Hematology 2024/2025

Hematology 2024/2025
Test for the whole group

WINTER SEMESTER
These hematologists are fucked up

GROUP 1 (16.10.2024) - Pass rate 30%

1. Provide the criteria for diagnosing bone marrow aplasia (SAA) - otherwise acute
aplastic anemia a. Cytopenia in at least two lines
b. Image of poor-celled bone marrow
c. Exclusion of other causes
2. Expand the CRAB criteria name
a. Calcium - hypercalcemia
b. Renal insufficiency - high creatinine and low creatinine clearance
c. Anemia normocytarna
d. Bone lesions - lytic bone lesions
3. What is CAR-T therapy
a. therapy, usually last-line, consisting in administering the patient's own modified
lymphocytes that have a CD attachment point for the patient's disease entity.
Complications: cytokine storm, neurological disorders, B-cell aplasia, organ
failure
4. When do we start treatment for chronic lymphocytic leukemia?
Treatment chronic lymphocytic leukemia (CLL) We start when there are clinical or
laboratory indications suggesting disease progression. In many cases, CLL can remain
stable for a long time, which is why in asymptomatic patients, the so-called "watch and
wait" (observation and regular control).

Criteria for initiating CLL treatment (according to IWCLL –

International Workshop on Chronic Lymphocytic Leukemia):

1. Clinical symptoms of disease progression:

● General symptoms (so-called B symptoms):

○ Unexplained weight loss >10% in 6 months.
○ Recurrent fever (>38°C) not related to infection.
○ Night sweats leading to significant discomfort.
○ Significant weakness or fatigue limiting daily activities (ECOG >2).
● Progressive enlargement of lymph nodes (>10 cm in greatest dimension) or their rapid
 growth.
● Progressive enlargement of the spleen (measured below the costal margin) or liver,
especially if it causes discomfort or pressure symptoms.

2. Hematological disorders:

● Progressive anemia: Hb <10 g/dl (caused by bone marrow invasion by leukemic

cells or autoimmune mechanism - AIHA).
● Thrombocytopenia: PLT <100 × 10⁹/l (caused by bone marrow
involvement or immune thrombocytopenia - ITP).
● Rapidly developing lymphocytosis: Doubling of the lymphocyte count in less than 6
months or a value exceeding 50 × 10⁹/l (lymphocytosis may be an indication only in the
case of other progression criteria).

3. Symptoms related to organ involvement: Invasion of organs (e.g. kidneys, lungs,

heart) by leukemic infiltration, which causes their dysfunction.

5. How do we define severe Hemophilia A -

a. Factor VIII activity: < 1% of normal
6. What is the most common hemolytic anemia -
a. AIHA autoimmune hemolytic anemia (not congenital spherocytosis) 7. To
what hematocrit value should we go when bloodletting in the case of polycythemia vera,
how often and how much blood - in men 45% and in women 42% hematocrit, 300-500 ml
of blood per session to achieve the desired hematocrit 8. How do we define
thrombocytopenia - : platelet count < 50 × 10⁹/L.
9. Causes of secondary polycythemia
a. Associated with hypoxia
i. Heart defects
ii. Lung diseases and hypoventilation
iii. Obstructive sleep apnea
iv. Being at high altitudes
b. Related to the production of erythropoietin
i. Tumors producing erythropoietin
ii. Cystic kidney disease
c. Associated with kidney defects
i. Narrowing of the renal arteries
ii. Renal ischemia
d. jatorgenne/polekowe
i. Taking anabolic drugs
ii. Erythropoietin supplementation
10. Isolated APTT prolongation - what to do
a. Diagnostics towards
i. congenital or acquired hemophilia
ii. Antiphospholipid syndrome
 iii. Presence of lupus anticoagulant
iv. Anticoagulants or heparin
v. DIC
b. The detection of a coagulation inhibitor is possible using a mixing test with healthy plasma

GROUP 8 (23.10.2024) - pass rate 79%

1. 4 causes of vascular diathesis.

to. Plamica Henocha-Schönleina
b. Ehlers-Danlos syndrome.
c. Senile purpura
d.Scurvy
2. What is the prognosis for Burkitt's lymphoma? Generally good, grows quickly but is
chemosensitive
3. What is the prognosis of a patient with acute promyelocytic leukemia.
a. Aggressive, frequent complications with CNS and DIC bleeding
b. Risk is determined based on WBC count
c. There may be complications from treatment with all-trans retinoic acid
d. >90% remission
4. 3 treatments for ITP.
a. Autoimmune thrombocytopenia - steroid therapy, immunosuppression,
splenectomy
5. How to treat multiple myeloma.
6. How to treat polycythemia vera.
7. How do we assess the stage of Hodgkin's lymphoma at the time of diagnosis. 8.
Severe hemophilia A - what factor and how many percentages.
9. DIC - how we diagnose.
a. according to the ISTH scale, >5 points indicate DIC
 b.
10. What are the complications of essential thrombocythemia?

Correction (oral with Prof. Helbig):

1. Myeloma diagnosis (clonal b cell + M protein)

2. The Ann Arbor scale reported a case of enlarged cervical and splenic nodes 3.
Philadelphia chromosome and the BRC-ABL gene in CML
4. IPI scale
5. How to recognize acute leukemia but other causes than blasts >20% (this sarcoma +
chromosomal aberrations)
6. Polycythemia typical mutation (JAK2 V617F)
7. Criteria for moderate hemophilia (1-5%)
8. Which leukemia most often has DIC (acute promyelocytic)
9. What drugs for CML (TKI)
10. What is the most malignant lymphoma (Burkitt's answer)

GROUP 3 (13.11.2024) - pass rate 100%

1. Criterion for the diagnosis of CML - Philadelphia chromosome

2. Four types of secondary polycythemia
3. Does normal electrophoresis rule out multiple myeloma - it does not rule it out, it
may be non-secreting
4. What abnormalities in laboratory tests should we expect in von Willebrand's
disease - it depends on the type, in type III APTT prolongation
5. What is acquired von Willebrand's disease and what diseases does it
occur in? 6. Vit K-dependent coagulation factors
 7. How is the dose of warfarin determined?
8. How is lymphoma diagnosed?
9. Hemolysis rates
10. What mutation in myelofibrosis

Improvement in group I 22/11/2024

1. First line treatment of autoimmune anemia

a. Steroids
2. The most important causes of megaloblastic anemia
a. Vit B12 deficiency
b. Folic acid deficiency
3. Why do we administer intrathecal chemotherapy and for what
diseases 4. First line of CML treatment
a.TKI
5. Causes of secondary thrombocythemia
a. Injuries
b. Cancer
c. Iron deficiency anemia
d. Splenectomy
e. Infections
6. How do we diagnose CLL
7. Expand the SLIM CRAB shortcut
8. The most common congenital hemolytic anemia
a. Congenital spherocytosis
9. What do we most often use CAR-T for?
a. lymphomas not dirty
10. Reasons for APTT prolongation
a. Hemophilia
b. Von Wilebrandt's disease
c. Haegamana anomaly