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HEMA-ONCO Flashcards

1
Q

One of the ff presents with normocytic, normochromic anemia

A. Iron deficiency
B. G6PD deficiency
C. Vitamin B12 deficiency
D. Congenital Aplastic anemia

A

G6PD deficiency

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2
Q

Anemia of inflammation is also referred to this type of anemia
A. Fanconi syndrome
B. Pearson syndrome
C. Transient anemia of childhood
D. Anemia of chronic disease

A

Anemia of chronic disease

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3
Q

Replacement of intracellular iron enzymes occur at this time after iron administration
A. 12-24 hr
B. 36-48 hr
C. 48-72 hr
D. 4 days

A

12-24 hr

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4
Q

It is the most common cause of inherited abnormality of the RBC membrane
Hereditary spherocytosis
Hereditary elliptocytosis
Hereditary stomatocytosis
Paroxysmal nocturnal hemoglobinuria

A

Hereditary spherocytosis

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5
Q

The most common manifestation/s of G6PD deficiency is/are
A. RBCs are microcytic, normochromic
B. It has an autosomal recessive inheritance
C. Majority of patients are symptomatic
D. Patients present with jaundice and hemolytic anemia

A

Patients present with jaundice and hemolytic anemia

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6
Q

This the most common anomaly in Fanconi anemia
A. Short stature
B. Renal malformation
C. Skin pigment changes
D. Cardiopulmonary abnormalities

A

Skin pigment changes

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7
Q

Thalassemia in a fetus with hydrops has most likely this form of hemoglobin
A. Alpha 2
B. Alpha 4
C. Beta 2
D. Beta 4

A

Alpha 4

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8
Q

Deficiency of this factor is one of the most common severe inherited bleeding disorder
A. IX
B. X
C. XI
D. XII

A

IX

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9
Q

Factor VIII deficiency is known as
A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. Pearson syndrome

A

Hemophilia A

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10
Q

This is the form of von Willebrand disease that presents symptoms similar to those seen in mild hemophilias
A. Type 1 VWD
B. Type 2A VWD
C. Type 2B VWD
D. Type 3 VWD

A

Type 3 VWD

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11
Q

The most common cause of acute onset of thrombocytopenia in children is
A. Idiopathic thrombocytopenic purpura
B. Thrombotic Thrombocytopenic Purpura
C. Drug-induced thrombocytopenia
D. Hemolytic Uremic Syndrome

A

Idiopathic thrombocytopenic purpura

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12
Q

To diagnose acute lymphoblastic leukemia, this feature alone is adequate
A. Morphology
B. Signs and symptoms
C. Chromosomal abnormalities
D. Diagnostic procedures

A

Morphology

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13
Q

A pathognomonic feature of hodgkin’s lymphoma is
A. Multinucleated cells
B. Reed-sternberg cells
C. Ann Arbor cells
D. BorTcells

A

Reed-sternberg cells

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14
Q

One of the ff is not a subtype of Nonhodgkin lymphoma
A. Lymphocytic lymphoma
B. Burkitt’s lymphoma
C. Anaplastic large cell
D. Diffuse large cell lymphoma

A

Lymphocytic lymphoma

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15
Q

The second most common malignancy in childhood and adolescence is

CNS tumors
Bone tumors
Renal tumors
Hepatomas

A

CNS tumors

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16
Q

It is the most common extracranial solid tumor in children

Astrocytoma
Craniopharyngioma
Medulloblastoma
Neuroblastoma

A

Neuroblastoma

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17
Q

It is the most commonly diagnosed malignancy in infants

Astrocytoma
Neuroblastoma
Medulloblastoma
Craniopharyngioma

A

Medulloblastoma

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18
Q

The most common primary malignant renal tumor in children is
A. Wilm’s tumor
B. Neuroblastoma
C. Germ cell tumor
D. Teratoma

A

Wilm’s tumor

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19
Q

This is the most common clinical presentation of children with Nephroblastoma
A. Fever
B. Abdominal pain
C. Abdominal mass
D. Easy fatigability

A

Abdominal mass

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20
Q

This the most common soft tissue sarcoma in children
A. Liposarcoma
B. Fibrosarcoma
C. Angiosarcoma
D. Rhabdomyosarcoma

A

Rhabdomyosarcoma

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21
Q

The classic manifestation of osteocarcinoma is
A. Sunburst pattern
B. Sun setting pattern
C. Cauliflower pattern
D. Onion-skinning pattern

A

Sunburst pattern

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22
Q

The most common intraocular tumor in children is
A. Retinoblastoma
B. Germ cell tumor
C. Non-germ cell tumor
D. Germinoma

A

Retinoblastoma

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23
Q

Hepatocellular carcinoma is commonly associated with hepatitis
A. A
B. B
C. D
D. E

A

B-orC

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24
Q

The most common benign tumor in infancy is
A. Hemangioma
B. Lymphangioma
C. Cystic Hygromas
D. Neuromas

A

Hemangioma

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25
Q

Adrenal tumors include the ff
A. Neuroma
B. Pheochromocytoma
C. Langerhans cytosis
D. Medulloblastoma

A

Pheochromocytoma

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26
Q

Bone tumors include
A. Wilm’s umor
B. Ependymoma
C. Germinoma
D. Ewing’s sarcoma

A

Ewing’s sarcoma

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27
Q

CNS tumors include
A. Ependymomas
B. Ewing’s tumor
C. Wilm’s tumor
D. Germinoma

A

Ependymomas

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28
Q

Give 3 examples of Microcytic anemia

A
  • iron deficiency anemia
  • thalassemia
  • sideroblastic anemia
  • lead poisoning
  • cooper deficiency

C SLIT

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29
Q

Give 3 examples of macrocytic anemia

A
  • vitamin b12 deficiency
  • folate deficiency
  • acquired aplastic anemia
  • congenital aplastic anemia

C FAV

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30
Q

Give 3 examples of Normocytic anemia

A
  • Anemia of chronic disease
  • anemia due to renal failure
  • rbc aplasia
  • malignancy
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31
Q

5-year-old child, with
hemophilia A of severe type,
presents to the emergency
unit with a groin pain after a minor
trauma to his back; his blood
pressure is
60/30 mm Hg; his pulse rate is
180/min; he holds his right hip in a
flexion position
with internal rotation. Of
the. following, the NEXT step in the
management of this
child would be:
A. factor VIII replacement
therapy
B. abdominal ultrasonography
C. abdominal computed
tomography (CT) scan
D. intravenous
1-deamino-8-d-arginine
vasopressin (DDAVP)
factor VIII assay

A

Factor VIII replacement
therapy

32
Q

The following conditions may be
associated with iron deficiency
EXCEPT one:
A. celiac disease
B. hookworm infestation
C. prolonged intravascular
hemolysis
D. congenital heart disease
with right to left shunt
E. prolonged use of isoniazid
(INH)

A

prolonged use of isoniazid
(INH)??

33
Q

One of the ff/s is a physiologic adaptation to anemia : *
a. Tachycardia
b. Decrease Arteria-Venous oxygen difference
c. Shift to the Left of the oxygen dissociation curve
d. All of the above

A

Tachycardia

34
Q

Physical Findings of anemia are the ff. EXCEPT: *
a. Pallor in Hb = 10 g/dl
b. Flow murmur
c. Hepatosplenomegaly
d. None of the above

A
35
Q

An initial laboratory tests to be requested on a patient who comes in due to pallor EXCEPT: *
a. WBC
b. Bone marrow smear exam
c. Reticulocyte count
d. Red cell indices

A

Bone marrow smear exam

36
Q

Microcytes are frequently seen in: *
a. Thalassemia
b. Diamond Blackfan Anemia
c. Liver Diseases
d. Folate deficiency

A

Thalassemia

37
Q

Anemia due to decrease RBC production: *
a. Heriditary Spherocytosis
b. Thalassemia
c. Megaloblastic Anemia
d. None of the above

A

Megaloblastic Anemia

38
Q

One of the ff is/are anemia secondary to increase RBC destruction : *
a. low reticulocyte count
b. G6PD Deficiency
c. Physiologic anemia of the newborn
d. All of the above

A

G6PD Deficiency

39
Q

True of Von Willebrand disease is/are: *
a. Thrombocytopenia occasionally present
b. most common inherited bleeding
c. Treated with Desmopressin
d. All of the above

A

All of the above

40
Q

True of Hemophilia B EXCEPT: *
a. factor VIII deficiency
b. Hemarthrosis is the hallmark finding
c. X-linked traits
d. None of the above

A

factor VIII deficiency

41
Q

True of Idiopathic (Autoimmune)Thrombocytopenic Purpura is/are: *
a. 1-4 wk after exposure to a common viral infection
b. Common initial manifestation - generalized petechiae and purpura
c. rarely with hepatosplenomegaly
d. All of the above

A

All of the above??

42
Q

True of Pediatric malignancies EXCEPT: *
a. Epithelial Tumors most common
b. Usually associated with Ionizing radiation exposure and several chemotherapeutic agents
c. usually originate from the deeper, visceral structures
d. None of the above

A

Epithelial Tumors most common

43
Q

Pediatric Cancer Management involves: *
a. A Multimodal, Multidisciplinary Approach
b. Diagnostic imaging is a critical phase of evaluation
c. systemic multiagent chemotherapy usually is necessary
d. All of the above

A

All of the above

44
Q

True of chemotherapy in children EXCEPT: *
a. Sequential single-drug therapy is recommended
b. The most common acute adverse effects are myelosuppression
c. All of the above

A

Sequential single-drug therapy is recommended

45
Q

True of Childhood leukemias: *
a. ALL most common (77% of cases)
b. genetic abnormalities in a hematopoietic cell give rise to an unregulated clonal proliferation of cells
c. 31% of all malignancies that occur in children younger than 15 yr
d. All of the above

A

All of the above

46
Q

True Hodgkin lymphoma except: *
a. is the most common cancer seen in adolescents
b. Associated with Epstein-Barr virus (EBV)
c. The Reed-Sternberg (RS) cell, a pathognomonic feature
d. None of the above

A

None of the above

47
Q

True of Neuroblastoma is/are: *
a. embryonal cancers of the peripheral sympathetic nervous
b. Crosses the midline of the abdomen
c. can result in Horner syndrome
d. All of the above

A

All of the above

48
Q

Coagulation Factors
16. Factor I =
17. Factor II =
18. Factor V =
19. Factor VII =
20. Factor VIII =
21. Factor IX =
22. Factor X =
23. Factor XI =
24. Factor XII =
25. Factor XIII =

A

Foolish
People
Try
Climbing
Long
Slopes
After
Christmas,
Some
People
Have
Fun

Coagulation Factors
16. Factor I =Fibrinogen
17. Factor II =Prothrombin
- fac. 3 = tissue thromboplastin
- fac. 4 = calcium ions
18. Factor V =Labile Factor
19. Factor VII =Stable Factor
20. Factor VIII =Antihemophilic Factor
21. Factor IX =Christmas Factor
22. Factor X =Stuart Factor
23. Factor XI =Plasma Thromboplastin Antecedent
24. Factor XII =Hageman Factor
25. Factor XIII =Fibrin Stabilizing Factor

49
Q

One of the following is an acquired aplastic anemia. *
a. Fanconi anemia
b. Pearson syndrome
c. Diamond-Blackman anemia
d. Transient erythroblastopenia of childhood

A

Transient erythroblastopenia of childhood

50
Q

One of the following characterizes Diamond-Blackfan anemia EXCEPT: *
a. RBCs are macrocytic
b. Common in 2-6 months old
c. RBCS are microcytic, normochromic
d. Corticosteroids are the main therapy

A

RBCS are microcytic, normochromic

51
Q

Transient erythroblastopenia of childhood has the following feature. *
a. It has familial predisposition
b. It requires regular blood transfusion
c. Anemia is evident by age 2-5months old
d. It is not associated with congenital anomalies

A

It has familial predisposition

52
Q

Megaloblastic anemias include the following EXCEPT: *
a. Iron deficiency anemia
b. Folate deficiency anemeia
c. Cobalamin deficiency anemia
d. Vitamin B12 deficiency anemia

A

Iron deficiency anemia

53
Q

This is the best assessment of
iron overload for patients with
thalassemia major:
A. Liver MRI
B. Serum iron
C. Serum ferritin
D. Bone marrow biopsy
E. Total iron binding
capacity

A

Serum ferritin??

Liver MRI??

54
Q

A 1-year-old child has folic acid deficiency since the age of 4 months, the best
indicator of this deficiency would
be: *
a. decrease level of RBC folate
b. significant fall of
reticulocytes count
c. high level of lactate
dehydrogenase LDH
d. increase number of
hypersegmented neutrophils
e. significant increment of mean corpuscular volume
MCV

A

decrease level of RBC folate

55
Q

The following are hematologic
features of congenital hypoplastic anemia
(Diamond-Blackfan Anemia)
include all the following EXCEPT *
a. Reticulocytopenia
b. normocytic anemia
c. elevated serum iron levels
d. deficiency or absence of
red blood cell bone marrow precursors elevated fetal
hemoglobin (Hb F)

A

normocytic anemia

56
Q

A 3-year-old male child develops hematoma and bruising of his right hand next day after falling on the ground; the mother stated that her child has a poorwound healing and a history of delayed umbilical separation during the neonatal period. Of the following, the MOST valuable test
for this case is
a. bleeding time
b. prothrombin time
c. clot solubility test
d. partial thromboplastin time
e. thrombin time

A

partial thromboplastin time??

57
Q

This is the MOST specific test that is helpful to differentiate
Diamond-Blackfan Anemia from transient erythroblastopenia of
childhood:
a. reticulocytes count
b. hemoglobin electrophoresis
c. bone marrow examination
d. mean corpuscular volume (MCV)
e. erythrocyte adenosine deaminase (ADA) enzyme level
assay

A

erythrocyte adenosine
deaminase (ADA) enzyme level assay

58
Q

9-month-old child with a hemoglobin concentration of 10
gm/dL and marked microcytosis; serum iron and total iron binding capacity are within normal limits;serum ferritin and hemoglobin electrophoresis are
also normal. Of the following, the MOST likely diagnosis would be:
*
a. iron deficiency anemia
b. sideroblastic anemia
c. ß-thalassemia minor
d. α-thalassemia trait
e. anemia due to chronic

A

sideroblastic anemia??

59
Q

A 5-year old male was seen with multiple ecchymosis all over
the extremities and trunk. On examination reveal a palpable
spleen 3 cm below the le􀅳 costal margin. Lab 􀅯ndings include:
hemoglobin, 11.3 g/dL; white blood
cell count, 8700/mm3; platelets count, 21000/mm3.Of the
following, the most proper NEXT
step is:
A. bleeding time
B. coagulation pro􀅯le
C. bone marrow study
D. platelets aggregation test
E. abdominal ultrasonography

A

coagulation profile??

60
Q

Transfusion of fresh frozen plasma (FFP) is efficacious for the
treatment of deficiency of all the
following coagulation factors
EXCEPT:
A. factor V
B. factor X
C. factor XI
D. factor XIII
E. protein C

A

factor XIII

61
Q

You are evaluating a 4-year-old child with ß-thalassemia major; he is on chronic transfusion therapy
since the age of 1 year; you suspect transfusion-induced
hemosiderosis. Of the following, the organ that is LEAST likely to be affected by iron deposition at this
time would be:
A. liver
B. heart
C. pancreas
D. pituitary gland
E. thyroid gland

A

pancreas??

62
Q

This is the valuable diagnostic feature that differentiate anemia of chronic disorder from iron
deficiency anemia :
A. leukocytosis
B. low serum iron
C. low or normal serum transferrin
D. normal bone marrow cellularity
E. normochromic normocytic RBC

A

low or normal serum transferrin

63
Q

This is the mainstay of
treatment for congenital hypoplastic anemia:
A. Androgen
B. corticosteroids
C. antithymocyte globulin (ATG)
D. fully matched-related stem cell transplantation fully
matched-unrelated stem cell
E. transplantation

A

corticosteroids

64
Q

Which of the following is the best treatment for a 5-year-old girl
with acute immune thrombocytopenia (ITP) and platelets count of 30,000/ml
and mild petechial rash all over her body?
a. corticosteroids
b. anti-D gamma globulin
c. platelets transfusion
d. intravenous
immunoglobulin (IVIG)
e. no treatment

A

corticosteroids??

??

65
Q

A 16-year-old female is found to have multiple bruising and
hypochromic microcytic anemia; during her first
pregnancy she noticed
disappearance of the
bruises; she has a past history of
uncomplicated emergency
appendectomy at
the age of 10 year. Of the following, the drug MOST likely beneficial for alleviation of her symptoms would
be:
a. ferrous sulfate
b. aminocaproic acid
c. recombinant factor VIII
d. recombinant factor IX
e. desmopressin acetate (DDAVP)

A

desmopressin acetate (DDAVP)??

66
Q

Vitamin K-dependent clotting factors include all the following
EXCEPT *
a. factor I
b. factor II
c. factor VII
d. factor IX
e. protein S

A

factor I

67
Q

The standard care for MOST children with severe hemophilia
would be: *
A. avoid trauma
B. avoid aspirin and other NSAID
C. avoid violent contact sports
D. aggressive treatment by F
VIII replacement therapy when significant bleeding
occurs
E. prevention by F VIII
replacement therapy to prevent spontaneous
bleeding and early joint deformities

A

aggressive treatment by F VIII replacement therapy when significant bleeding occurs??

prevention by F VIII
replacement therapy to prevent spontaneous
bleeding and early joint deformities??

68
Q

Spontaneous intracranial hemorrhage is more likely to occur
in
a. Factor VII deficiency
b. Factor VIII deficiency
c. Factor IX deficiency
d. Factor XI deficiency
e. Factor XIII deficiency

A

Factor VII deficiency

69
Q

All the following are true regarding Transient Erythroblastopenia of
Childhood(TEC) EXCEPT
a. corticosteroid therapy is of no value
b. virtually all children
recover within 1-2
months
c. Parvovirus B19
infections is a common causative agent
d. most of the affected children are older than
12 mo at onset
e. it is more common than congenital hypoplastic
(Diamond-Blackfan) anemia

A

Parvovirus B19
infections is a common
causative agent

70
Q

In hemophilia A, factor VIII level activity should be increased
to 100% in
a. Epistaxis
b. Hematuria
c. gum bleeding
d. tooth extraction
e. iliopsoas bleeding

A

iliopsoas bleeding

71
Q

A healthy 5-mo-old boy appears pale. Examination is
unremarkable. Lab findings include: Hb 8.1 g/dl; WBC 4,800/mm3; platelets
144,000/mm3; MCV, 111 fl; blood film showed hypersegmented
neutrophils; serum B12, 65 pg/mL
(low). The infant is vigorously breast fed. Of the following, your
NEXT step of the management
would be:
a. performing Schilling
test
b. transfuse packed RBCs
c. check serum B12 of the mother
d. parenteral administration
of vitamin B12
e. administration of both folic acid and vitamin B12

A

check serum B12 of the mother

72
Q

Splenectomy is recommended
in all the following conditions EXCEPT:
A. an 8-year-old child with hereditary stomatocytosis with hemolysis
B. a 6-year-old child with hereditary spherocytosis and significant hemolysis
C. a 7-year-old child with hereditary elliptocytosis and
a hemoglobin level of 7g/dL and corrected reticulocytes count of
more than 15%
D. a 6-year-old child with thalassemia major with splenomegaly and frequent blood
transfusion requirement
E. a 12-year-old child with chronic immune
thrombocytopenia not
responding to all modalities of medical treatment

A

an 8-year-old child with hereditary stomatocytosis with hemolysis

73
Q

Of the following, the LEAST likely feature of acute immune thrombocytopenia
(ITP) would be:
A. a preceding viral infection
B. isolated thrombocytopenia
C. mucocutaneous bleeding
D. isolated splenomegaly
E. increased number of megakaryocytes in the bone marrow

A

isolated splenomegaly

74
Q

This is the first laboratory marker in progressive iron deficiency anemia:
A. falling of serum ferritin
B. hypochromic microcytic anemia
C. decrease hemoglobin synthesis
D. depletion of bone marrow hemosiderin
E. decrease of serum iron and increase of the iron-binding capacity

A

depletion of bone marrow hemosiderin

75
Q

All the following may occur as a renal manifestation in a child with sickle cell
anemia EXCEPT:
A. polyuria
B. hematuria
C. hyposthenuria
D. nephrotic syndrome
E. acute renal injury

A

polyuria

76
Q

Fresh frozen plasma (FFP) transfusion is the best treatment
for which of the
following conditions
A. hemophilia a
B. hemophilia b
C. factor VII deficiency
D. immunoglobulin
replacement therapy
E. bleeding due to warfarin therapy

A

bleeding due to warfarin therapy

77
Q

Hodgkin lymphoma in children usually has favorable outcome; however, the prognosis may be
grim in some cases. Poor prognostic factors in Hodgkin Lymphoma include all the following
EXCEPT:
A. Scan positivity
B. Stage IV disease
C. Presence of bulky mediastinal mass
D. Presence of “B” symptoms
E. Age more than 15 year at the time of the diagnosis
F. Poor response to therapy manifested by positron emission tomography (PET)

A

Age more than 15 year at the time of the diagnosis

PEDIA (4 decks)

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