Oncology/Hematology

Question 1

What pathology is at hand: Histology - thyroid cells with optically clear nuclei

Answer 1

Papillary carcinoma of the thyroid

Question 2

What pathology is at hand: Histology - anemia with hypersegmented neutrophils

Answer 2

Vitamin B12 and folate deficiency

Question 3

What pathology is at hand: Histology - Eczema, recurrent infections, and thrombocytopenia

Answer 3

Wiscott-Aldrich syndrome

Question 4

What pathology is at hand: Histology - Hemosiderinuria and thrombosis

Answer 4

Paroxysmal nocturnal hemoglobinuria

Question 5

What is the translocation associated with diffuse large B-cell lymphoma and follicular lymphoma? What are the percentages associated?

Answer 5

t(14;18)

diffuse large B-cell lymphoma
~30%

follicular lymphoma
>90%

Question 6

What is the most common lymphoma in children?

Answer 6

Lymphoblastic lymphoma

Question 7

What is the translocation in Burkett Lymphoma? What is the associated oncogene?

Answer 7

t(8;14)

This activates the c-Myc oncogene

Question 8

What is the translocation associated with Mantle Cell Lymphoma? What is the associated dysregulation?

Answer 8

t(11;14)

Disrupting the regulation of cyclin D

Question 9

What are the 3 pathologies associated with Marginal cell MALToma?

Answer 9

Sjögren Syndrome
Hashimoto Thyroiditis
H. pylori

Question 10

What type of lymphoma is associated with long term celiac disease?

Answer 10

Intestinal T-Cell lymphoma

—> Enteropathy-associated T-cell lymphoma

Question 11

What is the most common type of Lymphoma in the US?

Answer 11

Diffuse large B-cell lymphoma

Question 12

What cancer is most commonly associated with a non-infectious fever?

Answer 12

Hodgkin Lymphoma

Question 13

What malignancy is associated with the appearance of Auer rods??

Answer 13

AML - Acute myelogenous leukemia

Question 14

What is the diagnostic criteria of Acute Leukemia?

Answer 14

• Rapid onset
• Over 50% myeloblasts (AML) or lymphoblasts (ALL) in the bone marrow
• Numerous blast (immature) cells (>20% blasts) in peripheral blood
• Often associated with pancytopenia (anemia, bleeding tendency, infection)

Question 15

High yield points:
Philadelphia chromosome (assoc. with poor prognosis)
B cell more common than T cell
Bone pain
Very good prognosis in children (up to 90% remission in patients)
PAS (+)
Difficult to DX on blood smear 
Associated with Down’s Syndrome 
What pathology is being described?

Answer 15

ALL - Acute Lymphoblastic leukemia

Question 16

High yield points:
Philadelphia chromosome rarely seen
Characteristic Auer Rods 
Most are CD 13/33 (+)
Median sage of onset is 65
PAS (-)
Associated with many risk factors (Down syndrome, radiation, benzene, alkylating agents, myeloproliferative disease, aplastic anemia, Fanconi Sd, Bloom Syndrome, etc)
What pathology is being described?

Answer 16

AML - Acute myelogenous leukemia

Question 17

High yield points:
Insidious onset and gradual progression (months to years)
Mature cells (rather than blasts)(>5% blasts)
Associated with hepatosplenomegaly and lymphadenopathy
Prominent infiltration of bone marrow by leukemic cells and peripheral WBC counts may be high
What pathology is at hand?

Answer 17

Chronic Leukemia

Question 18

High yield points:
Most common adult Leukemia
Adults over age 50
95% have B cells markers
Characteristic smudge cells
Autoimmune hemolytic anemia
Tends to be indolent

Disease is the same as small lymphocytic lymphoma
What pathology is being described?

Answer 18

CLL - Chronic Lymphoblastic leukemia

Question 19

High yield points:
May progress to AML (80%) or ALL (20%) - called a ‘Blast Crisis’
Age: 25-60
Numerous basophils and PMNs are LAP (-)
Hyperplasia of all 3 cell lines (granulocyte, erythroid, and megakaryocyte) but granulocyte precursora predominate
Philadelphia chromosome (t 9;22) is ALWAYS PRESENT
Fatigue, abdominal pain, splenomegaly, bleeding tendency
What pathology is being described?

Answer 19

CML - Chronic myelogenous leukemia

Question 20

What is being described:
Neoplastic transformation of a single myeloid precursor. Monoclonal proliferation of mature myeloid cells. What 3 diseases are associated?

Answer 20

Myeloproliferative disorders

These include:
Polycythemia Vera
Essential thrombocytosis
Myelofibrosis

Occasionally people also lump in CML

Question 21

Pt is found with a malignancy of plasma cells. These cells secrete what? What is the pathology at hand?

Answer 21

Multiple Myeloma

Generally, the cells secrete IgG or sometimes IgA

Question 22

Loss of tumor suppressor function can lead to cancer, by way of what mechanism?

Answer 22

Requires mutations in BOTH alleles

Question 23

What cancers are associated with a RET gene mutation?

Answer 23

MEN 2A and 2B

Medullary and Papillary thyroid carcinoma

Question 24

What medications are Nephrotoxic and Ototoxic?

Answer 24

Cisplatin and carboplatin
Loop diuretics
Aminoglycosides
Vancomycin

Question 25

What is the MC scenario to receive Arsenic exposure? What cancer is the Pt at risk for developing?

Answer 25

Ingesting ground water that contains arsenic over several years-living in an arsenic rich region.

Question 26

What are the main causes of megaloblastic anemia??

Answer 26

Deficiencies in folate, B12

• Orotic Aciduria
• Fanconi Anemia (type of aplastic anemia)

Question 27

What are the 2 types of non-megaloblastic Macrocytic anemia?

Answer 27

• Diamond Blackfan Anemia
• Liver disease
• Alcoholism

Question 28

Ham’s test is used to diagnose what?

Answer 28

Paroxysmal nocturnal hemoglobinuria

Question 29

Heinz bodies help to diagnose what pathology?

Answer 29

G-6-PD deficiency

Question 30

Basophilic stippling is used to diagnose what pathology?

Answer 30

Lead poisoning

Question 31

Osmotic fragility test is used to diagnose what pathology?

Answer 31

Hereditary spherocytosis