Putthoff, final CIS Flashcards

1
Q
52 y.o with low Hb low MCV and high RDW
high platelets
constipation, abdominal pain, weakness, malaise
general pallor with pale conjunctiva
most likely?
A

chronic blood loss anemia

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2
Q

what would blood look like with marrow replacement

A

leukoerythroblastocytes

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3
Q
37 y.o F with low Gb low MCV and norm RDW
low low platelets
weakness, malaise, dysfunctional uterine bleeding and enorrhagia
general pallor with pale conjunctiva
sparse petichiae on chest and lower extremity
serum ferritin low
most likely?
-IDA Fe deficiency anemia
-Primary chronic ITP
-secondary chronic ITP
-chronic blood loss anemia
-HUS
A

primary chronic ITP

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4
Q
37 y.o F with low Gb low MCV and norm RDW
low low platelets
weakness, malaise, dysfunctional uterine bleeding and enorrhagia
general pallor with pale conjunctiva
sparse petichiae on chest and lower extremity
serum ferritin low
most consistent with?
-massive splenomegaly
-sequestration
-increased normal megakaryocytes
-high TIBC
-abnormally large platelets
-poikilocytosis
-enlarged soft spleen with focal abscesses
dysplastic megakaryocytes
normal hemosiderin deposits
A

increased normal megakaryocytes

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5
Q
37 y.o F with low Gb low MCV and norm RDW
low low platelets
weakness, malaise, dysfunctional uterine bleeding and enorrhagia
general pallor with pale conjunctiva
sparse petichiae on chest and lower extremity
serum ferritin low
ITP or B cell neoplasm
what correlates with B cell neoplasm?
-abnormally large platelets
-splenomegaly/lymphadenopathy
-circulating autoAb
-cold agglutinis, IgA
-target cells and spherocytes
A

splenomegaly/lymphadenopathy

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6
Q

iron panel in IDA

A
free iron low
transferrin sat low
TIBC high
serum ferritin low
hepcidin low
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7
Q

iron panel in anemia of chronic disease

A
low free iron
high transferrin sat
low TIBC
high serum ferritin
high hepcidin
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8
Q

when do you see increased # megakaryocytes

A

myeloproliferative disease

primary ITP

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9
Q

Tx primary ITP

A

splenectomy

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10
Q
30 y.o M fatigue mild Lb loss
low grade fevers itchy dry skin
anemia with MCV 86 MCHC 35
PE mild spenomegaly and L axillary adenopathy
large cells!!! CD30- CD19+ BCL6+
A

HL, lymphoproliferative

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11
Q

42 y.o japanese F fever 102.2 and productive cough. right lower lobe pneumonia on CXR
mother had RA at 40 y.o
painful swollen joints especially at small articulations
RF+ and erosive, inflammatory arthritis of hands an elbows
elevated WBC with L shift and thrombocytosis
n/n anemia
most likely?
-splenic infarcts
-hemoglobulinuria
-inherited telomerase defects
-high serum ferritin level
-thymoma

A
  • high serum ferritin level

anemia of chronic disease

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12
Q

47 y.o F with malaise weakness. takes betaine supp and has ataxic gait
CBC shows macrocytosis and PS show multiple hypersegmented PMNs
elevated homocysteine and methymalonate
most likely?

A

B 12 deficiency

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13
Q
24 y.o F with weakness lethargy low libido
moderate microcytic hypochromic anemia
PS show target cells and nucleated RBC
basophilic stippling
high serum ferritin
increased HbA2, small HbF
most likely Dx?
A

Beta thalassemia minor

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14
Q
14 y.o M with epsodic blood transufions for beta thalassemia major
severe microcytic hypochromic anemia
HSM with anterior painless cervical adenopathy
thymus discernable
low temp with lymphocytosis
Hct low and high platelets
-TRALI
-myelodysplastic syndrome
-viral syndrome
-thymoma
-early aplastic anemia
A

viral syndrome

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15
Q

characteristic aplastic anemia on CBC

A

pancytopenia

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16
Q
57 y.o M with weakness lethargy
n/n anemia enlarged spleen and high WBC
immature myeloid cells and high platelets
15% blast in BM
myeloperoxidase is negative
BCR-ABL fusion genes
most likely
-CMML
-lymphoid blast crisis
-hairy cell leukemia
-Richter syndrome
-CML
A

CML

17
Q

what marks lymphoid blast crisis

A

tDt, CD 19 all those markers

18
Q

6 y.o M with easy bruising, epistaxis and ED visits requiring anterior posterior packs and vasoconstrictors
pain and swelling of R knee after playing with friends
significant bleeding into joint
PT normal PTT prolonged
most likely?

A

hemophilia A or B

19
Q

20 y.o M with fever, night sweats and 10Lb weight loss
bulky cervical lymphadenopathy and moderate splenomegaly
binucleated fiant cells with large circumscribed nucleoli
CD15+ and 30+
rare, reactive-appearing lymphoid cells
disorder is most likely
-DLBCL
-extranodal NK/T cell lymphoma
-EBV+
-Burkitt
-Sezary

A

EBV +

binucleated giant cells with circumscribe nucleoli- hodgkins. reed sternberg

20
Q
67 y.o M with fever night sweats weight loss
splenomegaly
binucleated giant cells
CD15+ 30+
most likely?
-T cell neoplasm
-rapidly transforms to DLBCL
-presents extranodal
-poor prognosis
-more common in adolescents
A

poor prognosis

21
Q

first 4 hodgkin marker

A

CD30 and 15+

22
Q

lymoho histiocytic cells, and CD markers assoc?

A

lymphocyte predominance HL

CD30- BCL6+