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Flashcards in Haem1 Deck (417)
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361

What's the link between DDAVP and vWF?

Desmopressin (DDAVP) raises level of vWF by inducing release of vWF from Weibel-Palade bodies in endothelial cells

362

Which cells in the stomach secrete intrinsic factor?

Parietal cells

363

Where is Vitamin B12 absorbed?

Terminal ileum

364

Name 2 causes of Vit B12 deficiency

Pernicious anaemia

365

What's the single most important test in determining prognosis in AML?

Cytogenetics (although gene-expression profiling, WCC at diagnosis, immunophenotyping, LDH are also used to help prognosticate)

366

Patients with deficiency in what part of the clotting cascade may be resistant to heparin treatment?

Antithrombin III deficiency - heparin works by enhancing its action.

367

What's first line management of ITP?

High dose prednisolone

368

What would you see on BMAT for someone with ITP?

Increased megakaryocytes

369

In ITP, immune complexes are directed against what?

Glycoprotein IIb-IIIa complex

370

What's the Mx of ITP?

Oral PNL (80% of pts respond)

371

What's the main cause of hypercalcemia in MM?

Due primarily to increased osteoclastic bone resorption caused by local cytokines (IL1, TNF) released by myeloma cells

372

Which of the following have been shown to increase risk of DVT? Tamoxifen, raloxifene, HRT, OCP

All of them

373

Name the two types of immunoglobulins most commonly produced in myeloma

IgG and IgA

374

What is Waldenstrom's macroglobulinemia?

Uncommon, seen in old men. Lymphoplasmacytoid malignancy, characterised by secretion of monoclonal IgM paraprotein. Features: weight loss, hyperviscosity / DVTs, hepatosplenomegaly, LNs, cryoglobulinemia eg Raynaud's

375

T/F? Thymomas a/w red cell aplasia

True

376

What's the initial treatment for CLL?

Fludarabine

377

What's the relationship between TTP & ADAMTS13?

TTP due to abnormally large and sticky multimers of vWF which cause plts to clump within vessels. This is due to a deficiency of ADAMTS13, which normally breaks down large multimers of vWF.

378

Tear-drop poikilocytes seen on blood film. Diagnosis?

Myelofibrosis.

379

What is the condition in which you see: target cells, Howell-Jolly bodies, Pappenheimer bodies, siderotic granules, acanthocytes? (one condition!)

Hyposplenism, eg post splenectomy

380

What is the condition in which you see: target cells, 'pencil' poikilocytes?

Iron defiency

381

What is the condition in which you see schistocytes?

Intravascular haemolysis

382

The combination of prolonged APTT & low platelets is seen in what prothrombotic condition?

Antiphospholipid syndrome

383

Is hereditary haemorrhagic telangiectasia AD or AR or X- linked inheritance?

AD

384

T/F? Trimethoprim may cause pancytopenia

True

385

Name 3 drugs that can cause pancytopenia

Cytotoxic

386

What anticoag should be used in a pregnant lady with a DVT?

Clexane. Less bleeding risk than heparin.

387

What's the management of thrombotic pnacytopenia?

Hydroxyurea

388

What's the relationship between activated protein C resistance and Factor V Leiden mutation?

APC resistance is due to mutated FVL.

389

What's the risk of having VTE in someone heterozygote for FVL? What about someone homozygous for factor V Leiden?

Heterozygote - 5x increased risk of VTE

390

What do you do to prevent haemorrhagic cystitis in someone getting cyclophosphamide?

Mesna