Heme/Onc

Question 1

Elderly M with hypochromic microcytic anemia is asxic. Dxic tests?

Answer 1

FOBT and sigmoidoscopy; suspect CRC

Question 2

Precipitants of hemolytic crisis in pts with G6PD deficiency

Answer 2

Sulfonamides, antimalarial drugs, fava beans (“HEMOLYSIS IS D PAIN And No Fun”)

Question 3

MC inherited cause of hypercoagulability

Answer 3

Factor V Leiden mutn

Question 4

MC inherited bleeding d/o

Answer 4

von Willebrand’s dz

Question 5

MC inherited hemolytic anemia

Answer 5

Hereditary spherocytosis

Question 6

Dxic test for hereditary spherocytosis

Answer 6

Osmotic fragility test

Question 7

Pure RBC aplasia

Answer 7

Diamond-Blackfan anemia

Question 8

Anemia a/w absent radii and thumbs, diffuse hyperpigmentation, café au lait spots, microcephaly, and pancytopenia

Answer 8

Fanconi’s anemia

Question 9

Meds and viruses that lead to aplastic anemia

Answer 9

Chloramphenicol, sulfonamides, radiation, HIV, chemo, hepatitis, parvovirus B19, EBV

Question 10

How to distinguish polycythemia vera from 2˚ polycythemia

Answer 10

• Both: increased Hct and RBC mass

- Polycythemia vera: normal O2 sat, low EPO levels

Question 11

Thrombotic thrombocytopenic purpura (TTP) pentad

Answer 11

“FAT RN”: Fever, Anemia, TCP, Renal dysfcn, Neurologic abnlities

Question 12

HUS triad

Answer 12

Anemia, TCP, acute renal failure

Question 13

Tx for TTP

Answer 13

• Emergent large-volume plasmapheresis
• Corticosteroids
• Antiplatelet drugs

Question 14

Tx for idiopathic thrombocytopenic purpura (ITP) in kids

Answer 14

• Usually resolves spontaneously

- May require IVIG and/or corticosteroids

Question 15

Which of the following are increased in DIC: fibrin split products, D-dimer, fibrinogen, plts, Hct

Answer 15

• Elevated: fibrin split products, D-dimer

- Decreased: plts, fibrinogen, Hct

Question 16

8 yo M presents with hemarthrosis and increased PTT with normal PT and bleeding time. Dx? Tx?

Answer 16

• Dx: hemophilia A or B

- Tx: consider desmopressin (for hemophilia A) or factor VIII or IX supplements

Question 17

14 yo F presents with prolonged bleeding after dental surgery and with menses. Nl PT, nl or increased PTT, and increased bleeding time. Dx? Tx?

Answer 17

• Dx: von Willebrand’s dz

- Tx: desmopressin, FFP, or cryoprecipitate

Question 18

4 causes of microcytic anemia

Answer 18

“TICS”: Thalassemia, Iron deficiency, anemia of Chronic dz, and Sideroblastic anemia

Question 19

60 yo AAM presents with b. pain. W/u for multiple myeloma might reveal ___.

Answer 19

Monoclonal gammopathy, Bence Jones proteinuria, “punched-out” lesions on XR of skull and long bb.

Question 20

Reed-Sternberg cells

Answer 20

Hodgkin’s lymphoma

Question 21

10 yo M presents with fever, wt loss, and night sweats
Exam: anterior mediastinal mass
Suspected dx?

Answer 21

Non-Hodgkin’s lymphoma

Question 22

Microcytic anemia with

• Decreased: serum iron, TIBC
• Normal or increased: ferritin

Answer 22

Anemia of chronic dz

Question 23

Microcytic anemia with

• Decreased: serum iron, ferritin
• Increased: TIBC

Answer 23

Iron deficiency anemia (IDA)

Question 24

80 yo M presents with fatigue, LAD, splenomegaly, and isolated lymphocytosis. Suspected dx?

Answer 24

Chronic lymphocytic leukemia (CLL)

Question 25

Lymphoma equivalent of CLL

Answer 25

Small lymphocytic lymphoma

Question 26

Late, life-threatening complication of chronic myelogenous leukemia (CML)

Answer 26

Blast crisis (fever, b. pain, splenomegaly, pancytopenia)

Question 27

Auer rods on blood smear

Answer 27

Acute myelogenous leukemia (AML)

Question 28

AML subtype a/w DIC

Answer 28

M3

Question 29

Lyte ∆s in tumor lysis syndrome

Answer 29

- Decreased: Ca2+ | - Increased: K+, phosphate, uric acid

Question 30

Tx for AML M3

Answer 30

Retinoic acid

Question 31

50 yo M presents with early satiety, splenomegaly, and bleeding. Cytogenics show t(9;22). Dx?

Answer 31

CML

Question 32

Heinz bodies

Answer 32

Intracellular inclusions seen in thalassemia, G6PD deficiency, and post-splenectomy

Question 33

AR d/o with a defect in the GPIIbIIIa platelet R and decreased plt aggregation

Answer 33

Glanzmann's thrombasthenia

Question 34

Virus a/w aplastic anemia in pts with sickle cell anemia

Answer 34

Parvovirus B19

Question 35

25 yo AAM with sickle cell anemia has sudden onset of b. pain. Management of pain crisis?

Answer 35

- O2 - Analgesia - Hydration - Transfusion (if severe)

Question 36

Significant cause of morbidity in thalassemia pts. Tx?

Answer 36

Iron overload. Tx with deferoxamine.