Hematology and Oncology USMLE

From which embryonic layer are angioblasts derived?

Name the site of red blood cell production during each of the following developmental phases.

What is the most common inherited hypercoagulable state?

The factor V leiden mutation inhibits factor V cleavage by which protein?

What is the effect of estrogen, endogenous or exogenous, on thrombosis?

What clotting factors require vitamin K for their synthesis?

What common laboratory test is used to access the intrinsic coagulation system?

What common laboratory test is used to assess the extrinsic coagulation pathway?

What commonly used anticoagulant interferes with the extrinsic pathway?

The use of the chelator, ethylene diamine tetra acetate (EDTA), as an anticoagulant, in tubes is designed to inactivate what factor in the blood?

What inhibitor of the coagulation cascade inactivates factor Va and VIIIa?

What are the two major functions of von Willebrand factor?

Dysfunction of what clotting component results in mucous membrane hemorrhage, petechiae, purpura, and prolonged bleeding time?

Dysfunction of what clotting component results in hemarthroses, purpura, and prolonged PT and/or PTT?

Name the coagulopathy associated with the following clinical and pathologic features:
Most common hereditary bleeding disorder

Most common type of hemophilia

Most common cause of acquired platelet dysfunction

Autosomal dominant (AD) disorder causing increased bleeding time

Autosomal recessive defect in platelet adhesion caused by GpIIb/IX

AR defect in platelet aggregation caused by deficiency of GpIIb/GpIIIa, a membrane receptor responsible for binding fibrinogen.

Common presentation includes hemarthroses and easy bruising, increased PTT, normal PT

Prolonged bleeding time with normal platelet count, normal PT and increased PTT

Prolonged PT, PTT, increased bleeding time, thrombocytopenia, presence of fibrin split products

Normal PT, PTT, normal platelet count, increased bleeding time

Syndrome characterized by antiplatelet antibodies (commonly anti-Ib-IX or IIb-IIIa), often post-viral infections

Syndrome characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever and neurologic symptoms

Widespread hyaline microthrombi in arterioles and capillaries causing schistocytes and helmet cells.

Splenomegaly, epistaxis, petechiae, generalized tender lymphadenopathy, serum antibodies (+)

List five of the most common causes of microcytic anemia

List four of the most common causes of normocytic anemia

List five of the most common causes of macrocytic anemia

What is the primary site of iron absorption? Vitamin B12? Folate?

What is the major cause of iron deficiency anemia in adults?

What are two common clinical complaints in an anemic patient?

Which amino acid substitution in the B globin gene is most commonly seen in sickle cell anemia?

What is the major type of hemoglobin in homozygous sickle cell anemia?

In sickle cell disease, what is the mechanism of ischemic necrosis of the bones, lungs, liver, brain, spleen or penis?

What is the major regulatory enzyme in heme biosynthesis?

What two common enzyme deficiencies can cause hemolytic anemia?

What hemolytic anemia is associated with exposure to oxidant stress?

What two common RBC membrane defects can cause hemolytic anemia?

What common cause of atypical pneumonia is associated with cold immune hemolytic anemia?

What type of anemia is caused by lack of intrinsic factor (IF) secretion by gastric parietal cells?

What two autoimmune diseases of the GI tract can cause megaloblastic anemia?

What parasites are capable of causing megaloblastic anemia?

How does gastric resection cause megaloblastic anemia?

What type of malignancy is associated with pernicious anemia?

Name three medications capable of causing autoimmune hemolytic anemia?

What types of malignancies are associated with autoimmune hemolytic anemia?

What laboratory tests are seen in hemolytic anemia?

Name two commonly used medications that can cause aplastic anemia

What test is used to monitor anticoagulation in a patient treated with heparin?

What test is sued to monitor anticoagulation in a patient treated with warfarin?

What happens to the total iron binding capacity, serum iron concentration and percent saturation of transferrin in each of the following diseases?

Name the types of anemia associated with the following clinical and pathologic features:

ABO incompatility, lymphoid neoplasm, Raynaud phenomena, anti-i antibodies

Atrophic glossitis

Autosplenectomy

Basophillic stipling of erythrocytes, blue/gray discoloration at gumline, wrist/foot drop

Celiac sprue

Chronic atopic gastritis

Colon cancer

Crescent-shaped erythrocytes and Howell-Jolly bodies

Deficiency of a or B globin gene synthesis

Deficiency of decay accelerating factor

Demyelination of the dorsal and lateral tracts of the spinal cord

End stage liver disease

Helmet cells, burr cells, triangular cells

Hypersegmented polymorphonuclears (PMNs)

Increased serum lactate dehydrogenase

Microcytosis, atopic glossitis, esophageal webs (Plummer-Vinson syndrome)

Pancytopenia and fatty infiltration of bone marrow

Systemic lupus erythematosus (SLE), chronic lymphocytic leukemia (CLL), lymphomas, drugs +direct Coombs test (due to IgG autoantibodies)

AD deficiency of spectrin, positive osmotic fragility test

What are the two major categories of lymphoma?

Interleukin (IL-5) secreting Reed Sternberg cells

Commonly arises from B cells

Constitutional symptoms including both fever, night sweats weight loss

Mediastinal lymphadenopathy, contiguous spread

Many cases associated with Epstein Barr virus

Peripheral lymphadenopathy, noncontiguous spread

Bimodal age distribution, but most common in young men

Peak incidence from 20 to 40 years of age

Associated with immunosuppression including AIDS

Painful lymphadenopathy with alcohol consumption

Most common hodgkin disease

Abundance of RS cells

Lacunar cells and collagen binding

Commonly seen in older patients with Hodgkin disease

Widely disseminated disease with poor prognosis

Most common in females

Abundance of lymphocytes

Commonly seen in men 35 years presenting with cervical or axillary lymphadenopathy

Higher proportion of RS cells relative to lymphocytes

Overexpression of cyclin D1

Starry-sky appearance on histopathology

Clinically similar to CLL: characterized by nodules of small lymphocytes

Older adults with BCL2 gene mutation

Often appear at extranodal sites and can cause small bowel obstruction

Child presenting with enlarging mandibular mass

Common in children who present with a mediastinal mass and a syndrome similar to that of acute lymphocytic leukemia (ALL)

TdT+ lymphocytes

Endemic in Africa and associated with Epstein Barr virus

0-14 years old

15-39 years old

40 to 59 years old

More than 60 years old

Very high white cell counts, often more than 200,000

Isolated lymphocytosis

TdT+ lymphoblasts

Name the four chronic myeloproliferative disorders