H1

Question 1

what are the three main causes of anaemia?

Answer 1

decreased RBC production (eg iron deficiency)

increased RBC destruction (haemolytic anaemia)

loss of RBC (bleeding)

Question 2

what is the life span of RBC?

Answer 2

120 days

Question 3

briefly describe the structure of haemoglobin

Answer 3

2 alpha chains
2 beta chains
Fe ion as heme group

Question 4

what is microcytic anaemia?

Answer 4

RBC smaller than the normal size

Question 5

what causes microcytic anaemia?

Answer 5

• iron deficiency

- thalassaemia (inherited anaemia)

Question 6

how does iron deficiency lead to microcytic anaemia?

Answer 6

low amounts of iron = reduced haemoglobin production. therefore RBC are smaller (microcytic) and have reduced Hb amount (hypochromic - paler )

Question 7

which factor decreases iron absorption?

a) acid pH
b) ferric salts (Fe 3+)
c) iron deficiency
d) hypoxia
e) pregnancy

Answer 7

b) ferric salts (Fe 3+)

Question 8

which factor increases iron absorption?

a) inflammatory disorders
b) iron overload
c) alkaline pH
d) haem iron (meat)
e) ferric salts

Answer 8

d) haem iron (meat)

Question 9

how is macrocytic anaemia caused by B12 and folate deficiency?

Answer 9

B12 and folate are needed for DNA syntheses.

impaired DNA synthesis = impaired cell division = large cells remain

Question 10

which one is NOT cause for macrocytic anaemia?

a) liver disease
b) myelodysplasia
c) hyperthyroidism
d) bone marrow failure
e) anticonvulsants/chemotherapy

Answer 10

c) hyperthyroidism

HYPOthyroidism causes macrolytic anaemia

Question 11

where is B12 absorbed?

Answer 11

ileum

Question 12

where is folate absorbed?

Answer 12

duodenum and jejunum

Question 13

which clinical feature is present in B12 deficiency but not in folate deficiency?

Answer 13

in B12 deficiency you get neurology

Question 14

how is the tongue affected in B12/folate deficiency?

Answer 14

glossitis

Question 15

which blood clotting factor is NOT produced in the liver?

Answer 15

VIII

Question 16

which blood clotting factors are vitamin K dependent

Answer 16

II, VII, IX, X

Question 17

what activates the extrinsic and intrinsic pathway for clotting?

Answer 17

extrinsic: via tissue factor produced by damaged tissue
intrinsic: collagen exposure

Question 18

which antiplatelet drug acts irreversible?

a) Aspirin
b) NSAIDs
c) Clopidogrel
d) Dipyridamole

Answer 18

a) Aspirin

Question 19

what is the lifespan for platelets?

a) 24 hours
b) 7-10 days
c) 30-25 days
d) 120 days

Answer 19

b) 7-10 days

Question 20

in haemostatic investigations, what does the INR and APTT measure?

Answer 20

INR measures the extrinsic pathway

APTT measures the Intrinsic pathway

Question 21

what are the key haemostatic investigations?

Answer 21

• full blood count - platelet count
• bleeding time - platelet defects
• Prothrombin time/ INR
• activated partial thromboplastin time (APTT)

Question 22

which haemotological disorders result in increased bleeding time?

a) haemophilia A
b) haemophilia B
c) von Willebrand disease
d) Warfarin therapy
e) Platelet defects

Answer 22

c) von Willebrand disease

and

e) Platelet defects

Question 23

which haemotological disorders result in increased APTT?

a) haemophilia A
b) haemophilia B
c) von Willebrand disease
d) Warfarin therapy
e) Platelet defects

Answer 23

a) haemophilia A
b) haemophilia B
c) von Willebrand disease

Question 24

which haemotological disorders result in decreased factor VIII amounts?

a) haemophilia A
b) haemophilia B
c) von Willebrand disease
d) Warfarin therapy
e) Platelet defects

Answer 24

a) haemophilia A

c) von Willebrand disease

Question 25

which haemotological disorders result in decreased factor IX amounts?

a) haemophilia A
b) haemophilia B
c) von Willebrand disease
d) Warfarin therapy
e) Platelet defects

Answer 25

b) haemophilia B