Heme / Onc

Question 1

macrocytic anemia in sickle cell patient is from

Answer 1

folate deficiency

could also be from hydroxyurea

Question 2

indications for hyper coagulability testing

Answer 2

Less than 45 yrs old
family history
recurrent or unusual site of VTE

Question 3

incr AFP and bHCG

Answer 3

nonseminomatous germ cell tumor

• yolk sac tumor
• choriocarcinoma
• embryonal carcinoma

Question 4

differential for anterior mediastinal mass

Answer 4

thymoma
teratoma
thyroid neoplasm
terrible lymphoma

Question 5

palpable venous cords

• syndrome name
• what cancers
• next step

Answer 5

migratory superficial thrombophlebitis / Trousseau syndrome
pancreas, stomach, lung, colon, acute leukemias
CT abd

Question 6

heavy smoking, abdominal pain, superficial thrombophlebitis

• dx
• next step

Answer 6

pancreatic ca

CT abd

Question 7

characteristics of Leydig cell tumors

Answer 7

high estrogen
low LH and FSH
gynecomastia

Question 8

diarrhea, steatorrhea, ulcers distal to duodenum

Answer 8

zollinger ellison syndrome (gastrin producing tumor)

Question 9

most common cause of anemia in alcoholics

Answer 9

folate deficiency

Question 10

Pappenheimer bodies associated with

Answer 10

sideroblastic anemia

Question 11

hypothyroidism associated with what type of anemia

Answer 11

macrocytic anemia

Question 12

GI malabsorption causes what type of anemia

Answer 12

iron deficiency anemia

Question 13

tx for Diamond blackfan anemia

Answer 13

corticosteroids

if doesn’t work: transfusion

Question 14

diamond blacken: type of anemia

Answer 14

macrocytic (but don’t see hyperseg neutrophils)

Question 15

other congenital abnormalities of diamond blackfan anemia

Answer 15

shield chest
webbed neck
triphalangeal thumbs
short stature
cleft lip

Question 16

tumor in females that produce a lot of estrogen and can cause precocious puberty or postmenopausal bleeding

Answer 16

granulosa cell tumor

Question 17

tumor producing androgens, causing masculinization of females

Answer 17

sertoli-leydig cell tumor

Question 18

characteristics of mets to bone

Answer 18

age greater than 50
worse at night
wt loss
cauda equina syndrome (weakness, urine incontinence/retention, saddle anesthesia)

Question 19

end stage renal failure and a lot of bleeding (nosebleeds, ecchymoses, GI bleeds, etc)

• dx
• pathology
• labs
• tx

Answer 19

uremic coagulopathy
dysfunctional platelets
bleeding time high (all else like PT and PTT normal)
DDAVP

Question 20

iron deficiency anemia in male or postmenopausal female. next step?

Answer 20

test occult blood to r/o GI causes of blood loss

Question 21

burr cells / echinocytes (serrated edges).. differential

Answer 21

liver dz

ESRD

Question 22

spur cells / acanthocytes seen in

Answer 22

liver dz

Question 23

target cells.. differential

Answer 23

thalassemia

obstructive liver dz

Question 24

hereditary spherocytosis

• lab findings
• tx
• complications

Answer 24

Lab:
neg coombs
incr MCHC
osmotic fragility on acidified glycerol lysis test
abnormal EMB test

Tx:
folic acid, blood transfusions, splenectomy

complications:
pigmented gallstones, Parvo B19 infxns

Question 25

indications for erythropoeitin

Answer 25

chronic renal failure and Hb less than 10%, with iron deficiency ruled out (if have IDA, give iron first)

hemodialysis patient with sxs attributed to anemia

Question 26

side effects of erythropoeitin

Answer 26

HTN
HA
flu- like sxs
red cell aplasia

Question 27

hypochromic and normochromic RBCs

Answer 27

acquired sideroblastic anemia (ex: from INH in TB tx without B6)

Question 28

peripheral smear of CLL

Answer 28

many small lymphocytes

smudge cells

Question 29

characteristics of CML

Answer 29

incr WBC, more than 100,000
incr basophils and neutrophils (myelocytes)
splenomegaly
incr plts
anemia

Question 30

sxs of hemochromatosis

Answer 30

cirrhosis
heart failure
DM
hypogonadism
arthritis