EXAM #2: REVIEW

Question 1

Describe the plasmodium lifecycle.

Answer 1

1) Sporozites infect the blood and travel to the liver
2) Sporozites transform into Merozites in the liver
3) Merozites can become:
- Trophozites that
- Schiznots that
4) Gametocytes are ingested by subsequent mosquitoes to continue the lifecycle

Question 2

What cytokines produced by the immune response to Malaria infection can cause a reduction in erythropoieses?

Answer 2

TNF-alpha

IL-1

Question 3

What species of Babesia are rodents the reservoir for?

Answer 3

B. merzoti

Question 4

What species of Babesia are cattle the reservoir for?

Answer 4

B. divergens

Question 5

Describe the Direct Coombs Test.

Answer 5

• Blood sample is taken from patient with hemolytic anemia
• Autoantibodies are bound to the RBCs
• RBCs are washed and presented with anti-human antibodies

Positive test results in agglutination

Question 6

Describe the Indirect Coombs Test.

Answer 6

• Patient serum is obtained with autoantibodies
• Donor blood is added to serum and autoantibodies bind
• Anti-human antibodies are added and cause RBC agglutination

Question 7

List the five indications for IVIG.

Answer 7

1) Primary humoral immunodeficieicny
2) Immune thrombocytopenia
3) Chronic inflammatory demyelinating polyneuropathy
4) Hypogammaglobulinemia
5) Post-exposure prophylaxis

Question 8

What are the indications for FFP?

Answer 8

1) Decreased coagulation factors in massive transfusion

2) Hemophilia

Question 9

What two antigens are primarily responsible for alloimmunization?

Answer 9

• HLA

- HPA

Question 10

What are the three indications for plasma?

Answer 10

1) Coagulation factor deficit
2) Massive transfusion
3) ADAMSTS13

Question 11

List the contents of cryoprecipitate.

Answer 11

• Fibrinogen
• vFW
• VIII
• XIII

Question 12

What are the indications for cyroprecipitate?

Answer 12

Bleeding–>fibrinogen
Von Willebrand’s Disease–> vFW
Factor VIII–> Hemophilia A

Question 13

What are the diagnostic criteria for TRALI?

Answer 13

1) No pre-exisiting lung injury or disease
2) Onset within 6 hours of infusion
3) Hypoxemia with SaO2 less than 90% on room air
4) Bilateral infiltrates on CXR
5) No circulatory overload

Question 14

What four transfusion reactions initially present with fever?

Answer 14

• TRALI
• TABI
• TA-GHD
• Acute hemolysis

Question 15

What antigen is primarily responsible for delayed hemolysis?

Answer 15

Kidd (anti-kidd antibody)

Question 16

What is the normal lymphocyte percentage in a neonate?

Answer 16

30%

Question 17

What are the signs/ symptoms of polycythemia?

Answer 17

• Poor feeding
• Ruddy complexion
• Irritability
• Tremors
• Lethargy
• Respiratory depression

Question 18

List the causes of polycythemia.

Answer 18

• INcreased EPO ?
• Smoking
• Alcohol
• Maternal DM
• Trisomy
• Erythrocyte transfusion

Question 19

What is the basis for the WHO categorization of AML?

Answer 19

• Pathology
• Cytogenetics
• Molecular characteristics

Question 20

What are the markers for Reed-Sternberg cells?

Answer 20

CD15

CD30

Question 21

What lab features are characteristics of Multiple Myeloma?

Answer 21

Increased IgG or IgA in serum or urine

Question 22

What is the general unifying feature of all AMLs?

Answer 22

Undifferentiated myeloblast accumulation in the bone marrow

Question 23

List the three major myeloproliferative neoplasms.

Answer 23

1) Polycythemia vera
2) Essential Thrombocythemia
3) Primary Myelofibrosis

Question 24

What lab value is associated with Solitary Plasmacytoma?

Answer 24

No or low immunoglobulin

Question 25

Generally, what is myelodysplastic syndrome?

Answer 25

Stem cell disorder that results in ineffective hematopoiesis

Question 26

Generally, what is Multiple Myeloma?

Answer 26

Mature B-cell cancer

Question 27

What are the PBS hallmarks of CLL?

Answer 27

1) Increased small round lymphocytes | 2) Smudge cells

Question 28

List the major plasma cell disorders.

Answer 28

1) Multiple myeloma 2) Plasmacytoma 3) Primary Amyloidosis 4) MGUS 5) POEMS Syndrome 6) Waldenstrom Macrolobinemia

Question 29

What are the three major causes of microcytic/ hypochromic anemia in children?

Answer 29

1) Iron deficiency 2) Pb toxicity 3) Thalassemia

Question 30

If you see a normocytic anemia and decreased RC count, what three things should your differential include?

Answer 30

1) DBA 2) TEC 3) Parvovirus B19

Question 31

List the three encapsulated bacteria that children with Sickle Cell Disease (that are functionally asplenic) are at risk of.

Answer 31

S. pneumonia H. influenza N. meningitidis

Question 32

When in surgical oncology is surgery used as a secondary treatment?

Answer 32

Advanced stage of the following: - Esophageal - Rectal - Lung - Breast BUT not stage 4 cancer.

Question 33

List the indications for radioembolization or Y90 therapy.

Answer 33

1) Unresectable liver tumors 2) Metastatic colon cancer 3) Neuroendocrine tumors

Question 34

List the five advantages of cryoablation.

Answer 34

1) Outpatient 2) No general anesthesia 3) Nephron sparing 4) Few complications 5) Can be repeated for residual tumor

Question 35

What are the risk factors for HCC?

Answer 35

1) Hepatitis B or C 2) Alcoholic cirrhosis 3) Metabolic Syndrome 4) Aflatoxin Exposure