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92 Cards in this Set
- Front
- Back
Auer rods on peripheral smear indicate...
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acute myeloblastic leukemia (AML)
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60 year old male with severe anemia, decreased neutrophil count, and small, abnormal B lymphocytes in the bone marrow (>30%) with levels at 90,000 per cubic millimeter. Has painless cervical lymphadenopathy and hepatosplenomegaly. Likely diagnosis?
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Chronic lymphocytic leukemia (CLL)
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Bone marrow aspiration and biopsy reveals the presence of the Philadelphia (Ph) chromosome in dividing marrow cells. Likely diagnosis?
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Chromic myeloblastic leukemia (CML)
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Follicular, cleaved cell, lymphocytic, histolytic
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Hodgkins Lymphoma
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Reed Sternberg cell
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Hodgkin's lymphoma
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Plasma cells, monoclonal protein
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Multiple myeloma
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What disease is characterized by abnormal monoclonal protein, anemia, and lytic bone lesions?
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Multiple myeloma
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30 year old white male with 3 month history of painless enlargement of bilateral cervical lymph nodes, fever, and night sweats. Likely diagnosis?
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Hodgkin's disease
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What hematologic measurement is abnormal in chronic heavy alcohol use?
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Mean corpuscular volume
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Most frequent cause of B12 deficiency in patients with classic pernicious anemia
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Lack of intrinsic factor
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In thalassemia anemia, what causes the anemia?
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Shortened lifespan of RBCs
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Teenage African American female presents with severe bone and joint pain. CBC shows severe anemia and elevate leukocyte and platelet counts. Most likely diagnosis?
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Sickle cell disease
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What 2 tests are used to confirm the diagnosis of homozygous sickle cell disease?
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Peripheral smear and hemoglobin electrophoresis
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The most helpful test to distinguish megaloblastic from nonmegaloblastic macrocytic anemia
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Peripheral smear
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What is the most common initial presentation of sickle cell disease?
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Failure to thrive in a child at risk
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4 year old with fever, bleeding, bone pain, generalized lymphadenopathy, splenomegaly, hepatomegaly. CBC shows anemia, leukocytosis (100,000 immature WBC) and thrombocytopenia. Prognosis is good. Likely diagnosis?
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Acute lymphocytic leukemia
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Type of anemia characterized by small red blood cells, MCV <76
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Microcytic anemia
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Name the classic types of microcytic anemia
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Iron deficiency anemia, thalassemia, sideroblastic anemia, anemia of chronic disease, lead poisoning
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Type of anemia characterized by large red blood cells, MCV >100
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Macrocytic anemia
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Causes of megaloblastic anemia
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B12 (cobalamine) deficiency, folate deficiency, and drugs. May be idiopathic.
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Type of anemia in which serum iron is decreased and TIBC is increased
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Iron deficiency anemia
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Basophilic stippling of RBCs is noted. Likely dx?
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Lead poisoning
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Classify the 2 types of macrocytic anemia
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Megaloblastic and nonmegaloblastic
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RBC with low hemoglobin and an enlarged area of central pallor
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Hypochromic
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RBC with a loss of central pallor, stains more densely, and is often microcytic.
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Spherocyte
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RBC that is hypochromic with a central darkening of hemoglobin. Seen in liver disease, thalassemia.
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Target cell
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Fragmented helmet or triangular-shaped RBC
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Schistocyte
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Elongated RBC with pointed ends
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Sickle cell
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Type microcytic hypochromic anemia that demonstrates low serum iron and low TIBC. Unresponsive to iron therapy.
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Anemia of chronic disease/inflammation
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3 possible etiologies of normocytic normochromic anemia
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Blood loss, hemolysis, decreased production
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In a patient presenting with normochromic normocytic anemia, what is the next test to classify the anemia according to marrow response?
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Reticulocyte count
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Low MCV, low RBC, high RDW, low serum Fe, high/nml TIBC
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Iron deficiency anemia
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Low MCV, normal/high RBC, normal RDW, high/norm serum Fe, normal TIBC
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Thalassemia
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Normal/low MCV, normal RBC, low serum Fe, low TIBC
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Anemia of chronic disease
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Pancytopenia, anemia, leukopenia, neutropenia, thrombocytopenia
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Aplastic anemia
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What is the best test to determine whether a patient as a hemolytic anemia?
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Reticulocyte count and blood smear
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A patient with a history of gastric carcinoma is pale and mildly icteric with a beefy, red, sore tongue. He presents with numbness in his feet, weakness, and ataxia. Peripheral blood smear shows macrocytosis and hypersegmented polymorphonuclear lymphocytes. This is due to deficiency of what vitamin?
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B12
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60 year old male with no symptoms and no abnormalities on physical exam has a CBC that shows hemoglobin of 9.0, leukocytes 40,000, and peripheral smear shows 97% small lymphocytes. Likely dx?
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Chronic lymphocytic leukemia
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What are the two most common histologic subtypes of Hodgkin's disease?
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Nodular sclerosing and mixed cellularity
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What are B symptoms?
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Fever, drenching night sweats, fatigue, weight loss
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What is the best test to determine whether a patient as a hemolytic anemia?
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Reticulocyte count and blood smear
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Increased ferritin, increased iron, decrease TIBC, hematocrit 20-30%
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Sideroblastic anemia
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59 year old African American with long-standing history of RA. Hemoglobin is 9, hematocrit 27. Iron and TIBC normal. Likely dx?
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Anemia of chronic disease
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A megaloblastic anaemia due to vitamin B12 deficiency dependent on impaired absorption of vitamin B12
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Pernicious anemia
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What test confirms the diagnosis of pernicious anemia?
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Schilling test
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What test is used to assess a patient's ability to absorb Vitamin B12 from the bowel?
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Schilling test
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What test will distinguish thalassemia minor from iron deficiency anemia?
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Serum ferritin determination
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Treatment for thalassemia minor
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Supportive
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Hypochromic microcytic anemia with increased serum iron, normal TIBC, increased ferritin, and normal HbA2
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Sideroblastic anemia
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Normal serum iron, normal TIBC, normal ferritin, elevated HbA2
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Beta-thalassemia trait
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What type of anemia requires a bone marrow aspiration for definitive diagnosis?
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Sideroblastic anemia
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Most likely vitamin deficiency related to pancytopenia
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Folate
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What factor is produced in the stomach and required for intestinal absorption of Vitamin B12?
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Intrinsic factor
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What is the most common cause of B12 deficiency?
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Pernicious anemia (lack of intrinsic factor)
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What is the most common cause of folate deficiency?
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Inadequate dietary intake
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What test is used to monitor progression of HIV infection and responses to therapy?
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Plasma viral load
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Most common presentation for Non-Hodgkin's lymphoma
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Painless lymphadenopathy
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What is the first step after finding a 1cm mobile, soft thyroid nodule with no associated lymphadenopathy?
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Fine needle aspiration
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Most common type of thyroid cancer
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Papillary
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What test excludes the diagnosis of polycythemia vera if it is suspected?
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Elevated plasma erythropoietin level
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What coagulation factor is NOT vitamin K dependent?
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Factor VIII
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What tumor marker is measured for testicular cancer?
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alpha-fetoprotein
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What tumor marker is measured for colon cancer?
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Carcinoembryonic antigen (CEA)
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What tumor marker is measured for ovarian cancer?
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CA 125
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What tumor marker is measured for prostate cancer?
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PSA
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What tumor marker is measured for carcinoid tumor?
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5-HIAA
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A Negri body is a pathognomonic sign of what disease?
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Rabies
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What type of megaloblastic anemia is associated with neurologic deficits?
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Vitamin B12 deficiency
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Headache, dizziness, visual disturbances, generalized itching, facial plethora, moderate splenomegaly. Likely diagnosis?
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Polycythemia vera
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The presence of Heinz bodies on peripheral smear indicates...
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G6PD deficiency
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What is the most common congenital hemolytic anemia in the white population?
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Hereditary spherocytosis
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What are the causes of microangiopathic hemolytic anemia?
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disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome, and artificial heart valves
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Hemoglobin electrophoresis confirms the diagnosis of what 2 types of anemia?
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Thalassemia and sickle cell disease
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What viruses may cause aplastic anemia?
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Hepatitis and parvovirus B19
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What is the most common type of childhood leukemia?
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Acute lymphocytic leukemia. 75% of cases occur in children less than 15 years of age. The rest of the cases occur after age 50.
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What type of leukemia is most commonly seen in elderly men?
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Chronic lymphocytic leukemia
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What is the first-line chemotherapy agent for chronic lymphocytic leukemia?
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Chlorambucil
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Which ALL patient generally has a better prognosis: a child or an adult?
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98% of children achieve complete remission after 4 weeks of chemotherapy, and 70% of children will be cured. Only 30-40% of adults will be cured.
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What 2 types of leukemia may have the Philadelphia chromosome?
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Acute lymphocytic leukemia (its presence indicates a poorer prognosis) and Chronic myelogenous leukemia (present in 95% of cases)
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What is the most common form of adult leukemia in Western countries?
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Chronic lymphocytic leukemia
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Which type of leukemia will have smudge cells on the peripheral blood smear?
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Chronic lymphocytic leukemia
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What is the most deadly phase of chronic myelogenous leukemia?
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Acute blast crisis phase (>30% blasts in blood or bone marrow)
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What type of leukemia have lymphocytes with hairlike cytoplasmic projections?
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Hairy cell leukemia
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Hodgkin's lymphoma has a bimodal age distribution. When are they?
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The first peak is in the second and third decades of life, the second peak is after the age of 50
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What type of lymphoma may be linked with EBV?
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Hodgkins
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What does the presence of B symptoms in Hodgkins lymphoma indicate?
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Poor prognosis
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What test will confirm your diagnosis of multiple myeloma?
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Protein electrophoresis may show IgM proteins or Bence Jones proteins
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Hemophilia A is a deficiency of what coagulation factor?
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Factor VIII
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Hemophilia B is a deficiency of what coagulation factor?
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Factor IX
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What disease is an autoimmune bleeding disorder in which patients develop antibodies against their own platelets?
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Idiopathic Thrombocytopenic Purpura (ITP)
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Name some things that can cause disseminated intravascular coagulation.
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Obstetric complications (amniotic fluid embolism, retained dead fetus, abruptio placenta), transfusion reactions, malignancy, trauma (brain injury, crush injury, burns), infection or sepsis, acute pancreatitis, ARDS
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What lab test can be used to monitor effective response to treatment in patients with iron-deficiency anemia?
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Reticulocyte count
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