Heam

Question 1

dabigatron is excreted how

how does it work

Answer 1

renally

direct thrombin inhibitor

Question 2

extrinsic pathway

intrinsic pathway

Answer 2

PTT

APTT

Question 3

prolonged PTT

Answer 3

warfarin
liver disease
vit k defic
DIC

Question 4

which factor is decreased the fastest in liver disease and why

Answer 4

factor 7

has the shortest half life

Question 5

prolonged APTT

Answer 5

haemophilia
heparin
DIC
WV dx
anti phospholipid

Question 6

ferritin is what

Answer 6

storage iron
acute phase protein
goes up in infections

Question 7

heriditary spherocytosis is what
what happens
what can be done treatment wise

Answer 7

genetic change in a protein leading to a change in the shape
RBCs cleared faster - hameolysis
splectomy and cholescectomy as gallstones due to increased bilirubin
folic acid 5mg/day due to defic

Question 8

iron therapy what should be seen

Answer 8

Hb should go up 10g/L per week

Question 9

pernicious anaemia is a problem with what

treatment

Answer 9

B12 absorption - B12 is needed for division of cells

loading dose of B12 then every 3months

Question 10

normocytic can be what

Answer 10

aplastic anaemia

anaemia of chronic disease

Question 11

Gp6D come from where

Answer 11

mediterranean

african origin

Question 12

lead poisoning

Answer 12

old fashioned house
pain
basophilic stippling
non megaloblastic macrocytic

Question 13

idiopathic thrombocytopenia purpura

Answer 13

had cold/virus before

Question 14

INR target for VTE
recurrent VTEs
AFib

Answer 14

2. 5
3. 5
4. 5

Question 15

tamoxifen increases the risk of what

Answer 15

VTE and endometrial cancer

Question 16

what do platelet transfusions have more of a risk of than other transfusions and why

Answer 16

bacterial infections

stored at room temp - provide a more favourable enviroment

Question 17

DVT warfarin target

Answer 17

INR 2-3

Question 18

burrkits lymphoma gene 
caused by what 
in who 
risk of
how can this risk be avoided

Answer 18

C-Myc gene translocation between 8:14
EBV
african population 
chemo can cause tumour lysis syndrome 
rasburicase is given before chemo to decrease the risk

Question 19

factor 5 leidan is also known as what

Answer 19

activated protein C resistance

Question 20

what is the most common inherited bleeding disorder

Answer 20

VW

Question 21

polycythaemia vera has excessive what
what key symptom/sign
predisposes people to what
20% suffer from what

Answer 21

excessive RBCs
intense itching after shower
blood clots
suffer from gouty arthritis

Question 22

antiphospholipid syndrome increases what

Answer 22

APTT

Question 23

neutropenic sepsis treatment

Answer 23

pevacillin and tazobactem

Question 24

hereditary spherocytosis dx

Answer 24

osmotic fragility test

Question 25

deficiency in both via B12 and folic acid treatment

Answer 25

IM B12 and start oral folic acid when B12 levels are normal

Question 26

rheumatoid arthritis and splenomegaly/neutropenia

Answer 26

Feltys

Question 27

aplastic crisis signs cause

Answer 27

decreased Hb presence of reticulocytes caused by paravirus infection

Question 28

chronic lymphocytic leukaemia is the commonest what where are the lymphocytes seen signs

Answer 28

leukaemia in adults lymphocytes in peripheral blood LNs enlarged, splenomegaly

Question 29

LMWH ix | unfractionated ix

Answer 29

Xa assay | APTT

Question 30

how much iron is in the plasma pool

Answer 30

4mg

Question 31

what is the iron turnover

Answer 31

4mg in the pool and move 20mg in a day

Question 32

adult male hb and hc | female

Answer 32

130 and 0.38-0.52 | 120 and 0.37-0.47

Question 33

what do erythroid precursors cluster around

Answer 33

a central nursing histiocyte

Question 34

hb concentration hc when are both of these not useful

Answer 34

spectrophotometric method ratio of blood bleed or plasma expansion

Question 35

reticulocytes

Answer 35

larger than normal still have rna stain purple/deep red blood film - polychromic

Question 36

cytoplasmic defects nuclear defects bad kidneys what do all of these lead to

Answer 36

impaired haemaglobinisation impaired cell division ero insta being produced erythropoiesis present but not effective to hyperprloiferation - low reticulocyte count

Question 37

MCV normal | macrocytic anaemia

Answer 37

80-100 | >100

Question 38

macrocytic causes true

Answer 38

megaloblastic CBF | non megaloblastic - alcol, liver, hypothyroid, marrow failure

Question 39

megaloblastic macrotyic anaemia causes

Answer 39

can't be fucked CBF cytotoxic drugs - methtrexate b12 and folate defic

Question 40

spurious causes of macrocytic anaemia

Answer 40

acute blood loss | cold agglutins

Question 41

cold agglutins

Answer 41

autoimmune disease against RBC - causes RBC to clump together leading to an increase in MCV

Question 42

non megaloblastic not assoc with anaemia | non megaloblasts assoc with anaemia

Answer 42

alcohol, liver dx, hypothyroidism | myelodysplasia, myeloma, aplastic anaemia

Question 43

what do b12 and folate do

Answer 43

enable chemical reactions that provide enough nucleotides for DNA synthesis

Question 44

causes of b12 defic

Answer 44

coeliac ,crohns, chronic pancreatitis, vegans, bypass

Question 45

causes of folate defic

Answer 45

dietary, coeliacs, crohns, haemolysis, exfoliating derm, pregnancy, malignancy, anti convulsants

Question 46

folate

Answer 46

dietary follasse -> mono glutamates | absorbed in jejunum

Question 47

b12 source body stores absorbed daily requirement

Answer 47

animals 2-4y ileum 1-3 ug/day

Question 48

folate source body stores absorbed daily requirement

Answer 48

leafy veg, yeast destroyed when cooking 4month D+J 100ug/day

Question 49

what can be caused in b12 deficiency

Answer 49

neuro problems | myelin sheath

Question 50

what is pernicious anaemia

Answer 50

AI condition with destruction of gastric parietal cells

Question 51

what is pernicious anaemia associated with

Answer 51

atrophic gastritis | other AI conditions

Question 52

what does pernicious anaemia lead to | and what are the by products of that

Answer 52

ineffective erythropoiesis - RC die prematurely in bone marrow dead RC - hb (bilirubin) and lactate dehydrogenase

Question 53

ix for pernicious

Answer 53

Anti IF - specific but not sensitive | Anti GPC sensative but not specific

Question 54

treatment for pernicious

Answer 54

vit b12 hydroxycobalamin infections for life

Question 55

mennorhagia blood loss iron defic

Answer 55

commonest cause of blood loss av 30-40ml/month which 15/20mg a month heavy >60ml which is over 30mg/month

Question 56

relative defic | absolute defic

Answer 56

pregnancy | vegetarian

Question 57

achlorhydra

Answer 57

absent or low production of HCl

Question 58

functional iron

Answer 58

hb

Question 59

transported iron

Answer 59

serum iron transferrin transferrin sat

Question 60

storage iron

Answer 60

serum ferratin

Question 61

what is tranferrin

Answer 61

protein with 2 binding sites for ion atoms

Question 62

what is ferratin

Answer 62

large intra cellular protein | spherical protein stores up to 4000 ferric ions

Question 63

when is transferrin high

Answer 63

genetic haemochromatosis

Question 64

hb tetramer made up of what

Answer 64

2 alpha globin chains and 2 beta globin chains | one team attached to each globin chain

Question 65

HbA HbA2 HbF

Answer 65

alpha2 beta 2 alpha2 8 2 alpha 2 gamma2

Question 66

alpha like chains on which chromosome how many per cell | beta

Answer 66

choromosome 16 4 per cell | chromsome 11 2 per cell

Question 67

embryonic Hb

Answer 67

gower 1 and 2 and portland

Question 68

foetal hb

Answer 68

HbF

Question 69

adult hb

Answer 69

HbA2 HbA

Question 70

when are adult levels of hb reached

Answer 70

6-12m of age