OME - Day 10

Question 1

80 year old man with fatigue, lymphadenopathy, splenomegaly, and with a white count of 80,000 (99% lymphocytes), diagnosis?

Answer 1

CLL

Question 2

Auer Rods, diagnosis and next step?

Answer 2

AML, M3, treat with all-trans retinoic acid

Question 3

Blast Crisis?

Answer 3

CML conversion into AML

Question 4

CALLA and TdT positive?

Answer 4

ALL

Question 5

Child, bone pain, frequent infection, diagnosis?

Answer 5

ALL

Question 6

How do you treat CML?

Answer 6

Imatinib

Question 7

T(9,22)?

Answer 7

Philadelphia Chromosome, BCR-ABL, CML

Question 8

What does the bone marrow look like in acute leukemia?

Answer 8

> 20% blasts

Question 9

What is the treatment of ALL?

Answer 9

ARA-C intrathecally

Question 10

Fever that come and go, cyclical fevers, diagnosis?

Answer 10

Pel-Epstein fever = Hodgkin’s

Question 11

How do you determine the stage of Lymphoma?

Answer 11

CT scan chest / abdomen

Question 12

How do you treat early stage lymphoma?

Answer 12

Radiation

Question 13

How do you treat late stage lymphoma?

Answer 13

Chemo

Question 14

Nontender lymphadenopathy made worse with alcohol, diagnosis?

Answer 14

Hodgkin’s Lymphoma

Question 15

Nontender Lymphadenopathy?

Answer 15

Excisional biopsy (not FNA)

Question 16

Picture of Reed-Sternberg Cells shows what?

Answer 16

Hodgkin’s Lymphoma

Question 17

Starry Sky pattern on biopsy shows what?

Answer 17

Burkitt’s Non-Hodgkin’s Lymphoma

Question 18

What are B symptoms?

Answer 18

Fever, weight loss, night sweats

Question 19

What are side effects of Bleomycin?

Answer 19

Pulmonary Fibrosis

Question 20

What are side effects of Cisplatin?

Answer 20

Ototoxicity, Nephrotoxicity

Question 21

What are side effects of Daunorubicin?

Answer 21

Dose dependent, irreversible, CHF

Question 22

What are side effects of Vincristine?

Answer 22

Peripheral Neuropathy

Question 23

< 10% Plasmacytosis in the marrow, but Multiple myeloma?

Answer 23

MGUS

Question 24

70 year old man with hypercalcemia, renal failure, anemia, and bone pain, diagnosis?

Answer 24

Multiple Myeloma (CRAB)

Question 25

Bone marrow biopsy on Waldenstrom's?

Answer 25

>10% Lymphocytosis

Question 26

Monoclonal expansion of IgG, diagnosis?

Answer 26

Multiple Myeloma

Question 27

Monoclonal expansion of IgM, diagnosis?

Answer 27

Waldenstrom's

Question 28

Pattern of testing in Multiple Myeloma?

Answer 28

SPEP + , UPEP +, Skeletal Survey +, Bone Marrow Biopsy > 10% plasmacytes

Question 29

SPEP positive, but nothing else in myeloma workup?

Answer 29

MGUS

Question 30

What are the symptoms of Waldenstrom's?

Answer 30

Hyperviscosity syndrome

Question 31

What is the first Step in Multiple Myeloma?

Answer 31

Serum and Urine Electrophoresis (called Immunofixation)

Question 32

How do you treat recurrent venous thrombosis?

Answer 32

Life long anticoagulation

Question 33

How does the presence of an inherited thrombophilia alter your management?

Answer 33

It doesn't

Question 34

Most common inherited thrombophilia?

Answer 34

Factor V Leiden

Question 35

Which can you not test for during an acute clot?

Answer 35

Protein C, Protein S, and Antithrombin 20210 A

Question 36

Which can you test for during an acute clot (but you wont)?

Answer 36

Those that are mutations: Factor V Leiden, Prothrombin