Haematology

Question 1

warm autoimmune haemolytic anaemia is

Coombs test?
mx?

Answer 1

+

steroids +/- rituximab
> dampen immune response

Question 2

feature of AIHA
Ix

Answer 2

Blood results
anaemia
reticulocytosis
low haptoglobin
raised LDh/ indirect bilirubin

Blood film
spherocytes / reticulocytes

Question 3

causes of warm AIHA?

Answer 3

IgG
extravascular site

idiopathic
SLE
CLL
Lymphoma
methyldopa

Question 4

Cold AIHA causes?

Answer 4

IgM

complement
intravascular

Question 5

acute chest syndrome
mx?

Answer 5

analgesia - opioids
02
abx

blood tranfusion

Question 6

thrombotic sickle crises are precipitated by?

Answer 6

infection
dehydration
deoxygenation

Question 7

TACO features?

Answer 7

pulmonary oedema

HTN

consider loop diuretic use and o2

Question 8

TRALI features?

Answer 8

hypoxia

pulmonary infiltrates CXR

fever
HTN

o2 care and stop transfusion

Question 9

two level DVT score likely>?

Answer 9

proximal leg vein USS within 4 hours
> if negative do d dimer test

Question 10

2 level dvt wells

Answer 10

active cancer (6 months)

paralysis
bedridden >3 days / surgery within 3 months

localised tenderness along the distribution of the deep venous system

swollen leg
calf swelling >3cm
pitting oedema
collateral superficial veins

Documentated DVT hx?
alternative likely? -2 points

Question 11

what differs primary polycythaemia rubra vera from secondary?

Answer 11

normal EPO and SpO2

Question 12

TACO presents with HTN/Hypotension?

Answer 12

Hypertension

Question 13

new B symptoms in someone with PMHx of CLL?

Answer 13

richter transformation

lymphoma / large cell lymphoma

Lymph node biopsy

Question 14

which blood product is most likely at risk of bacterial contamination?

Answer 14

platelet transfusion

stored at room temperature

Question 15

aplastic anaemia features?

Answer 15

normocytic anaemia

leukopenia
thrombocytopenia

Question 16

causes of AA?

Answer 16

fanconi anaemia, dyskeratosis congenita

drugs: cytotoxic, chloramphenicol, phenytoin

benzene

parovirus, heptitis
radiation

Question 17

what counts for calf swelling?

Answer 17

> 3cm

pitting oedema

Question 18

what is a long term drug for sickle cell disease?

Answer 18

hydroxycarbamide

> makes RBC bigger
stay rounder
more flexible

Question 19

beta thalassaemia trait

Answer 19

autosomal recessive

microcytic anaemia

HbA2

Question 20

Gold standard for staging Hodgkins lymphoma

Answer 20

PET/CT scan

Question 21

Mx of hodgkins?

gold standard/ mainstay?

Answer 21

chemotherapy

ABVD OR BEACOPP

Question 22

mx of hodgkins?

Answer 22

chemo

> radiotherapy
combined
chemo> radio

HSCT

Question 23

Burkitts lymphoma

Answer 23

starry sky

HIV RF

Question 24

Ix non hodgkins lymphoma

Answer 24

excisional node biopsy

CT CAP

HIV test
FBC / blood film

ESR / LDH

Question 25

Mx of non hodgkins lymphoma?

Answer 25

Chemo Rituximab + CHOP (chemo)

Question 26

what has better prognosis in non hodgkins?

Answer 26

low grade

Question 27

IDA presents what iron studies

Answer 27

transferrin is low ferritin is low TIBC is high

Question 28

TLS

Answer 28

chemotherapy can cause (Burkitts) potassium phosphate uric acid release > AKI, arrhythmia

Question 29

Hodgkins lymphoma best prognosis?

Answer 29

lymphocyte predominat

Question 30

most common type of hodgkins lymphoma?

Answer 30

nodular sclerosing mediastinal lymph nodes fibrous tissue containing alcunar cells

Question 31

burtons line?

Answer 31

blue-purple line at dental margin lead poisoning

Question 32

abdominal pain and neurological signs

Answer 32

lead poisoning Acute intermittent porphyria

Question 33

hereditory haemolytic anaemia

Answer 33

memrane: spherocytosis metabolism : g6pd deficiency haemoglobinopathies : sickle cell, thalassaemia

Question 34

acquired non immune - coombs negative HA?

Answer 34

MAHA prosthetic heart valves malaria dapsone

Question 35

polycythaemia rubra vera mx?

Answer 35

aspirin - reduce thrombotic events venesection chemotherapy > hydroxyurea phosphorus 32 therapy

Question 36

rituximab acts on

Answer 36

CD20