Haematology

Question 1

Which blood product causes transfusion transmitting bacterial infection?

Answer 1

Platelet transfusion

Question 2

Neonate with unconjugated hyperbilirubinaemia on phototherapy, does not improve. What is the next step of management?

Answer 2

Do exchange transfusion and find pathological causes like RH incompatibility and G6PD deficiency

Question 3

Middle-aged woman with generalised pruritus and tender hepatosplenomegaly. Elevated haemoglobin, haematocrit and leucocytes elevated liver enzymes. What is the best next step to evaluate this patient?

Answer 3

Abdominal Doppler ultrasonography for reduced hepatic vein flow, suspecting for myeloproliferative disorders. Next do JAK2 testing

Question 4

Triad of Wiskott Aldrich syndrome. How do you treat?

Answer 4

Microthrombocytopenia, eczema, recurrent infections. Hematopoietic stem cell transplantation.

Question 5

Drugs causing peripheral neuropathy

Answer 5

VIncristine, cisplatin, taxanes, phenytoin, isoniazid, amiodarone, hydralazine

Question 6

SLE with B symptoms with generalised lymphadenopathy. Elevated LDH. Diagnosis? Confirmatory test?

Answer 6

Non Hodgkin lymphoma, excisional lymph-node biopsy

Question 7

Which childhood lymphoproliferative disorder causes a bone pain?

Answer 7

ALL- neutropenia, thrombocytopenia, wbc- decreased or markedly increased

Question 8

Young girl adopted from Nigeria presents with sudden onset weakness, hypotonia, hyper reflexia of right arm and leg, which additional test is done to diagnose after neuro imaging?

Answer 8

Haemoglobin electrophoresis. Confirm stroke with MRI

Question 9

Von willebrand factor disease lab values.

Answer 9

All normal, elevated PTT

Question 10

Work up in 60 yr males with firm fixed breast mass ?

Answer 10

Mammogram then core biopsy. Same as a female

Question 11

60yr old female with blurred vision, headache, tingling, elevated protein, ESR. Dilated segmental tortuous retinal veins. No jaw tenderness, calcium normal? Next step?

Answer 11

Diagnosis- waldenstrom macroglobulinemia. Do serum protein electrophoresis

Question 12

Massive transfusion protocols requirement. Blood products transfused?

Answer 12

More than 2 of the following-
1. Penetrating mechanism of injury.
2. Positive fast.
3. SBP less than 90.
4. Pulse more than 120
Blood products- 1:1:1- PRBC, FFP, platelets

Question 13

Anaemia in diamond blackfan anaemia. Clinical findings and treatment.

Answer 13

Macrocytic, reticulopenia
CF- craniofacial abnormalities, triphalangeal thumbs, increase risk of malignancy
Rx- corticosteroids, RBC transfusions

Question 14

Therapy given when standard treatment fails

Answer 14

Salvage therapy

Question 15

Cells and associated diseases- target cells, bite cells, Heinz body, Howell jolly body, schistocyte, burr cell, spherocyte, basophilic stippling?

Answer 15

Target- thalassemia, bite Heinz - g6pd, Howell - asplenia, schistocyte- HUS, DIC, TTP, burr- EPO deficiency, spherocyte- AIHA, basophilic stippling- lead poisoning

Question 16

Cells and associated diseases- target cells, bite cells, Heinz body, Howell jolly body, schistocyte, burr cell, spherocyte, basophilic stippling?

Answer 16

Target- thalassemia, bite Heinz - g6pd, Howell - asplenia, schistocyte- HUS, DIC, TTP, burr- EPO deficiency, spherocyte- AIHA, basophilic stippling- lead poisoning

Question 17

Most common complication of sickle cell trait carrier

Answer 17

Hematuria

Question 18

Hereditary haemorrhagic telengiectasia

Answer 18

Osler Weber rendu syndrome- epistaxis, AV shunts, telengiectasias

Question 19

TTP Rx

Answer 19

Plasma exchange, high dose glucocorticoids, rituximab, caplacizumab