Hem Onc

Question 1

fetal erythropoeisis sites

Answer 1

yolk sac (3 to 8 wks)
Liver (6 wks to birth)
spleen (10 to 28 wks)
bone marrow (18 wks to adult)

Young Liver Synthesizes Blood

Question 2

Fetal hemoglobin

Answer 2

HbF
A2G2

Question 3

Adult hemoglobin

Answer 3

A2B2
HbA

Question 4

HbA2

Answer 4

adult hemoglobin present in small amounts
A2D2

Question 5

hemoglobin electrophoresis results

Answer 5

A Fat Santa Claus cant go far
(descending order of farthest) (farthest meaning closer to anode)
HbA
HbF
HbS
HbC

Question 6

coombs test use

Answer 6

detect Ab against RBCs

Question 7

Direct Coombs test done for

Answer 7

AIHA

Question 8

direct coombs test mech

Answer 8

patient blood + anti human globins (coombs reagent)

agglutinatn present- AIHA
agglutinatn abs- AIHA no

Question 9

indirect coombs test done for

Answer 9

pretransfusion testing

Question 10

indirect coombs test mech

Answer 10

patient blood + coombs reagent + donor blood

agglutinatn- reaction present
no agglutinatn- rxn absent

Question 11

hemoglobin made up of

Answer 11

heme + globin

Question 12

heme made up of

Answer 12

iron + protoporphyrin

Question 13

Etiologies of microcytic anemia

Answer 13

iron def
thalassemia
chronic ds
sideroblastic anemia

Question 14

tibc measures

Answer 14

transferrin levels

Question 15

ferritin tibc trend

Answer 15

inversely prop

Question 16

treatment of IDA

Answer 16

FeSO4
rule out risk factors

Question 17

m/c anemia in hosp pt

Answer 17

anemia of chronic ds

Question 18

pathophysio of anemia of chronic ds

Answer 18

acute phase prot formed
hepcidin formed
hepcidin functns-

1. dec erythropeitin prodcutn
2. inc sequestering of Fe to macrophages (as Fe is reqd by bacteria)

Question 19

sideroblastic anemia cause

Answer 19

low synth of protoporphyrin

Question 20

ringed sideroblast cause

Answer 20

as there is low protoporphyrin
Fe is trapped in mitochondria, which forms a ring around nucleus

Question 21

lead poisoning denatures which enzymes

Answer 21

ALA-D and ferrochelatase

Question 22

vit b6 def affects which enzyme

Answer 22

ALA-S

Question 23

which drug causes vit B6 def

Answer 23

isoniazid

Question 24

rx for sideroblastic anemia

Answer 24

pyridoxine (vit B6)

Question 25

dohle bodies

Answer 25

found in neutrophils they are peripheral inclusions

Question 26

neutrophil chemotactic agents

Answer 26

c5a, il-8, ltb4, 5-hete, kallikiren, platelet activating factor, n-formylmethionine (bacterial proteins)

Question 27

tear drop cells seen in

Answer 27

myelofibrosis

Question 28

bite cells seen in

Answer 28

g6pd def due to removal of heinz bodies

Question 29

target cells found in

Answer 29

HALT hbc ds asplenia liver ds thalassemia

Question 30

howell jolly bodies what are they and where are they seen

Answer 30

sickle cell ds basophilic nuclear remnants

Question 31

basophilic stippling seen in

Answer 31

sideroblastic anemia

Question 32

fanconi anemia

Answer 32

dna repair defect leading to bone marrow failure

Question 33

acute intermittent porphyria affected enzyme

Answer 33

porphobillinogen deaminase

Question 34

porphyria cutanea tarda affected enzyme

Answer 34

uroporphyrinogen decarboxylase

Question 35

adult t cell lymphoma cause

Answer 35

htlv

Question 36

treatment for heparin induced thrombocytopenia

Answer 36

stop heparin use alt anticoagulant (argatroban)

Question 37

if pt has renal insufficiency, what kind of heparin is used

Answer 37

unfractioned heparin

Question 38

warfarin reversal

Answer 38

vitamin k give ffp or pcc for rapid reversal

Question 39

factor 2 inhibitors

Answer 39

bivalirudin argatroban dabigatran

Question 40

factor 2 inhibitors reversor

Answer 40

ida-ruci-zumab

Question 41

factor 10a inhibitors

Answer 41

apixaban, rivaroxaban, edoxaban

Question 42

factor 10a inh reversor

Answer 42

andexanet alfa

Question 43

eptifibatide, tirofiban moa, use

Answer 43

block FIB-rinogen receptor (gp2b/3a), unstable angina

Question 44

cilostazol, dipyridamole moa, use

Answer 44

block phosphodiesterase, used in stroke prevention

Question 45

thrombolytics names

Answer 45

alteplase, reteplase, tenecteplase

Question 46

thrombolytics moa

Answer 46

aid onversion to plasminogen to plasmin which inhibits cleaves thrombin and fibrin