Hem/Onc

Question 1

What is the histological finding associated with Waldenstrom Macroglobulinemia?

Answer 1

PAS staining with IgM deposits around the nucleus of plasma cells

Rouleaux formations are also seen on a peripheral smeer

Question 2

What is the histological finding associated with Multiple Myeloma?

Answer 2

Plasma cells with a “fried egg” appearance

Question 3

What is the other name for B12

Answer 3

B12= cobalamin (cyanocobalamin)

Question 4

What is the other name for B1?

Answer 4

B1= Thiamine

Question 5

What is the other name for B2?

Answer 5

B2= Riboflavin

Question 6

What is the other name for B3?

Answer 6

B3= Niacin

Question 7

What is the other name for B6?

Answer 7

B6 = Pyridoxine

Question 8

What is the other name for B7?

Answer 8

B7= Biotin

Question 9

What are the characteristics of

chronic lymphocytic leukemia?

Answer 9

Chronic lymphocytic leukemia:

median onset at 70

lymphocytosis

anemia, fatigue, conjunctival palor, lymphadenopathy, splenomegaly may also be seen

peripheral smear: small but normal appearing lymphcytes with smudge cells

Question 10

What is the other name for B9?

Answer 10

B9 = Folate

Question 11

What electrolyte imbalance would you see in a patient experiencing Tumor Lysis Syndrome?

Answer 11

Tumor Lysis Syndrome:

High: K, Phos, Uric Acid

Low: Ca

Question 12

When should you look out for Tumor Lysis Syndrome?

Answer 12

Look for tumor lysis syndrome if the patient is experiencing Cardiac abnormalities and at the same time has just initiated chemo therapy for treatment of a cancer.

Question 13

your patient is: a young kid with fatigue and easy bruising.

High: K, phos, uric acid

low: calcium

whats the most likely diagnosis?

Answer 13

This patient probably has ALL and has tumor lysis syndrome.

Treatment for tumor lysis syndrome includes:

agressive hydration with IVF and allopurinol to decrease the uric acid levels

Question 14

What age group is typically affected in acute lymphoblast leukemia?

Answer 14

young children are typically affected by ALL.

look for a kid with fatigue, easy brusing, splenomegaly +/- lymphadenopathy

the plasma cells will be (+) for TDP lymphocytes

Question 15

What are the 5 signs/symptoms of thrombotic thrombocytopenia purpura

Answer 15

Thrombotic thrombocytopenic purpura

1. neurologic symptoms (seizure)
2. acute renal failure
3. microangiopathic hemolytic anemia (schistocytes)
4. thrombocytopenia
5. fever

*Treat TPP with plasma exchanges

Question 16

what is the most common inherited bleeding disorder?

What “buzzword” or test will confirm this diagnosis?

Answer 16

The most common inherited bleeding disorder is

von Willebrand Disease

look for a low ristoceitin cofactor assay for confirmation

Tx: DDAVP (desmopressin)

Question 17

Lab findings associated with

Iron deficiency anemia

Answer 17

Iron deficiency anemia

microcytic

high TIBC

high transferrin

Low Ferritin

decreased RBC count

*patient may present with pallor, SOB on exertion, tachycardia, and fatigue

Question 18

Lab findings consistent with

sickle cell anemia

Answer 18

Sickle Cell Anemia

normocytic

increased reticulocyte count

Increased lactate dehydrogenase

increased bilirubin

*patient may present with signs and symptoms of vasoocclusion: claudication, TIA, ACS

Question 19

Lab findings consistent with

B12 deficiency

Answer 19

B12 (cyanocoalbumin) deficiency

macrocytic anemia

megaloblastic

increased methylmalonic acid

Question 20

What are signs and symptoms of Polycythemia Vera?

Answer 20

Polycythemia Vera

puritis

blurry vision

burning pain in the hands before turning blue

patients with CV are in a hypercoagulable state