MRCP Part 2

Question 1

What is Zieve Syndrome?

Answer 1

Coombs-negative haemolysis
cholestatic jaundice, and transient hyperlipidaemia

associated with heavy alcohol use, typically following a binge.

typically resolves with abstinence from alcohol

Question 2

What is Evans Syndrome

Answer 2

ITP + AIHA

Question 3

Which is the only clotting factor that is unique to PT

Answer 3

Factor VII

Question 4

Both APTT and PT are prolonged in which factor deficiency

Answer 4

1, 2, 5, 10

Question 5

When is mixing study used and what does it show

Answer 5

When PT/APTT is prolonged, they are added to serum plasma. If values normalise - factor deficiency
if they do not - indicates presence of inhibitors such as lupus anticoagulant

Question 6

Should anticoagulation be given in UC patients?

Answer 6

Yes, because UC is a prothrombotic condition and LMWH is given, but UFH is better if considering surgery for severe flare.

Question 7

mechanism behind TRALI

Answer 7

Donor anti HLA Ab inhibits the neutrophils in pulmonary capillaries causing endothelial damage as result of cytokine damage due to neutrophils sequestration causing non-cardiogenic Pulmonary Oedema

Question 8

What type of hemolysis occurs in Paroxysmal Cold Haemoglobinuria and what triggers this

Answer 8

Acute intravascular hemolysis, triggered by cold

Question 9

What is the key pathogenic antibody in Paroxysmal Cold Haemoglobinuria and what is its target?

Answer 9

Donath LAndsteiner body and target is P blood group antigen

Question 10

Describe the biphasic action of the Donath–Landsteiner antibody

Answer 10

Binds RBCs in cold, then on warming activates complement → hemolysis