Hematology

Question 1

Megaloblastic, peripheral neuropathy, MMA (methylmalonic acid)

Answer 1

B12 deficiency

Question 2

Megaloblastic, no neuro sx

Answer 2

Folate deficiency

Question 3

Blood loss, microcytic, low ferritin, homocysteine

Answer 3

Iron deficiency

Question 4

Microcytic/normocytic, normal ferritin

Answer 4

Anemia of chronic dz

Question 5

Increased LDH (lactate dehydrogenase), reticulocyte, indirect bilirubin, decreased haptoglobin

Answer 5

Hemolysis

Question 6

Pancytopenia, low reticulocyte count, bone bx

Answer 6

Aplastic anemia

Question 7

X-linked enzyme deficiency, infection, fava beans, bite cells, heinz body

Answer 7

G6PD

Question 8

Most common bleeding d/o, elevated aPTT, von willebrand factor activity, RIPA (ristocetin-induced platelet aggregation), Desmopressin

Answer 8

Von Willebrand

ristocetin-induced platelet aggregation (RIPA) is an ex vivo assay for live platelet function. It measures platelet aggregation with the help of von Willebrand factor (vWF)

Desmopressin is a clotting promoter and antidiurenic

Question 9

X-linked recessive d/o, hemarthrosis, normal platelets, prolonged aPTT

Answer 9

Hemophilia

Question 10

Thrombophilia, DVT, PE, No screening

Answer 10

Factor V Leiden

Question 11

Anticardiolipin antibody, recurrent pregnancy loss, prolonged aPTT, Russel viper venom test, DVT

Answer 11

Antiphospholipid syndrome

Question 12

4+ days, thrombosis, ELISA, venous limb gangrene

Answer 12

Heparin induced thrombocytopenia

Question 13

Shiga toxin producing E. coli, 0157:H7, Quinine, Microangiopathic hemolytic anemia and thrombocytopenia

Answer 13

Immune thrombocytopenia

Question 14

65 y/o, Myeloid, Auer rod, Phi bodies, M3 all-trans-retinoic acid, >20% blasts

Answer 14

Acute Myelogenous Leukemia (AML)

Question 15

Children, lymphoid, >20% blasts, TdT

Answer 15

Acute Lymphoblastic Leukemia (ALL)

Question 16

Neutrophils, basophilia, leukocytosis, 9:22 translocation, Philadelphia Chromosome, Tyrosine kinase inhibitor

Answer 16

Chronic Myelogenous Leukemia (CML)

Question 17

Non functioning B cells, lymphadenopathy, Lymphocytosis, Flow cytometry, Rituximab

Answer 17

Chronic Lymphoblastic Leukemia (CLL)

Question 18

Painless cervical lymphadenopathy, B sx, Reed Sternberg cells, Mediastinal mass, Excisional node bx

Answer 18

Hodgkin Lymphoma

B sx: fever, night sweats, and weight loss

Reed Sternberg cells: “Owl’s Eye”

Question 19

Plasma cells, IgG, IgA, Bence Jones protein, Rouleaux formation, >10% clonal plasma cells

Answer 19

Multiple Myeloma

A Bence Jones protein is a monoclonal globulin protein or immunoglobulin light chain found in the urine (“bent yellow and blue”)

Rouleaux formation: RBCs in a coin stacking formation

Question 20

Vaso occlusion, hemolytic anemia, cold, hypoxia, alcohol, infection, Howell Jolly bodies, PCN <5 y/o, hydroxyurea

Answer 20

Sickle Cell

Howell–Jolly bodies are histopathological findings of basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes. During maturation in the bone marrow, late erythroblasts normally expel their nuclei, but in some cases a small portion of DNA remains. Its presence usually signifies a damaged or absent spleen because a healthy spleen would normally filter this type of red blood cell.