haematology/ oncology

Question 1

most common causes of cancer in the UK:

Answer 1

1. Breast
2. Lung
3. Colorectal
4. Prostate
5. Bladder

Question 2

what is CA 15-3 a marker for

Answer 2

breast ca

Question 3

what is AFP a marker for

Answer 3

Hepatocellular carcinoma, teratoma (if HCG high non-seminoma)

Question 4

what is CEA a marker for

Answer 4

colorectal cancer

Question 5

what is S-100 a marker for

Answer 5

Melanoma, schwannomas

Question 6

what is Bombesin a marker for

Answer 6

Small cell lung carcinoma, gastric cancer, neuroblastoma

Question 7

which thyroid malignancy is calcitonin raised in?

Answer 7

medullary thyroid cancer

Question 8

cx of concurrent B12 and folate deficiencies:

how do we prevent this?

Answer 8

subacute degeneration of the chord

TREAT B12 DEFICIENCY 1ST (think alphabetical)

Question 9

polycythaemia vera features: (6)

Answer 9

raised Hb
plethoric appearance
pruritus
HTN
splenomegaly

JAK2 mutation

Question 10

iron studies results in iron deficiency anaemia

Answer 10

decreased:
serum iron
transferrin
ferritin

increased:
TIBC (total iron binding capacity)

i.e. body is trying to compensate for low iron stores

Question 11

DIC typical blood picture:

Answer 11

low platelets
low fibrinogen
raised PT and APTT
raised fibrinogen degradation products
schistocytes due to microangiopathic haemolytic anaemia

Question 12

tumour lysis syndrome electrolyte dierangement:

Answer 12

high potassium
high phosphate
low calcium

Question 13

tumour lysis syndrome prevention

Answer 13

iv fluids
allopurinol
rasburicase

(don’t give rasburicase and allopurinol together as it reduces effect or rasburicase)

Question 14

LT mgt for sickle cell

Answer 14

hydorxyurea (increases HbF levels and used in prophylaxis of painful crisis)

pneumococcal vaccine every 5 yrs

Question 15

blood film hyposplenism
(post splenectomy, coeliac)

Answer 15

target cells
Howell-Jolly bodies
Pappenheimer bodies
siderotic granules
acanthocytes

Question 15

Fe deficiency blood film

Answer 15

target cells
‘pencil’ poikilocytes
if combined with B12/folate deficiency a ‘dimorphic’ film occurs with mixed microcytic and macrocytic cells

Question 16

myelofibrosis blood film

Answer 16

‘tear-drop’ poikilocytes

Question 16

intravascular haemolysis blood film

Answer 16

schistocytes

Question 16

Megaloblastic anaemia blood film

Answer 16

hypersegmented neutrophils

Question 17

myleoma blood film

Answer 17

Rouleax formation

Question 18

AML blood film

Answer 18

Auer rods

Question 19

causes of massive splenomelagy (5)

Answer 19

myelofibrosis
chronic myeloid leukaemia
visceral leishmaniasis (kala-azar)
malaria
Gaucher’s syndrome

Question 19

multiple myeloma features

Answer 19

Calcium ^^
Renal failure
Aanaemia (and thrombocytopenia
Bone lesions/#s
Bleeding
Infection

Question 20

reversal agent for:
dabigatran

Answer 20

Idarucizumab

Question 21

reversal agent for: rivaroxaban apixaban (also sometimes for edoxaban but not authorised)

Answer 21

Andexanet alfa

Question 22

ITP (idiopathic thromocytopenia) mgt

Answer 22

PO prednisolone

Question 23

von Willebrand's mgt

Answer 23

tranexamic acid for mild bleeding desmopressin factor VIII concentrate