Haematology

Question 1

incidental finding of thrombocytopenia
normal PT and APTT
petechiae, fatigue

Answer 1

immune thrombocytopenic purpura

Question 2

Mx of ITP

Answer 2

self limiting, if severe: prednisolone

Question 3

petechiae, neurological symptoms, anaemia

Answer 3

thrombotic thrombocytopenic purpura

Question 4

Mx of TTP

Answer 4

plasmapheresis

Question 5

polycythaemia rubra vera Px

Answer 5

itching after hot shower, redder skin
low erythropoetin
high MCV high haematocrit

Question 6

polycythaemia mutation

Answer 6

JAK2 mutation

Question 7

ALL Px

Answer 7

children, bone marrow failure, testicular enlargement, hepatosplenomegaly

Question 8

ALL Ix

Answer 8

Blast cells

Question 9

AML Px

Answer 9

bone marrow failure, hepatosplenomegaly

Question 10

AML Ix

Answer 10

Auer rods

Question 11

CML Px

Answer 11

weight loss, fever, massive splenomegaly, gout

Question 12

CML Ix

Answer 12

Philadelphia chromosome, mature myeloid cells

Question 13

CLL Px

Answer 13

Asymptomatic, old males

Question 14

CLL Ix

Answer 14

smudge cells, increased lymphocytes

Question 15

Complication of CLL

Answer 15

can transform into non-hodgkins lymphoma (Richter transformation)

Question 16

Symptoms of lymphoma

Answer 16

lympadenopathy (rubbery tender lymph nodes)
fever, weight loss, night sweats

Question 17

differentiating Hodgkins vs non-Hodgkins

Answer 17

Hodgkins has Reed-Sternberg cells (owls)

Question 18

Burkitt’s lymphoma: associated with, Ix

Answer 18

Epstein Barr virus
Malaria
HIV

Starry sky appearance on lymph node biopsy

Question 19

MALT lymphoma Px

Answer 19

affected area: around stomach
associated with H pylori

Question 20

Diffuse large B cell lymphoma

Answer 20

CLL can turn into this
Hepatitis C

Question 21

paraprotein spike, bence jones protein

Answer 21

multiple myeloma

Question 22

dark urine in the morning, fatigue, dyspnea.
Ix:

Answer 22

paroxysmal nocturnal haemogloninuria
flow cytometry for CD55 and CD59

Question 23

most common cause of aplastic crisis in pts with sickle cells

Answer 23

parvovirus b19 infections

Question 24

anaemia, bone pain, hypercalcaemia, renal failure
lytic lesions

Answer 24

multiple myeloma

Question 25

positive coombs test?

Answer 25

autoimmune haemolytic anaemia

Question 26

iron deficiency anaemia, high ferritin and iron. pappenheimer bodies

Answer 26

sideroblastic anaemia

Question 27

haemophilia A inheritance

Answer 27

x linked recessive

Question 28

Dx of haemophilia A

Answer 28

prolonged APTT normal PT

Question 29

Pathophis of haemophilia A

Answer 29

factor 8 deficiency

Question 30

Mx fo haemophilia A in mild vs severe bleeds

Answer 30

mild: desmopressin and tranexamic acid
severe: recombinant factor 8

Question 31

post partum haemorrhage, prolonged APTT and PT, low Hb, low fibrinogen

Answer 31

DIC

Question 32

investigation for multiple myeloma

Answer 32

urine electrophoresis to look for Bence-Jones protein

Question 33

hereditary haemochromatosis

Answer 33

iron deposition in the tissues
Px: diabetes mellitus, hyperpigmentation, testicular enlargement, erectile dysfunction, weakness

Question 34

hereditary haemochromatosis Ix

Answer 34

low TIBC, high ferritin, high transferrin

Question 35

rouleaux, when does it occur

Answer 35

stacks of RBC
multiple myeloma, waldrens macroglobulinemia

Question 36

howell jolly bodies

Answer 36

nuclear remnants found in RBC
hyposplenism

Question 37

schistocytes

Answer 37

jagged fragments of RBC
haemolysis

Question 38

tear drop cells

Answer 38

abnormality of bone marrow function (myelofibrosis)

Question 39

nocturnal haemoglobinuria cause

Answer 39

defect in phosphotidylinitol glycan A