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Heme and GI 1B Flashcards

1
Q

When we have Follicular lymphoma, what is DDX between this and Follicular Hyperplasia?

What are the genetics for Follicular Lymphoma?

A

Follicular Hyperplasia: tingible body in GC express Bcl-2

Follicular Lymphoma: no tingible macrophages, disrupts architecture

t(14;18) BCL-2 (inhibits apoptosis)

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2
Q

Mantle Cell lymphoma has genetic properties?

What does the cyclin allow?

A

t(11;14) of cyclin D1

CD5+++++++++

G1/S phase

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3
Q

Marginal Zone has a unique treatment, what is it?

What is the genetic properities? What are the CD markers?

A

can treat with antibiotics

t(11;18) CD19, CD20

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4
Q

What is the DDX of toxoplasmosis assuming there is a ring enhancing lesion on MRI?

A

EBV infection, Primary Central Nervous System lymphoma

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5
Q

Adult T cell lymphoma has what CD markers?

What is the virus?

A

CD4 and CD 30

HTLV

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6
Q

Adult T cell lymphoma has lytic bone lesions, hypercalcemia, cutaneous lesions, common in Japan, what is the DDX?

A

Multiple Myeloma

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7
Q

What is the CD marker for Pautrier Microabscess?

What is Mycosis fungoides, cutaneous T cell lymphoma?

A

CD4 and CD 30

Skin patches and plaques, cutaneous T cell lymphoma

Look out for cerebriform nuclei

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8
Q

What is CD15 and CD30, Pax 5 positive?

A

Hodgkin Lymphoma

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9
Q

Hodgkin Lymphoma: Mixed Cellularity, what is the main item seen with it?

What is the main IL marker?

A

eosinophillia

IL-5

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10
Q

What Hodgkin lymphoma has the best outcome?

A

Nodular Sclerosis, Broad Bands of Fibrosis

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11
Q

ALL: what is the main marker for pre-T and pre-B cells?

A

TDT+

pre-B cells: CD10, CD19, CD20

Pre-T cells: CD 2 and CD 8

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12
Q

What is the typical translocation for ALL?

Where would ALL spread too, may need special help with chemo?

A

t(12;21)

CNS and Testes

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13
Q

In the world of Leukemias:

Down Syndrome after the age of 5?

Down Syndrome before the age of 5?

A

Acute Lymphoblastic Leukemia

Acute Megakaryocyte Leukemia (elevated megakaryocytes), no MPO

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14
Q

CLL, is positive for what three things?

What can it transform too?

A

CD 5, CD 20, CD 23

Richter transformation into an aggressive lymphoma (DLBCL)

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15
Q

What is this from?

Assuming we have a leukemia?

A

CLL smudge cell

THis has dead background artifact

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17
Q

When there is filamentous, hair-like projections?

No peripheral lymphadenopathy

But what kind of spleenomegaly?

A

Hairy Cell Leukemia

Red Pulp Massive Splenomegaly

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18
Q

Hairy Cell Leukemia stains positive for TRAP.

What will a bone marrow biopsy have?

What is the mutation?

What does it have excellent response too?

A

Dry tap on aspiration

BRAF 600

2-CDA

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19
Q

AML has a positive stain for what?

What is seen on the peripheral smear?

A

Myeloperoidase +

circulating myeloblasts, commonly presents with DIC

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20
Q

What is the AML genetic mutation?

What is the treatment?

A

APL t(15;17)

all-trans retinoic acid and arsenic

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21
Q

What is the risk factor for AML?

What is the give away on a path stain?

A

Radiation, chemotherapy, myeloproliferative disorders

Auer Rods, activate the coagulation cascade

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22
Q

What glaring physical sign does AML have?

What is the DDX?

A

bleeding gums

Phenytonin use

24
Q

What is the big give away for CML?

What is seen in high amounts on CML?

A

Granulocytes in different stages

basophils, low LAP

25
Q

What is CML genetic issue?

What CD marker isnt there?

What can CML become?

A

t(9;22) BCR-ABL

no CD 20

AML or ALL –>Blast crisis

26
Q

What is the obliteration of bone marrow with fibrosis due to low fiboblast activity?

What is seen on the path smear?

A

Myelofibrosis

Dacrocytes, extramedullary hematopoiesis

Increases PDGF, FYI

27
Q

PCV Lung disease has what signs?

PCV reactive polycthemia has what signs?

A

Decreased SaO2 and Elevated EPO

Increased SaO2 and Elevated EPO, nucleated RBC (immature) in smear

28
Q

If I have Leukoerthyroblastic Activity: myelofibrosis in action, why will there be more immature cells than normal?

A

The spleen does not have a reticulin gate, spleen, RBC, and WBC are immature cells in blood

29
Q

What is Langerhans Cell Histiocytosis mutation?

What is the two markers?

A

BRAF 600E

CD1a and S-100

30
Q

Langerhans Cell Histiocytosis has a mass located where?

Yes they have lytic bone lesions

What type of thing is seen on histology?

A

Mastoid Bone

Birbeck Granules

31
Q

Name that Heme disease:

Langerhan’s over Front and back of Scalp

Hepatospleenomegaly

Skin Rash

Malignant

Less than 2 years old

A

Letter-Siwe Disease

32
Q

What Heme disease is this:

Calvaral Bone defects

Floating Teeth

Malignant

Skin Rash

A

Hand-Schuller Christian Syndrome

33
Q

What heme disease is no skin involvement

Bone Fracture

Langhan’s Cells

No Skin involvement

Benign?

A

Eosinophillic Granuloma

34
Q

What is systemic overactivation of macrophages and cytotoxic T cells, fever, pancytopenia, hepatosplenomegaly?

Bone Marrow biopsy shows a macrophage phagocytosing marrow elements, what is elevated?

A

Hemophagocytic lymphohistiocytosis

Elevated Serum Ferritin levels

35
Q

What heme issue arises when there is an increased surface area to volume ratio?

What heme issue arises when there is a decreased surface area to volume ratio?

A

Target Cells

Spherocytes

36
Q

When I have the intrinsic anemias, what is the test that increases H.S. fragility?

What is a hallmark lab test for H.S.?

A

Osmotic Fragility

MCHC

37
Q

What does pyruvate kinase deficiency, increase, that causes less oxygen binding affinity for hemoglobin?

38
Q

Follicular Lymphoma has a BCL-2 problem, what is different about the lymph nodes?

A

They exhibit waxing and waning

39
Q

If we have a polyposis syndrome issue, what is th most likely inheritance pattern?

A

Autosomal Dominant

40
Q

Adenomatous Polyps have the following flavors, apparently, who is the most likely to be neoplastic

Tubular

Villous

Tubulovillous

A

Tubular: lowest

Villous: worst

Tubulovillous is medium

41
Q

What polyp has intussception, bleeding, but no diarrhea?

What polyp has hypokalemia, diarrhea after stopping food?

A

Hamartomatous Polyps

Villous

42
Q

When there is pain from postprandial epigastric pain, via intestinal hypoperfusion, when does the pain resolve?

43
Q

What GI issue has a thumbprint sign on imaging due to mucosal edema/hemorrhage?

The patient will have hematochezia and even currant jelly sputum

A

Colonic Ischemia

44
Q

Ileus is another name for what?

A

intestinal hypomotility without obstruction

45
Q

What is meconium ileus associated with?

A

Cystic Fibrosis

46
Q

When there is necrotizing enterocolitis, we will have thin, curviliinear areas of lucancy that parallel the bowel wall, what area of the gut is this located?

A

terminal ileum and proximal colon

47
Q

What has cardiac symptoms, arthralgias, neuro symptoms, with a PAS+ stain?

A

Whipple Disease

48
Q

Celiac Disease has what two positive HLA things?

A

HLA-DQ2 and HLA-DQ8

49
Q

What is longitudinal lacterations, due to severe vomiting, usually alcholics and bulimics?

A

Mallory-Weiss Syndrome

50
Q

What is a transmural, usually distal esophageal rupture due to violent retching?

A

Boerhaave Syndrome

51
Q

Basophilic Stippling is seen where?

Ringed Sideroblasts are seen where?

A

Seen in Peripheral Smear

Seen in Bone Marrow

52
Q

Howell-Jolly Bodies are due to asplenia, what do they contain?

A

Basophilic nuclear remmants found in RBC

53
Q

Alpha Thalassemia has two varieties, what the general race usually?

Cis Deletion

Trans Deletion

A

Asian

African

54
Q

What general race has Beta Thalassemia?

A

Mediterranean populations

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