Oncology + Haematology

Question 1

How long should you transfuse units of blood over?

Answer 1

2 hours

Question 2

What is the best abx for Neutropenic sepsis?

Answer 2

IV Piperacillin w tazobactam

Question 3

What is the best abx for Neutropenic sepsis?

Answer 3

IV Piperacillin w tazobactam

Question 4

What bloods will tell you someone has Beta Thalassaemia Major? (2 things)

Answer 4

1. Microcytic anaemia
2. Raised HbA2

Question 5

How do you differentiate between types of leukaemia? (3 steps)

Answer 5

1. Look at lymphocytes
2. Look at WCB
3. Look at blast cells / bands
   E.g
4. Low lymphocytes = AML / CML
5. WBC: 100+ = Chronic, so consider CML (rule out AML)
6. Band cells = confirm CML
   (blast = acute, bands = chronic)

Question 6

What cells are characteristic of Sickle cell disease / coeliac disease?

Answer 6

Howell-Jolly cells lol

Question 7

What are you suspecting if a child has super painful swelling of their hands and feet?

Answer 7

Sickle cell crisis

Question 8

What test gives you the definitive Dx of sickle cell disease?

Answer 8

Hb electrophoresis

Question 9

What can you do for a pt in sicke cell crisis in ITU?

Answer 9

Exchange transfusion

Question 10

What are the CF of Post-thrombotic syndrome (DVT complication 50%)? (4 things)

Answer 10

1. Painful heavy calves
2. Pruritis
3. Swelling
4. Varicose veins

Question 11

What is the Mx option for Post-thrombotic syndrome (DVT complication 50%)?

Answer 11

Ted stockings

Question 12

What is the most common inherited thrombophilia, therefore most probable DVT cause in young ppl like in 20s?

Answer 12

Factor V leiden

Question 13

What should you give in SVC obst (n Pemberton sign positive)?

Answer 13

Dexamethasone

Question 14

What are the blood results in Immune Thrombocytopenic Purpura (ITP)? (2 things)

Answer 14

1. Isolated low platelet count
2. Normal bone marrow

Question 15

What is the Mx of Immune Thrombocytopenic Purpura (ITP)?

Answer 15

Oral prednisolone

Question 16

What can you give before pt starts chemo to reduce risk of Tumour Lysis syndrome?

Answer 16

Allopurinol

Question 17

What ppl have an increased risk of Anaphylactic reactions to Blood transfusion?

Answer 17

igA deficient ppl

Question 18

What do you give to reduce Pyrexia in Non-haemolytic Febrile Tranfusion Reaction?

Answer 18

Paracetamol (IV / PO)

Question 19

What is the MOA of Apixaban / Rivaroxaban?

Answer 19

Direct factor Xa inhibitor

Question 20

What is the MOA of Dabigatran?

Answer 20

Direct thrombin inhibitor

Question 21

What are causes of raised APTT? (3 things)

Answer 21

1. Heparin
2. Haemophilia B
3. Antiphospholipid syndrome

Question 22

What is a resp complication of Sicke cell disease?

Answer 22

Acute chest syndrome

Question 23

What are the CF of Acute chest syndrome (resp complication of SCD)? (4 things)

Answer 23

1. SOB
2. Cough
3. Chest pain
4. CXR: new pulm infiltrates

Question 24

What is the MX for Acute chest syndrome? (3 things)

Answer 24

1. Analgesia
2. Abx
3. Blood transfusion

Question 25

What complication of SCD do you get a sudden drop of Hb in?

Answer 25

Aplastic crisis

Question 26

What is the MOA of Ondans3tron?

Answer 26

5HT3 antagonist

Question 27

What is the MOA of Ondans3tron?

Answer 27

5HT3 antagonist

Question 28

What is FIRST Line for CML?

Answer 28

Imatinib (TK inhibitor)

Question 29

What are the CF of Polycthaemia Vera? (5 things)

Answer 29

1. Raised Hb 2. Red face 3. Pruritis 4. Splenomegaly 5. HTN

Question 30

What do you give to reduce risk of clots in Polycthaemia Vera?

Answer 30

Aspirin

Question 31

Which chemo causes low Mg?

Answer 31

Cisplatin the sis of mg

Question 32

What does positive Coombs test indicate?

Answer 32

AI Haemolytic anaemia

Question 33

What are the CF of AI Haemolytic anaemia? (5 things)

Answer 33

1. Anaemia 2. High reticulocytes 3. Raised LDH 4. Blood film: spherocytes / reticulocytes 5. Positive Coombs test

Question 34

What is the Tx for AI Haemolytic anaemia? (2 things)

Answer 34

1. Steroids 2. + / - Rituximab

Question 35

What can cause DIC? (4 things)

Answer 35

1. Sepsis 2. Trauma 3. Obstetrics complications (e.g HELLP syndrome) 4. Cancer

Question 36

What do the bloods say in DIC? (4 things)

Answer 36

1. Low platelets 2. Low fibrinogen 3. Raised Fibrinogen degradation products 4. Raised PT + APTT

Question 37

What do the bloods say in Iron defiency anaemia?

Answer 37

1. Low ferritin 2. Low serum iron 3. Low transferring saturation 4. High total iron-binding capacity (TIBC)

Question 38

Which chemo is assoc w Cardiac toxicity?

Answer 38

Doxorubicin

Question 39

What does each letter in the Toxicity bear correlate to? (7 things)

Answer 39

1. A = Asparagine = Neurotox 2. C = Cisplatin = Ototox / Nephrotox 3. V = Vincristine / Vinblastine = “Christ my nerves, blast my bones” (Vc = peripheral neuropathy / Vb = myelosuppression) 4. B = Bleomycin = Pulm fibrosis 5. D = Doxorubicin = Cardiotox 6. Ψ = Cyclophosphamide = Bladder / nephrotoxic 7. M = MTX = Nephrotox

Question 40

What is Microcytic anaemia Dx when iron levels are normal?

Answer 40

Beta thalassaemia trait / major

Question 41

How differentiate between Beta thalassaemia trait vs Beta thalassaemia major?

Answer 41

* Trait = Hb around 100 * Major = Hb less than 60

Question 42

How do you differentiate between CML and CLL?

Answer 42

* CML = Massive splenoMegaLy * CLL = Lymphadenopathy