Name that Disease

Question 1

18 yo pt presents w/ ↑ PTT, normal PT and easy bruising. They are F9 deficient.

Answer 1

Hemophiliac B

Question 2

Pt is an alcoholic who presents w/ ↑ PTT & PT.

Answer 2

Vitamin K Deficiency

Question 3

Pt is Shaun White who presents to clinic after falling on the half pipe during the Olympics. He is jaundiced and bleeding w/ ↑ PTT & PT, ↑ D-dimer, ↓ platelets and schistocytes on smear. What is the dx and tx?

Answer 3

DIC, tx w/Heparin

Question 4

Pt presents with unilateral lower leg swelling and redness. What test do you want to perform and what is the dx?

Answer 4

Venous doppler, DVT

Question 5

This side effect to a certain anticoagulant can be fatal

Answer 5

Type II HIT

Question 6

Pt presents w/normal PTT & PT, ↑ bleeding time and schistocytes on smear.

Answer 6

TTP

Question 7

Pt presents w/mild mucosal bleeding, ↑ bleeding time & PTT.

Answer 7

von Willebrand Disease

Question 8

Pt is a 5 year old presenting w/ renal failure, thrombocytopenia & microangiopathic anemia.

Answer 8

HUS

Question 9

Pt is HIV+ 40 yo male presenting w/petechiae, epistaxis & bruising. Labs show ↓ platelets, normal PTT & PT.

Answer 9

ITP

Question 10

Pt presents w/massive splenomegaly and TRAP+.

Answer 10

Hairy cell leukemia

Question 11

Pt is 65 yo male presenting w/a gum lesion, ↓ platelets, PTT & PT. Smear shows Auer rods & genetic testing shows t15:17 mutation. What is dx & tx?

Answer 11

AML, tx is ATRA

Question 12

Pt is 15 yo presenting w/a thymic mass and CD7+.

Answer 12

T-ALL

Question 13

Pt is 22 yo male w/hx of EBV presenting to clinic w/fatigue, weight loss, fever, night sweats. Smear shows Reed-Sternberg cells.

Answer 13

Hodgkin’s lymphoma

Question 14

Pt is 40 yo presenting w/exquisite LUQ tenderness, ↓ RBCs, ↑ platelets & WBCs. Genetic testing shows t9:22 positive.

Answer 14

CML

Question 15

Pt is 12 yo African American male presenting w/bone pain, fatigue & petechiae. Labs show ↓ neutrophils & platelets, TdT+ and genetic testing shows 9:22+. What is the dx and prognosis?

Answer 15

B-ALL, bad prognosis

Question 16

Pt is 60 yo presenting w/fever, night sweats, ↑ WBC and smudge cells on smear. What is dx and what staging system is used?

Answer 16

CLL, Rai staging

Question 17

Pt is African American presenting w/renal insufficiency, anemia, bone pain, ↑ globulin, Rouleaux formation on smear, Bence-Jones+ and lytic punch out lesions on x-ray.

Answer 17

Multiple Myeloma

Question 18

Pt is 55 yo woman w/hx of breast cancer presenting w/SOB, pallor, ↓ platelet & RBCs. What is dx, tx & staging.

Answer 18

MDS, methotrexate & FAB

Question 19

Pt presents w/splenomegaly and is t9:22-.

Answer 19

CMMoL

Question 20

Pt presents w/splenomegaly, HA, fatigue, ↓ Epo & Jak2 mutation. What is dx and tx?

Answer 20

PV, phlebotomy & hydroxyurea

Question 21

Pt is 70 yo presenting w/ ↓ platelets, RBCs & WBCs, teardrop cells on smear and Jak2 mutation positive.

Answer 21

Primary Myelofibrosis