IM HemOnc - Rd 2

Question 1

What is the Gold standard test to diagnose HIT?

Answer 1

Serotonin release assay

Question 3

Empiric anticoagulation should only be started in what setting of a blood clot?

Answer 3

PE

NOT a DVT w/no symptoms of PE

Question 4

Lupus anticoagulant (anti-phospholipid Ab) presents w/what lab abnormality?

Answer 4

Prolonged PTT

Question 5

Treatment for TTP?

Answer 5

Plasma exchange

Question 6

Middle-aged Pt that has hemolysis, cytopenias, and hypercoaguable state (portal vein thrombosis) has what?

Answer 6

PNH

Question 9

Pt with blanching ruby-colored papules on the lips, unremitting epistaxis, increased Hct, has what?

Answer 9

AV shunting d/t Osler-Weber-Rendu (hereditary telangiectasia)

AD

Question 11

Pt with mild hypercalcemia in the setting of metastatic breast cancer should be treated how?

Answer 11

Bisphosphonates

Question 13

Pt that has blood transfusion and then develops DIC is d/t what etiology?

Answer 13

Acute hemolytic transfusion d/t ABO incompatibility

Question 14

HIT can cause what unexpected problem?

Answer 14

Arterial thrombosis

Question 16

OSA causes transient periods of hypoxia, what is the result?

Answer 16

Increased EPO

Question 18

How do you diagnose CLL?

Shows what?

Answer 18

Flow cytometry

Clonalality of mature B cells

Question 19

Pt that has ESRD, retinal hemorrhages, HA, and Very high HTN, what is going on?

D/t what?

Answer 19

HTN crisis

SE of EPO therapy

Question 22

Pt that has unexplained ITP after all else has been ruled out, what else must you consider?

Answer 22

HIV

HepC

Question 25

vWF deficiency presents w/what lab values?

Answer 25

Prolonged bleeding time

Inc PTT

Question 28

What is a hemoglobinopathy?

Answer 28

Sickle cell or thalassemia

Question 29

Anemia in old man that has arthritis most likely has what?

Answer 29

Fe deficiency anemia 2/2 chronic NSAID use and GI Bleed

Question 30

What is the mechanism of pancytopenia in SLE?

Answer 30

Peripheral immune-mediated destruction

Question 31

What presents w/HTN, transient vision disturbances, aquagenic pruritus, facial plethora and splenomegaly?

Treat how?

Answer 31

Polycythemia Vera

Serial phlebotomy
Also can add Hydroxyurea

Question 34

Tumor lysis syndrome presents how with the following electrolytes?

Ca
PO4
K+

WHY?

Answer 34

Dec
Inc
Inc

Cell contents are freed when cell dies and PO4 and K+ are high INTRACELLULARLY, thus when they are released Ca binds PO4 and becomes LOW

Question 35

Pt that presents w/HA, N, dizziness and polycythemia most likely has what?

Look out for what?

Answer 35

Chronic CO poisoning

Environmental work exposure

Question 36

Anemia of lymphoproliferative disorders is d/t what?

Answer 36

Bone marrow infiltration w/cancerous cells

Question 37

GVHD involves activation of what cells?

Answer 37

Donor T lymphocytes

Question 40

Pt that has fatigue and dyspnea following a respiratory infection treated w/Amoxicillin that has anemia and reticulocytosis has what?

Treatment?

Answer 40

Autoimmune hemolytic anemia —> warm agglutination

High dose glucocorticoids

Question 42

Hereditary Spherocytosis presents how?

At increased risk for what?

Lab studies show what?

Answer 42

Hemolytic anemia, jaundice, splenomegaly

Bilirubin gallstones, Parvo B19

high MCHC, high RDW

Question 45

Pt that is acutely ill and has underlying liver disease has an increased risk of developing what in as little as 7-10 days? What lab values?

Answer 45

Vit K deficiency Inc PT and PTT

Question 48

What presents w/progressive fatigability and lab studies that show increased Iron?

Answer 48

Sideroblastic anemia