Haem

Question 1

Treatment of neutropenic sepsis

Answer 1

IV tazocin (piperacilin and tazobactam)

Question 2

Treatment of Waldenstroms macroglubulinaemia

Answer 2

Chemotherapy

Plasmapheresis

Question 3

How long should you treat provoked DVT for?

Answer 3

3 months

Question 4

How would you treat low fibrinogen levels?

Answer 4

Cryoprecipitate

Question 5

When would you see a c-myc gene translocation?

Answer 5

Burkitt’s lymphoma

Question 6

How would you treat von Willebrand’s disease

Answer 6

Tranexamic acid/desmopressin/factor VIII concentrate

Question 7

What investigation should you do in polycythemia rubra vera?

Answer 7

Do JAK-2 mutation screen

Question 8

Adverse effect of anthracyclines?

Answer 8

They can cause cardiomyopathy

danrubicin, doxorubicin, mephalan

Question 9

Adverse effects of vinblastin/vincristine?

Answer 9

Can cause neuropathy

Question 10

Adverse effect of cis-platin?

Answer 10

Nephrotoxicity

Question 11

Auer rod

Answer 11

AML

Question 12

Philadelphia chromosome

Answer 12

CML

Question 13

How to reverse heparin

Answer 13

Protamine

Question 14

How to reverse warfarin?

Answer 14

1) omit dose
2) administer vitamin K
3) administer clotting factors (FFP or factor concentrate)

Question 15

What type of anticoagulant would you use for prophylaxis in elective hip and knee surgery?

Answer 15

NOAC e.g. apixaban, rivaroxiban, dabigatran

Question 16

Normal quantity of free light chain production

Answer 16

Normally 0.5g/day (if more then excess can leak into urine as bence-jones protein)

Question 17

CD20+ve cells

Answer 17

Follicular non-hodgkins

Question 18

CD30+ve cells

Answer 18

Hodgkins lymphoma

Question 19

Reed steernberg cells

Answer 19

Hodgkins

Question 20

When is platelet transfusion contraindicated?

Answer 20

In HUS and TTP

Question 21

Most common type of hodgkin lymphoma

Answer 21

Nodular sclerosing

Question 22

This type of hodgkins lymphoma is associated with lacunar cells

Answer 22

Nodular sclerosing

Question 23

Which type of hodgkin lymphoma carries the best prognosis?

Answer 23

Lymphocyte predominant

Question 24

Which type of hodgkin lymphoma carries the worst prognosis?

Answer 24

Lymphocyte depleted

Question 25

What does a raised LDH suggest?

Answer 25

Suggests cell lysis

Question 26

Severe pain on alcohol consumption

Answer 26

Hodgkins

Question 27

What is aplastic anaemia?

Answer 27

Normocytic anaemia Leukopenia Thrombocytopenia

Question 28

Treatment of aplastic crises?

Answer 28

Treatment is by managing symptoms of anaemia --> usually with a blood transfusion

Question 29

First line management of hairy cell leukaemia?

Answer 29

Chemotherapy

Question 30

When should you give aspirin to pregnant women who have anti-phospholipid syndrome?

Answer 30

Initiate once a fetal heart is seen on ultrasound and continue up until 34 weeks

Question 31

Mirror image nuclei?

Answer 31

These are reed sternberg cells - seen in Hodgkins

Question 32

If you are giving more than two units of packed red cells, what should you also give?

Answer 32

Should give loop diuretic - giving more than two units can result in fluid overload

Question 33

What blood product is most likely to cause an iatrogenic septicaemia with a gram positive organism?

Answer 33

Platelets

Question 34

When would you see smudge/smear cells?

Answer 34

CLL

Question 35

Diagnostic test for hereditary spherocytosis

Answer 35

Osmotic fragility test

Question 36

Which condition might you see a rouleaux in?

Answer 36

Myeloma

Question 37

What might you see on a blood film post-splenectomy?

Answer 37

Howell-Jolly bodies, target cells, pappenheimer bodies

Question 38

What is evan's syndrome?

Answer 38

ITP in association with warm AIHA

Question 39

What happens during a sequestration crisis?

Answer 39

The sickle cells cause the spleen to become grossly enlarged. This causes abdominal pain. This is more common in childhood and eventually repeated sequestration and infarction of the spleen results in auto-splenectomy. A sequestration crisis may result in severe anaemia, marked pallor and cardiovascular collapse due to loss of circulating volume

Question 40

Why might you use irradiated blood products?

Answer 40

They reduce the risk of graft versus host disease

Question 41

What type of blood should you use for transfusions in pregnancy?

Answer 41

CMV negative blood

Question 42

Which antibiotics can cause haemolysis in G6PD?

Answer 42

Co-trimoxazole and ciprofloxacin

Question 43

The COC and surgery?

Answer 43

Stop pill 4 weeks before surgery

Question 44

These are recommended for the treatment of post-thrombotic syndrome

Answer 44

Compression stockings (e.g. graduated compression stockings)

Question 45

What might myelodysplasia progress to?

Answer 45

May progress to AML

Question 46

"CRAB" features of multiple myeloma

Answer 46

hyperCalcaemia Renal failure Anaemia (and thrombocytopenia) Bone fractures/lytic lesions

Question 47

Investigation for myeloma

Answer 47

Serum electrophoresis

Question 48

When does transfusion associated graft versus host disease occur?

Answer 48

Usually occurs 4-30 days after a transfusion

Question 49

What can you give to stimulate release of von willebrand factor?

Answer 49

Desmopressin

Question 50

Most common type of lymphoma in the UK?

Answer 50

Diffuse large B cell lymphoma

Question 51

What is Ritcher's transformation?

Answer 51

When CLL transformed to high grade lymphoma (non-hodgkins)

Question 52

What is cryoprecipitate mainly made from?

Answer 52

Factor VIII

Question 53

Abdominal pain, motor peripheral neuropathy and blue line around gums

Answer 53

Lead poisoning

Question 54

Most useful test to establish polycythemia rubra vera?

Answer 54

JAK2 mutation screen

Question 55

Most common inherited thrombophilia?

Answer 55

Activated protein C resistance (factor V leiden)

Question 56

Common cause of tumour lysis syndrome

Answer 56

Burkitt's lymphoma

Question 57

Characteristic blood film finding of CLL

Answer 57

Smear cells (also called smudge cells)