Hematology Uniques

Question 1

• decreased plts
• decreased Hgb
• increased LDH

Answer 1

primary thrombocytopenia

Question 2

• HgbS on hemoglobin electrophoresis

- sickled cells

Answer 2

Sickle cell anemia

Question 3

• eosinophilia, lymphocytosis

- low plts

Answer 3

• immune thrombocytopenia purpura

Question 4

• elevated blasts

Answer 4

non-hodgkin’s lymphoma

Question 5

• neuro abnormalities/balance issues
• normocytic or macrocytic anemia
• elevated MMA

Answer 5

B12 deficiency anemia

Question 6

• elevated Hct

- elevated uric acid and vit B 12 level

Answer 6

polycythemia

Question 7

• positive direct Coomb’s test

Answer 7

Autoimmune helolytic anemia

Question 8

• pancytopenia w/ circulating blasts
• auer rods
• hyper cellular bone marrow

Answer 8

Acute Myeloid Leukemia

Question 9

• stool culture positive for e. coli, shiga toxin

Answer 9

hemolytic uremic syndrome

Question 10

• pancytopenia
• macrocytic anemia
• absent/few retics
• empty/fatty bone marrow

Answer 10

Aplastic anemia

Question 11

• Reed-Sternberg cells

Answer 11

Hodgkin’s lymphoma

Question 12

• PT, PTT and bleeding times increased

Answer 12

Acquired disordered bleeding

Question 13

• “starry sky” pattern histologically due to benign macrophages interspersed among tumor cells

Answer 13

Burkitt’s lymphoma

Question 14

• ELISA positive for IgG PF4

Answer 14

HITT

Question 15

• only increased PTT

Answer 15

Hemophilia

Question 16

• scattered storage histiocytes with wrinkled, green-blue cytoplasm (sea-blue histiocytes)

Answer 16

CML

Question 17

• Birbeck granules in cytoplasm

Answer 17

Langerhans cell histiocytosis

Question 18

• decreased plts
• anemia
• schistocytes
• decreased H+H
• elevated LDH
• very elevated indirect bilirubin
• elevated BUN/Cr
• decreased haptoglobin
• positive ADAMTS-13
• negative direct Coombs test

Answer 18

thrombotic thrombocytopenia purpura

Question 19

• isolated lymphocytosis

- smudge cells on smear

Answer 19

chronic lymphocytic leukemia

Question 20

• normal PT/INR
• elevated PTT, bleeding time
• abnormal vWF assays

Answer 20

vWF disease

Question 21

• rouleaux formation on on smear
• elevated beta-2 microglobulin
• > 100 ratio on serum free monoclonal light chain assay
• > 3 M spike on SPEP
• Bence jones proteins on UPEP

Answer 21

Multiple myeloma

Question 22

• elevated LDH

- presence of CD55/CD59 in flow cytometry

Answer 22

• PNH

Question 23

• microcytic, hypochromic anemia
• decreased ferritin
• increased iron binding capacity, transferrin

Answer 23

iron deficiency anemia

Question 24

• terminal deoxynucleotidyl transferase

Answer 24

acute lymphoblastic leukemia

Question 25

- leukocytosis w/ myeloid, left shift | - low LAP

Answer 25

Chronic myeloid leukemia

Question 26

- normocytic/microcytic - low serum iron/transferrin - normal/increased ferritin

Answer 26

Anemia of Chronic disease

Question 27

- agglutinated RBC on smear - elevated retics - serum cold agglutinin titer

Answer 27

Cold agglutinin disease

Question 28

- ringed sideroblast

Answer 28

Erythroid myelodysplastic syndrome

Question 29

- increased MCHC | - spherocytes

Answer 29

hereditary spherocytosis

Question 30

- macrocytic anemia | - elevated homocysteine

Answer 30

Folic acid deficiency anemia

Question 31

- heterophile antibody response IgM

Answer 31

EBV/Mono

Question 32

- increased indirect bilirubin | - bite cells, heinz bodies in peripheral smear

Answer 32

G-6-P dehydrogenase deficiency