15. Hematology

Question 1

What is heterophile positive?

Answer 1

EBV

Question 2

Is eosinophilia associated with protozoans?

Answer 2

No, only invasive worms

Question 3

What is RBC mass vs. RBC count?

Answer 3

RBC mass = total RBC’s, RBC count = per unit of volume

Question 4

Relative polycythemia?

Answer 4

Decrease in volume but RBC mass is actually normal

Question 5

2 things to consider with inappropriate polycythemia?

Answer 5

1. Polycythemia vera - neoplastic process of stem cell

2. Tumor or cyst with excess EPO production

Question 6

Myeloproliferative diseases?

Answer 6

1. Polycythemia vera
2. CML
3. Essential thrombocythemia
4. Myelodysplastic syndrome
5. Myelofibrosis

Question 7

Why does polycythemia lead to increased risk of thrombosis?

Answer 7

Increased viscosity and increased peripheral resistance

Question 8

How does polycythemia vera affect volume status?

Answer 8

Hypervolemia - only polycythemia that does this

Question 9

Patient with polycythemia - itch after shower why?

Answer 9

Mast cells in the skin; temperature causes degranulation leading to generalized itching (histamine)

Question 10

What is the epo level in polycythemia vera and why?

Answer 10

Low because you have plenty of RBC’s, normal O2 sat which negatively feeds back on epo production

Question 11

Blast count - acute vs. chronic?

Answer 11

over 30% is acute

Question 12

Age under 15 - leukemia?

Answer 12

ALL

Question 13

Age 15- 39 - leukemia?

Answer 13

AML - blast with Auer Rods

Question 14

Age 40 - 59 - leukemia?

Answer 14

AML and CML (differentiate with blast % in the marrow)

Question 15

Age 60 and over - leukemia?

Answer 15

CLL

Question 16

What can you use to test for CML besides bcr-abl?

Answer 16

Low alkaline phosphatase

Question 17

Splenomegaly with tear drop cell?

Answer 17

Myelofibrosis with myelodysplasia

Question 18

CD10+ B cell?

Answer 18

CALLA antigen that is marker for B cell ALL

Question 19

TRAP +?

Answer 19

Hairy cell leukemia

Question 20

What do we look for on AML histology?

Answer 20

Auer rods

Question 21

What leukemia is associated with DIC?

Answer 21

AML because of the Auer rods

Question 22

Treat AML with?

Answer 22

Vitamin A

Question 23

What does vitamin A do in AML?

Answer 23

Matures the blast cells

Question 24

What is the translocation in AML?

Answer 24

t(15,17)

Question 25

Painful lymphadenopathy?

Answer 25

NOT cancer, indicative of inflammation

Question 26

Painless lymphadenopathy?

Answer 26

Cancer - lymphoma or metastasis

Question 27

What’s in a lymph node follicle?

Answer 27

B cells

Question 28

What two tissues are resistant to invasion by cancer?

Answer 28

Cartilage and elastic tissue

Question 29

What is the neoplastic cell in mycosis fungoides?

Answer 29

CD4+ helper T cells

Question 30

What do we call mycosis fungoides that goes to the blood?

Answer 30

Sezarry syndrome

Question 31

CD1+ cell in clonal proliferation on blood smear?

Answer 31

Langerhans histiocytosis