Hematology Case Studies With Answers Pdf To Word
Wink Wink Patho Exam 1. The combination of amoxicillin, omeprazole, and clarithromycin is the most appropriate first-line treatment. Depends on subtype and stage. There was no deletion of chromosome 17p. C. In light chain amyloidosis, increased plasma cells are often found in the marrow.
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Hematology Case Studies With Answers Pdf 2020
The following day he returned for his second treatment. D. Bone marrow lymphocytic infiltration. Increased reticulin fibrosis would have been seen on the bone marrow biopsy if the patient had PMF. The CT scan at diagnosis is show in in Figure 98–2. ΑHCD may occur in patients presenting with all but which one of the following features? Hematology case studies with answers pdf 2020. If it is necessary to treat the leukemia before infection has been eradicated, use of low-dose pentostatin has been successful. Anemia of chronic disease results from the effect of elevated cytokines on hematopoiesis, including upregulation of hepcidin, leading to increased ferritin from iron malutilization and downregulation of ferroportin, the main iron exporting system. There were scattered centroblasts and mature plasma cells and so-called lymphoepithelial lesions with invasion and necrosis of the glandular epithelium. Immunoelectrophoresis of the serum revealed bowing of the immunoglobulin (Ig) A arc but no comparable change in the κ or λ arcs.
The possible tumor related M-band disappeared. Serum urea, electrolytes, calcium, phosphate, and liver function tests were normal. Future changes to the classification are to be expected. She has no comorbidities and a good performance status. C. Radioimmunotherapy.
Hematology Case Studies With Answers Pdf Document
He was on no medications. The lymphocyte immunophenotype was CD19+, CD20dim+, CD5+ CD23+, CD10- FMC7-. There were no serious complications and restaging showed no evidence of minimal residual disease (MRD) as determined by polymerase chain reaction analysis of blood and marrow samples. Hydrochlorothiazide use. Whereas nearly all cases of eBL contain the EBV genome, this is found in only about 15% of cases of the sporadic form and about 30% of cases associated with immunodeficiency. This therapy caused some abdominal discomfort and diarrhea, but the treatment did not need to be interrupted. Hematology case studies with answers pdf document. DNA-based testing for factor V Leiden and prothrombin G20210A mutations are reliable. He tells you that he has always been told by his physicians that he has mild anemia; his medical history is otherwise unremarkable. A. EMPs most frequently arise in the upper aerodigestive tract. Flow cytometry of the peripheral blood lymphocytes shows a monoclonal B population with dim expression of λ light chain and CD20 that is positive for expression of CD5, CD19, and CD23. She has had chronic fatigue and anemia. MBL is rarely found in individuals younger the age of 40 years, but it is progressively more common at ages over that. CBC results on the day of the procedure are shown below in Table 2.
In about half the cases of amyloidosis, the amyloid is composed of Ig light chains. D. Patients with MBL are often mildly immunosuppressed. 5-cm left axillary lymph node with two smaller adjacent 1-cm left axillary nodes. Dx= hemoglobinuria (paroxysmal nocturnal hemoglobinuria). There was no del(17), and sequencing revealed no mutation in the TP53 gene. Paula Manuel Bostwick. Hematology Questions and Answers | Mayo Clinic Internal Medicine Board Review Questions and Answers | Oxford Academic. She had developed thirst that was hard to satisfy and had little energy. This patient was treated with a low-dose bendamustine and rituximab regimen. C. Unusual bruising or bleeding. Elevated ESR (option a) is not associated with prognosis in NLPHL. The proportion of cells staining positively with Ki67 was 11%.
Hematology Case Studies For Students
A repeat endoscopy showed improvement in the superficial erosions and ulcers, but the antrum still appeared nodular, and an endoscopic ultrasound showed persistent thickening of the gastric wall. Marrow infiltration needs to be assessed with a biopsy given that PET/CT is not sensitive enough in FL in the absence of transformation. Hematology Case Studies (made up) Flashcards. Your patient presents with several hardened lymph nodes, facial edema, and "B symptoms" such as fever, night sweats, and weight loss. The MIPI is based on scores assigned for age, performance status, LDH and WBC.
Hyperdiploidy defined as more than 46 chromosomes but fewer than 76 chromosomes occurs in nearly half of patients with myeloma. Ponatinib has been associated with vascular adverse events, including myocardial infarction, strokes, and peripheral vascular disease, and these are more common in patients with preexisting cardiovascular risk factors. Which of the following tests is useful, but not essential, for a diagnosis of CTCL? She returned to see her doctor 3 months later, by which time the lethargy had increased, and the ankle edema had become more pronounced. Switching to dabigatran would result in inferior outcomes. A chest radiograph shows a right middle and upper lobe air space infiltrate. Very intensive chemotherapy was then given with two cycles of cyclophosphamide, vincristine, doxorubicin, and methotrexate alternating with two cycles of iphosphamide, etoposide, and high-dose cytosine arabinoside (CODOX-M/IVAC). Hematology case studies for students. RBC transfusion if severe. The patient had been given four courses of melphalan and prednisone. He has a 10% annual risk of multiple myeloma. It is more common in men than women.
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Electrolyte levels were normal, and the estimated creatinine clearance was 45 mL/min. Which of the following is the best next step? It looks like your browser needs an update. Case studies are board-style questions with explanations and links to related articles featured in Hematopoiesis, an e-newsletter that is sent to hematology trainees on a quarterly basis. Which of the following are unusual (<10%) in the cytogenetic analysis of myeloma marrow at diagnosis? Which of the following tests would most likely help confirm the diagnosis? This patient has advanced stage (IIIBSX) classic Hodgkin lymphoma with an International Prognostic Score (IPS) of 3 for leukocytosis, lymphopenia, and low serum albumin. She was urgently referred to a hematologist, and further investigations were carried out. It is often advised that the implant in the other breast should be removed because bilateral breast lymphomas are found in about 5% of cases. This revealed the presence of material in the biopsy, which generated birefringence under polarized light when stained with Congo red dye.
The low erythropoietin rules out erythropoietin-mediated causes, leaving the presumptive diagnosis of polycythemia vera. She has no chronic illnesses and is receiving no medications except for combination estrogen-progesterone birth control pills that she started using approximately 1 year earlier. GEP was not performed. Peripheral sensory neuropathy is a well-known side effect. 5 mg/d, aspirin 75 mg/d, metformin 500 mg × twice daily, and omeprazole 20 mg/d. It may be preceded by IgM monoclonal gammopathy of undetermined significance. The plasma cells have the t(11;14) in about 50% of cases, but the other genetic changes typical of myeloma are not usually seen. The blasts were CD34+, CD117+, HLA-DR+, CD13+ and CD33+ and were identified as myeloblasts. A complete blood count (CBC) was performed and revealed a hemoglobin of 121 g/L, which was just within the reference range for a woman. However, acute thrombosis and heparin can cause lower antithrombin activity results, which should be verified at another time, when heparin and acute thrombosis are not factors.
A 62-year-old man with chronic atrial fibrillation has been treated with warfarin. A 48-year-old man presents to the emergency department with a 6-week history of progressively worsening abdominal pain and night sweats. The immunophenotype showed expression of CD19, CD22, CD10, and CD25. He has a history of smoking which is a behavioral risk factor associated with AML. Eradication of H. Pylori. PE reveals adenopathy & hepatosplenomegaly.
Immunoelectrophoresis confirmed the presence of μ and κ arcs of different mobility. Λ chains are three times more common than λ chains, which contrasts with myeloma, in which the κ:λ incidence ratio is 2:1, the same ratio as present in normal Igs. Abdominal percussion revealed very apparent shifting dullness. Annual CT scans are recommended for follow-up by some authorities, but PET/CT is not indicated in follow-up. 20-\mathrm{V}$ stopping potential when the target is illuminated with 340-nm ultraviolet radiation. The clinical course of CLL is chronic in most patients.
He is a one pack per day smoker and has coronary artery disease and hypertension. There is no reason to suspect familial predisposition in this case. He also reports a 6-month history of recurrent headaches and fatigue. For patients meeting the GHSG criteria for early stage favorable disease, the standard of care is two cycles of ABVD (Adriamycin [doxorubicin], bleomycin, vinblastine, and dacarbazine) + 20 Gy involved-site radiotherapy (ISRT) based on the randomized phase 3 GHSG HD10 trial. The Ki67 percentage, however, exceeds 30%, which raises the risk category to low intermediate. The lactate dehydrogenase (LDH) level was 690 IU/L (normal <214 IU/L). Although he was clearly monocytopenic, he had mononuclear cells that showed a rounded nucleus with gray cytoplasm with irregular shaggy borders. D. Monoclonal heavy chains are frequently found in the urine. The blood film confirmed the lymphocytosis, and most of the lymphocytes were of small size without conspicuous nucleoli.