Haem

Question 1

What causes high ferritin with iron overload?

Answer 1

Haemochromatosis

Repeated transfusions

Question 2

If eGFR<15, what anticoagulant?

Answer 2

LMWH

Question 3

Monitoring of heparin?

Answer 3

aPTT

Question 4

Rx for polycythaemia?

Answer 4

Aspirin
Venesection
Hydroxyurea (slight risk of CML)

Question 5

Diagnosis of G6PD?

Diagnosis of spherocytosis?

Answer 5

G6PD - enzyme assay at time and after 3 months

Sphero - EMA binding test

Question 6

Extrinsic pathway?

Answer 6

TF/VII activate X

Measurement: PTT

Question 7

Intrinsic pathway?

Answer 7

9a/8a activate factor X

Measurement: aPTT

Question 8

Common pathway?

Answer 8

Xa binds Va and activates prothrombin to thrombin

This converts fibrinogen to fibrin

Question 9

TTP?

Answer 9

MAHA and thrombocytopaenia

ADAMTS-13 gene

Fever, bleeding, AKI, drowsy, seizure

NORMAL COAGULATION

Question 10

Management of essential thrombocytosis?

Answer 10

Hydroxyurea

Interferon alpha if young

Question 11

When to stop heparin before surgery

Answer 11

Day before

Question 12

When to stop warfarin before surgery?

Answer 12

5 days before

Question 13

What can potentiate warfarin?

Answer 13

Liver disease
Cranberry juice
P450 inhibitors (cipro, amiodarone, valproate)

Question 14

What drug can cause neutrophilic?

Answer 14

Steroids

Question 15

Platelet transfusion limit in active bleeding?

Answer 15

30 in most cases

100 in CNS

Question 16

Platelet transfusion limit prior to planned procedure?

Answer 16

50 for most

75 if high risk

100 if surgery at critical site

Question 17

Platelet transfusion limit if no bleeding or planned procedure?

Answer 17

10

Question 18

What to prescribe if HF patient receiving packed red cells?

Answer 18

Furosemide STAT

Even if already on regular furosemide

Question 19

How long is elective RBC transfusion done over?

Answer 19

90-120 mins

Question 20

DIC what is given?

Answer 20

FFP or cryoprecipitate

Question 21

What DOAC to AVOID if renal failure?

What one should be used?

Answer 21

AVOID Dabigatran

USE apixaban

Question 22

Major constituent of cryoprecipitate?

Answer 22

Factor VIII

used in haemophilia

Question 23

ALL?

Answer 23

Kids
Low everything
Bone pain, testicular etc

Question 24

AML?

Answer 24

Anaemia
WCC high but neutropenia
Thrombocytopaenia

AUER RODS
Mostly blasts

Question 25

CLL?

Answer 25

Asymptomatic, picked up randomly May have lymphadenopathy Lymphocytosis and anaemia SMUDGE cells Immunophenotyping Ix Warm haemolytic anaemia Richters transformation

Question 26

CML?

Answer 26

``` 60-70 y/o PHILADELPHIA CHROMOSOME Decreased ALP Increase in different stages of maturation Thrombocytosis and anaemia ``` Imatinib Can undergo blast transformation

Question 27

Myelofibrosis?

Answer 27

Pancytopaenia Tear drop poikilocytes Dry tap High urate and LDH