Haematology

Question 1

What part of the coagulation test will be abnormal in patients with haemophilia?

Answer 1

Activated partial thromboplastin time (APTT)

Question 2

What is the advice from the British Society of Gastronenterology on the duration of iron in iron deficiency anaemia and how long after Hb normalises should it be continued?

Answer 2

Sustained improvement would be indicated by a rise in haemoglobin of 10 g/L after two weeks, or 20 g/L after 4 weeks.

Advise four weekly checks of Hb until the haemoglobin is in the normal range, then three-monthly checks for a year and six-monthly checks for 2-3 years.

Iron should be continued for 2-3 months after the haemoglobin normalises, to build iron stores – this may need to be longer if there is ongoing malabsorption or blood loss.

Question 3

In which ethnic group is Benign Ethnic Neutropenia most common?

Answer 3

Black / Afro-carribean
(absolute low neutrophils in absence of other secondary causes)

Question 4

What is the typical presentation of hyperviscosity syndrome and how should you manage it?

Answer 4

Presents with triad of neurological disturbances including headache & hearing loss, visual disturbances and mucosal bleeding

Suspect in anyone presenting with some of these symptoms who has a haematological malignancy

Need to discuss same day with haematologist if susepct