Hematology/ Oncology

Question 1

Macrocytic Anemia MCV

Answer 1

> 100

Question 2

Causes of nonmegaloblastic Anemia

Answer 2

Liver disease
EtOH
Drugs
Metabolic

Question 3

Causes of Megaloblastic Anemia

Answer 3

B12 or Folate deficiency

Question 4

Drugs that cause a nonmegaloblastic anemia

Answer 4

5FU
Ara-C
AZT, Zidovudine

Question 5

Causes of Microcytic Anemia

Answer 5

Thalassemia
Iron Deficiency
Chronic Inflammation
IDA

Question 6

Thalassemia Hx, Dx, Tx

Answer 6

Anemia 
Dx: Iron studies normal 
Hgb Electropheresis 
find any other hemoglobin other than normal = beta thalassemia 
Tx: beta-transfusion 
for iron overload use defuroxamine

Question 7

Normocytic anemia Dx

Answer 7

LDH elevated
Bilirubin Elevated
Haptoglobin Decreased
Means hemolysis

Question 8

G6PD deficiency Hx, Dx

Answer 8

African American male taking Dapsone, TMP-SMX, Nitrofurantoin
Dx-Heinz bodies, Bite cells
Tx: Supportive
Avoid Stress

Question 9

Sickle Cell Vasoocclusive Crises Dx and Tx

Answer 9

Acute chest-MI
Brain CVA- Exchange transfusion 
Priapism 
Dx: Hgb electrophoresis 
Smear- Sickled Cells 
Long term treatment hydroxyurea 
Acute- IVF, pain meds, O2

Question 10

AHI Coombs test

Answer 10

IgM-cold type caused by mycoplasma and mono
IgG warm Type-AI, CA,
use steroids, rituximab, splenectomy

Question 11

AML M3 Variant Treatment

Answer 11

All Transretnoic Acid

presence of Auer Rods

Question 12

CML bone marrow biopsy finding

Answer 12

Philadelphia Chromosome t(9,22) BCR-ABL

Question 13

Non-tender lymphadenopathy indicates?

Answer 13

Cancer

Question 14

Hodgkins with B symptoms presentation

Answer 14

Night Sweats
Fever
Weight loss
LN pain with ingestion of alcohol

Question 15

Hodgkins Tx

Answer 15

ABVD or BEACOPP

Question 16

Non-Hodgkins Tx

Answer 16

Rituximab or R-CHOP

Question 17

Reed Sternberg cells found in what disease and what are the markers

Answer 17

CD 15 , CD 30

Hodgkins

Question 18

Adriamycin, Doxirubicin AE

Answer 18

Cardiotoxicity

Question 19

Vincristine/Vinblastine

Answer 19

Peripheral Neuropathy

Question 20

Bleomycin AE

Answer 20

Pulm Fibrosis

Question 21

Cisplatin AE

Answer 21

Ototoxicity

Nephrotoxicity

Question 22

Cyclophosphamide AE

Answer 22

Hemorrhagic cystitis

Question 23

which is worse hodgkins or non-hodgkins

Answer 23

Non-hodgkins

Question 24

Plasma cell disorder presentation (Multiple Myeloma) CRAB

Answer 24

Hypercalcemia
Renal Failure
Anemia
Bone Pain

Question 25

Multiple Myeloma Dx

Answer 25

Spep=M spike Upep=M-Spike Skeletal changes BMBx->10% Plasma

Question 26

Multiple Myeloma Tx

Answer 26

>70, no donor=chemo | <70, donor-Stem cell transplant

Question 27

MGUS Hx, Dx, Tx

Answer 27

Asx Dx- online Spep Positive BMBx <10% Plasma cells Tx: Monitor and observe

Question 28

Waldenstroms Hx, Dx, Tx

Answer 28

``` Hyperviscosity with constitutional symptoms Dx: Spep positive Upep and skeletal negative BMBx- >10% plasma Tx: Rituximab Plasampheresis ```

Question 29

TTP presentation | FATRN

Answer 29

``` Fever Anemia (microangiopathic) Thrombocytopenia Renal Failure Neuro Sxs ```

Question 30

TTP Dx

Answer 30

Decreased platelets PT/PTT normal Fibrinogen Normal D-Dimer Normal

Question 31

TTP Tx

Answer 31

Exchange transfusion

Question 32

DIC Dx

Answer 32

Platelets decreased PT/PTT increased D-Dimer Increased Fibrinogen Decreased

Question 33

``` Elevated T. bili LDH Decreased Haptoglobin ```

Answer 33

Hemolysis | perform Smear

Question 34

Folate Deficiency Presentation

Answer 34

Pt: Tea and Toast Diet Dx: Folate level MMA normal Tx: Folic Acid

Question 35

B12 Deficiency Presentation

Answer 35

``` Pt: Neuro Sxs Strict vegan Dx: Decreased B12 increased MMA Schillings Test Tx: PO- nutritional deficiency IM B12- Impaired Absorption ```

Question 36

Schillings test

Answer 36

Give IM B12 then oral B12 if Urine (+) B12-nutritional def Urine (-) B12- Absorption

Question 37

Iron Deficiency Anemia Presentation

Answer 37

``` Pt: Slow bleeds Old Male (+) Fecal Occult Blood Test Woman W/ Mennorrhagia Dx: Decreased Fe, Ferritin Increased TIBC Tx: replace, 324mg Iron Stool Softeners ```

Question 38

Anemia of Chronic Disease Presentation

Answer 38

``` Pt: Chronic Inflammatory Disease (SLE, RA) Usually Asx Hgb >8 Dx: Increased Ferritin Decreased TIBC, Fe Tx: Usually nothing maybe EPO ```

Question 39

Heriditary Spherocytosis Presentation

Answer 39

``` (Spectrin, ankryin, Pallidin) Pt: Hemolysis Smear shows Spherocytes Dx: Smear Osmotic Fragility Test Tx: Splenectomy ```

Question 40

Paroxysmal Nocturnal Hemolglobinuria Presentation

Answer 40

Deficiency PIGA gene Dx: Flow cytometry showing deficiency CD 55 Tx: Supportive Ecluzimab

Question 41

AML presentation

Answer 41

``` Pt: Acute 67 y.o. Exposure- Benzine, Radiation CML: Blast crisis transformation Dx: Smear Bone marrow Bx->20% blasts + Myeloperoxidase non-M3 Variant-Chemo ```

Question 42

CML presentation

Answer 42

Pt: Asx with increase white count Dx: Bone marrow Bx- Philadelphia Chromosome t(9.22) BCR-ABL Tx: Imatinib can transform into AML (Blast Crisis)

Question 43

ALL presentation

Answer 43

``` Pt: Acute, Young Patient Dx: Smear BMBx >20% blasts (Positive Tdt) Tx: Chemo ppx CNS with ARA-C ```

Question 44

CLL Presentation

Answer 44

``` Pt: Chronic Older Patient Dx: Diff BMBx Tx: >65 +Asx= no treatment >65 + Sx = Chemo <65 +Donor = Stem Cell Transplant ```

Question 45

Von Willebrand Disease Presentation

Answer 45

``` Decreased vWF and Factor 8 Pt: Platelet bleeding (superficial-Gums, vagina, petechiae) Normal platelet count Dx: vWF Tx: DDVAP Factor 8 ```

Question 46

DIC Presentation

Answer 46

Very sick patient Sepsis, ICU Shock

Question 47

Heparin Induced Thrombocytopenia Tx

Answer 47

Stop heparin Start Argatoban Bridge to Warfarin

Question 48

HIT Presentation

Answer 48

Presents 7-14 days after starting

Question 49

Idiopathi Thrombocytopenic Purpura Presentation, Tx

Answer 49

``` Usually a Female with AI Diagnosis of exclusion Tx: Steroids-Acute Critically Low- IVIg Splenectomy-Refractory Rescue therapy-Rituximab ```