HemOnco

Question 1

ALL good prognostic factors?

Answer 1

Good prognostic factors
- Hyperdiploidy
• French-American-British (FAB) L1 type
• common ALL
• pre-B phenotype
• low initial WBC
• del (9p)
- trisomy 4,10&17
- t(12;21) > fusion protein TEL-AML1
- t (9;22) > low levels of resistance to chemo

Question 2

ALL poor prognostic factors?

Answer 2

• hypodiploidy
  • FAB L3 type
  • T or B cell surface markers
  • Philadelphia translocation, t(9;22)
  • age < 2 years or > 10 years
  • male sex
  • CNS involvement
  Non caucasian

Question 3

Acute intermittent porphyria?

Answer 3

Abdominal
Neurological
Psychiatric

Question 4

Acute intermittent porphyria?

Answer 4

Mutation of HMBS gene
(Codes for porphobilinogen deaminase)

Causes build up of Aminolevulinic acid and porphobilinogen

Question 5

Alpha-globulin genes is located on which Chromosome?

Answer 5

16

Question 6

Most useful prognostic marker for Myeloma?

Answer 6

Beta 2 microglobulin

Question 7

Diagnostic test for lead poisoning?

Answer 7

Coproporphyrin in urine

Question 8

Most common cause of svc obstruction?

Answer 8

Primary malignancy

Question 9

1st line for CML?

Answer 9

Imatinib (tyrosine kinase inhibitor)

Question 10

Drug that causes hemolysis in G6PD?

Answer 10

G6PD deficiency: sulph- drugs: sulphonamides, sulphasalazine and sulfonylureas (glimepiride)

Question 11

In idiopathic thrombocytopenic purpura what are the autoantibodies most commonly directed at?

Answer 11

Glycoprotein IIb/Illa complex

Question 12

Leucocyte Alkaline Phosphatase high in?

Answer 12

Raised in
• myelofibrosis
• leukaemoid reactions
• polycythaemia rubra vera
• infections
• steroids, Cushing’s syndrome
• pregnancy, oral contraceptive pill

Question 13

Blood film in coeliac disease shows?

Answer 13

Hyposplenism e.g, pest-splenectomy, coellae disease (eceurs in around 30% of coellae patients)
• target cells
• Howell-Jolly bodies
• Pappenheimer bodies
• siderotic granules
• acanthoeytes

Question 15

Genetic mutation associated with prostate cancer!

Answer 15

BRCA2

Question 16

chemical mediator responsible for tissue oedema in hereditary angioedema?

Answer 16

Bradykinin

Question 17

Patient starting rituximab should start?

Answer 17

Hepatitis B virus

Question 18

Cisplatin MOA?

Answer 18

Causes cross-linking in DNA

Question 19

Translocation with follicular lymphoma?

Answer 19

T(14:18)

Question 20

Low LAP causes?

Answer 20

Low in
• chronic myeloid leukaemia
• pernicious anaemia
• paroxysmal nocturnal haemoglobinuria
• infectious mononucleosis

Question 21

High LAP?

Answer 21

• leukaemoid reactions
• Myelofibrosis
• polycythaemia rubra vera
• infections
• steroids, Cushing’s syndrome
• pregnancy, oral contraceptive pill

Question 22

Most common cause of neutropenic sepsis

Answer 22

Gram positive , coagulase negative

Question 23

NK1 receptor blocker for N&V?

Answer 23

Aprepitant

Question 24

Cisplatin and cyclophosphamide MOA?

Answer 24

Cross linking DNA

Question 25

Mantle cell lymphoma translocation?

Answer 25

t(11:14)

Question 26

Interferon alpha used in ttt of ?

Answer 26

Hairy cell leukemia

Question 27

Docetaxel MOA?

Answer 27

Prevents microtubule depolymerisation & disassembly, decreasing free tubulin

Question 28

Best diagnostic test for PNH?

Answer 28

CD59- CD55

Question 30

AML poor prognostic factors?

Answer 30

Deletion of chromosome 5&7

Question 32

Confirming hereditary spherocytosis?

Answer 32

EMa binding test

Question 33

TLS prevention?

Answer 33

Allopurinol or Rasuricase (preferred in high risk patients)

Question 34

Ist line for ITP?

Answer 34

Oral prednisolone

Question 35

Bombesin is a tumor marker for?

Answer 35

SCLC

Question 36

Association with thymoma

Answer 36

Associated with • myasthenia gravis (30-40% of patients with thymoma • red cell aplasia • dermatomyositis • also : SLE, SIADH

Question 37

Activated protein C resistance (factor V leiden) prevalence?

Answer 37

5% Most common inherited thrombophilia

Question 38

Combined B and T cell deficiency?

Answer 38

SCID WAS Ataxic (Severe combined Immunodeficiency) (Wiskott Aldrich Syndrome) (ataxic Telangiectasia)

Question 39

Problem in methaemoglobinemia?

Answer 39

Oxidation of Fe2> Fe3

Question 40

Cold AIHA?

Answer 40

Mycoplasma EBV

Question 41

Warm AIHA?

Answer 41

Lymphoma CLL Methyldopa

Question 42

Initial management of APML (acute promyelocytic myeloid leukemia)

Answer 42

All-trans retinoic acid

Question 43

APML (acute promyelocytic myeloid leukemia) features?

Answer 43

DIC: Hemorrhagic symptoms Thrombotic symptoms t(15;17)

Question 44

TTP treatment of choice

Answer 44

Plasma exchange

Question 45

Treatment of neutropenia

Answer 45

Filgratism (G-CSF)

Question 46

Triad of WAS?

Answer 46

Recurrent chest infections Eczema Thrombocytopenia

Question 47

Benign ethnic neutropenia in which ethnicity?

Answer 47

Black African or Afro-Caribbean

Question 48

AML leukemia good prognosis >> Acute promyelocytic leukemia translocation?

Answer 48

t(15;17)

Question 49

Complications of PRV

Answer 49

Myelofibrosis or AML (5-15%)

Question 50

Urine darkens on standing in which condition?

Answer 50

Acute intermittent porphyria

Question 51

Ttt of choice for essential thrombocytopenia?

Answer 51

Hydroxyurea (hydroxycarbamide)

Question 52

Skin prick test read after?

Answer 52

15-20 mins

Question 53

Skin patch testing read after?

Answer 53

48 hours

Question 54

Tumor markers for detecting recurrence of testicular teratoma?

Answer 54

Alpha-fetoprotein Beta-HCG

Question 55

Acute promyelocytic leukaemia (APML)

Answer 55

t(15;17) DIC All-trans retinoic acid

Question 56

Medication that targets breast cancer in post menopausal?

Answer 56

Anastrazole

Question 57

Warfarin induced skin necrosis associated with

Answer 57

Protein C deficiency

Question 58

Haemorrhagic cystitis due to cyclophosphamide prevention

Answer 58

Mesna

Question 59

Factor V leiden risk due to?

Answer 59

10 times kore slowly activated by protein C

Question 60

Factor V leiden risk due to?

Answer 60

10 times more slowly activated by activated protein C

Question 61

Normal po2 with decreased oxygen saturation

Answer 61

Methaemoglobinemia 1st line >> IV methylene blue

Question 62

CA 125

Answer 62

Primary peritoneal cancer Ovarian cancer

Question 63

Drugs that cause methemoglobinemia?

Answer 63

Co-trimoxazole Sulphonamides Primaquine Nitrates Sodium nitroprosside Dapsone

Question 64

Cancer associated with HTLV-1

Answer 64

Adult T cell leukemia

Question 65

DIC blood film

Answer 65

Schistocytes Helmet cells

Question 66

CLL investigation of choice

Answer 66

Immunophenotyping CD (5/23/19/20)

Question 67

Infection associated with platelet transfusion

Answer 67

Bacterial

Question 68

Translocation with follicular lymphoma?

Answer 68

(14;18) Causing increased BCL-2 transcription

Question 69

Dapsone used for …. Causes ….

Answer 69

Dermatitis herpitiforms (with coeliac disease) Causes methemoglobinemia

Question 70

Cisplatin S/E?

Answer 70

Nephrotoxicity (the primary dose-limiting side effect) Ototoxicity peripheral neuropathy hypomagnesaemia

Question 71

Mx of CLL?

Answer 71

FCR

Question 72

Causes of sideroblastic anemia

Answer 72

Congenital cause: delta-aminolevulinate synthase-2 deficiency Acquired causes • myelodysplasia • alcohol • lead • anti-TB medications

Question 73

TA-GvHD presentation

Answer 73

4-30 days after transfusion Fever - Diarrhea - liver dysfunction- BM suppression- rash

Question 74

TA-GvHD prevention

Answer 74

Irradiation

Question 75

Neutropenic sepsis caused by

Answer 75

Coagulase negative, gram positive bacteria staph epidermidis

Question 76

Raynaud’s see in which type of cyroglobulinemia

Answer 76

Type I

Question 77

Advantage of capecitabine over fluorouracil?

Answer 77

Oral administration

Question 78

Poor prognostic factor in ALL

Answer 78

Philadelphia chromosome

Question 79

Warm AIHA?

Answer 79

Lupus Leukemia Lymphoma

Question 80

Most common presenting symptom for myelofibrosis?

Answer 80

Lethargy

Question 81

Burkitts lymphoma translocation

Answer 81

t(8;14) C-myc gene translocation

Question 82

Most important determinant for giving cryopercipitate

Answer 82

Low fibrinogen level

Question 83

SE of aromatase inhibitors (anastrazole)

Answer 83

Osteoporosis

Question 84

Purpose of blood product irradiation

Answer 84

Depleted T-lymphocyte numbers reduce the risk of transfusion graft versus host disease

Question 85

Bacterial infection after transfusion of which blood product

Answer 85

Platelets

Question 86

Most common reason for increased susceptibility to infections in CLL?

Answer 86

Hypogammaglobulinemia

Question 87

Hodgkin’s lymphoma type with best prognosis

Answer 87

Lymphocyte predominant

Question 88

Hodgkin’s lymphoma type with worst prognosis

Answer 88

Lymphocyte depleted

Question 89

Most common type of Hodgkin’s lymphma

Answer 89

Nodular sclerosing

Question 90

t(14;18)

Answer 90

Follicular lymphoma Due to increased BCL-2 transcription

Question 91

First line ttt for Methemoglobinemia

Answer 91

Methylene Blue