Blood

Question 1

acute lymphadenitis morphology

Answer 1

reactive germinal centres with mitotic figures

Question 2

chronic lymphadenitis morphology

Answer 2

Bcell - follicular hyperplasia with oblong germinal centres surrounded by naive b cells
t cell - paracortical hyperplasia

Question 3

lymphoid sinus histiocytosis cause

Answer 3

cancer (drained into lymphocyte)

Question 4

morphology splenomegaly

Answer 4

red pulp congestion then fibrosis
white pulp necrosis from haemolytic strep

Question 5

Increased bleeding time

Answer 5

due to platelet disorders

Question 6

TTP

Answer 6

inherited/ acquired deficiency ADAMTS13
high molecular weight vWF
microthrombi
transient neurological

Question 7

HUS

Answer 7

post viral/ verotoxin producing ecoli

Question 8

Congenital haemorrhagic disorder plt disfunction

Answer 8

Both AR
Bernard soulier GP1b/IX mild bleeding
Thrombasthenia GP11b111a signif bleed

Question 9

vWD bloo results

Answer 9

inc bleeding time and PTT (due to vWF helping VIII stabilisation)

Question 10

Haemophilia inheritence

Answer 10

X linked recessive

Question 11

Main cause DIC

Answer 11

gram -ve sepsis

Question 12

Order of how common blood types

Answer 12

00
A
B
AB

Question 13

Intravasc/ extravasc haemolysis

Answer 13

extra in spleen
both conjugated hyperbilirubinaemia and reduced haptoglobin
intra haemoglbinaemia and haemoglobinurea

Question 14

G6PD defiicincy

Answer 14

X linked
intra and extravasc haemolysis
heinz bodies (also in thalassaemia)

Question 15

Sickle cell cause

Answer 15

substitution valine for glutamic acid on beta globin chain
BM shows normoblastic hyyperplasia

Question 16

Less severe sickle cell

Answer 16

heterozygous, <6m fetal Hb, hydration (otherwise sickle loads)

Question 17

Beta thalassaemia clinical signs

Answer 17

iron overload, marrow expansion, haemolytic anaemia

Question 18

Beta thalassaemia major blood smear

Answer 18

anisocytosis, hypochromia, target cells, stippled and fragmented RBCs

Question 19

Hydrops fetalis

Answer 19

alpha thalassamia no alpha chains, death in utero

Question 20

Warm antibodies

Answer 20

autoimmune haemolysis
37 degrees igG
60% idiopathic
lymphoma, leukamia, SLE

Question 21

Cold agglutinins

Answer 21

Autoimmune haemolysis <30degrees
IgM and complement
acute mycoplasma and EBV
chronic idiopathic lymphoma

Question 22

Cold haemolysin

Answer 22

Autoimmune haemolysis <30 degrees
IgG complement
post infective: measles, mumps, mycoplasma

Question 23

Blood film traumatic haemolysis

Answer 23

schistocytes
e.g. metallic valve

Question 24

Megaloblastic anaemia blood film

Answer 24

megaloblastic cells, metamyelocytes and hypersegmented neutrophils

Question 25

Iron deficiency anaemia blood levels

Answer 25

LOW iron, ferritin, plasma transferrin saturation INC TIBC

Question 26

Anaemia chronic disease cause and blood levels

Answer 26

serum iron low, ferritin high, TNF and IL1 -> blocked ferroportin macrophages, ferritin stuck in macrophages

Question 27

Basophilia

Answer 27

assoc CML and myeloproliferative disorders

Question 28

interleukins causing lymphopoesis

Answer 28

CKit ligand and IL7

Question 29

ALL

Answer 29

85% pre B cell children can have neurological sequelae anaemia, thrombocytopenia, >30% lymphoblasts good prognosis

Question 30

CLL

Answer 30

most common adult leukaemia M>F 60yo hepatosplenomegaly lymphocytosis Poor prognosis

Question 31

Burkitts lympmhoma

Answer 31

african assoc EBV other HIV mature B cells mandible growth african ileocaecal or peritoneal mass other

Question 32

Multiple myeloma

Answer 32

benz jones protein MIP1a and RANKL stimulate osteoclasts renal failure and infection

Question 33

Hodgkins lymphoma

Answer 33

common young adults painless single mass reed sternberg cells assoc EBV

Question 34

AML

Answer 34

>20% myeloid blasts in BM auer rods M>F 15-39 less CNS involvement than ALL

Question 35

CML

Answer 35

splenomegaly ++ basophilia t(9,22) philadelphia chromosom BCR-ABL BM transplant in stable phase curative

Question 36

Polycythaemia vera BM

Answer 36

early - ypercellular with giant plts and megakaryocyte fragments late - marrow fibrosis with extramedullary haematopoesis and organomegally