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
Which cells in the stomach secrete intrinsic factor?
Parietal cells
Where is Vitamin B12 absorbed?
Terminal ileum
Name 2 causes of Vit B12 deficiency
Pernicious anaemia
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)
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.
What's first line management of ITP?
High dose prednisolone
What would you see on BMAT for someone with ITP?
Increased megakaryocytes
In ITP, immune complexes are directed against what?
Glycoprotein IIb-IIIa complex
What's the Mx of ITP?
Oral PNL (80% of pts respond)
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
Which of the following have been shown to increase risk of DVT? Tamoxifen, raloxifene, HRT, OCP
All of them
Name the two types of immunoglobulins most commonly produced in myeloma
IgG and IgA
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
T/F? Thymomas a/w red cell aplasia
True
What's the initial treatment for CLL?
Fludarabine
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.
Tear-drop poikilocytes seen on blood film. Diagnosis?
Myelofibrosis.
What is the condition in which you see: target cells, Howell-Jolly bodies, Pappenheimer bodies, siderotic granules, acanthocytes? (one condition!)
Hyposplenism, eg post splenectomy
What is the condition in which you see: target cells, 'pencil' poikilocytes?
Iron defiency
What is the condition in which you see schistocytes?
Intravascular haemolysis
The combination of prolonged APTT & low platelets is seen in what prothrombotic condition?
Antiphospholipid syndrome
Is hereditary haemorrhagic telangiectasia AD or AR or X- linked inheritance?
AD
T/F? Trimethoprim may cause pancytopenia
True
Name 3 drugs that can cause pancytopenia
Cytotoxic
What anticoag should be used in a pregnant lady with a DVT?
Clexane. Less bleeding risk than heparin.
What's the management of thrombotic pnacytopenia?
Hydroxyurea
What's the relationship between activated protein C resistance and Factor V Leiden mutation?
APC resistance is due to mutated FVL.
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
What do you do to prevent haemorrhagic cystitis in someone getting cyclophosphamide?
Mesna
