hematology oncology quiz

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Hematology-Oncology Quiz for Post Graduates:

Hematology -Oncology Quiz for Post Graduates Dr.Jitendra Vachhani Dr.Nitin Rathod Dr.Maulik Shah Shri M.P.Shah Medical College, Jamnagar.

HEMATOLOGY:

HEMATOLOGY

Slide 3:

Define “BOMBAY “ blood group…

Answer :

Answer It lacks antigens A,B & H

Slide 5:

Name Vitamin K dependant coagulation factors. (any 4)

Answer :

Answer factors II, VII, IX, and X and protein C and protein S

Identify the hematological abnormality:

Identify the hematological abnormality

Slide 8:

↓ Hb , ↑↑ MCV, = megaloblastic anemia . The MCV can be mildly increased in post blood loss or hemolytic anemia , because the newly released RBC's, the reticulocytes , are increased in size over normal RBC's, which decrease in size slightly with aging.

Slide 9:

Give the status of following laboratory values in an intravascular hemolytic anemia A. haptoglobin B. lactate dehydrogenase (LDH) C. reticulocyte count D. unconjugated bilirubin E. urine hemosiderin

Answer :

Answer A. haptoglobin - B. lactate dehydrogenase (LDH) C. reticulocyte count D. unconjugated bilirubin E. urine hemosiderin

Slide 11:

At what temperature are platelet concentrates stored ?

Slide 12:

ANSWER 20 degrees centigrade

Slide 13:

Q: You are asked to review the peripheral blood smear from a patient with anemia. Serum lactate dehydrogenase is elevated and there is hemoglobinuria . Patient has h/o undergone a cardiac surgery in past also. This patient is likely to have which physical examination finding in Chest examination?

Slide 14:

IDENTIFY THE ABNORMALITY IN SMEAR

Answer :

Answer Prosthatic Valve leading to hemolysis

ONCOLOGY :

ONCOLOGY

Slide 17:

Enumerate THREE congenital disorders that are associated with an increased risk of developing acute leukemia. Answer

Answer :

Answer Down Syndrome Fanconi Anemia Bloom Syndrome

Slide 19:

Enumerate the 4 drugs that are used in remission induction chemotherapy in A.L.L.

Answer :

Answer Vincristine Prednisolone L- asparginase Daunomycin ( Anthracycline )

Slide 21:

What is the no. of chromosome whose anamaly is associated with familial cases of retino blastoma ?

Answer :

Answer Chromosome 13

Slide 23:

Enumerate THREE classical symptoms of superior mediastinal syndrome

Answer :

Answer Dyspnoea Dysphagia Facial puffiness

Slide 25:

A child presents with chronic ear discharge, skin rash, seborrhoic dermatitis, skull defects, hepatosplenomegaly , and lymphadenopathy . What is likely diagnosis…

Answer :

Answer Lengerhans cell histiocytosis

Slide 27:

Name two drugs drugs used in frontline management of chemotherapy related vomitting

Answer :

Answer Ondansetron Prednisolone

Slide 29:

Which are the two most important prognostic factors in childhood ALL ?

Slide 30:

ANSWER Age at Diagnosis : < 1 year & >10 years TLC : > 1,00,000

Slide 31:

Which malignancy is prevented by a vaccine to a fair extent in modern days ? Also name the vaccine.

Slide 32:

Answer : Cervical Cancer in females is prevented by preventing HPV infection by using vaccine against HPV. Presently two HPV vaccines available in india . Quadruvalent & bi valent .

Slide 33:

IMAGINATI N…!!

Slide 34:

What type of malignancy is most commonly associated with the physical finding shown below? ( system wise)

Slide 35:

Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin. When seen in individuals older than age 40, this disorder is commonly associated with an internal malignancy, usually adenocarcinoma , and most commonly of the GI tract or uterus;

Identify the hematological abnormality and name the condition :

Identify the hematological abnormality and name the condition

Slide 37:

fragmented RBC's + "helmet" cells. + " schistocytes “ = microangiopathic hemolytic anemia (MAHA) or intravascular hemolysis . This finding is typical for disseminated intravascular coagulopathy (DIC).

Name the condition & abnormality:

Name the condition & abnormality

Answer :

Answer Severe, chronic anemias (such as thalassemias and sickle cell anemia ) can increase the bone marrow response to form RBC's . This drive for erythropoiesis may increase the mass of marrow and lead to increase in marrow in places

Identify the abnormality:

Identify the abnormality

Slide 41:

The WBC's seen here are lymphocytes, but they are blasts--very immature cells with larger nuclei that contain nucleoli. Such lymphocytes are indicative of acute lymphocytic leukemia (ALL). ALL is more common in children than adults. Many cases of ALL in children respond well to treatment, and many are curable.

WHAT’S YOUR DIAGNOSIS ?:

WHAT’S YOUR DIAGNOSIS ?

Slide 43:

A 72-year-old woman feeling fatigued for the past 6 weeks. 6 kg weight loss in the past 3 mths . She has nausea, but no vomiting, hemoptysis , or hematemesis . She does not have a cough. On physical examination she is afebrile . A stool sample is positive for occult blood. Her serum carcinoembryonic antigen (CEA) is elevated but her alpha-fetoprotein (AFP) is not.

Slide 44:

Which of the following is the most likely diagnosis? A. Hepatic adenomas B  Metastatic adenocarcinoma C  Multifocal biliary tract dysplasia D Hepatocellular carcinoma E Micronodular cirrhosis The representative gross appearance of her liver is depicted here.

Slide 45:

The multiple mass lesions seen here are characteristic for metastases, and a common primary site would be the colon. The central necrosis of the larger masses is often seen with metastatic adenocarcinoma . The CEA may be elevated with malignancies originating in the gastrointestinal tract.

Slide 46:

A 48-year-old woman develops increasing malaise over the past 4 months. On physical examination there are no abnormal findings. Labs: Hgb = 8.5 g/ dL , WBC =241,400/ microliter . A bone marrow biopsy shows a 100% cellular marrow. of the cells from the marrow yields the karyotype shown here. Which of the following is the most likely diagnosis?

Slide 47:

Likely Diagnosis ? A Chronic myelogenous leukemia B  Metastatic breast carcinoma C  Myeloid hyperplasia D Granulomatous infection E  Multiple myeloma Chromosome analysis- karyotype

Slide 48:

The karyotype is 46, XX, t(9:22). The t(9:22) abnormality is the Philadelphia chromosome that is characteristic for chronic myelogenous leukemia . There is a BCR-ABL fusion gene upregulating a tyrosine kinase that drives cell proliferation.

Slide 49:

A previously healthy 40-year-old man is found to have systemic hypertension with blood pressure of 160/105 mm Hg on physical examination. Laboratory studies shown his plasma renin is increased and his serum potassium decreased. Laparoscopic resection is performed and the lesion shown here.

Slide 50:

Which of the following is the most likely diagnosis? A  Adenoma B  Metastasis C  Carcinoma D  Hyperplasia E  Sarcoma

Slide 51:

This small discrete mass of the adrenal gland is typical for a benign neoplasm. Note how the adenoma resembles the normal adrenal cortex around it. Many adrenal adenomas are non-functioning, but this one is producing aldosterone to cause reduction in potassium and to stimulate renin secretion. adrenal adenoma

Slide 52:

A 30-year-man a progressively worsening cough for 1 month. On exam: a few small lymph nodes are palpable in his axillae , and the tip of the spleen is palpable. Labs: Hgb 10.2 g/dl, Hct 31.1%, MCV 90 fL , WBC count 67,400/ microliter , and platelet count 36,220/ microliter .

Slide 53:

Which of the following is the most likely diagnosis? A  Acute myelogenous leukemia B  Plasma cell leukemia C  Chronic lymphocytic leukemia D  Acute lymphoblastic leukemia E  Hairy cell leukemia F Leukoerythroblastosis His peripheral blood smear

Slide 54:

The Auer rod seen in one of these large 'blasts' is typical for an acute myelogenous leukemia , which is most often seen in adults. There is a marked leukocytosis . acute myelogenous leukemia

Slide 55:

A 26-year-old man Sudden onset of severe chest, back, and abdominal pain. On exam: he is afebrile , No lymphadenopathy or splenomegaly . He has right upper quadrant tenderness. His peripheral blood smear is shown here. Which of the following conditions is he most likely to have?

Slide 56:

most likely diagnosis? A  Epstein-Barr virus infection B  Chronic atrophic gastritis C  Pigmented gallstones D  Hepatitis A infection E  Esophageal web F  Inflammatory bowel disease His peripheral blood smear is shown here

Slide 57:

The sickled erythrocytes seen here are indicative of sickle cell anemia , which in the Homozygous state is marked by 'crises’ of sickling of erythrocytes that plug vessels and lead to ischemia with marked pain. The chronic hemolysis increases bilirubin which contributes to Gallstone formation. Pigmented gallstones

Slide 58:

32yr F has painless right cervical adenopathy . A cervical lymph node biopsy is performed and the microscopic appearance is shown here. What is the most likely diagnosis?

Slide 59:

The large Reed-Sternberg cell seen here is indicative of Hodgkin lymphoma . The Reed-Sternberg cells and variants produce cytokines that attract a variety of cells which form the bulk of the mass effect with this malignancy.

ma fUt mtblt...!:

ma fUt mtblt ...!

Slide 61:

Thalesemia Transfusion of Blood components Acute leukemias in children Drugs and G6 PD Defficiency Neuro blastoma Oral iron therapy

Oral Iron Therapy:

Oral Iron Therapy a. To be given during food intake . false b. Earliest improvement is seen as retic count ↑. false c. GI Upset is the commonest complaint. TRUE d. Iron tolerance test is very helpful to determine iron absorption . TRUE Back to mains

NEUROBLASTOMA:

NEUROBLASTOMA a. It’s the most common intra-abdominal solid tumour in childhood . TRUE b. It is welknown to undergo spontaneous regression,maturation . TRUE c. Surgery alone is curative in stage I TRUE d. All patients will have high catecholamine metabolites level in Urine. FALSE Back to mains

Drugs causing definite hemolysis in G6PD Deficient patients:

Drugs causing definite hemolysis in G6PD Deficient patients a. cotrimoxazole TRUE b. Nalidixic acid TRUE c. Amoxycilin FALSE d. Dapsone TRUE Back to mains

ACUTE LEUKEMIAS IN CHILDREN:

ACUTE LEUKEMIAS IN CHILDREN a. The Most common cancer in children TRUE b. Commonest age of presentation is 5-8 yrs FALSE c. ALL & AML can be differentiated clinically. FALSE d. CNS involvement carries bad prognosis TRUE Back to mains

THALESEMIA:

THALESEMIA a. 3% of world’s population carry gene for β thalesemia TRUE b. Only thalesemia major needs blood transfusion therapy FALSE c. Desferoxamine can cause ototoxicity & hearing loss. TRUE d. Antenatal diagnosis is possible earliest at 16 wks with amniotic fluid examination. FALSE Back to mains

TRANSFUSION OF BLOOD COMPONENTS:

TRANSFUSION OF BLOOD COMPONENTS a. Single donor platelet is usually more concentrated than Random donor. TRUE b. One RDP per 10kg increases usually 40,000/ cmm platelet. FALSE c. Irradiation of blood is done to make it aseptic (infection free). FALSE d. Factor V &VIII are lost if FFP is not transfused in 30 min. TRUE Back to mains

Thank you for participation:

Thank you for participation