Haematology

Question 1

Which anaemias can be caused alcohol consumption

Answer 1

B12 and Folate deficiency anaemia (Macrocytic)

Question 2

Hypersegmented neutrophils is seen in..

Answer 2

Megaloblastic (B12 anaemia)

Question 3

If normocytic anaemia but reticulocytes are high think…

Answer 3

Haemolytic anaemia

Question 4

↑reticulocytes
↓Haptoglobins
↑LDH ↑Bilirubin

Answer 4

Haemolytic anaemia

Question 5

Low or normal reticulocytes with normocytic anaemia could indicate

Answer 5

Aplastic anaemia = no production of new RBCs

or

Anaemia of renal disease (EPO isn’t being produced properly)

Question 6

Parvovirus B19 can cause normocytic anaemia.. Bloods will show

Answer 6

All cell lines being low

Can cause aplastic crisis

Question 7

Essential thrombocythaemia =

Answer 7

Overproduction of platelets >600

Question 8

Recent DVT or PE and high platelets think..

Answer 8

Essential thrombocythaemia (high platelets)

Question 9

Polycythaemia vera =

Answer 9

Overproduction of RBC

Pain or itching after hot bath/exercise

Complications - recent gout or skin discolouration

JAK2 mutation

Question 10

Myelofibrosis =

Answer 10

Proliferation of Megakaryocyte causing fibrosis of bone marrow

Mainly cause B symptoms

Early satiety (due to splenomegaly)

Sudden massive hepatosplenomegaly

Dry tap on BM

Question 11

Teardrop poikilocytes seen in..

Answer 11

myelofibrosis

Question 12

CML =

Answer 12

malignancy of excess proliferation of myeloid lineage (especially granulocytes)

Associated with philadelphia chromosome (BCR-ABL 9:22)

Tends to be asymptomatic or B symptoms

Question 13

Blood findings for CML

Answer 13

High WBC

Low Hb and Low platelets

Question 14

Treatment for CML

Answer 14

Imatinib (tyrosine kinase inhibitor)

Question 15

AML

Answer 15

Cancer of the bone marrow (Abnormal immature myeloblasts)

Gum infiltration (hypertrophy and bleeding)
Bone pain
Pancytopaenia (low HB, low platelets, low WCC)

Question 16

Down’s syndrome put you at an increased risk of..

Answer 16

Acute myeloid leukaemia (AML)

Question 17

Auer rods seen in

Answer 17

Acute myeloid leukaemia (AML)

Question 18

Chronic lymphocytic leukaemia =

Answer 18

Cancer of the bone marrow (too many lymphocytes - high WCC)

Tends to affect older people

Symmetrical painless lymphadenopathy

Can lead to infections due to hypogammaglobulinaemia (reduced Anti bodies)

Question 19

Richter transformation

Answer 19

CLL turning into Large B cell lymphoma which is a type of NH lymphoma(symptoms have suddenly worsened)

Question 20

Smear cell seen with

Answer 20

Chronic lymphocytic leukaemia (CLL)

Question 21

Which cancer is commonly seen in children

Answer 21

ALL (Acute lymphoblastic leukaemia)

Cancer of the lymphoid line - large number of immature lymphocytes

WCC high, RBC low, >20 blasts

Symptoms = bleeding, infection, bone pain, lymphadenopathy, fever

Question 22

Multiple myeloma

Answer 22

Clonal proliferation of plasma cells -> increase in monoclonal Abs (IgG or IgA)

Bence jones proteins

if abnormal U&Es, high calcium (cancer spread to bone and is breaking it down) and backpain, fractures-> think myeloma

Question 23

Bence jones protein (free light chains) seen in..

Answer 23

Multiple myeloma

Question 24

Investigations for Multiple myeloma

Answer 24

Serum electrophoresis (high IgG mainly or IgA seen)

or Bence Jones protein

Question 25

Which one is more prevalent: Hodgkin's or Non-hodgkin's

Answer 25

Non-Hodgkins (90% of cases)

Question 26

Hodgkin's lymphoma

Answer 26

B cell malignancy Symptoms: cervical lymphadenopathy, swinging fevers, alcohol induced pain

Question 27

Swinging fevers (Pel-ebstein fever) seen in

Answer 27

Hodgkin's lymphoma

Question 28

Risk factors for Hodgkin's lymphoma

Answer 28

EBV | Autoimmune conditions

Question 29

Reed-sternberg cells seen in...

Answer 29

Hodgkin's lymphoma

Question 30

Subtypes of Hodgkin's lymphoma

Answer 30

``` Nodular sclerosing (Most common type) Mixed cellularity (Reed Sternberg seen) Lymphocyte rich (best prognosis) Lymphocyte depleted (Rare and worst prognosis) ```

Question 31

Burkitt's lymphoma

Answer 31

Highly aggressive Associated with EBV and HIV Occurs more in Africa and South America

Question 32

Tumor lysis syndrome

Answer 32

Group of metabolic abnormalities that can occur as a complication during the treatment of cancer, where large amounts of tumor cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream Can get gout -> treatment allopurinol

Question 33

Waldenstrom's macroglobulinaemia -> which AB is found on electrophoresis

Answer 33

IgM | it's IgG in myeloma

Question 34

MALT lymphoma associated with..

Answer 34

H pylori

Question 35

Haemophilia A genetics

Answer 35

X-linked recessive (only get in males)

Question 36

Haemophilia A symptoms and investigations

Answer 36

Haemarthrosis (bleeding into joints) Bleeding after surgery Increased APTT but normal PT Management - avoid NSAIDs Treatment - desmopressin and TXA acid

Question 37

Von Willebrand disease

Answer 37

Autosomal dominant (most common inherited clotting disorder) Seen in men and woman Excessive bleeding from minor cuts/surgery, menorrhagia Treatment - desmopressin and TXA acid

Question 38

DIC =

Answer 38

Disseminated intravascular coagulation System activation of clotting cascade -> multiple clots throughout the body

Question 39

DIC causes

Answer 39

Sepsis Trauma Malignancy