Rapid Review: Hematology/Oncology

Question 1

Four causes of microcytic anemia

Answer 1

Thalassemia, iron deficiency, anemia of chronic disease, and sideroblastic anemia

Question 2

An elderly man with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?

Answer 2

Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

Question 3

Precipitants of hemolytic crisis in patients with G6PD deficiency

Answer 3

Sulfonamides, antimalarial drugs, fava beans

Question 4

The most common inherited cause of hypercoagulability

Answer 4

Factor V Leiden mutation

Question 5

The most common inherited bleeding disorder

Answer 5

von Willebrand’s disease

Question 6

The most common inherited hemolytic anemia

Answer 6

Hereditary spherocytosis

Question 7

Diagnostic test for hereditary spherocytosis

Answer 7

Osmotic fragility test

Question 8

Pure RBC aplasia

Answer 8

Diamond-Blackfan anemia

Question 9

Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au lait spots, microcephaly, and pancytopenia

Answer 9

Fanconi’s anemia

Question 10

Medications and viruses that lead to aplastic anemia

Answer 10

Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovivrus B19, B19

Question 11

How to distinguish polycythemia vera from secondary polycythemia

Answer 11

PV should have normal O2 saturation and low erythropoietin levels

Secondary polycythemia is due to increased EPO

Question 12

Thrombotic thrombocytopenic purprua pentad?

Answer 12

Fever, anemia, thrombocytopenia, renal dysfunction, neurologic abnormalities

Question 13

HUS triad?

Answer 13

Anemia, thrombocytopenia, and acute renal failure

Question 14

Treatment for TTP

Answer 14

Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs. Platelet transfusion is contraindicated!

Question 15

Treatment for ITP in children

Answer 15

Usually resolves spontaneously; may require IVIG and/or corticosteroids

Question 16

Lab findings in DIC?

Answer 16

Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit and decreased

Question 17

An 8 year old boy presents with hemarthrosis and increased PTT with normal PT and bleeding time. Diagnosis and treatment?

Answer 17

Hemophilia A or B. Consider desmopressin (for hemophilia A) or factor 8 or 9 supplements

Question 18

A 14 year old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or increased PTT, and increased bleeding time. Diagnosis and treatment?

Answer 18

von Willebrand’s disease; treat with desmopressin, FFP, or cryoprecipitate

Question 19

A 60 year old AA man presents with bone pain. What might a workup for multiple myeloma reveal

Answer 19

Monoclonal gammopathy, Bence Jones proteinuria, and “punched out” lesions on x-ray of the skull and long bones

Question 20

Reed-Sternberg cells

Answer 20

Hodgkin’s lymphoma

Question 21

A 10 year old boy presents with fever, weight loss, and night sweats. Examination shows an anterior mediastinal mass. Diagnosis?

Answer 21

Non-Hodgkin’s lymphoma

Question 22

Microcytic anemia with decrease serum iron, decreased total iron binding capacity, and normal or increased ferritin

Answer 22

Anemia of chronic disease

Question 23

Microcytic anemia with decreased serum iron, decreased ferritin, and increased TIBC

Answer 23

Iron deficiency anemia

Question 24

An 80 year old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. What is the suspected diagnosis?

Answer 24

Chronic lymphocytic leukemia

Question 25

The lymphoma equivalent of CLL

Answer 25

Small lymphocytic lymphoma

Question 26

A late, life-threatening complication of chronic myelogenous leukemia

Answer 26

Blast crisis (fever, bone pain, splenomegaly, pancytopenia

Question 27

Auer rods on blood smear

Answer 27

AML

Question 28

AML subtype associated with DIC. Treatment?

Answer 28

M3 (APL). Retinoic acid.

Question 29

Electrolyte changes in tumor lysis syndrome?

Answer 29

Decreased Ca, increased K, increased phosphate, increased uric acid

Question 30

A 50 year old man presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis?

Answer 30

CML

Question 31

Heniz bodies

Answer 31

Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy

Question 32

Virus associated with aplastic anemia in patients with sickle cell anemia

Answer 32

Parvovirus B19

Question 33

A 25 year old AA man with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?

Answer 33

O2, analgesia, hydration, and, if severe, transfusion

Question 34

A significant cause of morbidity in thalassemia patients. Treatment?

Answer 34

Iron overload; use deferoxamine.