Haematology

Question 1

low platelets, abnormal clotting obvious septic person

Answer 1

DIC

Question 2

Headache seizure abdo pain high bp high bili low haptoglobin high LDH schistocytes low platelets

Answer 2

TTP

Question 3

Massive splenomeg

Answer 3

Myelofibrosis

Question 4

Pelger Huet Cells

Answer 4

Myelofibrosis

Question 5

Recurrent miscarriages

Answer 5

Anti-phospholipid Syndrome

Question 6

Platelets of 150 in pregnant woman

Answer 6

Gestation thrombocythaemia. Think something else if less than 100

Question 7

Someone who is 10w pregnant, sister had DVT last year at age 33, father on long-term anticoagulant

Answer 7

Anti-thrombin III deficiency

Question 8

Smear cells

Answer 8

CLL

Question 9

Auer Rods

Answer 9

AML

Question 10

Kid with cancer

Answer 10

ALL

Question 11

Dry tap on BM aspirate

Answer 11

myelofibrosis

Question 12

High fever after transfusion

Answer 12

bacterial contamination

Question 13

Pregnant woman who is iron deficient and does not want to take iron supplement had a transfusion in her first pregnancy and now she is pregnancy again and has another transfusion. Nurse set up transfusion, 30mins later returns and find her unconscious, cyanosis and faced puffed up

Answer 13

IgA deficiency because previous transfusion sensitised her

Question 14

Patient who had recently been stabbed in LUQ and had been transfused with O negative blood. He lost consciousness or something a few minutes after the transfusion

Answer 14

Haemorrhage with splenic haemorrhage due to stab wound

Question 15

Patient who has had several transfusions in the past now develops abdo pain, haemoglobinuria within 10 mins of starting transfusion

Answer 15

ABO Incompatibility

Question 16

Patient had RTA which required a trasfusion. After few days of transfusion patient comes back jaundiced and slightly anaemic

Answer 16

Delayed haemolytic transfusion reaction

Question 17

Patient becomes increasingly short of breath very soon after transfusion O2 sats low

Answer 17

TRALI

Question 18

thalassaemia patient looks tanned and has diabetes

Answer 18

Transfusion haemosiderosis

Question 19

Little old lady, with Hb of 68, complete well, 4 units of blood ordered, frothy pink sputum

Answer 19

Fluid overload

Question 20

Normal INR
AF/DVT Target INR
Recurrent DVT/PE/Prosthetic valve INR

Answer 20

0.8-1.2
2-2.5
2.5-3.5

Question 21

Prosthetic heart valve INR 2.0

Answer 21

Increase warfarin

Question 22

INR 3.5-5

Answer 22

Decrease dose

Question 23

INR 5-8 without bleed

Answer 23

Stop and start when in therapeutic range

Question 24

INR 5-8 with a bleed

Answer 24

Stop and give Vit K

Question 25

INR >8 with or without bleed

Answer 25

Stop and give Vit K monitor INR

Question 26

INR >8 with major bleed

Answer 26

Stop, prothrombin complex given or FFP or recombinant factor 8 with Vit K

Question 27

Monitoring anticoagulant state Pt on aspirin and clopidogrel

Answer 27

None needed

Question 28

Monitoring anticoagulant state Pt on warfarin for AF

Answer 28

PT

Question 29

Monitoring anticoagulant state Pt taking warfarin after mitral valve insertion

Answer 29

PT

Question 30

Monitoring anticoagulant state of Pt on LMWH who was unstable after surgery

Answer 30

APTT

Question 31

Monitoring anticoagulant state of Pt on LMWH who had surgery but is stable

Answer 31

None needed

Question 32

Fibrinogen levels in liver disease and DIC

Answer 32

Low

Question 33

normal Hb with positive sickle solubility test

Answer 33

Sickle cell trait

Question 34

Low Hb with positive sickle test

Answer 34

Sickle cell disease

Question 35

African man with haemolysis after anti-malarials

Answer 35

GPDDD

Question 36

older man with polychromasia and spherocytes TEST

Answer 36

Hereditary Spherocytosis, do osmotic fragility test

Question 37

Thalassaemia intermedia test

Answer 37

HbA2 levels

Question 38

Autoimmune HA Test

Answer 38

Combs Test

Question 39

Temporal Arteritis Blood measurement

Answer 39

ESR

Question 40

HIV Measurements to monitor control

Answer 40

CD4 levels and viral load

Question 41

Patient has prolonged APTT, normal PT and normal bleeding time

Answer 41

Haemophilia A

Question 42

patient has menorrhagia, prolonged APTT, normal PT and prolonged bleeding time. Her mother had similar problems

Answer 42

vWD

Question 43

patient has alcoholic liver cirrhosis

Answer 43

Vit K def or decreased synthesis of clotting factors

Question 44

Elderly Patient is asymptomatic and has generalised lymphadenopathy, with abnormal bloods

Answer 44

CLL

Question 45

Smear Cells

Answer 45

CLL

Question 46

CML Management

Answer 46

Imatinib TK inhibitor. If not dasanitib

Question 47

EBV causes

Answer 47

Infectious mononucleosis

Question 48

Elderly patient presents with MASSIVE splenomegaly with low platelets, red cells and normal white cells

Answer 48

Myelofibrosis

Question 49

Patient comes in with DIC and has a leukaemia

Answer 49

Acute Promyelocytic Leukaemia

Question 50

20% blasts in BM, aeur rods, sudan black stain

Answer 50

AML

Question 51

Bone pain, bence jone proteins, high calcium, kidney failure,

Answer 51

Multiple Myeloma

Question 52

Patient with back pain, high IgG, plasma cells>20%

Answer 52

Multiple Myeloma

Question 53

Patient with no signs or symptoms and just raised IgG

Answer 53

MGUS

Question 54

Patient with collapsed vertebrae, no other lytic lesions, normal calcium, no anaemia

Answer 54

Osteoporosis

Question 55

Patient with lump on clavicle and you see a lytic lesion on the Xray. There is also a raised IgA but no other lesions/abnormal calium/anaemia. No other symptoms.

Answer 55

Solitary Plasmacytoma. If other symptoms present, then multiple myeloma

Question 56

Post Transplant Uncontrolled proliferation of B cells following infection

Answer 56

EBV reactivation

Question 57

Cold AIHA

Answer 57

IgM antibody, EBV, mycoplasma stuff Essentially AIHA at lower body temepratures which means there's probably some kind of trigger for it such as infection, lymphoproliferative disorders or idiopathic

Question 58

Warm AIHA

Answer 58

IgG antibody is present and Warm AIHI is associated with, lymphoma, CLL, SLE, Drugs