How dose mesna prevent haemorrhagic cystitis in pts getting cyclophosphamide?
It binds to the urotoxic metabolites produced by cyclophosphamide, which reduces then the incidence of haemorrhagic cystitis
T/F? Cyclophosphamide is an alkylating agent?
True. Works by cross-linking DNA.
What's the treatment of choice for TTP?
Plasma exchange first-line.
Is haemochromatosis inheritance AR or AD?
AR
In the general population, what is the most useful marker for screening for haemochromatosis?
Transferrin saturation
A liver biopsy is positive for Perl's stain. Diagnosis?
Perl's stain = iron; pt has haemochromatosis
What would you expect regarding the following parameters in someone with HH? Transferrin saturation, ferritin, and total iron binding capacity? (low, normal, high)
Transferrin saturation - high
With regards to HH, monitoring of what parameter is best to assess adequacy of venesection?
Ferritin
What % of pts with MGUS go on to get MM in 5 yrs?
10% at 5 yrs;
T/F? B2-microglobulin is a useful marker of prognosis in MM?
True; a raised level implies poor prognosis
Reed-Sternberg cells = what diagnosis?
Hodgkin's lymphoma
T/F? Hodgkin's lymphoma is commonest in the young (20s) and older ppl (60s)
True
What's the Ann-Arbor staging of Hodgkin's lymphoma?
Ann-Arbor staging of Hodgkin's lymphoma
What's the most common type of Hodgkin's lymphoma?
Nodular sclerosing
Name 3 poor prognostic factors in CLL
Male
5-15% of ppl with polylcythemia rubra vera progress to what?
Myelofibrosis or AML
What's the management of polycythemia rubra vera?
Venesection - first line treatment
What's the best test to screen the gen pop for HH? How about an asymptomatic first degree relative of someone with known HH?
Gen pop = use transferrin saturation (better than ferritin level)
Would amiodarone enhance or decrease warfarin's function? (ie increase or decrease INR?)
Increase / enhances warfarin, ie expect an increased INR with concommitant use of warfarin
Do people with rheum arthritis get thrombocytosis or thrombocytopenia?
Tend towards thrombocytosis
Which haematological malignancy is a/w gingival hyperlasia?
AML
Anti-thymocyte globulin (ATG) and anti-lymphocyte globulin (ALG) is used in what condition?
Aplastic anaemia
What's the most common bleeding disorder? What's the most common clotting disorder?
Bleeding - vWF
T/F? Plasma exchange is first line therapy for ITP
False. First line is a trial of oral PNL; 80% of pts respond. If not responding, do splenectomy, +/- IVIg +/- immunosuppressive drugs
What diseases are thymomas associated with?
Thymomas are the most common tumour of the anterior mediastinum
Associated withmyasthenia gravis (30-40% of patients with thymoma)red cell aplasiadermatomyositisalso : SLE, SIADH
What malignancies are ABV, HTLV-1 and HIV-1 associated with?
EBV: Hodgkin's and Burkitt's lymphoma, nasopharyngeal carcinomaHTLV-1: Adult T-cell leukaemia/lymphomaHIV-1: High-grade B-cell lymphoma
What are the high and low risk chemotherapeutic agents with regard to infertility?