Uworld Hem/Onc 1

Question 1

Symptoms of ALL

Answer 1

Lympadenopathy, Splenomegaly, Petechia, Bone Pain.

Question 2

Unique markers of ALL

Answer 2

+Tdt, +cALLa

Question 3

Middle maged man drinks a lot, has erectle dysfunction, and pigmentation of the skin. What does he have, and what kind of cancer is he at risk for?

Answer 3

Hemachromatosis, most likely Hepatocellular Carcinoma

Question 4

What do you see with Hemochromatosis

Answer 4

Hyperpigmentation, joint pain, hepatomegaly and cirrhosis, DM, HYPOGONADISM THAT INCLUDES ERECTILE DYSFUNCTION, Restrictive cardiomyopathy

Question 5

Bone Marrow Aplasia vs Bone Marrow Infiltration?

Answer 5

Bone Marrow Aplasia - aplastic anemia.

Bone Marrow Infiltration - Lymphoma or leukemia.

Question 6

What diseases are described as Intravacular Hemolysis?

Answer 6

DIC, TTP, HUS, PNH,

Question 7

32 male has pains nad swelling in his right leg, and has been on warfarin for 2 weeks. however, his life caused him to be a little bit non-compliant. His INR is 1.3. Venous doppler US shows a right popliteal vein thrombus that extends into the femoral vein and is worse than a pregious US> Best next step?

Answer 7

Replace Warfarin with Rivaroxaban. Direct Xa inhibitors (the bans) are as effective as warfarin in acute DVT or PE WITHOUT the needed INR monitoring.

Question 8

When would a one year old have Iron Deficiency Anemia

Answer 8

Excessive Cows milk, and on labes you see an increased RDW, a Mentzer index >13 and a low reticulocyte.

Question 9

Young man has a nose bleed that wont stop. He has ruby colored papules. Digital clubbing are shown. HCT is 60%. What does she have, and what is responsibile for the raised HCT?

Answer 9

Osler Weber Rendu syndrome, aka heredetary hemorrhagic telangiectasia. He has telangiectasias in the mouth, and recurrent epistaxis. The bleeding was arteriovenous malformations.

Question 10

Explain function of Arteriovenous Malformations in HHT?

Answer 10

AVMs occur in many places in the body, like mini shunts between the arteries and the veins. if in the lungs, it would cause chronic hypoxemia, digital clubbing, and a reactive polycythemia.

Question 11

Polycythemia Vera, why does this cause increased Hct? What age would this present?

Answer 11

Its a myeloproliferative disorder, causes increased production of ALL 3 blood cell lines and splenomegaly. Age is 60.

Question 12

How does ABO mismatching present, and at what time?

Answer 12

fever, chills, fklank pain and hemoglobinuria within an hour of transfusion.

Question 13

What blood abnormalities would be seen in a person with antiphospholipid antibody syndrome

Answer 13

Prolonged partial thromboplastin time. But this is FALSELY prolonged. It a lab artifact that does not correlate with the bleeding in vivo.

Question 14

What is Mentzer index?

Answer 14

MCV/RBCs

Question 15

What would be the Mentzer index of a person with Beta Thalassemia? Why would you want to know this?

Answer 15

<13, to differ it from Iron deficiency anemia.

Question 16

What are the physical features of Fanconi Anemia?

Answer 16

Short, hypo/hyperpigmented macules, abnormal thumbes, Genitourinary Malformations.

Question 17

What IS Fanconi Anemia?

Answer 17

congenital cause of aplastic anemia, a recessive disorder caused by a DNA repair defect.

Question 18

What autoimmune hemolytic disorder is associated with a hypercoagulable state?

Answer 18

PNH

Question 19

What is a treatment for PNH?

Answer 19

Eculizumab

Question 20

Patient has symptoms of a PE. He’s young, not obvious risk factors. PT/PTT normal, D dimer is elevated. What is the mechanism of his issue?

Answer 20

He has Factor V leiden, since its the most common. This means he CANNOT RESPOND to ACTIVATED PROTEIN C. So he is unable to degrade F8 degradation. He is more prone to clotting.

Question 21

What levels would be elvated in Prothrombin mutations

Answer 21

increased prothrombin levels.

Question 22

When do you suspect Antithrombin deficiency?

Answer 22

When thers setting of DIC. Cirrhosis, or nephrotic syndrome. Basically its acquired, when you lost the protein.

Question 23

What electrolyte levels would you expect in Tumor Lysis Syndrome

Answer 23

increased phosphorous, potassium, uric acid.

Decreased Calcium.

Question 24

Why see decreased calcium in Tumor Lysis Syndrome

Answer 24

the increased phosphate levels would bind and precipitate calcium, reducing the intravascular levels.