotype presents with target cells, hemoglobin crystal,s microspherocytes, mild splenomegaly, mild hemolytic anemia

Back 160

HbCC

Front 161

HbE is common to what region of the world?

Back 161

far east, West coast US

Front 162

62 yo woman presents with sharp back pain, rouleaux, hyper Ca, neuropathy, and decreased in normal immunoglobins

what does she have?

Back 162

plasma cell myeloma

Front 163

12 yo girl has lower abdominal pain, fever, and is CD20+ with vaculoated cells on a starry sky... what translocation is common and what does she have?

Back 163

t(8;14), burkitt's

Front 164

55yo male has cough, chest pain, DOE, fever, pruitis, supraclavicular lymphnode enlargment.

RBC are normocytic, normochromic
15cm mediastinal mass with PLEURAL effusion
RS cell is present
CD30 +

Back 164

HL - nodular sclerosising

Front 165

72 yo female presents with lymphadenopathy in neck and axilla, weight loss, and fatigue.

see cleaved lymophocytes

what is it and what translocation is common?

Back 165

follicular lymphoma

t(14;18)

Front 166

65yo male with a swollen neck, splenomegaly, with small mature lymophocytes on biopsy. CD20+, serum hypoglobulimea... what doe she have?

Back 166

CLL

Front 167

68 yo presents with indigestion, no infection or bleeding or organmegaly. Pt has hypercell BM, with increase # of megakaryoctyes, no fibrosis, - for philly chrom, normal Fe... what does he have?

Back 167

essential thrombocytothemia

txt with platletpharesis, hydroxyurea

Front 168

53 yo male with fatigue, weight loss, no appetite, and gets fully quickly. he has hepatosplenomegaly, no lymphadenopathy, eosinophilia/basophilia, with normochromic normocytic anemia, increased WBC... what does he have?

Back 168

CML, txt with gleevac and BMT

Front 169

40 white woman with increased menses, gum bleeding, and small purple spots on legs, with fatigue.

macrocytic anemia, neutropenia, and thrombocytopenia with <5% blasts in blood.
hypercell BM with 17% blasts

what does she have? txt?

Back 169

MDS -- RAEB

BMT

Front 170

42 yo male with gum bleeding and prolonged oozing, no lymphadenopathy, large bruise. he has a prolonged PT, normal PTT, and increased d-dimers. LOTS of auer rods, +for MPO... what is common trans, txt, and dx?

Back 170

t(15;17)

promylocytic leukemia

txt with ATRA

Front 171

26yo male has severe rectal pain, fatigue, hemorroids, with increase in LDH, normal retic, an increase in blasts (eosinophils noted). what does he have?

Back 171

inv 16 with M4 AML

mylemonocytic leukemia

Front 172

6 yo boy with fatigue, headaches, palable lymph nodes in supraclavicular region, SPLENOMEG, no edema, bruises. incrased blasts and LDH, MPO is NEGATIVE

trans location? dx?

Back 172

t(9;22) ALL B cell

Front 173

> 20% blasts in blood or BM is automatically...

Back 173

AML

Front 174

MPO is + in what cell type?

Back 174

myeloid

Front 175

sudan black is + in what cell type?

Back 175

myloblasts and monoblasts

Front 176

NSE is + in what cell time?

Back 176

monocytes

Front 177

CD13, CD33, CD 117 are Ag for what?

Back 177

meyloid

Front 178

CD2, 3, 4, 8, 19 and 20 are for fhwat cell type?

Back 178

lymphoid

Front 179

t(15;17)

Back 179

acute promylocytic leukemia

Front 180

11q23

Back 180

AML with MLL

Front 181

MPO, SB -
CD13, 33, 34, 117 +

Back 181

AML with min diff

Front 182

MPO, SB +
CD13, 33, 34, 117 +

Back 182

AML withOUT maturation

Front 183

auer rods are in what?

Back 183

M3 and M2

Front 184

auer rods
CD13, 33, 34, 117 +
mature PMN

Back 184

M2 AML with maturation

Front 185

+NSE
3% blasts are MPO +
CD13, 33
11b, 11c, 14, 36, 64 +

Back 185

M4

acute mylomonocytic

Front 186

CD13, 33
CD14, 11b, 11c, 36, 64

80% or more are monocytic lineage

young pt
extramedullary sarcoma

Back 186

acute monoblastic/monocytic leukemia

M5

Front 187

>80% blasts are erythroid precurosers, MPO-, no dysplasia

or

>50% erythroid precurors
>20% myloblasts

Back 187

acute erythroid leukemia

M6

Front 188

cytopenia, psudeopod formation, BM fibrosis

CD13, 333
CD 41, 61 (megakaryocytic)

Back 188

acute megakaryblastic leukemia

M7

Front 189

difference between acute vs chronic leukemia?

Back 189

acute > 20% blasts

chronic:
<10% blasts
evidence of maturation

Front 190

what disease:
increased RBC
decreased EPO
hypercell BM with fibrosis (later)

Back 190

polycythemia vera

Front 191

BCR-ABL fusion in 100% of what cases?

Back 191

CML

Front 192

massive fibrosis of BM
splenomegaly
portal HTN
L side pleural effusion
tear drop cells
lerukoertyhroblastic rxn
extramedullary hematopoiesis

what condition?

Back 192

myelofibrsis and myeloid metaplasia

Front 193

5q- and trisomy 8 related to what?

Back 193

MDS

Front 194

pancytopenia
leukoertythroblastic rxn
ringed sideroblasts
blasts <20%

Back 194

MDS "preleukemia"

Front 195

CD10 -
TdT +

= ?

Back 195

T cell ALL

Front 196

CD10+
TdT +

= ?

Back 196

B Cell ALL

Front 197

>60 yo pt
generalized lymphadenopathy
immune hemolytic anemia
lymphoblasts <10%
"smudge cells"
neutropenia
*hypogammaglob*

Back 197

CLL

Front 198

what is the only leukemia without lympahdenopathy?

Back 198

hairy cell

Front 199

for type and crossmatch, IgM detection, if it is negative what does that mean? if it is positive, what do you do next?

Back 199

it rules out an ABO incompatibility

if pos, do an indirect coombs

Front 200

delayd hemolytic transfusion rxn takes how long to manifest? is it intra or extravascular?

Back 200

3-7 days, extra

Front 201

how do you manage HTR?

Back 201

1. hydration, diruesis
2. txt DIC with FFP
3. txt shock with steroids

Front 202

in a febrile rxn what is increased?

Back 202

IL1beta
IL6
TFN alpha

Front 203

in febrile rxn, what is the pt reacting to?

Back 203

donor leukocyte

Front 204

after transfusion, pt presents with VERY high fever. describe etiology and txt.

Back 204

prolly gram + coci from skin, txt with broad spec abx

Front 205

what is the usual rate of transufion for a non bleeding pt? what rate do you transfuse at for a pt at high risk for circulatory overload?

Back 205

normal: 2ml/kg/hr

risk: 1ml/kg/hr

Front 206

tranfusion related acute lung injury is reacting to what?

Back 206

HLA specifci abs

Front 207

ARD, pulm edema, hypoexmia, chills and fevers are characteristics of what?

Back 207

TRALI

Front 208

how can you prevent transfusion assosciated graft v host disease? what ags are present?

Back 208

irritated blood, HLA ag

Front 209

who is at risk for transfusion related GvHD?

Back 209

premie infants, immunocomp'd

Front 210

you store RBC, what happens to them?

Back 210

1. increase in plasma K
2. loss of 23 DPG
3. need to maintain ATP level

Front 211

what is crytoprecipitate made up of?

Back 211

from FFP, thawing, and collecting that precipitate

Front 212

if you remove the leukocytes, what are you decreasing the incidence of?

Back 212

alloimmunization to HLA ag, and some viral infections CMV

Front 213

what pts would be harmed from a platlet transfusion?

Back 213

ITP, TTP

Front 214

what does cyroprecipitate contain?

Back 214

factor VIII and vWF

Front 215

factors that worsen coagulopathy in massive transfusion (3), and how do you correct it?

Back 215

1. hypovolemia
2. DIC
3. Acidosis


correct with transfusion of FFP

Front 216

what do platlet dense granules container? (3)

Back 216

1. ADP
2. Calcium
3. serotonin

Front 217

what do platlet alpha granules cotnain? (6)

Back 217

1. fibrinogen
2. factor V
3. vWF
4. fibronectin
5. PF4
6. thrombospondin

Front 218

indications for use of thrombolytics

Back 218

1. MI
2. pulm emoblism
3. ischemic stroke

Front 219

indication for use of ASA

Back 219

1. acute coronary syndrome
2. ischemic stroke
3. stent replacement

Front 220

you can use what within 3 hours of ischemic stroke?

Back 220

t-PA

Front 221

antifibrinolytics are contra-indicated in what?

Back 221

anything to do with the head:

intracranial bleed, hematoma, stroke, hydrocephalus

Front 222

demopressin is used in...

Back 222

vWD, hemophilia A, uremic bleeding

Front 223

side effect of demopressin

Back 223

tachyphylaxis

Front 224

txt of CML

Back 224

imatinib-gleevac, TK inhibitor

Front 225

true or false

nilotanib causes a rash

Back 225

true

Front 226

true or false

dasatinib causes peripheral edema?

Back 226

FALSE

dasatinib causes pleural edema
imatinib caues peripheral edema

Front 227

fludarabine + clycophophamide +/- rituximab is 1st line for what?

Back 227

CLL

Front 228

what can be treated with ATRA?

Back 228

APL

Front 229

hydroxyurea, anangrelide, interferon alpha is used to treat what?

Back 229

MDS

Front 230

do you give hyrdoxyurea in PV?

Back 230

NO, only in ET

Front 231

low grade NHL can be treated with what?

Back 231

CVP and anti-20 rituximab

Front 232

CHOP up what?

Back 232

Diffuse large b cell lymphoma

Front 233

cuntaneous t cell is treated with what?

Back 233

vorinostat

Front 234

mantle cell is treate with what?

Back 234

hyper CVAD

Front 235

CBV regiment takes care of what?

Back 235

lymphoma

Front 236

Cy/TBI treats what?

Back 236

lymphoma, acute leukemia

Front 237

VP-16 and TBI treats?

Back 237

acute leukemia

Front 238

BAC
Bu/Cy
BEAM

all treat?

Back 238

lymphoma

Front 239

true/false

melphalan treats MGUS

Back 239

FALSE

treats MM

Front 240

you see helmet cells (schistocytes) on blood smear, this could mean:

Back 240

1. DIC
2. microangiopathic hemolytic anemia
3. SLE
4. HUS
5. thrombocytopenia purpura
6. malignant HTN

Front 241

you see tear drop cells on blood smear, this could mean:

Back 241

Dacrocytes are found in myelofibrosis, myeloid metaplasia, pernicious anemia, thalassemia, and some hemolytic anemias.

Front 242

you see howell jolly bodies, this means that the ____ is absent

Back 242

SPLEEN gone when you see HJ bodies

Front 243

you see target cells on smear, this means...

Back 243

HbC disease

or severe liver disease

Front 244

you see helmet cells, this means...

Back 244

auto immune hemolytic anemia

or traumatic anemia

Front 245

you see spur cells...

Back 245

PNH

Front 246

you see howell jolly bodies, this could mean the pt has (3):

Back 246

1. hemolytic anemia
2. megaloblastic anemia
3. hyposplenism

Front 247

pt has heinz bodies which occurs post oxidative stress, this could mean the pt has: (4)

Back 247

1. G6PD def
2. alpha thal
3. unstable Hb
4. splenectomized pt

Front 248

Is this indirect or direct coombs?
1. cross matching the donor RBC with pt serum
2. detection of Ab to RBC in pt's serum

Back 248

indirect coombs

Front 249

direct or indirect coombs?

used in diagnosis of:
1. HDN
2. AHIA and drug induced hemolytic anemia
3. hemolytic transfusion rxns

Back 249

direct coombs

Front 250

What is tested before RBC transfusions?

Back 250

1. ABO and Rh
2. Ab screen to detect clinically sig Abs
3. in vitro compatibility of pt's serum with donor'[s RBC

Front 251

cross matching means...

Back 251

adding pt serum to ABO, Rh, matched donor RBC

MANDATORY in pt with sig Abs

Front 252

true or false

extravascular hemolysis does not activate complement

Back 252

TRUE

Front 253

upon transfusion pt has dyspnea, headache, heart failure, and distention of jugular veins... what happened??

Back 253

circulatory overload

occurs in children, old people and severely anemic

Front 254

what is citrate used for in blood products?

Back 254

used as an anticoagulant, chelates calcium

Front 255

what coagulation factors does FFP contain? and what do you txt with it?

Back 255

contains ALL coag factors

txt: DIC, massive transfusion, liver failure, reversal of coumadin, TTP, HUS, reversal of warfarin

Front 256

what do you use albumin for?

Back 256

volume expansion! use to replace blood volume in blood loss, for plasmaphersis procedures

Front 257

what day does reticulocytosis start? what day does it reach its max?

Back 257

starts 2 days later, maxes at day 8

Front 258

in massive transfusion, what should you measure?

Back 258

PT and PTT

Front 259

is coagulopathy more or less predictable than thrombocytopenia in massive transfusion?

Back 259

coagulopathy is LESS predictable than thrombocytopenia

Front 260

what is richter's syndrome?

Back 260

transformation of CLL to diffuse large cell lymphoma

Front 261

monoclonal B cell markers (CD19, CD20, SIg +) with CD 5+ is diagnostic of what 2 diseases?

Back 261

CLL or mantle cell lymphoma

Front 262

large lymphocytes with azurophilic granules would imply...

Back 262

large granular lymphocytic leukemia

Front 263

every pt with diagnosis of lymphoma should do what?

Back 263

CT and PET scan
bilat BM aspiration
biopsy
blood chemistries

Front 264

true or false

MM is curable

Back 264

FALSE

txt with chemo and radiation, steroids, autologus stem cell transplantation = all pallitive

Front 265

you see a monoclonal Ab spike (M-protein_ what is your differential?

Back 265

1. MM
2. WM
3. MGUS

Front 266

if you have roulaeux formation of the RBC what does this mean?

Back 266

hypergammaglobulinemia

Front 267

large platlets with not glycoprotein Ib, platlets wont aggregate to ristocetin -- what is this?

Back 267

bernard soulier

Front 268

there are no alpha granules in large platlets

Back 268

grey platlet syndrome

Front 269

what is the most common cause of defective platlet function?

Back 269

aspirin therapy

Front 270

why do you do immunosupression therapy in a person with hemophilia?

Back 270

because they can form Abs to infused factor VIII

Front 271

neck lymphadenopathy, hepatosplenomegaly, and bilateral axillary adenopathy are clinical features of what malignancy?

Back 271

chronic lymphoid leukemias

Front 272

treatments of hyperviscosity syndrome

Back 272

plasmapheresis
venesection
leurkopheris

txt underlying disease!

Front 273

myeloid sarcoma with monocytic diff and an increase in eospinophils is due to what gene alteration in AML?

Back 273

inv(16)

Front 274

if you treat acute promyelocytic leukemia with ATRA what could happen?

Back 274

DIC due to release of granules

Front 275

-7q and -5q are seen in what 2 diseases?

Back 275

AML and MDS

Front 276

pt has a parvovirus infection and presents with pancytopenia, hypocellular BM, without abnormal cells in blood or bone... what is it?

Back 276

aplastic anemia

Front 277

hematopoietic stem cell is id'd via what CD marker?

Back 277

CD34

Front 278

what hematologic malignancies can be treated by autologous transplant? (4)

Back 278

1. HL
2. NHL
3. MM
4. leukemias

Front 279

what hematologic malignancies can be traeted b y allogenic transplantation?

Back 279

AML
ALL
CML
MDS
HL
NHL
Aplastic Anemia
Thalassemias
Sickle cell
SCID

Front 280

if you needed a transplant, what is the likelihood that your sibling is an HLA match?

Back 280

25%

Front 281

which refractory anemia presents with:

dimorphic RBC
pappenheimer bodies
erythroid hyperplasia
anemia
>15% ringed sideroblasts

Back 281

refractory anemia with ringed sideroblasts

Front 282

which refractory anemia?

blasts 5-19% in BM
blasts <20% in blood
anemia
macroovaloycytes
nucleated RBC
neuropenia, and thrombocytopenia
immature neutrophils in blood

Back 282

RA with excess blasts

Front 283

which refractory anemia:

no increase inblasts, monocytes or auer rods
dysplasia of 2 or more myeloid cell lines
BM is hypercell

Back 283

RA with multilineage dysplasia

Front 284

what kind of refractory anemia is this:

after iron therapy
macrocytic cells
no blasts in blood
BM is hypercell with <5% blasts

Back 284

just plain old refractory anemia (without ringed sideroblasts)

Front 285

what are good prognosis for MDS? what about poor?

Back 285

normal, 5q-, 20q-

poor: chrom 7

Front 286

you see pseudo pelger huet nuclei and cytoplasmic vacuoles... what deltion is this ass'd with?

Back 286

17p deletion, high p53 mutation -- UNBALANCED

Front 287

monosomy 7 is ass'd with what? and when does it present?

Back 287

childhood, median 10 months, ass'd with NF type 1 in males

Front 288

what are high grade MDS?

Back 288

RAEB1 and 2, 40-60% chance of evolution to AL

Front 289

how to treat RAEB?

Back 289

combo therapy of topotectan and cytoarabine, BMT

Front 290

pt is 50 yo presents with B sx and splenomegaly. Was exposed to radiation, ,2% blasts in blood, baso and eosinophilia, platlet is INCREASED, BM is hypercell

Back 290

CML chronic phase

Front 291

CML pt has 10-19% blasts in blood or BM, with basophils >20%, increases WBC and spleen -- what phase?

Back 291

accelerated

Front 292

CML pt with >20% blasts in blood or BM, extramedullary prolif of blasts, clusters of blasts in BM - what phase?

Back 292

blast phase

Front 293

reticulin and collagen fbrosis of the BM, with splen enlargeent, taer drop cells, and immature myeloid/erythroid cells in blood. extramedullary hematopoesis is present. what is this?

Back 293

spent phase of PV

Front 294

low EPO and high RBC, splenomegaly, high platlet and WBC = what?

Back 294

PV

Front 295

what has reticulin and collagen fibrosis in BM with new bone formation??

Back 295

fibrotic stage of chronic idiopathic myelofibrosis