Hemat Onco

Question 1

Döhle bodies (light blue, peripheral inclusions) due to left shift are seen in

Answer 1

Neutrophils

Question 2

Platelets contain dense granules such as

Answer 2

Calcium, ADP, Serotonin, Histamine

Question 3

Platelets contain alpha granules such as

Answer 3

vWF, fibrinogen, fibronectin, platelet factor 4

Question 4

Macrophages naming varies by specific tissue type eg-

Answer 4

Osteoclasts in the bone, histiocytes in connective tissue

Question 5

Lipid A from bacterial LPS binds CD14 on macrophages to initiate

Answer 5

Septic shock

Question 6

Basophils mediate allergic reaction and contain granules like

Answer 6

Heparin (anticoagulant) and histamine (vasodilator)
Leukotrienes are synthesised and released on demand

Question 7

Mast cells contain basophilic granules and mediate -

Answer 7

Local tissue allergic reactions

Question 8

Mast cells are activated by tissue trauma, C3a and C5a, surface IgE cross linking by antigen (IgE receptor aggregation) and cause

Answer 8

Degranulation and release of histamine, heparin, tryptase and eosinophil chemotactic factors

Question 9

Cromolyn sodium prevents

Answer 9

Mast cell degranulation (used in asthma prophylaxis)

Question 10

Vancomycin, opioids, radiocontrast dye can elicit

Answer 10

IgE-independent mast cell degranulation

Question 11

CD56, CD16 (FcR)

Answer 11

NK cells

Question 12

CD4+ helper T cells are the primary target of

Answer 12

HIV

Question 13

Neutrophil lysosomes (Azurophilic granules) contain

Answer 13

Proteinases, acid phosphatases, myeloperoxidase, B glucuronidase

Question 14

Neutrophil chemotactic agents

Answer 14

C5a, IL 8, LTB4, 5 HETE, Kallikrein, platelet activating factor, bacterial proteins

Question 15

Aspirin irreversibly inhibits COX, thereby inhibiting

Answer 15

TXA2 synthesis

Question 16

What drugs inhibit ADP-induced expression of GpIIb/IIIa by blocking P2Y12 receptor

Answer 16

Clopidogrel, Prasugrel and Ticagrelor

Question 17

Abciximab, Eptifibatide, Tirofiban

Answer 17

Inhibit GpIIb/IIIa directly

Question 18

Risocetin activates

Answer 18

vWF to bind GpIb

Question 19

Failure of aggregation with Risocetin assay occurs in

Answer 19

von Willebrand disease and Bernard-Soulier syndrome

Question 20

Desmopressin promotes the release of

Answer 20

vWF and factor VIII from endothelial cells

Question 21

Drug induced hemolytic anemia caused by

Answer 21

Penicillins, Cephalosporins, NSAIDS

Question 22

Drug induced hemolytic anemia caused by

Answer 22

Penicillins, Cephalosporins, NSAIDS

Question 23

Acute intermittent porphyria

Answer 23

Affected enzyme: Porphobilinogen deaminase
Accumulated substrate: Porphobilinogen, ALA
Treatment: Hemin and glucose

Question 24

Porphyria cutanea tarda

Answer 24

Affected enzyme: Uroporphyrinogen decarboxylase
Accumulated substrate: Uroporphyrin (tea coloured urine)
Treatment: Sun avoidance, Hydroxychloroquine

Question 25

Lead poisoning

Answer 25

Affected enzyme: Ferrochelatase and ALA dehydratase Accumulated substrate: Protoporphyrin, ALA

Question 26

von Willebrand disease

Answer 26

Menorrhagia and epistaxis

Question 27

Antithrombin III inhibits factors -

Answer 27

IIa and Xa

Question 28

Burkitt lymphoma

Answer 28

t(8,14) translocation of c-myc and heavy chain Ig Starry sky appearance, tingible body macrophages

Question 29

Diffuse large B cell lymphoma

Answer 29

Most common type Mutations in BCL 2 and BCL 6

Question 30

Follicular lymphoma

Answer 30

t(14;18) - translocation of heavy chain Ig (14) and BCL 2 (18) Painless waxing and waning lymphadenopathy

Question 31

Mantle cell lymphoma

Answer 31

t(11;14) translocation of cyclin D1 (11) and heavy chain Ig (14) Very aggressive

Question 32

Marginal zone lymphoma

Answer 32

t (11;18) Chronic inflammation, Sjögren’s syndrome, chronic gastritis (MALT lymphoma)

Question 33

Primary central nervous system lymphoma

Answer 33

EBV related associated with AIDS Ring enhancing lesion on MRI

Question 34

Argatroban can be used in HIT, when heparin is bad for the patient

Answer 34

Directly inhibits factor IIa (thrombin)

Question 35

Apixaban, Edoxaban, rivaroxaban directly inhibits factor Xa

Answer 35

Used in stroke prophylaxis for atrial fibrillation Bleeding is reversed with andexanet alfa

Question 36

Cilostazol blocks phosphodiesterase, decreases cAMP hydrolysis and increases cAMP in platelets

Answer 36

Intermittent claudication

Question 37

Tranexamic acid

Answer 37

Antifibrinolytic (prevents clot breakdown)

Question 38

Vincristine, Vinblastine

Answer 38

M phase specific (Mitosis) Binds B tubulin and inhibits it’s polymerization into microtubules - Prevents mitotic spindle formation Adverse effects - Neurotoxicity (crisps the nerve) Myelosuppression (blasts the marrrow)

Question 39

Paclitaxel

Answer 39

M phase specific Hyperstabilizes polymerised microtubules - Prevents mitotic spindle breakdown Adverse effect: Neuropathy

Question 40

Cisplatin (makes kidneys got ciSPLATin) G1 specific (Duplicates cellular content)

Answer 40

Cross links DNA Adverse effects: Nephrotoxicity, Ototoxicity

Question 41

Busulfan G1 specific

Answer 41

Cross links DNA Adverse effect: Pulmonary fibrosis

Question 42

Busulfan G1 specific

Answer 42

Cross links DNA Adverse effect: Pulmonary fibrosis

Question 43

Cyclophosphamide

Answer 43

Cross links DNA Requires liver bio activation Adverse effects: Hemorrhagic cystitis - Tx : Mesna SIADH

Question 44

Carmustine G1 specific

Answer 44

Cross links DNA Crosses BBB Used in glioblastoma multiforme Adverse effects: CNS toxicity

Question 45

Azathioprine, 6 MP S phase specific (DNA synthesis)

Answer 45

Inhibits de novo purine synthesis Activated by HGPRT Metabolised by Xanthine oxidase Allopurinol/ Febuxostat inhibit Xanthine oxidase

Question 46

Methotrexate S phase specific (DNA synthesis)

Answer 46

Inhibits ribonucleotide reductase Adverse effect: Myelosupression Tx - Leucovorin rescue

Question 47

Cladribine S phase specific (DNA synthesis)

Answer 47

Purine analogue Used in hairy cell leukaemia

Question 48

5 FU S phase specific (DNA synthesis)

Answer 48

Pyramidine analogue inhibits thymidylate synthase Adverse effect: Hand-Foot syndrome