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MRCP 1 > Haem > Flashcards

Haem Flashcards

1
Q

Ann Arbour staging system for lymphoma?

A

I - single node group
II - node on one side of the diaphragm
III - nodes on both sides of the diaphragm
IV - extra-nodal spread

The spleen is a lymph node in this case!

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2
Q

Elliptocytosis?

A

Hereditary elliptocytosis

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3
Q

Teardrop cells?

A

Myelofibrosis

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4
Q

Film finding in coeliac (or any hyposplenism)

A

Howell-Jolly bodies
Spherocytes

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5
Q

G6PD inheritance?

A

X linked recessive (only males)

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6
Q

Hered spher inheritence?

A

AD

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7
Q

Neontal jaundice, maybe gallstones, how do you differentiate between G6PD and hered spher?

A

G6PD - African and Mediterranian
Hered spher - Northern European

(also G6PD only male)

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8
Q

Primaquine and haemolysis mentinoned? Also fava beans

A

GDPD

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9
Q

Burkitt’s gene?

A

C-myc t(8:14)

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10
Q

Lymphoma, ‘starry sky’ appearance on microscopy?

A

Burkitt’s

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11
Q

CA 125?

A

Ovarian Ca

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12
Q

CA 15-3?

A

Breast Ca

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13
Q

S-100?

A

Melanoma, schwannoma

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14
Q

Aplastic vs sequestration crisis in SCD?

A

Aplastic there is a fall in retics. Response to parvovirus infection

Sequestration causes a pooling of blood and increased retics usually with abdominal pain and haemodynamic compromise

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15
Q

Diagnostic test for hered spher?

A

EMA binding test

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16
Q

Chemo agent causing hypomagnasaemia?

A

Cisplatin

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17
Q

Haem question, aquagenic pruritis?

A

Polycythemia

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18
Q

DIC blood film?

A

Schistocytes

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19
Q

High plts and burning sensation in the hands?

A

ET

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20
Q

Treatment for ET

A

Hydroxycarbamide/hydroxyurea
Interferon alpha in young patients

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21
Q

TACO vs TRALI?

A

In TACO patient is HYPERtensive, often elderly with CCF

TRALI is rarer and patients are HYPOtensive

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22
Q

SCD chest crisis management

A

Oxygen therapy to maintain saturations > 95%
Intravenous fluids to ensure euvolaemia
Adequate pain relief
Incentive spirometry in all patients presenting with rib or chest pain
Antibiotics with cover for atypical organisms
Early consultation with the critical care team and haematology

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23
Q

HUS or TTP?

A

Neuro signs point towards TTP

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24
Q

Investigation of choice in CLL?

A

Immuophenotyping via flow cytometry

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25
Q

Preferred drug in tumour lysis prevention?

A

Rasburicase

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26
Q

Chemotherapy agent haemorrhagic cystitis?

A

Cyclophosphamide

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27
Q

Drug to prevent haemorrhagic cystitis with Cyclophosphamide use?

A

Mesna

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28
Q

Most common symptom of SVCO?

A

SOB

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29
Q

Deficiency in TTP? What should this do?

A

ADAMTS13
Cleave vWF

30
Q

Change in haemoglobin in methaemoglobinaemia?

A

Oxidised from Fe2+ to Fe3+

31
Q

Causes of methaemoglobinaemia?

A

drugs: sulphonamides, nitrates (including recreational nitrates e.g. amyl nitrite ‘poppers’), dapsone, sodium nitroprusside, primaquine
chemicals: aniline dyes

32
Q

Management of methaemoglobinaemia?

A

NADH methaemoglobinaemia reductase deficiency: ascorbic acid
IV methylthioninium chloride (methylene blue) if acquired

33
Q

Most common inherited thrombophillia?

A

Factor V Leiden (activated protein C resistance)

34
Q

Most common inherited bleeding disorder?

A

vWD

35
Q

Anastrozole and letrozole mechanism?
Most significant SE?

A

Aromatase inhibitors which reduce peripheral oestrogen synthesis
Osteoporosis/fracture

36
Q

Symptoms of bleeding and isolated thrombocytopenia?

A

Think ITP

37
Q

Management of ITP?

A

Emergency treatment: life-threatening or organ threatening bleeding Platelet transfusion, IV methylprednisolone and intravenous immunoglobulin
Platelet count >30109/L Observation
Platelet count <30109/L Oral prednisolone

38
Q

Best screening test for hereditary angioedema between attacks?

A

C4 levels

39
Q

Electrolyte low in tumour lysis?

A

Calcium

40
Q

Treatment of TTP?

A

Plasma exchange
Steroids and rituximab may also be used

41
Q

Anaemia in a young Italian?

A

Thalassaemia

42
Q

Cover for minor procedures in patients with vWD?

A

DDAVP

43
Q

Preferred agent for TLS? Mechanism?

A

Rasburicase
Urate acid oxidisation

44
Q

Best initial blood test for CML?

A

BCR-ABL

45
Q

DVT and or foetal loss?

A

Antiphospholipid

46
Q

Pathogenesis of HIT?

A

IgG against platelet factor 4 and heparin

47
Q

Most common manifestation of HIT?

A

DVT

48
Q

Haemoglobinuria, anaemia, large vessel thrombosis in a young man?

A

PNH

49
Q

Treatment for PNH?

A

Ecilizumab

50
Q

Older man lymphadenopathy, hepatosplenomegaly, hyperviscosity symptoms, IgM?

A

Waldenstrom’s

51
Q

Ig in Waldenstrom’s?

A

IgM

52
Q

First line treatment for early Hodgkin’s?

A

Combined chemo (ABVD) and radiotherapy

53
Q

Haemophilia inheritance pattern?

A

X linked recessive

54
Q

After skin, what is the most common form of cancer in transplant patients?

A

Lymphoma

55
Q

Microcytic anaemia with RAISED ferritin, increased iron in the stores?

A

Sideroblastic anaemia

56
Q

Anti CD20 used in lymphoma?

A

Rituximab

57
Q

Anaemia and low haptoglobin?

A

Suggests intravascualr haemolysis

58
Q

What is low in G6PD

A

NADPH

59
Q

Philadelphia chromosome?

A

CML
t(9;22)

60
Q

BCR-ABL function?

A

Tyrosine kinase

61
Q

Imatinib?

A

Tyrosine kinase inhibitor

62
Q

Lymphocyte predominant or deplete? Positive or negative prognostic factors?

A

Predominant is good
Deplete bad

63
Q

Low factor VIII?
Low factor IX?

A

VIII - haemophilia A
IX - haemophilia B

64
Q

Renal failure, haemolysis just after starting malaria treatment?

A

Blackwater fever

65
Q

What is responsible for GVHD?

A

Donor T-lymphocytes

66
Q

What is responsible for TRALI?

A

Donor antibodies

67
Q

LMWH action?

A

Binds to antithrombin III

68
Q

First line treatment in APML?

A

ATRA

69
Q

What’s important to ensure before starting EPO therapy?

A

Iron stores - need to be replete

70
Q

Auer rods?

A

AML

71
Q

What is the most important acute blood test to measure in an acute leukaemia and why

A

Clotting screen - check no evidence of DIC

MRCP 1 (24 decks)

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