Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCP Part 1 > Hematology & Oncology > Flashcards

Hematology & Oncology Flashcards

(92 cards)

Start Studying
1
Q

Pathological Blood Films

Target Cells
Tear Drop Poikilocytes
Spherocytes
Basophilic Stippling
Howell - Jolly Bodies
Heinz Bodies
Schistocytes
Pencil Poikilocytes
Burr Cells
Acanthocytes
Hypersegmented Neutrophils

A

Target Cells - IDA, Hyposplenism, Sickle Cell / Thalassaemia

Tear Drop Poikilocytes - Myelofibrosis

Spherocytes - Hereditary Spherocytosis, MAHA, Warm AIHA

Basophilic Stippling - Lead Poisoning (Clover Leaf Morphology) , Thalassemia, Sideroblastic Anaemia , Myelodysplasia

Howell - Jolly Bodies AND Pappenheimer bodies - Hyposplenism

Heinz Bodies - G6PD Deficiency, Alpha Thalassaemia

Schistocytes - DIC, Mechanical Heart Valve , Intravascular Haemolysis

Pencil Poikilocytes - IDA

Burr Cells - Pyruvate Kinase Deficiency

Acanthocytes - Abetaproteinemia

Hypersegmented Neutrophils - Megaloblastic Anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lead Poisoning Associated with what Symptom?

A

Neuropsychiatric
Abdominal Pain
Peripheral Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Intravascular Hemolysis Causes ? (So Schistocytes in Blood Film)

A

G6PD Deficiency
Red Cell Fragmentation - TTP, DIC, HUS
PNH
Cold AIHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Extravascular Hemolytic Anemia Causes? (No schistocytes in blood film)

A

Warm AIHA
Hereditary Spherocytosis
Hemolytic disease of the newborn
Haemoglobinopathy - Sickle Cell, Thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Triad of HUS

A

MAHA
Thrombocytopenia
Renal Failure AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which Enzymes affected in Lead Poisoning

A

ferrochelatase and ALA dehydratase function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment for Lead Poisoning ?

A

Chelating Agents
dimercaptosuccinic acid (DMSA)
D-penicillamine
EDTA
dimercaprol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drugs that Trigger Acute Intermittent Porphyria

A

Drugs which may precipitate attack
(Blood Problems Have A Sneaky Behaviour)
* Barbiturates
* Pill- OCP
* Halothane
* Alcohol
* Sulphonamides
* Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Polycythemia Rubra Vera
Diagnostic Criteria

A

Low ESR and Raised Leukocyte ALP

JAK2 Positive + High Hematocrit (>0.52 Males or >0.48 Females) + High Red Cell Mass (>25%) + Mutation in JAK 2

JAK Negative then A1+A2+A3 + 1 more A OR 2 B

A1 - Raised Red Cell Mass OR Hematocrit
A2 - Absence of Mutation in JAK2
A3 - No secondary causes of Erythrocytosis
A4 - Palpable Splenomegaly
A5 - Presence of an acquired genetic abnormality (excluding BCR-ABL) in the haematopoietic cells

B1 - Thrombocytosis
B2 - Neutrophils elevated
B3 - Radiological Splenomegaly
B4 - Low EPO or Low Erythroid Colonies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where do you see Chocolate Cyanosis ?

A

Methaemoglobinaemia - normal pO2, low SpO2

CO poisoning - low pO2, low or false normal SpO2

Cyanide poisoning - normal pO2 and SpO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of Hyposplenism (Holly Jowell Bodies and Siderocytes)

A

splenectomy
sickle-cell
coeliac disease,
dermatitis herpetiformis
Graves’ disease
SLE
amyloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ann Arbor Staging

A

I = 1 lymph node group
II = >1 lymph node groups, same side of diaphragm
III = >1 lymph node group on different side of diaphragm
IV = Mets

A = no systemic symptoms other than pruritus

B = weight loss > 10% in last 6 months, fever > 38c, night sweats (poor prognosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lugano Classification
(Double Check)

A

Lugano classification

Stage I - SINGLE lymphatic site (i.e., nodal region, Waldeyer’s ring, thymus, or spleen).

Stage IE - single extralymphatic organ or site (IE)

Stage II - 2 or more LN involvement on SAME side of Diaphragm

Stage IIE -Contiguous extra lymphatic extension from a nodal site

Stage III - 2 or More LN on BOTH SIDES of Diaphragm + MAY involve LOCALISED involvement of Spleen IIIS / Extranodal Organ IIIE / Both IIIE+S

Stage IV - DIFFUSE AND DISSEMINATED Organ Spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sickle Cell Anemia Crisis Types

A

Thrombotic (triggered by infection, dehydration etc …)

Acute Chest Syndrome - Most Common Cause of Death after Childhood

Anaemia -
Sequestration (Increased CORRECTED Reticulocytes + Splenomegaly)

Aplastic (Reduced CORRECTED Reticulocyte Count + associated with Parvovirus B19 )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Corrected Reticulocyte Count Formula

A

(Patients Hct/ Normal Hct) * % Reticulocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Latex Fruit Allergy Associated with

  1. Which Condition
  2. Which Fruits
A

Myelomeningocele spina bifida

Before a night of PASSION-filled MANGO-tango, I put my STRAWBERRY-flavoured condom on my BANANA, careful to leave out my 2 CHESTNUTS.

Then undressed the KIWI girl, expecting the size of PINEAPPLES but ends up with AVACADO’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mucosal / GI bleeding more common in Hemophilia A/B or vWD ?

A

Hemophilia B and vWD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tumor Markers for

  1. Ovarian Cancer
  2. Teratoma
  3. Melanoma / Schwannoma
  4. SCLC, gastric cancer, neuroblastoma
A

CA 125
AFP
S-100
Bombesin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Superior Vena Cava Syndrome Features

A

Facial Swelling
Dyspnea
Visual Disturbance
Early Morning Headaches
Pulseless Jugular Venous Distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Superior Vena Cava Syndrome Causes

A

SCLC , Lymphoma’s

Metastatic seminoma, Kaposi’s sarcoma
Breast cancer

Aortic aneurysm
mediastinal fibrosis
Goitre
SVC thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

SVCO Management

A

**ONCOLOGICAL EMERGENCY **

Endovascular Stenting

Radical Chemotherapy or Chemo-radiotherapy > Stenting if Lymphoma / SCLC

Glucocorticoids often given although weak evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

TACO vs TRALI Presentation and Management

A

TACO - HYPERtension + Pulmonary Edema (IV Furosemide + Stop Transfusion)

TRALI - Non Cardiogenic Pulmonary Edema due to activation of host neutrophils increasing vascular permeability

HYPOtension + Hypoxia
(Oxygen + IV fluids for BP + Supportive Care)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hereditary Angioedema

  1. Acute Attack Treatment
  2. Screening Tests
  3. Prophylactic
  4. Presentation
A
  1. IV C1 Esterase Inhibitor Concentrate Infusion –>
    FFP
  2. C4 is THE reliable test
    C1 Esterase INH is low in Acute Attacks
  3. Anabolic Steroid -Danazol
  4. Painless / Non Pruritic Swelling –> Painful Macular Rash
    Abdominal Pain from Abdominal Visceral Edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Antiphospholipid Syndrome Treatment in Pregnancy

A

Low Dose Aspirin once Pregnancy Confirmed on Urine

LMWH once FETAL HEART SEEN –> discontinued at 34 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What do we do to minimize vJCD via blood product ?
1. late 1999 onward, all donations have undergone removal of white cells (leucodepletion) in order to reduce any vCJD infectivity present 2. from 1999, plasma derivatives have been fractionated from imported plasma rather than being sourced from UK donors. 3. from 2004 onward, recipients of blood components have been excluded from donating blood Bovine Spongiform Ecephalopathy (BSE)
26
Associations of VTE
Central Venous Catheters (Femoral > Subclavian) Puerperium 3rd Generation OCP Hormone Replacement Therapy (E+P >E) Antipsychotics - Olanzapine
27
Investigating for Allergies ?
Skin prick: food allergies and pollen. ***Contraindicated in anaphylaxis and patients on oral antihistamine*** Skin patch: contact dermatitis RAST (Serum Specific IgE) : all others ie food allergies, pollen, venom etc
28
Warm AIHA 1. Causes 2. IgG or IgM associated 3. What type of Hypersensitivity ? 4. What's Evan's Syndrome ? 5. Treatment
Neoplasm - CLL, NON HODGKIN LYMPHOMA Connective Tissue Diseases - SLE Drugs - Ceftriaxone, Piperacillin HIV or Viral Vaccines ASSOCIATED WITH PSC IgG Type 2 Hypersensitivity AIHA + Autoimmune Thrombocytopenia = Evans Syndrome Transfuse INCOMPATIBLE blood Corticosteroids Rituximab Splenectomy Hematopoietic Stem Cell Transplant
29
Cold AIHA 1. Causes 2. IgG or IgM associated 3. What type of Hypersensitivity ? 4. What's Evan's Syndrome ? 5. Treatment
1. Primary (Cold Agglutinin Disease) Secondary - EBV, CMV, Mycoplasma NON HODGKIN Lymphoma, Wladenstrom's Drugs - Lenalidomide IgM COMPLEMENT AND MAC ?????
30
Causes of Sideroblastic Anemia
MALT Myelodysplasia Alcohol Lead Poisoning TB drugs
31
Causes of TTP
Post Infection Pregnancy SLE HIV Drugs: Ciclosporin, OCP, Penicillin, clopidogrel, Acyclovir
32
Pentad for TTP
Fever Altered Mental Status Thrombocytopenia MAHA AKI
33
Urine colour changes to dark in which conditions in Hematology PAPA mnemonic
1) Phenylketonuria 2) Alkaptonuria 3) Paroxysmal nocturnal haemoglobinuria 4) Acute intermittent porphyria
34
Hereditary Spherocytosis 1. Inheritance 2. Investigations
1. Autosomal Dominant from Northern Europe 2. EMA binding test and the cryohaemolysis test If Atypical Presentation then Electrophoresis Elevated MCHC 3. Supportive + Transfusions Splenectomy
35
EBV associated with which Cancers ? H Pylori Associated Malignancy ? Protozoal Associated Cancer
Nasopharyngeal Cancer Hodgkin Lymphoma Burkitt's Lymphoma Gastric MALToma - Antral Cancer Protozoal = Burkitt
36
Side effect of Anastrozole MOA Side Effect
Aromatase Inhibitor Reduces Peripheral Synthesis of Estrogen ER+ AND Post Menopausal DEXA scan prior as osteoporosis
37
Multiple Myeloma Prognostic Marker
B2-microglobulin
38
High Risk TLS patients which prophylactic Drug ? vs Low Risk Patients ? MOA of these drugs ?
High Risk - Rasburicase (Purine (Nephrotoxic) to allantoin (Non Nephrotoxic) converter via Recombinant Urate Oxidase) Low Risk - Allopurinol Prevent Uric Acid to Purine Conversion NEVER GIVE RASBURICASE AND ALLOPURINOL together
39
 Rx of ITP > Oral Prednisolone  Rx of TTP > Plasma Exchange  Rx of Hereditary Spherocytosis > Supportive + Folic Acid  CLL > FCR  CML > Imitinab  Waldenstor Gammaglobulinemia > Rituximab  Lead poisoning > DMSA
40
When conditions are platelet transfusion contraindicated ?
Chronic bone marrow failure Autoimmune thrombocytopenia Heparin-induced thrombocytopenia Thrombotic thrombocytopenic purpura
41
Platelet Transfusion Targets
Active Bleeding then <30x10^9 Active Bleed into Critical Sites like Orbit or CNS <100x10^9
42
Leukemoid Reaction vs CML
In Leukemoid reaction High LAP toxic granulation (Dohle bodies) in the white cells 'left shift' of neutrophils i.e. three or fewer segments of the nucleus Neutrophils Mature have Segmented Nucleus Eosinophil = Two Lobed Nucleus Basophil = Bean Shaped Nucleus
43
SVCO Treatment Immediate ?
Immediate Dexamethasone injections 1) Cord compression in extra nodal Non Hodgkin's lymphoma 2) SVC obstruction Endovascular Stenting as definitive
44
CLL when to treat
Indications for treatment progressive marrow failure: the development or worsening of anaemia and/or thrombocytopenia massive (>10 cm) or progressive lymphadenopathy massive (>6 cm) or progressive splenomegaly progressive lymphocytosis: > 50% increase over 2 months or lymphocyte doubling time < 6 months systemic symptoms: weight loss > 10% in previous 6 months, fever >38ºC for > 2 weeks, extreme fatigue, night sweats autoimmune cytopaenias e.g. ITP
45
Irradiated Blood Products (T lymphocyte depleted) when to give ?
Irradiated if : 1. Hodgkin 2. Drugs like : Bendamustine or Fludarabine 3. Autologous Stem Cell Transplant - 3 months post or 6 months if whole body irradiation given Allogenic Stem Cell Transplant - Irradiated blood till 1) 6 months post + 2) off immunosuppression 3) No Clinical Evidence of GvHD
46
CMV Negative Blood Products when to give ?
1) Intra-uterine transfusions. 2) Neonates up to 28 days post expected date of delivery. 3) Pregnancy.
47
Drugs that cause Pancytopenia
ACS Antibiotics: Trimethoprim, Chloramphenicol. AED: Carbamazepine Anti-rheumatoid: Penicillamine, Gold Carbimazole Cytotoxics Sulfonylureas: Tolbutamide
48
Drugs Causing Drug induced Auto-immune Hemolytic Anemia ?
49
Common Pathogen Associated with Neutropenic Sepsis ?
Coagulase-negative Gram-positive Staphylococcus epidermidis Neutropenic sepsis Bacterial peritonitis Bacterial endocarditis (withing 2 months of Valve replacement surgery)
50
Staphylococcus epidermidis associated with what pathologies ?
Neutropenic sepsis Bacterial peritonitis from Dialysis Bacterial endocarditis (withing 2 months of Valve replacement surgery)
51
Most Common Symptom Associated with SVCO
Dyspnea
52
Factor 5 Leiden Pathophysiology Explain
Antithrombin III --> Inhibit 12,11,9 and 7 Protein C and S --> Inhibit 5 & 8 Factor V Leiden - Gain of Function Mutation --> Activated Protein C RESISTANT --> Doesn't allow Protein C to inactivate Factor 5 --> Thrombosis
53
Most Common Inherited Thrombophilia ?
Factor 5 Leiden
54
How does Heparin work ?
Stimulates Antithrombin III Inhibiting Factors 12,11,9 and 7
55
Why is Warfarin initially Procoagulant ?
Wafarin is a Vit K antagonist (10,9,7 and 2) but ALSO inhibit Protein C and S initially So give bridging LMWH Otherwise Wafarin Induced Skin Necrosis can happen
56
Pathophysiology of How Protein C and S are activated ?
Thrombin + Thrombomodulin --> Thrombin Thrombomodulin Complex TTC activated Protein S via Gamma Carboxylation in Liver --> Protein S then Activate Protein C
57
High LAP vs Low LAP conditions
Raised in myelofibrosis leukaemoid reactions polycythaemia rubra vera infections steroids, Cushing's syndrome pregnancy, oral contraceptive pill Low in chronic myeloid leukaemia pernicious anaemia paroxysmal nocturnal haemoglobinuria infectious mononucleosis
58
Chemotherapy induced Nausea and Vomiting Antiemetics (check though again)
Give Metoclopramide if Low Risk Unless _________ 2nd Line Domperidone 3rd Line Ondansetron + Dexamethasone Triptan - (An 1- Agonist) Cyproheptadine (Di - 2) Antagonist Ondansetrone - (Tri - 3) Antagonist
59
AML Poor Prognostic Factors ?
Poor prognostic features AML(mnemonic) : Age > 60 years Myeloblast > 20% blasts after first course of chemo Location by cytogenetics: deletions of chromosome 5 or 7
60
When to discharge patients post anaphylaxis ?
2, 6, 12 hours 1 adrenaline shot, 2 OR Previous Biphasic Reaction, >2 OR If Severe Asthma , Late Night Presentation or Slow Release
61
CLL most common Cells to Proliferate ? B Cells or T cells ?
CLL - Smudge B cells causing Hypogammaglobinemia
62
BRCA1/2 on Which Chromosomes ? Which is more associated with Prostate Cancer ?
BRCA 1 - 17 (Ovarian) BRCA 2 - 13 (Prostate) BRCA 2
63
Gartner Syndrome ? 1. Mutation Which Gene on Which Chromosome ? 2. Extra-Colonic Manifestations
Mutation of APC on Chromosome 5 Skull Osteoma Thyroid cancer Epidermoid cysts
64
Cryoglobulinemia 1. Types 2. Symptoms (SKIN) 3. Investigations 4. Treatment
Type 1 - Monoclonal (IgG or IgM) MM or Waldenstrom macroglobulinaemia **a/w Raynauds** Type 2 Polyclonal Hep C / Sjogren / RA / Lymphoma Type 3 Polyclonal Sjogren / RA 2. Skin T1 - Acrocyanosis , Livedo Reticularis , Raynaud's T2 - NON BLANCHING Macules and Papules (due to antibody/antigen deposition within vessels and recruiting complement causing leukocytoclastic vasculitis 2. Kidney - MPGN , Thrombosis Intra-articular - Mixed - Arthralgia Nerves - Mixed - Mononeuritis Multiplex 3. Low C4 and RA titers in Mixed Type High ESR 4. Hep C Treatment Suppress B cells with Rituximab --> Plasma Cells --> Abnormal Ig Plasmapheresis
65
Treatment of ITP ? vs Treatment of TTP ?
Repeat Platelet count if >30x10^9 + Safety Net (avoid contact sports if <50x10^9) If Injury Prone Profession or Impact on QoL Frequent Symptoms 1st Line Prednisolone (BONE MARROW ASPIRATE BEFORE IF SUS of Malignancy) 2nd Line IVIG Tranexamic Acid if Menorrhagia If No response after 3 months of Steroids then consider splenectomy or Mycophenolate TTP Plasma Exchange with FFP in the meantime If Acute / Idiopathic TTP with Cardiac or Neurological Impairment OR REFRACTORY = Rituximab
66
Referral Criteria for ITP ?
Nose Bleed >20 mins Prolonged Gum Bleeding Hematuria or Malena Following Trauma to Head
67
ITP causes in Kids vs Adults ?
Kids - Post Live Vaccination (MMR) Adults - Recent Viral Infection
68
In ITP where do the Antibodies attack ?
Glycoprotein IIIb/2a OR Ib-V-IX complex.
69
Vitamin B12 Deficiency Treatment
1mg IM Hydroxocobalamin 3 times a week for 2 weeks then Once / 3 months Stop once normalized Life Long if Pernicious or Celiac If Neurological Impairment : 1mg Hydroxocobalamin IM on alternate days until no further improvement --> 1mg / 2 months for lifelong (if secondary to Pernicious or Celiac)
70
Gold Standard Investigations for Hematological Malignancies (AML,ALL,CML,CLL)
ALL- bone marrow biopsy AML - bone marrow biopsy (look for myeloblasts) CLL - flow cytometry/ immunophenotyping CML - FISH/PCR to look for BCR-ABL gene
71
Translocation (11:22) in ?
Ewing Sarcoma
72
Facts about Skin Prick , RAST and Skin Patch Testing
Skin Prick Test: 1- Easy to perform 2- Inexpensive 3- Use control (Histamine'+' and Sterile water '-') 4- Read after 15 min 5- Useful for food allergy and pollen 6- Use diluted antigen and the pierce the skin 7- +Ve test is formation of wheal RAST: 1- Check amount of IgE to specific Ag 2- Result from 0 '-Ve'----- to----- 6' +Ve' 3- Useful in food allergy, inhaled pollen, bee/wasp 4- Used if skin prick can not be used Skin Patch Test: 1- Useful for contact dermatitis 2- need dermatologist 3- Read after (48+48)hours 4- Test allergen and irritant
73
When would you investigate for Li-Fraumeni Syndrome ?
*Individual develops sarcoma under 45 years OR *First degree relative diagnosed with any cancer below age 45 years and another family member develops malignancy under 45 years or sarcoma at any age
74
Polycythemia Rubra Vera associated with Low or High ESR ?
Low ESR
75
How does Celiac Disease Cause Hyposplenism
excessive loss of lymphocytes through the inflamed enteric mucosa, leading to spleen's reticuloendothelial atrophy
76
Which Blood Group is for Universal Donor for RBC and FPP ?
O - is universal donor and AB + is universal recipient for whole blood but vice versa for FFP.
77
What organism to Screen before starting Rituximab ?
Hepatitis B
78
Capecitabine is the Oral Form of what drug ?
5FU - Pyrimidine Antagonist
79
How is CLL (Monoclonal B cell proliferation) different to MM
MM 1. A pleuripotent stem cell proliferates --> multiple abnormal plasma cells 2. Cytogenic progression is more common --> risk of transformation to AML 3. More varied B cells --> more varied cytokine release --> more varied systemic features eg osteoclast-activating cytokines causing bony lytic lesions CLL 1. A single committed B cell proliferates --> monoclonal B cell proliferation 2. Cytogenic progression is less common but a notable risk = Richter's transformation --> high grade Lymphoma eg DLBCL 3. Body recognizes abnormal B cells and gathers them in the lymph nodes/spleen --> Lymphadenopathy (LAD). Progression of LAD/splenomegaly is one of the indications for treatment.
80
Multiple Myeloma vs MGUS vs Waldenström Macroglobulinemia
MM IgG > 30 g/l >10% plasma cells on bone marrow biopsy Elevated B2 Microglobulin and Lower Albumin (worse prognosis) + CRAB MGUS <10% plasma cells on bone marrow biopsy Normal B2 Microglobulin No CRAB Waldenström Macroglobulinemia IgM K subtype (not IgG) Cryoglobulinemia Type 1 - Acracyanosis, Raynauds Phenomenon, Cold AIHA (DAT+), Hyperviscosity Syndrome Triad ( Visual, Bleeding and Neurological) HEPATOSPLENOMEGALY unlike MM No Bone Pain BUT has Lymphoplasmaocytic Lymphoma + NEUROPATHY (IgM attacks Myeline Sheath) >10% Lymphoplasmocytic Cells on Bone Marrow Biopsy - CD19/CD20/CD22 + Treatment - Plasmapharesis Plasma exchange IVIG Chemo - Rituximab based
81
Key facts about MM (just in case to remember)
MM--> ALL Type 2 RTA "Proximal" - Fanconi Syndrome Not seen on Bone Scan - X ray for Lytic Bony Lesions Multinucleated Giant Cells on Biopsy on BJ deposition in the Tubules (not toxic to glomerulus) IgGk --> IgA --> K or Lamda REDUCED Anion Gap Metabolic Acidosis Beta 2 Microglobulin --> Higher = Worse Prognosis Albumin Level = Lower = Worse Prognosis Serum ALP --> Normal Histopathology = Monoclonal >10% Clock Face Chromatin , Abundant RER , Prominent Golgi , Perinuclear Halo, Peripheral Nucleus Immunohistochemistry - CD138 +
82
If its not JAK2 mutation for ET then what else is the mutation ?
CALR (calreticulin) If its not JACK its CARL
83
In Sickle Cell Crisis what is the prophylactic drug we give to reduce Crisis ?
Hydroxyurea (increase HbF levels) and analgesia managed by Morphine
84
Benign Neutropenia common in which ethnicity ?
Black Africans or Afro-Caribbeans
85
Hairy Cell Leukemia Facts 1) Clinical Features 2) Bone Marrow Aspirate 3) What stain
1) pancytopenia splenomegaly skin vasculitis in 1/3 patients 2) 'dry tap' despite bone marrow hypercellularity 3) Tartrate resistant acid phosphotase (TRAP) stain positive Management chemotherapy is first-line: cladribine, pentostatin immunotherapy is second-line: rituximab, interferon-alpha
86
Poor Prognostic Factor for Hodgkin Lymphoma
Male >45 Stage 4 WBC > 15000 or Lymphocytes <600 Hb <10.5 Albumin < 40
87
Poor prognostic factors for CLL
Male >70 lymphocyte count > 50 prolymphocytes comprising more than 10% of blood lymphocytes lymphocyte doubling time < 12 months raised LDH CD38 + TP53 mutation Deletion of Long Arm of 13q = Good Prognosis Deletion of Short Arm of 17p = Poor Prognosis
88
Treatment for PNH ?
Eculizumab (Inhibit C5 Convertase so no MAC) If Given Neisseria Meningitides Vaccine Hematopoietic Stem Cell Transplant if Aplastic Anemia
89
Which Gene Mutations in Which Chromosomes and cause what Pathologies 1. ALK 2. C-KIT 3. EGFR 4. KRAS
ALK ch 2 = adenocarcinoma lung C-KIT ch 4 = (GIST) and AML EGFR ch 7 =RCC and NSCLC KRAS. ch 12. = pancreatic cancers
90
Treatment of Methylglobinemia ?
Congenital = Ascorbic Acid If Severe - MethylBlue but CI in G6PD
91
Translocations and Associations
Indolent 1. Follicular - T(14:18) BCL2 Hepatosplenomegaly 2. Marginal Zone - BCL10 H Pylori Salivary and Thyroid Gland involvement Aggressive 1. Mantle Zone T(14:11) BCL1 Cyclin D 2. Burkitt's Lymphoma T(14:8) cMYC 3. DLBC BCL6 EBV + HIV
92
ALL Good vs Bad Prognostic Factors
Good - Bad L1 - L3 Low WBC - High Wbc Undiff - B or T differentiation hyperdiploidy-HYPO diploidy t1:19/11:21 - T9:22 Female - Male 2-10 - <2 or >10

MRCP Part 1 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions