Heme/Onc Questions + Formatives Review

Question 1

Immune Deficiency Linked to Increased Lymphomas

Answer 1

Wiskott Aldrich (T-Cell) - X-Linked

Question 2

Teenage Mass with CD2 and CD7

Answer 2

Lymphoblastic Lymphoma - T-Cell + Teenager + Thymus

Question 3

Follicular Lymphoma - Sample Markers (2) + Translocation

Answer 3

CD5 -
CD10 +
t:18:14 - Bcl2

Question 4

CLL - Markers (3) + Smear vs. ALL

Answer 4

Markers - CD5+ / CD19+ / CD20+

Smear = Smaller more mature cells - Also usually smudge cells

Question 5

Russell Bodies - 2 Disease + Key Difference

Answer 5

Russell Bodies - Multiple Myeloma + Waldenstrom-Macroglobulinemia (Lymphoblastic Lymphoma)

Question 6

Anaplastic Large Cell Lymphoma (4)

Answer 6

ALK
2,5 Trans-location
Horseshoe Shaped Cells
CD-30

Question 7

Drugs interacting with Methotraxate (4)

Answer 7

1) Aspirin
2) NSAIDS
3) Penicillins
4) Cephalosporins

Question 8

HER2 Breast Cancer Drugs (3)

Answer 8

1) Tratsuzumab
2) Lapatinib
3) Peruzumab

Question 9

Drug Correlated with Rash Efficacy (1) - 3 Keys

Answer 9

Erlotinib - EGFR Tyrosine Kinase Inhibitor

Used for Non-Small Cell Lung Cancer
CYP3A4

Question 10

HPV - Carcinogenesis Pathway

Answer 10

Blocks Rb protein - No Rb protein = no inhibition of Cyclin D1 - Easy progression from G1-S

Question 11

Von Hipple Lindaue - Genetics + Mechanism

Answer 11

1) Autosomal Dominant

2) Loss of VHL allows stabilization of HIF = Allows tumor angiogenesis

Question 12

ATRA Syndrome - Cause + Findings (4)

Answer 12

ARTA - Used for 15/17 translocation in AML-M3

Cytokine storm - Causes hypotension + pleural effusions + respiratory distress + can be deadly

Question 13

5-FU - Key Deficiency

Answer 13

Dihydropyrimidine dehydrogenase

Question 14

Pneumocystis Carini - Key Immune Deficiency

Answer 14

Hyper IgM - Defective CD40 - X-Linked Recessive

Question 15

AML - Poor Prognosis Markers (4)

Answer 15

1) 9:22 + 9:11 + Loss of Chromosomes

Question 16

LAD-1 - Inheritance + Missing Marker + Triad

Answer 16

Autosomal Recessive

Missing CD18

Delayed Separation of the Umbilical Cord

Question 17

Job’s Syndrome - 4 Keys

Answer 17

1) Hyper IgE Syndrome (B-Cell) - Eosinophilia
2) Triad - Eosinophilia + Eczema + Recurrent Sinopulmonary Infactions
3) Autosomal Dominant
4) JAK/STAT3 Over-activation

Question 18

Myeloperoxidase Deficiency - 3 Keys

Answer 18

Loss of Conversion of H2O2 to HOCl

Increased Candida Infection

Normal Nitro Blue Test

Question 19

LAP Stain - Uses (2)

Answer 19

LAP+ = Leukemoid Reaction (Acute Infection
LAP- = CML

CML = Basophils vs. Acute Leukemoid = Neturophils

CML - Lots of granulocytes (lots of lobs)

Question 20

CML Keys

Answer 20

1) Classicly presents just with elevated WBC/Hb/Platelet and Enlarged Spleen
2) t(9:22) BCR-Abl - RIsk of AML/ALL Progression
3) Treatment = Busulfan

Question 21

Heriditary Spherocytosis - Key Points (3)

Answer 21

1) Red Spherocytes - Normocytic + Extravascular
2) Autosomal Dominant
3) Spectin/Anykin
4) Osmotic Fragility Test

Question 22

Major Tests for Heme/Onc (8)

Answer 22

1) Nitro Blue - Chronic Granulomatous Disease
2) D-Dimer - DIC
3) Schilling Test - B12
4) Metabisulfite Test - HbS - Trait/Disease
5) Osmotic Fragility - Heriditary Spherocytosis
6) Sucrose Test - PNH + CD55 Follow-Up
7) Ristocetin Test - Benard Soulier + vWF Disease
8) Mixing Test - Lack of a Factor vs. Ab against a Factor

Question 23

3 Transfusion Issues Prevented by Leukodelpletion

Answer 23

1) TRALI
2) Febrile Reaction
3) CMV infection

Question 24

TRALI - Keys (4)

Answer 24

1) 1-2 Hours After Transfusion
2) Severe Hypotension + Pulmonary Edema

3) Antibodies against donor HLA - Antibodies cause massive immune reaction with endothelial damage and fluid leak (pulm. edema)
4) #1 Cause of Transfusion Death

Question 25

Mantle Cell Lymphoma - CD Marker + Translocation

Answer 25

CD5 Positive

t:11/14 - Cyclin D1

Question 26

Horseshoe Shaped Nuclei

Answer 26

ALK - T-Cell + CD30 + 2,5 Trans

Question 27

Cloverleaf Cells - Disease + Findings (2)

Answer 27

A-TALL - Aggressive + HLTV-1 Infection

Question 28

Diseases with Large Platelets

Answer 28

1) ET
2) ITP
3) Bernard Soiler

Question 29

High Uric Acid - Class of Diseases

Answer 29

Myeloproliferative

Question 30

Darocytes

Answer 30

Tear Drop Cell - Myelofibrosis - Fibrosis of bone marrow with intravascualr hemolysis and atypical megakarocytes - extramedullay hematopoesis