Hematology

Question 1

Polycythemia Vera sxs

Increased red cells, increased plts and white cells

Answer 1

Fatigue 
Headache 
Hand/foot burning 
Itching w/ blue/red skin discoloration 
tinnitus 
blurred vision 
Thrombosis from platelet aggregation

Question 2

Secondary polycythemia causes

Answer 2

OSA
COPD
CO2
High altitude

Question 3

CML

Answer 3

“Philadelphia chromosome”

Increases with age
Fatigue, nights sweats, fevers
High WBCs > 150,000 sight left shift
Tx: imitinib

Question 4

CLL

Answer 4

65 or elderly man
Lymphs on diff

SMUDGE cells 
Splenomegally
Lymphadenopathy
Pallor 
Tx: no therapy needed, good prognosis

Question 5

AML

Answer 5

Pancytopenia w/ blasts
Bone marrow biopsy to distinguish type (8 subtypes)

AUER RODS
Acute onset, rapid increase in PMNs
Fever, weak, bone pain, pallor, lymphadenopathy, bleeding
Tx : chemo

Question 6

ALL

Answer 6

3-7 yo kid
80% childhood leukemias

Bleeding, fatigue, sob, bone pain
Cure 80%

Question 7

Multiple myeloma

Answer 7

Older male >65
Fractures, bone pain, anemia
Renal failure 
"Bence jones proteins"
No fever, no splenomegaly 

Tx: chemo/stem cell tx

Question 8

Thalassemia

Answer 8

MCVs very low… 50s

“Target cells”

Alpha : huge spleens
Beta: Greeks, Italian
Tx: Regular RBC transfusion

Question 9

Sideroblastic anemia

Answer 9

Kids with Lead poisoning

“Basophillic stippling” on smear

Episodic paralytic ileus

Tx: remove exposure

Question 10

B12 deficiency anemia

Answer 10

High MCV, high RDW
Megaloblastic
Glossitis
Anorexia
Diarrhea paresthesias
AMS
"Positive schillings test"

Question 11

Folate deficiency

Answer 11

High MCV
High RDW
“Howell-jolly bodies”

Question 12

Hemolytic anemia

Answer 12

Increased retic count
No bleeding
Indirect (Unconjugated) bilirubinemia

Question 13

G6PD

Deficiency

Answer 13

Causes hemolytic anemia

“Heinz bodies”

Question 14

Hodgkin’s lymphoma

Answer 14

15-35 yo young adult -most common

"Reed sternberg cells"
Painless, rubbery lymphadenopathy in neck
Wt loss / sweats 
Tx: chemo / radiation
Fairly good prognosis

Question 15

Non-hodgkins lymphoma

Answer 15

Painless lymphadenopathy that is more wide spread.
Wt loss and drenching night sweats
Dx: lymph node biopsy 
Tx: chemo radiation
6-8 yr prognosis

Question 16

ITP

Answer 16

Most common in childhood
Self limited, mild
Well appearing
Skin purpura, oral bleeding

Question 17

TTP

Answer 17

20-50 yo acutely ill
Purpura and petechia.
Marked anemia

Tx: plasmapheresis

Question 18

DIC

Answer 18

Abnormal and excessive clotting cascade activation

Bleeding and clotting

Question 19

Von willebrands disease

Answer 19

Most common inherited
Bleeding gums
Prolonged bleeding time

Tx: avoid NSAIDs

Question 20

Hemophilia A

Answer 20

Factor VIII deficiency

Spontaneous hemarthrosis

Question 21

Hemophilia B

Answer 21

Factor IX deficiency

Christmas disease
Spontaneous hemarthrosis

Question 22

Polycythemia Vera

Answer 22

60-70 yo Male with increased red cells 
Bone marrow problem 
NOT due to EPO 
Splenomegaly
Expanded blood volume 
Increased viscosity (thrombosis) 
Tx: phlebotomy