Deja - Internal - Hematology

Question 1

5 Macrocytic anemias:

Answer 1

B12
Folate
Alcoholism
Hypothyroidism
Liver disease

Question 2

6 Normocytic anemias:

Answer 2

Chronic disease
Renal failure
Aplastic anemia
Spherocytosis
Autoimmune destruction
Mechanical obstruction

Question 3

Symptoms of iron def. anemia:

Answer 3

1. Pallor
2. Tachycardia
3. Easy fatigability
4. Pica
5. Esophageal webs

Question 4

Triad of Plummer-Vinson:

Answer 4

1. Microcytosis
2. Atrophic glossitis
3. Esophageal webs

Question 5

Drugs that commonly cause sideroblastic anemia:

Answer 5

1. INH.
2. Chloramphenicol
3. Cu chelators
4. Lead

Question 6

Some other causes of sideroblastic anemia?

Answer 6

1. Alcoholism.

2. Heredity.

Question 7

How is sideroblastic anemia diagnosed?

Answer 7

Iron stain of bone marrow shows ringed sideroblasts with Prussian blue stain.

Question 8

What can intravascular hemolysis lead to in children?

Answer 8

“Pigment” gallstones.

Question 9

How is pernicious anemia diagnosed?

Answer 9

1. UP MMA.
2. UP homocysteine levels.
3. Atrophic gastritis on gastroscopy.
4. Abnormal Schilling test (not used as much any more).

Question 10

What is the MCC of folate deficiency?

Answer 10

Hypoalimentation.

Question 11

What are other causes of folate deficiency?

Answer 11

1. Pregnancy.
2. Tropical sprue.
3. Hemolytic anemia.
4. Long-term treatment with TMP-SMX.
5. Methotrexate use.
6. 5-flourouricil use.

Question 12

Folate deficiency in pregnancy?

Answer 12

Neural tube defects in the developing fetus.

Question 13

How can the diagnosis of folate deficiency be differentiated from that of B12?

Answer 13

Normal MMA and NO neurologic symptoms in folate.

Question 14

6 etiologies of aplastic anemia:

Answer 14

1. Parvo B19 in SCA.
2. Hepatitis.
3. Chloramphenicol.
4. Benzene.
5. Radiation therapy.
6. Idiopathic.

Question 15

How is aplastic anemia diagnosed?

Answer 15

1. Normocytic, normochromic pancytopenia.

2. Hypocellular bone marrow in a bone marrow biopsy.

Question 16

What can trigger an attack in a patient with G6PD deficiency?

Answer 16

1. Infection.
2. Fava beans.
3. Dapsone.
4. Sulfa drugs.
5. Primaquine.
6. NSAIDs.

Question 17

Heinz bodies of G6PD def.?

Answer 17

Inclusions within RBCs made of denatured Hb.

Question 18

What 2 infections are associated with cold autoimmune hemolytic anemia?

Answer 18

1. Mycoplasma pneumonia.

2. Mononucleosis.

Question 19

Platelet <50.000:

Answer 19

Increased RISK for bleeding.

Question 20

Platelet <20.000:

Answer 20

Significant bleeding begins.

Question 21

Platelet <10.000:

Answer 21

Patient at risk for an intracranial bleeding.

Question 22

ALL - Which subtype is more common in children?

Answer 22

80% are L1.

Question 23

Of the adult cases of ALL, what subtype is most common?

Answer 23

L2.

Question 24

What is the L3 subtype morphologically identical?

Answer 24

Burkitt lymphoma.

Question 25

How is ALL diagnosed?

Answer 25

Peripheral blood smear with increased blast cells and TdT+, PAS+, CALLA+.

Question 26

Prognosis of ALL in children:

Answer 26

80% remission.

Question 27

Prognosis of ALL in adults:

Answer 27

30% remission.

Question 28

Subtypes of AML:

Answer 28

``` M1-M7. M1-M3: Granulocytic differentiation. M4-M5: Monocytic precursors. M6: Erythroblasts. M7: Megakaryocytes. ```

Question 29

What hematologic disorder is the M3 subtype associated with?

Answer 29

DIC

Question 30

Prognosis of AML in adults:

Answer 30

Those younger than age 60 have about a 70-80% remission rate.

Question 31

What are the unique signs and symptoms of CML?

Answer 31

1. Abdominal pain/fullness. 2. Anorexia. 3. Diaphoresis. 4. Bone pain.

Question 32

Different phases of CML:

Answer 32

1. Chronic phase: HSM and increase in WBCs. 2. Accelerated phase: Platelet and RBC decrease while patient develops symptoms of night sweats, fever, bone pain, and weight loss. 3. Blastic phase: Acute phase of the disease. Blood and marrow are rapidly filled with proliferating blasts.

Question 33

Blast crisis:

Answer 33

Acute phase of the disease in which the blood and marrow are rapidly filled with proliferating blast cells. --> Takes about 3-4yrs to develop and death is usually within 3-6months.

Question 34

Prognosis after a bone transplant in CML?

Answer 34

About 60% of patients go into remission.

Question 35

What can CML progress to?

Answer 35

AML.

Question 36

Treatment for hairy cell leukemia?

Answer 36

1. IFN-alpha. | 2. Splenectomy.

Question 37

Lymphoma - Can involve the GI tract as well as the head and neck?

Answer 37

DLBCL.

Question 38

Lymphoma - Can involve the CNS and bone marrow:

Answer 38

Lymphoblastic lymphoma.

Question 39

Lymphoma - Derived from thymic T cells?

Answer 39

Lymphoblastic lymphoma.

Question 40

What can the myeloproliferative diseases transform into?

Answer 40

Acute leukemias.

Question 41

Possible long-term complication that occurs in about 20% of patients with polycythemia vera?

Answer 41

Fibrosis of the bone marrow.

Question 42

Classical signs-symptoms of essential thrombocytosis?

Answer 42

1. Burning and throbbing hands and feet as well as splenomegaly. 2. Bleeding from nose and gums due to platelet dysfunction.

Question 43

Idiopathic myelofibrosis?

Answer 43

Disorder in which there is extensive extramedullary hematopoiesis causing replacement of marrow with fibrous connective tissue.

Question 44

What is the pathogmononic sign of myelofibrosis?

Answer 44

Peripheral smear shows tear drops.

Question 45

What is the ratio of white to African Americans who have multiple myeloma?

Answer 45

1:2.

Question 46

What is the triad that is often seen in MM?

Answer 46

1. Anemia. 2. Back pain. 3. Renal failure.

Question 47

5 Microcytic anemias:

Answer 47

LISTS ``` Lead poisoning Iron def. Sideroblastic Thalassemias SCA ```