Haematology/Oncology

Question 1

What is methameglobinaemia?

Answer 1

Haemoglobin which has been oxidised from Fe2+ to Fe3+. This causes tissue hypoxia as Fe3+ cannot bind oxygen

Question 2

Treatment idiopathic thrombocytopenia purpura?

Answer 2

1. Oral prednisolone

2. IVIG

Question 3

Diagnostic criteria for multiple myeloma?

Answer 3

One major and one minor criteria (or three minor criteria in an individual who has other sighs/symptoms)
Major
1. Plasmacytoma
2. 30% plasma cells in a bone marrow sample
3. Elevated levels of M protein in the blood or urine
Minor
1. 10 to 30% plasma cells in a bone marrow sample
2. Minor elevations in the level of M protein in the blood or urine
3. Osteolytic lesions
4. Low levels of other antibodies in the blood

Question 4

Reversal agent for apixaban and rivaroxaban?

Answer 4

Andexant alfa

Question 5

Reversal agent for dabigitran

Answer 5

idarucizumab

Question 6

Treatment for a flare of acute intermittent porphyria?

Answer 6

IV haem arginate

Question 7

Treatment of acute hereditory angio-oedema?

Answer 7

IV C1 inhibitor concentrte or FFP

Question 8

Prophylaxis for attacks of hereditary angi-oedema?

Answer 8

Danazol

Tranexamic acid

Question 9

Treatment for thrombotic thrombocytopenic purpura

Answer 9

Plasma exchange

Question 10

Causes of normoblastic macrocytic anaemia?

Answer 10

Alcohol 
Liver disease 
Hypothyroid 
Pregnancy 
Reticulocytosis 
Myelodysplasia
Cytotoxic drugs

Question 11

Smudge/smear cells

Answer 11

CLL

Question 12

Treatment of essential thrombocytosis?

Answer 12

Hydroxycarbamide
Interferon alpha
Low dose aspirin reduced teh thrombotic risk

Question 13

Causes of microcytic anaemia?

Answer 13

Iron deficiency anaemia
Thalassemia
Congenital sideroblastic anaemia
Lead poisoning

Question 14

Complications of CLL

Answer 14

Anaemia
Hypogammaglobulinaemia (causing recurrent infections)
Warm autoimmune haemolytic anaemia
Transformation to high grade lymphoma

Question 15

What is richters transformation?

Answer 15

Leukemia cells enter the lymph node and change into high grade fast growing non hodkins lymphoma

Question 16

Worst prognosis for hodgkins lymphoma (type)

Answer 16

Lymphocyte depleted

Question 17

Best prognosis for hodgekins lymphoma (type)

Answer 17

Lymphocyte predominent

Question 18

Reed eternberg cells

Answer 18

Hodgkeins lymphoma

Question 19

Most common type of hodgkins lymphoma

Answer 19

Nodular sclerosing

Question 20

What is paroxysmal nocturnal haemoglobinuria

Answer 20

Acquired disorded leading to intravascular haemaolyssi.

• Causes by increased sensitivity of cell membranes to complement due to lack of GPI.
• Patients are more prone to venous thrombosis
• Diagnosis by flow cytometry of blood to detect low levels of CD59 and CD55

Question 21

What type of Ig causes warm autoimmune haemolytic anaemia

Answer 21

IgG

Question 22

What type of antibody causes cold autoimmune haemolytic anaemia

Answer 22

IgM

Question 23

causes of warm autoimmune haemolytic anaemia?

Answer 23

• Idiopathic
• Autoimmune disease such as SLE
• Neoplasia (lymphoma, CLL)
  Drugs - methyldopa

Question 24

Causes of cold haemolytic anaemia

Answer 24

Lymphoma
Mycoplasma
EBV

Question 25

Blood results in autoimmune haemolytic anaemia

Answer 25

``` Anaemia Reticulocytosis Low haptoglobin Raised LDH and bilirubin Sperocytes and reticulocytes Positive coombs tests ```

Question 26

Target cells

Answer 26

``` Sick cell Thalassemia Iron deficiency anaemia Hyposplenism Liver disease ```

Question 27

Tear drop poiklocytes

Answer 27

Myelofibrosis

Question 28

Spherocytes

Answer 28

Hereditary sperocytosis | Autoimmune haemolytic anaemia

Question 29

Basophillic stippling

Answer 29

Lead poisoning Thalassaemia Sederoblastic anaemia Myelodysplasia

Question 30

Howell Jolly Bodies

Answer 30

Hyposplenism

Question 31

Heniz bodies

Answer 31

G6PD deficiency | Alpha thalassemia

Question 32

Schistocytes

Answer 32

Intravscular haemolysis Mechanical heart valve DIC

Question 33

Pencil poikilocytes

Answer 33

Iron deficiency anaemia

Question 34

Burr cells

Answer 34

Uraemia | Pyruvate kinase deficiency

Question 35

Acanthocytes

Answer 35

Abetalipoproteinemia

Question 36

Hypersegmented neutrophils

Answer 36

Megaloblastic anaemia

Question 37

Gene translocation in burkitts lymphoma

Answer 37

C-myc

Question 38

Poor prognostic factors in CLL?

Answer 38

``` Male sex Over 70 Lymphocyte count over 50 Raised LDH TP53 mutation CD38 positive Deletion of 17p ```

Question 39

Treatment for ITP?

Answer 39

1. Oral prednisolone | IVIG