Pathology

Question 1

What is the basophilic stippling

Answer 1

Basophilic ribosomal RNA precipitates. Seen in reticulocytes

Question 2

Characteristics seen in Burkitt lymphoma

Answer 2

t(8;14)-translocation of c-myc (transcription factor)
Bx: starry sky, medium-sized lymphocytes with high mitotic index (↑ ki-67)
Jaw lesion (endemic form)
Pelvis or abdomen tumors (sporadic form)
VIH association

Question 3

Obliteration of BM with fibrosis. Atypical megakaryocytic hyperplasia. Massive splenomegaly. Dacrocytes. JAK2 mutation

Answer 3

Myelofibrosis

Question 4

Stem cell disorder shown as defects in cell maturation of nonlymphoid lineages. Pancytopenia, oval macrocytosis and neutrophil hyposegmented, hypogranulated. Due de novo mutations or chemotherapy

Answer 4

Myelodysplastic syndrome

Question 5

Type of leukemia that presents intracytoplasmatic Auer rods and is associated with a t(15;17) chromosomal translocation

Answer 5

Acute promyelocytic leukemia, formerly M3 AML

Question 6

Typical findings in intravascular hemolysis

Answer 6

↓ haptoglobin, ↑ schistocytes in blood smear

Question 7

Describe laboratory findings seen in Disseminated Intravascular Coagulation

Answer 7

Activation of coagulation cascade.

• Thrombocytopenia
• ↑ DD (due fibrinolysis)
• Prolonged coagulation profile times
• ↓ fibrinogen (due consumption)
• Schystocytes

Question 8

Mention aplastic anemia laboratory and bone marrow bx findings

Answer 8

Anemia, leukopenia, thrombocytopenia
↑ EPO
↓ reticulocytes
Normal MCV
Normal haptoglobin
Bx: hypocellular bone marrow with fatty infiltration

Question 9

Minifestations of von Willebrand disease

Answer 9

AD. Intrinsic pathway coagulation defect. Normal platelet count, normal PT, ↑ bleeding time, ↑ PTT.

Question 10

Splenic manifestations in Sickle cell anemia

Answer 10

Splenic infarct/sequestration crisis → fibrosis and atrophy

Autosplenectomy

Question 11

Clinical manifestations of Polycythemia vera

Answer 11

Aquagenic pruritus, facial pletora, splenomegaly.
Associated wuth peptic disease and gouty arthritis
↑ RBC, ↑ WBC, ↑ Platelets, + JAK2 mutations, ↓ EPO

Question 12

This neoplasm can present as mediastinal mass → SVC-like syndrome). ↑↑↑ lymphoblasts

Answer 12

T-cell acute lymphoblastic leukemia

Question 13

Mention general characteristics of Gaucher disease

Answer 13

Hepatosplenomegaly, pancytopenia due splenic sequestration, osteoporosis, avascular necrosis, bone crises, Gaucher cells.
↑ Glucocerebroside

Question 14

General characteristics of Scurvy

Answer 14

Deficiency of Vit C.
Swollen gums, easy bruising, petechiae, normo-normo anemia, phrynoderma, coiled hair, poor wound healing. Coagulation studies normal

Question 15

Myeloid stem cell proliferation: mature granulocytes and splenomegaly, low leukocyte alkaline phosphatase.
Philadelphia chromosome +

Answer 15

Chronic myelogenous leukemia

Question 16

Mention the triad of Plummer-Vinson syndrome

Answer 16

Iron deficieny anemia, esophageal webs and dysphagia

Question 17

General characteristics of Thrombotic thrombocytopenic purpura

Answer 17

Inhibition of ADAMTS13 → ↓ degradation of vWF multimers → ↑ platelet adhesion and aggregation
Thrombocytopenia, microangiopathic hemolytic anemia, acute kidney injury, fever, neurologic symptoms
Normal PT and PTT

Question 18

Indolent course with painless fluctuating lymphadenopathy. t(14;18) chromosomal translocation → BCL-2 activation

Answer 18

Follicular lymphoma

Question 19

X-linked disorder, intravascular hemolysis, insufficient NADPH, triggered by infections, sulfa drugs, fava beans. Low haptoglobin and high reticulocytes

Answer 19

G6PD deficiency

Question 20

Neoplasms associated with Epstein Barr infection

Answer 20

Burkitt lymphoma, nasopharyngeal carcinoma

Question 21

This intoxication shows as weakness, abdominal pain, constipation, neurologic manifestations. In blood smear: basophilic stippling and hypochromic microcytic anemia

Answer 21

Lead poisoning

Question 22

In this hemolytic anemia, there is splenomegaly, spherocytes, negative coombs test, high osmotic fragility and the risk of pigmented gallstones and aplastic crises

Answer 22

Hereditary spherocytosis