Hematology

Question 1

What is the most common Non-Hodgkins lymphoma in adults?

Answer 1

Diffuse Large B-cell Lymphoma

Question 2

What lymphoma is associated with Hoshimoto’s and Sjorgen Syndrome?

Answer 2

MALToma — Marginal Cel Lymphoma

Question 3

If you are diagnosed with Marginal Cell Lymphoma of the Antum of the stomach, what should be the treatment?

Answer 3

Treat the H.Pylori and Maltoma should resolve.

Question 4

What characteristic of Follicular Lymphoma makes it become carcinogenic?

Answer 4

BCL-2 Activation – anti-apoptotic, but too much, prevents cell from dying.
t(14,18)

Question 5

If irregular myeloid cells have a t(15,17), what most likely is the occuring?

Answer 5

Acute Myeloid Leukemia – M3

Question 6

What leukemia is associated with DIC and how do you treat it?

Answer 6

AML – t(15,17)

– All trans retinoic acid – allows the maturity of the cells and the patients have to take it the rest of their lives.

Question 7

What translocation is associated with Cyclin D1 over activation?

Answer 7

Mantle Cell Lymphoma – t(11,14)

Question 8

What is always associated with Chromic Myeloid Leukemia?

Answer 8

Philadelphia Chromosome – t(9,22)

Question 9

What cancer and translocation is associated with c-myc oncogene activation?

Answer 9

Burkitt Lymphoma – t(8,14)

Question 10

What histology is associated with Burkitt Lymphoma?

Answer 10

Starry Sky Appearance – sheets of solid lymphocytes with interspaced macrophages

Question 11

What Non-Hodgkin lymphoma is associated with EBV?

Answer 11

Burkitt Lymphoma (African Type) – Jaw Lesion

Question 12

What most commonly is associated with sporatic t(8,14) translocation?

Answer 12

Burkitt Lymphoma - Localized to Pelvis / Abdomen – Peyer’s Patches/Testicle

Question 13

What is the most common T-cell lymphoma in adults? What is a risk factor?

Answer 13

Adult T-cell Lympoma – HTLV Virus (IV Drug Abuse)

Question 14

What are the similarities between Adult T-cell Lymphoma and Multiple Myeloma?

Answer 14

• Lytic Bone Lesions

- Hypercalcemia

Question 15

What is associated with atypical CD4+ cells with a cerebriform nuclei with skin patches and plaques?

Answer 15

Mycosis Fungoides

– if systemic Sezary Syndrome

Question 16

What is a prognostic indicator of Hodgkin Lymphoma?

Answer 16

Percent of Reed-Sternburg Cells

Question 17

What markers are unique indicating Hodgkin Lymphoma?

Answer 17

CD15 and CD30

Question 18

What is the most distinct clincal difference between Hodgkin and Non-Hodgkin’s Lymphoma?

Answer 18

Hodgkin – Localized LAD, painless, Neck / Mediastinum – Bimodal Distribution + Constituitional Symptoms
NonHodgkin – Multiple-nodules, extranodal involvment.
- Variable Age Onset - NO Constitutional Symptoms

Question 19

How does the remedy for cyanide poisoning work?

Answer 19

Give the patient Amyl-Nitrite – converts heme into methemoglobin (Fe+2–>Fe+3), which then Cyanide has a higher affinity for and is bound up in heme instead of ETC.

Question 20

How do you treat acute iron poisoning?

Answer 20

Deferoxamine - chelating agent

Question 21

How do you treat a build up of methemoglobinemia?

Answer 21

From oxidative stress converting the irons into different forms that do not bind oxygen.
– Treated with Methylene Blue, will reduce them back into Fe+2 form.

Question 22

How can non-hodgkins B-cell lymphoma be treated?

Answer 22

Rituximab – binds CD20 on B-cells and they will be destroyed by immune system

Question 23

What would you give a patient who is about to undergo a cardiac catheterization due to acute coronary syndrome?

Answer 23

Abciximab – binds GBIIb/IIIa receptor to prevent aggregation of platelets during the procedure

Question 24

What is the difference between HbS and HbC?

Answer 24

HbS – glutamate –> valine (less negative charge)
– able to sickle and cause disease
HbC – glutamate –> lysine (positive charge)
– minimal anemia and hemalysis

Question 25

What are direct thrombin inhibitors?

Answer 25

Argatraban Bivalirudin Dabigatran

Question 26

What common drugs to treat DVTs causes prolonged PPT, but Normal PT and Thrombin Time?

Answer 26

Factor Xa Inhibitors DIRECT -- Rivaroxaban - Apixaban INDIRECT -- Fondaparinux

Question 27

What would most commonly cause fatigue, fever, bone pain, and dysphagia in a 9 year old male?

Answer 27

T-cell Acute Lymphoblastic Leukemia - -- Less common than B-ALL - -- MEDIASTINAL MASS -- can obstruct vessels and esophagus when they get large enough - -- Superior Vena Cava Syndrome

Question 28

What might be the diagnosis of an 8 year old male who has progressive fatigue, intermittent fevers, bone pain, and enlarged spleen. Lab finding indicate cells with surface markers CD10 and CD19.

Answer 28

B-Cell Acute Lymphoblastic Leukemia - - Most common child leukemia - - CD10, CD19, CD20

Question 29

What is the most common cause of B-thalassemia?

Answer 29

Disruption of transcription, processing, or translation of the protein.

Question 30

If a patient notices everyday when he wakes up in the morning he has hematuria without any other symptoms, what might be found on labs?

Answer 30

Paroxysmal Noctural Hemaglobinuria Pancytopenia -- Aplastic Anemia -- Thrombotic Complications Defective CD55 -- Glycosylphosphatidylinositol anchor **Excessive hemolysis of ALL cells due to complement