Hemato

Question 1

…………… are the drugs of choice for stabilizing bony metastatic lesions to prevent hypercalcemia of malignancy and pathologic fractures.

Answer 1

Bisphosphonates (eg, zoledronic acid, pamidronate)

Question 2

Anemia can be due to decreased red blood cell (RBC) production, increased RBC destruction, and frank blood loss.
lymphoproliferative disorders is due to

Answer 2

bone marrow infiltration with cancerous cells.

Question 3

to 30% of patients on erythropoietin therapy develop new or worsening

Answer 3

hypertension,

Question 4

Can help differentiate CML from leukemoid reaction

Answer 4

Leukocyte alkaline phosphatase (LAP) score

Question 5

is diagnosed by flow cytometry (shov,ing a clonality of mature B cells)

Answer 5

CLL

Question 6

is defined as treatment for a disease when standard therapy fails, such as radiation therapy for prostate-specific antigen recurrence after radical prostatectomy for prostate cancer

Answer 6

Salvage therapy

Question 7

……… that target the 5HT3 receptor are considered first-line treatment for chemotherapy- induced nausea.

Answer 7

Serotonin (5HT) receptor antagonists (eg, ondansetron)

Question 8

……… is the most common cause of inadequate respo nse to ESAs in patients on dialysis.

Answer 8

Iron deficiency

Question 9

Risk factors for venous thromboembolism (VTE) are either

Answer 9

inherited (eg, Factor V Leiden, prothrombin gene mutation, protein C deficiency) or
acquired (eg, immobilization, surgery, malignancy, medications).

Question 10

Febrile nonhemolytic transfusion reaction (FNHTR), the most common adverse transfusion reaction, is a benign occurrence caused by

Answer 10

cytokine release from leukocytes within the donor blood product.

Question 11

Alcohol also directly hastens folate deficiency by

Answer 11

reducing folate absorption in the small intestine,
impairing uptake/storage in the liver,
and increasing urinary excretion.

Question 12

Side effect of phenytoin

Answer 12

Folic acid deficiency
Gingival overgrowth/hyperplasia
reduced bone density

Question 13

2nd most common of hereditary throbophelia in those of white ethnicity

Answer 13

Prothrombin mutation

Question 14

Signs and symptoms of SVO include

Answer 14

dyspnea, venous congestion, and swelling of the head, neck and arms.

Question 15

……… is the most commo n cause of SVC syndrome.

Answer 15

Malignancy

Question 16

AIDS-defining malignancies such as

Answer 16

invasive cervical carcinoma (human papillomavirus),
Kaposi sarcoma (human herpesvirus 8),
CNS system lym phoma (Epstein-Barr virus [EBV]),
and NHL

Question 17

Patients with HIV are at significantly increased risk of malignancy due to immune dysregulation and reactivation of oncogenic viruses. One of the most common malignancies is non-Hodgkin lymphoma, which is due to the reactivation of the ……………

Answer 17

Epstein-Barr virus in B-lymphocytes.

Question 18

Most common of hereditary thrombophelia in those of white ethnicity

Answer 18

Factor V Leiden

Question 19

……… is the most commoly inherited hypercoagulable disorder in the Caucasian population, leading to increased risk of thrombosis.
Testing should be considered for an unprovoked first-time thrombus in young (age <45) patients or those with unusual site of thrombus.

Answer 19

Factor V Leiden

Question 20

In……… , leukocyte count, erythrocyte count, and coagu lation studies are normal

Answer 20

ITP

Question 21

………… often cause mild, asymptomatic hemolysis

Answer 21

Mechanical aortic valves

Question 22

chelates calcium and magnesium and may reduce their plasma leve ls, causing paresthesias.

Answer 22

Citrate

Question 23

This patient most likely has hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome), an autosomal dominant disorder characterized by

Answer 23

diffuse telangiectasias (eg, ruby-colored papules that blanch v,ith pressure), recurrent epistaxis, and widespread arteriovenous malformations (AVMs).

Question 24

………… is the most common cancer in men and often presents with manifestations of metastatic disease

Answer 24

Prostate adenocarcinoma

Question 25

Hemato logic abnorma lities occur in over half of SLE patients and include:

Answer 25

• Anemia, resulting from immune destruction, but also from coexisting renal disease or chronic inflammation • Leukopenia (eg, neutropenia), often immune-mediated and correlating with disease activity • Thrombocytopenia, most commonly due to immune thrombocytopenic purpura (ITP)

Question 26

This patient is on isoniazid (INH), a pyridoxine (vitamin B6) antagonist that can cause acquired. ……… It frequently manifests as microcytic hypochromic anemia, simulating iron deficiency anemia.

Answer 26

sideroblastic anemia.

Question 27

! ADAMTS13 level >>> uncleaved vWF multimers >>> platelet trapping & activation

Answer 27

TTP

Question 28

Clinical features of TTP

Answer 28

• Hemolytic anemia (t LOH, ! haptoglobin) vv ith schistocytes • Thrombocytopen ia (t bleeding time, normal PT/PTT) • Renal failure • Neurologic manifestations • Fever

Question 29

Management of TTP

Answer 29

Plasma exchange Glucocorticoids Rituximab

Question 30

Patients with aggressive hematologic malignancies are at risk of tumor lysis syndrome when initiated on cytotoxic chemotherapy. Intrace llular contents are released, resulting in…………… Major complications include acute renal injury (uric acid/calcium phosphate tubular injury) and cardiac arrhythmias.

Answer 30

hyperuricemia, hyperkalemia, hyperphosphatemia, and hypoca lcemia (due to calcium phosphate binding).

Question 32

Vitamin B6, folate, and vitamin B12 are involved in the metabolism of homocysteine.………… lowers homocysteine levels by acting as a cofactor for the enzyme cystathionine 13 -synthase, vthich metabolizes homocysteine into cystathionine.

Answer 32

Vitamin B6

Question 33

The ………… are the most common source of symptomatic pulmonary embo lism

Answer 33

proximal deep leg veins