Hematology/Immunology

Question 1

Name the condition: Blood enzyme disorder with skin lesions caused by the sun.

Answer 1

Porphyria

Question 2

When is TIBC increased and decreased?

Answer 2

INCREASED: Fe deficiency anemia, PG and hormonal birth control.
DECREASED: Anemia chronic disease, sideroblastic anemia and hemochromatosis.

Question 3

What defines a “left shift”? a “right shift”?

Answer 3

Over 6% immature band neutrophils (indicates bacterial infection.

Hypersegmented neutrophils - macrocytic anemia. B12-Folate deficiency

Question 4

Common causes of microcytic anemia?

Answer 4

Iron def, thalassemia, sideroblastic anemia, lead poisoning

Question 5

Common causes of normocytic anemia?

Answer 5

Acute blood loss, hemolysis, anemia of chronic dz, anemia of renal failure, myelodysplastic syndromes

Question 6

Common causes of macrocytic anemia?

Answer 6

Folate or B12 def, drug toxicity, alcoholism/chronic liver dz

Question 7

What is contraindicated in patients with G6P deficiency?

Answer 7

Oxidant drugs (e.g. Vit C > 5 gram), sulfa-drugs

Question 8

What is a primary presenting symptom of sickle cell crisis?

Answer 8

Bone pain after exertion

Question 9

What vascular bleeding disorder occurs in children after acute URI and report joint pain, abd pain, and possible renal involvement?

Answer 9

Henoch-Schonlein Purpura

Question 10

Disorder that follows URI or viral infection and present with petechiae and other bleeding (gums).

Answer 10

Idiopathic thrombocytopenia purpura

Question 11

Disorders of 30-40yo due to inhibitor of vWF-cleaving protease and unchecked platelet aggregation.

Answer 11

Thrombotic thrombocytopenic purpura

Question 12

What are common organisms that might cause Hemolytic Uremic Syndrome?

Answer 12

E. Coli O157:H7, Shigella, Staphylococcus, or other E. Coli

Drugs to - esp chemo, and OCPs

Question 13

In what condition are Bence Jones proteinuria found?

Answer 13

Multiple myeloma

Question 14

MC hereditary coagulation disorder presenting with possible hx of heavy menses, epistaxis, easy bruising, GI bleeds.

Answer 14

Von Willebrand’s Dz

Question 15

Causes of DIC.

Answer 15

Complications of obstetrics, infection (Gm - with endotoxin), malignancy (adenocarcinoma of the pancreas, prostate, or leukemia)

Question 16

Hemophilia A is associated with a genetic deficiency of what factor?

Answer 16

Factor VIII `

Question 17

Hemophilia B is associated with a genetic deficiency of what factor?

Answer 17

Factor IX `

Question 18

Name the disorder: absolute inc in red cell mass, ssx: fatigue, weakness, dizziness, HA, visual problems, itching after warm bath, easy bruising or bleeding with little or no injury

Answer 18

Polycythemia vera (malignant)

Question 19

What are SSX of multiple myeloma?

Answer 19

Bone/back pain, unexplained fractures, bleeding problems, aggravation of arrhythmias

Question 20

What finding is pathognomonic for AML found MC in adults 15-39 yo?

Answer 20

Auer rods

Question 21

Which leukemias is MC in children and has 90% survival rate?

Answer 21

ALL

Question 22

What leukemia is found in older people (65 yo average) and has a very poor prognosis? What cytogenetic abnormality is found in 95% of pts with this leukemia?

Answer 22

CML

The Philadelphia chromosome

Question 23

What leukemia is found in the much older population and usually presents with no symptoms? What type of cell is found in this leukemia?

Answer 23

CLL

Slowest and sneakiest
Virgin B cell (smudge cells)

Question 24

Name the CA: 20yo or 60 yo age predominance. “single/asymptomatic node spreads,” unexplained recurrent fevers, night sweats.

Answer 24

Hodgkin’s Lymphoma

Question 25

What cell is seen in Hodgkin's disease?

Answer 25

Reed-Sternberg cells

Question 26

MC Lymphoma, most deadly, associated with Burkitt's and immunoblastic lymphomas

Answer 26

Non-hodgkins lymphoma

Question 27

B-lymphocyte tumor, LA in the maxilla or mandible, assoc w/ EBV in US, Malaria in Africa, predisposes to Non-hodgkin's lymphoma.

Answer 27

Burkitt's lymphoma

Question 28

Tests for H. pylori.

Answer 28

Nitrogen breath test (sens) Serum IgG Serum IgM Serum, Salivary, or Stool IgA (sens)

Question 29

Tests for syphilis

Answer 29

VDRL/RPR

Question 30

Gm + antimicrobials

Answer 30

Bacitracin Vancomycin Penicillin G

Question 31

Gm - antimicrobials

Answer 31

Aminoglycosides | Polymyxins

Question 32

Broad spectrum antimicrobials

Answer 32

``` Quinolones Ampicillin Cephalosporins Tetracyclines Chloramphenicol Sulfonamides ```

Question 33

Target INR on warfarin therapy?

Answer 33

2-3

Question 34

What problem might a pt with a potential penicillin allergy in taking a cephalosporin?

Answer 34

15% cross reactivity

Question 35

What virus is associated with Hodgkin's lymphoma?

Answer 35

EBV

Question 36

Symptom picture for multiple myeloma?

Answer 36

Calcemia (Hyper) Renal failure Anemia Bony Lesions

Question 37

What workup would you find in dermatomyositis and polymyositis?

Answer 37

ANA pos in 30% Elevated muscle enzymes Inc creatinine kinase, ALT, AST Muscle biopsy shows lymphocytic infiltrate

Question 38

What two conditions often have positive HLAB27?

Answer 38

Ankylosing spondylitis | Reiter's Syndrome (Reactive arthritis)

Question 39

What is the constellation of symptoms of Scleroderma?

Answer 39

``` Calcification Raynaud's Esophageal dysmotility Sclerodactyly Telangiectasias ```

Question 40

What lab work is indicated in a patient with SLE?

Answer 40

ANA - screen Anti-dsDNA and Anti-Smith Titers of Anti-dsDNA and C3, C4 to monitor treatment

Question 41

What dose of epi IM in anaphylaxis? Benadryl?

Answer 41

.3-.5 1:1000 IM, q5-15 min | 50mg IV or IM q4-6hrs