Haematology

Question 1

cause of haemolytic anaemia that can be triggered by broad beans, henna, illness and drugs

Answer 1

G6PD

Question 2

what causes bite and blister cells on blood film

Answer 2

G6PD

Question 3

haemosiderin urine (very dark) suggests intra or extravascular cause of haemolytic anaemia

Answer 3

intravascular

Question 4

Reed sternberg cells in what

Answer 4

Hodgkin’s lymphoma

Question 5

Which lymphoma is mostly curable, which is lower grade but not normally curable

Answer 5

Hodgkins mostly curable
NH med survival 10y but not normally curable in advanced stages

Question 6

Which type of lymphoma presents with a solitary enlarged lymph node

Answer 6

hodgkins

Question 7

Which type of lymphoma presents with alcohol induced pain

Answer 7

hodgkins

Question 8

which lymphoma is more common

Answer 8

non hodgkin

Question 9

What type of lymphoma presents with painless, slowly progressive peripheral lymphadenoapthy

Answer 9

Low grade non hodgkins

Question 10

What blood test helps prognosticate in hodgkins lymphoma

Answer 10

ESR

Question 11

What type of lymphoma presents with rapidly growing bulky lymphadenoma

Answer 11

high grade non hodgkins

Question 12

What type of lymphoma presents with abdominal mass

Answer 12

Burkitt’s lymphoma

Question 13

what happens to ferritin in pregnancy

Answer 13

falls in the last 2/3 irrespective of iron stores

Question 14

when to recheck fbc after rx oral iron

Answer 14

2-4 weeks

Question 15

Action if IDA not responded to oral iron

Answer 15

refer to haem

Question 16

How long to continue iron supplement and monitoring

Answer 16

3 months after normal FBC
Then bloods 3 monthly for a year

Question 17

what is pernicious anaemia

Answer 17

autoimmune
affects gastric mucosa
leads to B12 deficiency

Question 18

severe b12/folate defic can lead to

Answer 18

pancytopenia
SACDC

Question 19

If you don’t know the B12 AND folate status, giving folate in isolation can do what?

Answer 19

worsen b12 deficiency

Question 20

pernicious anaemia rx

Answer 20

B12 monthly for life

Question 21

what is coombs test for

Answer 21

autoimmune haemolytic anaemia

Question 22

acute medical treatment of ABO incompatibility

Answer 22

hydrocort IV
chlorphenamine IV

Question 23

when after transfusion can you test FBC

Answer 23

6-12h

Question 24

In which transfusion reactions do you stop the transfusion

Answer 24

TRALI
Anaphylaxis
Haemolytic (ABO) reaction

Question 25

What is post transfusion purpura

Answer 25

plt destruction 5-12 days later- potentially fatal

Question 26

Myeloma is a malignancy of which cells in the BM

Answer 26

plasma

Question 27

Features of myeloma

Answer 27

CRAB hypercalcaemia Renal failure Anaemia Bone (lytic lesions)

Question 28

what antibodies are produced in myeloma

Answer 28

paraproteins- light chains IgA and IgG

Question 29

skull XR finding myeloma

Answer 29

rain drop skull

Question 30

1st line imaging in suspected myeloma

Answer 30

whole body MRI for bone lesions

Question 31

Treatment of myeloma

Answer 31

symptomatic Chemo and RT of bone where neoplastic plasma cells are Stem cell transplant

Question 32

abdominal and neuropsych sx in 20-40 yo female

Answer 32

acute intermittent porphyria

Question 33

acute intermittent porphyria genetics

Answer 33

autosomal dominant

Question 34

Urine turns deep red on standing

Answer 34

acute intermittent porphyria

Question 35

most common type of acute lymphoblastic leukaemia

Answer 35

b cell

Question 36

most common childhood malignancy

Answer 36

ALL

Question 37

G6pd inheritance

Answer 37

x linked

Question 38

drugs that precipitate g6pd

Answer 38

anti-malarials: primaquine ciprofloxacin sulph- group drugs: sulphonamides, sulphasalazine, sulfonylureas

Question 39

Amyloid AA is due to

Answer 39

chronic long term inflammatory conditions eg crohns

Question 40

Amyloid AL type is due to

Answer 40

myeloma, NH lymphoma, waldenstrom

Question 41

Amyloid ATTR type is due to what

Answer 41

genetic, autosomal dominant

Question 42

How is amyloid diagnosed

Answer 42

biopsy (traditionally rectal)

Question 43

Do you give oral iron in beta thalassaemia

Answer 43

only if ferritin low

Question 44

CLL is more likely in which patient group

Answer 44

HIV/AIDS

Question 45

Philadelphia chromosome linked with what

Answer 45

CML

Question 46

CML rx

Answer 46

tyrosine kinase inhibs (imatinib)

Question 47

Haemophilia A clotting factor

Answer 47

VIII

Question 48

Haemophilia B clotting factor

Answer 48

IX

Question 49

Haemophilia C clotting factor

Answer 49

XI

Question 50

coag findings in haemophilia

Answer 50

prolonged APTT normal PT

Question 51

Hereditary spherocytosis rx

Answer 51

folate supplements splenectomy if severe

Question 52

ITP rx

Answer 52

pred occasionally IV Igs 2nd line splenectomy

Question 53

TTP enzyme

Answer 53

ADAMST13

Question 54

coag screen in TTP

Answer 54

usually normal as opposed to DIC which presents similarly

Question 55

TTP rx

Answer 55

plasma exchange

Question 56

myelodysplastic syndrome can progress to what

Answer 56

AML

Question 57

What presents with massive splenomegaly

Answer 57

myelofibrosis chronic myeloid leukaemia Malaria

Question 58

what can myelofibrosis progress to

Answer 58

AML

Question 59

Sickle cell prophylaxis of acute events

Answer 59

hydroxyurea

Question 60

commonest inherited coag disorder

Answer 60

von willebrand

Question 61

von willebrand fbc and coag might show

Answer 61

quite normal

Question 62

VW treatment

Answer 62

desmopressin prophylactic TXA prior to surgery

Question 63

Waldenstroms macroglobulinaemia is related to what molecule

Answer 63

IgM paraprotein

Question 64

2 features of Waldenstroms

Answer 64

reynauds hyperviscosity features eg visual loss

Question 65

heinz bodies are seen in

Answer 65

G6PD

Question 66

Rouleaux formation

Answer 66

myeloma

Question 67

Howell-Jolly bodies

Answer 67

hyposplenic or asplenic disorders such as post splenectomy or megalobastic anaemia

Question 68

Schistocytes

Answer 68

metallic heart valves or haemolytic anaemia.

Question 69

Raised haemoglobin, plethoric appearance, aquagenic pruritus, splenomegaly, hypertension →

Answer 69

polycythaemia vera

Question 70

Polycythaemia vera mutation

Answer 70

JAK2 mutation

Question 71

Heparin prolongs

Answer 71

APTT

Question 72

warfarin prolongs

Answer 72

PT

Question 73

increase in granulocytes at different stages of maturation on blood film

Answer 73

CML

Question 74

What are the few cells that have lymphoid lineage

Answer 74

NK cells Lymphocytes Plasma cells

Question 75

sickle cell inheritance

Answer 75

autosomal recessive

Question 76

first line in polycythaemia vera

Answer 76

venesection

Question 77

History of DVT and painful, heavy calves pruritus swelling varicose veins venous ulceration

Answer 77

Post thrombotic syndrome

Question 78

Most common inherited thrombophilia

Answer 78

Factor V leiden

Question 79

microcytosis disproportionate to the anaemia suggets

Answer 79

beta thalassaemia trait

Question 80

what happens to transferrin saturation in IDA

Answer 80

low

Question 81

what type of transfusion has highest risk of bacterial contamination compared to other types of blood products

Answer 81

platelet

Question 82

Length of treatment in VTE

Answer 82

provoked (e.g. recent surgery): 3 months unprovoked: 6 month

Question 83

Treatment of choice for cancer patients with VTE

Answer 83

DOAC

Question 84

DOAC reversal agents

Answer 84

Rivaroxaban and apixaban- Andexanet Dabigatran - Idarucizumab Edoxaban - nil