Hematology

Question 1

Normal or ↓ MCV
↓ TIBC
↑ Ferritin (high iron stores)
↓ serum erythropoietin

Answer 1

anemia of chronic disease

Question 2

↓ MCV (microcytic)
↓ MCH (hypochromic)
↑ TIBC
↓ Ferritin (best test, low iron stores)

Target cells, pica, and nail spooning

Answer 2

IDA

Question 3

Tx of IDA…

Answer 3

Ferrous sulfate 325mg TID + CBC.q 3 mo

PRBCs if Hg < 8

Question 4

+ Heinz Bodies and Bite Cells on smear

Answer 4

G6PD Deficiency

Question 5

(+ Direct Coombs Test)

Answer 5

Autoimmune hemolytic anemia

Question 6

(+) osmotic fragility test, spherocytes

Answer 6

hereditary spherocytosis

Question 7

The below lab profile indicates what type of anemia?

↑ Retic
↑ LDH
↓ Haptoglobin
↑ Bilirubin (indirect)

Answer 7

hemolytic

Question 8

Very ↑ Retic count

howell-jolly bodies

target cells

Answer 8

sickle cell

Question 9

profoundly decreased MCV

normal TIBC/Ferritin

Elevated iron

Answer 9

thalassemia

Question 10

Tx of beta thalassemia

Answer 10

transfusion

desferoxamine (chelation)

Question 11

Hg electrophoresis shows HbA2 and HbF…

Answer 11

beta thalassemia

Question 12

Hg electrophoresis shows HbA2

Answer 12

Beta thalassemia trait

Question 13

Chinese/SE Asians

Hg electrophoresis shows HgH, HgBart’s

Answer 13

Alpha thalassemia

Question 14

Smooth beefy, sore tongue. Neurologic symptoms

Answer 14

B12 deficiency

Question 15

Diagnostic for pernicious anemia…

Answer 15

schilling test

Question 16

recurrent history of nosebleeds and heavy menses, recent nosebleeds

FHx of similar sxs

Incrased PTT, bleeding time

NORMAL PT

Answer 16

von willebrand disease

Question 17

This disease has missing factor that prevents platelets to adhere to the vessel wall. Therefore, bleeding doesn’t stop as quickly as it should

Answer 17

vWD

Question 18

How can you differentiate vWD and hemophilia?

Answer 18

lack of hemarthrosis

Question 19

Tx of vWD

Answer 19

DDAVP (desmopressin)

Question 20

Missing clotting factor VIII

Answer 20

hemophilia A (aight)

Question 21

Missing clotting factor IX… christmas disease…

Answer 21

Hemophilia B

Question 22

Genetic inheretance of hemophilia

Answer 22

X linked (will affect males)

Question 23

Hemarthrosis

Increased PTT
Normal PT and Platelets

Answer 23

hemophilia

Question 24

Which leukemia?

Pediatric patient

LAD

Bone Pain

Bleeding

Fever

Answer 24

ALL

Question 25

20% blasts in bone marrow can indicate which leukemia?

Answer 25

ALL

Question 26

Which leukemia? Middle age patient (peak age 50) Sometime asymptomatic +/- fatigue, LAD, splenomegaly

Answer 26

CLL

Question 27

Dx of CLL

Answer 27

Smudge cells and mature lymphocytes on peripheral smere

Question 28

Tx of CLL

Answer 28

observation... if lymphocytes > 100,000 start chemo

Question 29

Which leukemia? Adult patient Anemia, thrombocytopenia, neutropenia. Splenomegaly, gingival hyperplasia and Leukostasis (WBC > 100k)

Answer 29

AML

Question 30

Which leukemia? Aur rods and 20% blasts in bone marrow

Answer 30

AML

Question 31

Which leukemia? Strikingly increased WBCs (> 100k) Hyperuricemia Adult patient

Answer 31

CML

Question 32

Dx of CML can be done via...

Answer 32

philadelphia chromosome

Question 33

AML can be treated with...

Answer 33

bone marrow transplant

Question 34

Which lymphoma has bimodal peaks in 20s and 50s?

Answer 34

hodgkin's

Question 35

non-hodgkins is common in what age group?

Answer 35

> 50 yo

Question 36

Reed sternberg cells indicate...

Answer 36

hodgkin's

Question 37

Which lymphoma? Painless LAD with contiguous spread to local lymph nodes

Answer 37

hodgkin's

Question 38

Which lymphoma? extranodal spread to GI and skin lymph nodes

Answer 38

non-hodgkin's

Question 39

Which lymphoma? B sxs present a/w EBV

Answer 39

hodgkin's

Question 40

Mediastinal adenopathy on CXR indicates which lymphoma?

Answer 40

hodgkin's

Question 41

Which lymphoma? SOB intussusception bowel obstruction abdominal mass

Answer 41

non-hodgkin

Question 42

biologic available for non-hodkin lymphoma

Answer 42

rituximab

Question 43

Patient presents with: pruritis after hot baths burning pain rubor of hands/feet (redness)

Answer 43

polycythemia vera

Question 44

4 Hs of polycythemia vera...

Answer 44

hypervolemia (increased RBCs) Hisaminemia Hyperviscosity (Increased Hct) Hyperuricemia

Question 45

Tx of polycythemia vera...

Answer 45

repeated phlebotomy

Question 46

Tx for DIC...

Answer 46

cryoprecipitate, FFP, heparin

Question 47

Bleeding and thrombosis occuring at the dsame time... Decreased platelets increased bleeding time, PT, PTT, D-Dimer

Answer 47

DIC

Question 48

Autoimmune reaction to platelets usually after a viral illness Insidious onset, chronic

Answer 48

idiopathic throbocytopenic purpura (ITP)

Question 49

Associated with HIV, HCV, SLE, CLL CBC normal except low platelets. (+ Direct Coombs Test)

Answer 49

idiopathic throbocytopenic purpura (ITP)

Question 50

↓ Platelets + anemia + schistocytes (RBC fragments) on smear and NEG Coombs After administration of quinidine, cyclosporine or pregnancy

Answer 50

TTP

Question 51

Purpura and “FAT RN”- ``` Fever Anemia Thrombocytopenia Renal failure Neurological symptoms ```

Answer 51

TTP

Question 52

Post-infection: E.coli or Shigella Children Severe kidney problems

Answer 52

HUS