haem high yield

Question 1

causes of microcytic anaemia

Answer 1

TAILS

thalassaemia
anaemia of chronic disease
Iron deficiency
Lead poisoning
Sideroblastic

Question 2

causes of macrocytic anaemia

Answer 2

megaloblastic
-folate deficiency
-B12 defiency

non-megaloblastic
-alcohol
-liver
-hypothyroidism
-reticulocytosis
-cold-agglutinins
-aplastic anaemia

Question 3

raised HbA2

Answer 3

beta thal trait and beta thal major

Question 4

hair on end skull x-ray

Answer 4

B thal major

Question 5

HbA, <50% HbS

Answer 5

sickle cell trait

Question 6

HbS, no HbA

Answer 6

sickle cell anaemia

Question 7

pulmonary infiltrates in someone with sickle cell

Answer 7

acute chest syndrome

Question 8

treatment of sickle crisis

Answer 8

opiate analgesia
hydration
rest
oxygen
red cell exchange in severe

Question 9

which drug can reduce severity of sickle cell disease

Answer 9

hydroxycarbamide

Question 10

which vaccine for sickle cell people

Answer 10

pneumococcal every 5 years

Question 11

causes of intravascular haemolysis

Answer 11

ABO incompatible blood transfusion
severe malaria
G6PD deficiency

Question 12

autoimmune haemolysis

Answer 12

warm - IgG
cold - IgM (activate at cold temperatures)

Question 13

LDH in haemolysis

Answer 13

raised

Question 14

managament of autoimmune haemolytic anaemia

Answer 14

• Blood transfusions
  
  • Prednisolone (steroids)
  • Folic acid
  • Rituximab (a monoclonal antibody against B cells)
    -Splenectomy

Question 15

treatment of secondary iron overload

Answer 15

desferrioxamine

Question 16

pernicious anaemia

Answer 16

cause of B12 deficinecy
-antibodies against parietal cells or intrinsic factor
-atrophic gastritis: no intrinsic factor

can predispose to gastric cancer

Question 17

treatment for severe thrombocytopenia in ITP

Answer 17

prednisolone
IV immunoglobins
blood transfusion

Question 18

treatment of ITP in adults

Answer 18

oral prednisolone first line
IVIG may be used

Question 19

what does vWF do

Answer 19

helps platelet adhesion in primary homeostasis
carries factor 8 (intrinsic pathway)

Question 20

coag tests for vWF deficiency

Answer 20

APTT may be normal or prolonged if factor VIII deficiency is present
-PT will be normal

Question 21

what clotting factors does vit K help make

Answer 21

2,7, 9 and 10

Question 22

what is wafarin

Answer 22

vitamin K antagonist

Question 23

haemophilia A

Answer 23

favtor VIII deficiency

Question 24

haemophilia B deficiency

Answer 24

factor 9 deficiency

Question 25

coag screen result for haemophilia

Answer 25

isolated prolonged APTT

Question 26

what antibodies for anti-phospholipid

Answer 26

lupus anticoagulant (LA) anticardioplipin antibody anti-beta2 glycoprotein

Question 27

antiphospholipid syndrome management

Answer 27

primary prohylaxis: - low dose aspirin -LMWH in high risk scenarios secondary prophylaxis: -life long warfarin

Question 28

who gets AML

Answer 28

elderly

Question 29

auer rods

Answer 29

AML

Question 30

who gets ALL

Answer 30

children

Question 31

signs of ALL

Answer 31

leukaemic effects -fever -bone pain -lymphadenopathy -hepatosplenomegaly

Question 32

what confirms diagnosis of ALL

Answer 32

bone marrow aspirate -morphology and immunophenotyping

Question 33

polycythaemia vera Mx

Answer 33

aspirin venesection

Question 34

itch after hot bath

Answer 34

polycythaemia vera -loads of haemoglobin

Question 35

Hodgkin's lymphoma symptoms

Answer 35

B symptoms -night sweats -weight loss -itch -fever pain worse when drinking alcohol

Question 36

reed sternberg cells

Answer 36

hodgkins lymphoma

Question 37

which lymphoma is associated with H. pylori

Answer 37

MALT

Question 38

which lymphoma associated with EBV, malaria and HIV

Answer 38

Burkitt

Question 39

pencil poikilocytes

Answer 39

iron deficiency anaemia

Question 40

schistocytes

Answer 40

haemolytic anaemias -mechanical heart valves -DIC

Question 41

heinz bodies

Answer 41

G6PD deficiency

Question 42

when should a leg vein USS be carried out

Answer 42

within 4 hours

Question 43

starry sky appearance

Answer 43

burkitt's lymphoma

Question 44

bence jones

Answer 44

myeloma

Question 45

symptoms of myeloma

Answer 45

C - hypercalcaemia R - renal impairment A - anaemia B - bone pain B - bleeding I - infection

Question 46

rain drop skull

Answer 46

myeloma

Question 47

imaging of choice for myeloma

Answer 47

whole body MRI

Question 48

how do you monitor response to myeloma treatment

Answer 48

paraprotein level

Question 49

what mutation for polycythaemia vera

Answer 49

JAK2

Question 50

platelet count over 1000

Answer 50

essential thrombocytosis

Question 51

genetics for CML

Answer 51

philadelphia crhomosome -t(9:22)

Question 52

what happens in CML

Answer 52

myeloproliferative -proliferation of myeloid cells -increase in granulocytes at different stages of maturation

Question 53

treatment for CML

Answer 53

imatinib

Question 54

smear/smudge cells

Answer 54

CLL

Question 55

what is sideroblastic anaemia

Answer 55

when red cells fail to form haem

Question 56

what happens in G6PD deficiency

Answer 56

increased red cell susceptibility to oxidative stress

Question 57

imaging for staging lymphoma

Answer 57

PET/CT

Question 58

most common type of Hodgkin's lymphoma

Answer 58

nodular sclerosing

Question 59

how would you differentiate TRALI from TACO

Answer 59

there is hypotension in TRALI

Question 60

which haemophilia is most common

Answer 60

haemophilia A = 8

Question 61

what is acute chest syndrome in sickle cell

Answer 61

occulsion of pulmonary vasculature - dyspnoea -chest pain -pulmonary infoltrates -low pO2

Question 62

what is aplastic crisis in sickle cell

Answer 62

caused by infection with parovirus - sudden fall in haemoglobin -bone marrow suppression causes a reduced reticulocyte count

Question 63

what is a sequestration crises in sickle cell

Answer 63

sickling with organs like spleen or lung causes pooling of blood with worsening anaemia - increased reticulocyte count

Question 64

what blood picture for autoimmune haemolytic anaemia

Answer 64

macrocytic anaemia -reticulocytosis -raised LDH -spherocytes on film

Question 65

what medication for long term management of sickle cell

Answer 65

hydroxyurea

Question 66

what drug can cause macrocytic anaemia

Answer 66

methotrexate

Question 67

what is the initial investigation for polycythaemia vera

Answer 67

JAK2 mutation screen

Question 68

Mx of beta thalassaemia major

Answer 68

lifelong blood transfussions -this leads to iron overload -iron chelation therapy

Question 69

what must be screened for before tarted infliximab

Answer 69

TB

Question 70

what must be screened for before starting rituximab

Answer 70

Hep B

Question 71

what does a high TIBC

Answer 71

theres lot's of spots free for iron to bind, so overall means iron deficiency

Question 72

managment of non-Hodgkin's lymohoma

Answer 72

rituximab