Millions of Americans suffer from hematologic diseases, which are abnormalities of the blood and blood-forming organs. Hematologic diseases include rare genetic disorders, anemia, HIV-related ailments, sickle cell disease, and chemotherapy or transfusion-related consequences, in addition to blood cell malignancies.
Question 1: A 48-year-old man comes to the emergency room with a 6-week history of stomach pain and night sweats that has gotten worse. Palpable bilateral 2-cm axillary lymph nodes and widespread abdomen discomfort with no rebound or guarding were notable physical examination findings. The abdomen and pelvis were imaged using computed tomography, which revealed retroperitoneal and mesenteric lymphadenopathy. An axillary node excisional biopsy revealed diffuse large B-cell lymphoma. The axillary, mesenteric, and retroperitoneal lymph nodes displayed fluorodeoxyglucose-abundance on positron emission tomography. The bone marrow test revealed no abnormalities.
(a) Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone in combination therapy (R-CHOP)
(b) Cyclophosphamide, doxorubicin, vincristine, and prednisone in combination therapy (CHOP)
(c) Transplantation of autologous stem cells
(d) Radiation therapy in the involved field
Answer: (a)
Explanation: R-CHOP chemotherapy is the mainstay of care for this patient, who has advanced-stage diffuse large B-cell lymphoma. When used with CHOP chemotherapy for aggressive B-cell lymphomas, rituximab, an anti-CD20 monoclonal antibody, improves overall survival.
Question 2: A 39-year-old man appears with a three-month history of exhaustion, nocturnal sweats, and lethargy. On examination, you notice splenomegaly and swollen, painless cervical lymph nodes. Hb 103 g/l (normal 135-180 g/l), WCC 12.0 (normal 3.4-11), and ESR 70 (12) are all found in blood tests. Reed-Sternberg cells are histologically multinucleated large cells. What is the most likely source of the symptoms this patient is experiencing?
(a) Burkett s lymphoma
(b) Hodgkin s lymphoma
(c) Non- Hodgkin s lymphoma
(d) All of the above
Answer: (b)
Explanation: This is a patient who has lymphoma and is experiencing ‘B symptoms.' They have anemia and a high ESR, both of which indicate a dismal prognosis.
Question 3: A 22-year-old woman has been complaining of chronic weariness. Her GP, she says, "keeps putting this down to depression." She hasn't lost any weight and hasn't shown any signs of a fever. She recalls having a persistent sore throat a few months ago, but nothing since. You notice cervical lymphadenopathy and moderate splenomegaly on examination. Hb 120g/l (normal 115-165g/l), WCC 6.0 (normal 3.9-5.6), and platelet count 310 are the results of her whole blood count (normal 140-450). What is the best course of action for the next investigation?
(a) Bone marrow aspiration
(b) Monospot test
(c) FISH studies
(d) None of the above
Answer: (b)
Explanation: This question requires you to determine the source of this regular occurrence in general practice, which can be distinguished from a malignant hematological cause.
Question 4: Shortness of breath, weariness and growing pain in his left leg and back have plagued a 68-year-old man. In the last year, he has lost two stones in weight. His renal function was found to be abnormal at his most recent examination. Hb 104g/l (normal 135-180), MCV 93fl (normal 80-102fl), and WCC 2.8 are all found in routine blood tests (normal 3.4-11.0). Which of the following investigations would be most helpful in determining the cause of his symptoms in the beginning?
(a) Ultrasound
(b) Blood film
(c) Both a and b
(d) DEXA
Answer: (d)
Explanation: This is a patient with characteristic Multiple Myeloma symptoms. Because of its subtle nature, this is a challenging diagnostic to make. However, at this time, urine (or perhaps serum) electrophoresis would be the most useful method for detecting multiple myeloma.
Question 5: Hematology is the study of?
(a) Cells
(b) Blood
(c) Lymphocytes
(d) All of the above
Answer: (b)
Explanation: The process that transports nutrients, gases, hormones, and cells throughout the body is the circulatory system.
Question 6: The medical term used for white blood cells?
(a) Granulocytes
(b) Platelets
(c) Lymphocytes
(d) Erythrocytes
Answer: (c)
Explanation: Erythrocytes are red blood cells, thrombocytes are platelets, and lymphocytes are called white blood cells. Granulocytes are the sub-group of white blood cells.
Question 7: Which of the following is not a granulocyte?
(a) Basophil
(b) Neutrophil
(c) Eosinophil
(d) Monophil
Answer: (d)
Explanation: Granulocytes, which comprise the above, and lymphocytes, which include monocytes, are the two groupings of white blood cells.
Question 8: Which of the following does not contribute to the formation of red blood cells?
(a) Spleen
(b) Bone marrow
(c) Kidney
(d) Thymus
Answer: (d)
Explanation: In adults, the bone marrow is the primary location of hematopoiesis, and it houses all progenitor cells for both white and red blood cells.
Question 9: What physiological circumstance would result in a hematocrit increase?
(a) Protein concentration
(b) Dehydration
(c) Hemolysis
(d) Iron deficiency
Answer: (b)
Explanation: The fraction of blood made up of red blood cells (volume of RBCs/total blood volume) is known as hematocrit.
Question 10: In high altitudes, what is the hemoglobin value?
(a) Increase
(b) Decrease
(c) Both a and b
(d) None of the above
Answer: (a)
Explanation: As the temperature drops, the oxygen concentration drops, causing the blood cells to produce excessively in number so that they restore the oxygen deficiency in the blood.
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