Hematology and Oncology

Question 1

Anaphylactic Transfusion Reaction

Answer 1

IgA Deficiency patients, reaction of anti-IgA antibodies with transfused blood.

HIVES, Wheeziness, Stridor, Angioedema, Rash
Respiratory distress
Hypotention

Question 2

Pharmacological causes of megaloblastic anemia

Answer 2

Methotrecate
Trimethoprim
Prymethamine

Due to folate disruptions

Question 3

Causes of Aplastic Anemia

Answer 3

Autoinmmune
Infections: Parvovirus B12, EBV
Drugs: carbamazepine, chloramphenicol, sulfonamides
Radiation or toxins

Question 4

Aplastic Anemia

Answer 4

Bone marrow failure due to hematopoietic stem cell deficiency (CD 34+)

Anemia, fatigue, weakness, pallor
Thrombocytopenia: mucosal bleeding, petechiae
Leukopenia: recurrent infections

Biopsy: Hypocellularity with fat and stromal cells

Question 5

Fanconi Anemia

Answer 5

Presents 4 - 12 years

Pancytopenia
Abnormal skin pigmentation, short stature, upper limb anormalities

Question 6

Chronic Leukemia Manifestation

Answer 6

Asymptomatic with a HIGH WBC > 60.000

PMN = CML
Lymph = CLL

Question 7

CML treatment

Answer 7

IMATINIB

Tyrosine Kinase Inhibitor

Question 8

CLL treatment young

Answer 8

with donor = stem cell transplant

Question 9

CLL treatment old

Answer 9

Symptomatic = Chemo

Asymptomatic = nothing and wait

Question 10

Acute Leukemia manifestation

Answer 10

Infections :: loss of WBC
Anemia :: loss of RBC
Bleeding :: loss of platelets
Bone pain

Question 11

Acute Leukemia diagnostic

Answer 11

At least 20% blasts in bone marrow or peripheral blood

Question 12

AML markers

Answer 12

Myeloperixod

Auer Rods

Question 13

CML

Answer 13

Philadelphia chromosome
t9:22
BCR:ABL

Question 14

CML complication

Answer 14

Blast crisis = AML

Question 15

ALL markers

Answer 15

cALLc

TdT

Question 16

4 y/o with bone pain, pallor, petechiae, palpable spleen

Answer 16

ALL, pediatric leukemia

Question 17

Polycythemia Vera signature symptom

Answer 17

Aquagenic Pruritus

Question 18

Polycythemia Vera manifestation

Answer 18

High viscosity: hypertension, erythromelalgia, transient visual disturbance
Gouty arthritis due to high RBC turnover
Aquagenic pruritus
Bleeding
Headache, dizziness

Facial plethora (Ruddy Cyanosis)
Splenomegaly

Question 19

Polycythemia Vera physiopathology

Answer 19

JAK2 activation mutation. Leads to RBC proliferation w/o the need of prior EPO activation of JAK2.

LOW EPO.

Question 20

ABO incompatibility

Answer 20

A/B father with O mother.

Only mild symptoms

Question 21

HIGH alpha-FP and beta-HCG

Answer 21

Mixed germ cell tumors

Mediastinum mass

Question 22

Heparin Induced Thrombocytopenia

Answer 22

Platelet factor IV

Risk of arterial thrombosis

Question 23

Sickle Cell Acute Anemia

Answer 23

Aplastic Crisis, secondary to parvovirus B19

Question 24

Anemia in chronic alcoholics

Answer 24

B9

5 to 10 weeks

Question 25

NHL risk factors

Answer 25

SLE, Sjogren Due to persistent B cell stimulation

Question 26

PTT features

Answer 26

``` Thrombocytopenia MAHA Fever Kindey failure Neurologic changes ```

Question 27

Hereditary Spherocytosis diagnosis

Answer 27

Abnormal Eosin-5-malemide binging test

Question 28

Maternal anti-D IG (rhogam) dates

Answer 28

28 weeks pregnant | 72 hours post delivery

Question 29

Kleihauer-Betle Test

Answer 29

Used to determine the needed rhogam dose to prevent alloimmunization

Question 30

Brain Metastases

Answer 30

Lung Breast Melanoma Renal

Question 31

Rapid progressing gynecomastia + high bhCG levels

Answer 31

bhCG secreting germ cell tumor Order testicular US

Question 32

Splenomegaly, anemia, jaundice Following URI

Answer 32

Hereditary Spherocytosis High reticulocites Negative coombs Hich MCHC

Question 33

Blood transfusion with anaphylactis reaction

Answer 33

IgA Deficiency

Question 34

Sickle Cell Disease patients prevention for capsulated infections

Answer 34

St. Pneumo vaccine (they become functional asplenic :: splenic autoinfarction) Algo give twice monthly penicillin prophylaxis until age 5

Question 35

Beta Thalassemia Major treatment

Answer 35

Frequent transfusions Chelation therapy :: iron overload :: transfusions

Question 36

Serum Sickness Like Reaction

Answer 36

Fever Arthralgias Urticarial Rash Diffuse Lymphadenopathy After exposure to beta lactams

Question 37

Stroke treatment in SCD

Answer 37

Exchange transfusion