Haem

Question 1

What is the best way to measure someones iron store level?

Answer 1

Serum ferritin

Question 2

What type of cell on blood smear indicates myelofibrosis?

Answer 2

Tear drop cells (dacrocytes)

Question 3

What conditions causes a schistocyte on blood smear?

Answer 3

Haemolytic anaemia, DIC

Question 4

What conditions cause a spherocyte?

Answer 4

Haemolytic anaemia

Hereditary spherocytosis

Question 5

What conditions cause a target cell?

Answer 5

Obstructive jaundice
Liver disease
Haemaglobinopathies
Hyposplenism

Question 6

Pt post op who had 3 blood units. PC: fever, low BP, cyanosis, dry cough. Dx?

Answer 6

TRALI - tissue related lung injury

Question 7

What is a TRALI?

Answer 7

2-6hrs after transfusion, neutrophils get sequestered in lungs and ABs form against donor WBCs. ABs then attack the pt’s lungs

Question 8

How do you differentiate between immediate haemolytic transfusion reaction and a delayed haemolytic reaction?

Answer 8

IHTR < 24hrs post transfusion

DHR >24hr post transfusion

Question 9

What are 2 differentials for megaloblastic anaemia?

Answer 9

B12 deficiency

Folate deficiency

Question 10

Limb parasthesia and numbness. Hypersegmented neutrophils. Dx?

Answer 10

B12 deficiency

Question 11

What is pernicious anaemia?

Answer 11

AI condition where ABs bind to intrinsic factor thus preventing B12 absorption

Question 12

What condition is associated w pernicious anaemia?

Answer 12

Thyroid disease

Question 13

What does PT vs PTT measure?

Answer 13

PT = extrinsic pathway 
PTT = intrinsic pathway

Question 14

Normal PT and platelets. Abnormal PTT and bleeding time. Dx?

Answer 14

vWF deficiency

Question 15

Normal bleeding time and platelets. Prolonged PT and PTT. DDx?

Answer 15

Factor V deficiency
Vitamin K deficiency
Warfarin therapy

Question 16

Fever + neutropenia. Dx?

Answer 16

Septicaemia

Question 17

Neutropenia, anaemia, thrombocytopenia. >20% myeloblasts. Dx?

Answer 17

AML

Question 18

Neutropenia, anaemia, thrombocytopenia. >20% lymphoblasts. Dx?

Answer 18

ALL

Question 19

Sx of thrombotic thrombocytopenia purpura?

Answer 19

PENTAD 
Fever
Thrombocytopenia 
Microangiopathic haemolytic anaemia 
Renal failure 
Neuro Sx

Question 20

Headaches, dizziness, severe pruritus after hot baths. Dx?

Answer 20

Polycythaemia vera

Question 21

What is myelofibrosis?

Answer 21

Fibrosis of bone marrow due to abnormal megakaryocytes which produce XS fibrosising factors.

Question 22

List 4 causes of massive splenomegaly

Answer 22

CML
Thalassaemia
Polycythaemia rubra vera
Kala-azar

Question 23

What cell type on blood film indicates haemolysis?

Answer 23

Schistocytes

Question 24

What is the function of G6PD?

Answer 24

Maintaining levels of glutathione (protects against oxidative stress)

Question 25

What happens if someone with G6PD deficiency takes anti malarias?

Answer 25

Denatures Hb producing HEINZ BODIES

Question 26

What is characteristic of microangiopathic haemolytic anamiea?

Answer 26

Anaemia and schistocytes on blood smear

Question 27

Which test is used for investigating potential sickle cell?

Answer 27

Sodium metabisulfate

Question 28

What test is used for B12 deficiency?

Answer 28

Schilling's

Question 29

What test can be used to investigate causes of haemolytic AI anaemia?

Answer 29

Coomb's

Question 30

What stain is used to differentiate between AML and ALL?

Answer 30

Sudan black

Question 31

What are the erythropoetin and red cell mass levels in polycythaemia rubra vera?

Answer 31

HIGH red cell mass | LOW erythropoetin

Question 32

Which iron protein is raised in iron deficiency anaemia?

Answer 32

Transferrin - it is the iron carrying protein so increases when reduced iron

Question 33

Malaise, SoB, parasthesia in hands. Schillings positive. Dx?

Answer 33

Pernicious anaemia

Question 34

Pancytopenia, macrocytosis with bone marrow hypocellularity. Dx?

Answer 34

Aplastic anaemia

Question 35

What type of Hb is raised in aplastic anaemia?

Answer 35

Foetal

Question 36

Fatigue. Fevers. Bleeding gums. Blood film shows auer rods, hypogranular neutrophils. Stains with Sudan black B. Dx?

Answer 36

AML

Question 37

What cells are seen on blood film in ALL?

Answer 37

Lymphoblasts

Question 38

Philadelphia chromosome present. Dx?

Answer 38

CML

Question 39

Tx of CML?

Answer 39

Imatinib (tyrosine kinase inhibitor)

Question 40

What is the INR?

Answer 40

Ratio between pt's prothrombin time vs normal

Question 41

What is a normal INR?

Answer 41

0.9 to 1.3

Question 42

Pt with rheumatic mitral valve + AF. INR?

Answer 42

2 - 3

Question 43

Is multiple myeloma hereditary?

Answer 43

NO

Question 44

List risk of multiple myeloma

Answer 44

Radiation, herbicides/insecticides, herpes HHV-8, HIV

Question 45

What test differentiates between hypersplenism and aplastic anaemia?

Answer 45

Reticulocyte test - reduced in AA but raised in hypersplenism

Question 46

What AB is associated with pernicious anaemia?

Answer 46

Anti-intrinsic factor AB

Question 47

How do you investigate leukaemia?

Answer 47

bone marrow aspirate under microscopy

Question 48

What is the numerical definition of acute leukaemia?

Answer 48

>20% of bone marrow cells being blasts

Question 49

What type/part of AB is Bence Jones protein?

Answer 49

Light chain

Question 50

Why do you get bence jones proteins?

Answer 50

Myeloma cells produce them