Hematology

Question 1

Factor 5 Leiden is a mutation in ______ rendering it ________ resulting in ______

Answer 1

Factor V; unable to be broken down by protein C; hyper-coagulability

Question 2

Burkitt’s Lymphoma is translocation ______. It is characterized by ______ on histology.

Answer 2

t(8;14); starry sky appearance due to macrophages dispersed between lymphocytes.

Question 3

Burkitt’s Lymphoma is associated with _____ virus.

Answer 3

Ebstein-Barr Virus

Question 4

Mantle Cell Lymphoma is translocation _______. The cell marker is

Answer 4

t(11;14), CD5 positivity on B cells (CD20)

Question 5

Follicular Cell Lymphoma is translocation _______. It is a mutation in _______ which causes _______.

Answer 5

t(14;18), Bcl-2 (normally inhibits apoptosis); over-expression leads to proliferation.

Question 6

Howell Jolly bodies are _______ seen in _______.

Answer 6

Nuclear remnants; splenectomies (treatment for hereditary spherocytosis)

Question 7

Hereditary spherocytosis is due to _______.

Answer 7

Cytoskeletal abnormalities that make RBC rigid.

Question 8

Hereditary spherocytosis is an (extrinsic/intrinsic) hemolytic anemia resulting in (extravascular/intravascular) hemolysis

Answer 8

Intrinsic; extravascular (by the spleen)

Question 9

Heinz bodies are _______.

Answer 9

Oxidized remnants of Hgb

Question 10

G6PD Deficiency has _______ and _______ on peripheral blood smear

Answer 10

Heinz bodies and bite cells

Question 11

Describe the presentation of G6PD deficiency

Answer 11

Sudden episode of jaundice, dark urine and anemia

Question 12

Inheritance of G6PD deficiency

Answer 12

X-linked recessive

Question 13

G6PD deficiency pathology

Answer 13

G6PD is necessary in RBC because it is the only mechanism to produce NADPH. NADPH is needed to reduce H2O2, otherwise oxidative damage occurs

Question 14

Triggers for G6PD deficiency attack

Answer 14

Anti-malarials, antibiotics, sulfa drugs, fava beans, infections

Question 15

G6PD is an (extrinsic/intrinsic) hemolytic anemia resulting in (extravascular/intravascular) hemolysis

Answer 15

Intrinsic; extravascular (by spleen)

Question 16

Smudge cells on peripheral smear are indicative of _______

Answer 16

Chronic Lymphocytic Leukemia

Question 17

In clinical doses of Warfarin, _______ (Factor) is affected and (PT/PTT) is abnormal.

Answer 17

Factor VII (7); prolonged PT

Question 18

How does warfarin overdose affect clotting time?

Answer 18

Prolongs PT and PTT. Warfarin is an antagonist of Vitamin K and at an high doses, it blocks Factors 7, 9, 10, 2 - affecting both the intrinsic and extrinsic pathways.

Question 19

Vitamin K Dependent clotting factors

Answer 19

SNoTT (Seven, Nine, Ten, Two)

Question 20

Warfarin’s impact on platelets

Answer 20

Warfarin does not affect platelet count or function

Question 21

Feeling itchy after a hot shower is indicative of ______ (disease)

Answer 21

Polycythemia Vera

Question 22

In Polycythemia Vera, there is an ______ in Epo

Answer 22

Decrease

Question 23

In Polycythemia Vera, the ESR is ______. ESR is a measure of ______

Answer 23

decreased; how fast RBC settle

Question 24

Haptoglobin is responsible for ______ and in hemolytic anemia, levels are ______

Answer 24

Binding free hemoglobin; decreased because it has bound so much Hgb

Question 25

The TTP pentad consists of

Answer 25

Fever, neurologic, MAHA, thrombocytopenia with purpura and acute renal failure

Question 26

Enzyme problem and pathophysiology in Thrombotic Thrombocytopenic Purpura (TTP)

Answer 26

Defect in ADAMTS13. This enzyme is responsible for "cutting and maintaining" ultra-large VWF. Without it, increase in VWF causes platelets to get stuck there (thrombocytopenia) and hemolysis as RBC get stuck and cut.

Question 27

CLL is commonly caused by ______ cells and has cell markers

Answer 27

B cells; CD19 and CD20

Question 28

Infectious mononucleosis is caused by ______ virus and presents with ______

Answer 28

Ebstein-Barr Virus; sore throat, fever, cervical lymphadenopathy, possible splenomegaly

Question 29

The PT and PTT time in Thrombotic Thrombocytopenic Purpura show _______

Answer 29

Normal times

Question 30

In thrombotic thrombocytopenic purpura, there may be signs of liver or kidney dysfunction. Why?

Answer 30

The formation of microthrombi can occur anywhere - including liver and kidneys.

Question 31

In DIC, PTT is ______, PT is ______, Bleeding time is ______ and D-Dimer is ______

Answer 31

All increased. Consumption of clotting factors leads to increase in PTT and PT; consumption of platelets leads to increase in bleeding time; Clot formation and breakdown leads to increase in D-Dimer

Question 32

Idiopathic thrombocytopenic purpura is caused by ______

Answer 32

antibodies to platelets

Question 33

In ITP, individuals typically present ______ and on labs ______

Answer 33

Bleeding, bruising for several months but otherwise healthy; low platelet count with other normal values

Question 34

In ITP, the antibody is targeted towards

Answer 34

GPIb or GPIIb/IIIa

Question 35

DIC develops as a result of release of ______

Answer 35

Tissue factor