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Year 5 Pathology > Past Papers Haem > Flashcards

Past Papers Haem Flashcards

1
Q

blood transfusion, rash several hours later

A

Allergic reaction

Delayed HTR if Days later

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2
Q

RTA, 6 units blood

SOB, fever, tachycardia

A

TRALI

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3
Q

B thalassaemia, regular transfusions

Malaise and erectile dysfunction

A

Transfusion associated haemosiderosis

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4
Q

AAA repair

several days later fever, low Hb, jaundice

A

Delayed HTR

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5
Q

myelodysplastic syndrome (MDS)
minutes after transfusion
tachycardic, transfusion site pain, Hypotension

A

ABO incompatibility

or Immediate transfusion reaction

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6
Q 
Blood transfusion
several DAYS later
Fever, Low Hb/signs of anaemia, Jaundice
Extravascular haemolysis
IgG mediated
A

Delayed HTR

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7
Q

acute transfusion reaction (mins)

risk higher in IgA deficiency

A

anaphylaxis

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8
Q 
Transfusion reaction
in minutes to hours
bleeding, dark urine, no rash 
abdo pain, flush, vomiting
host IgM-mediated (attack donor RBC)
A

ABO incompatibility (immediate HTR)

severest if group A to group O

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9
Q

Transfusion reaction
minutes to hours
no rash, shock and high fever
Commonly in platelet transfusion

A

Bacterial contamination

Hep B/C, HIV

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10
Q

Transfusion reaction
minutes to hours
Rise temp of ≤1ºC (MILD fever), rigors

commonest transfusion reaction
after pregnancy

WBC release cytokines, and prevented by leukodepletion

A

Febrile non-haemolytic transfusion reaction

NB ABO has drop in BP as RBC targeted, but febrile non-HTR there is NO drop in BP

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11
Q 
Transfusion reaction 
in HOURS
Pulmonary oedema/fluid overload 
HF:  ↑JVP, ↑PCWP
no fever
A

Transfusion-associated circulatory overload

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12
Q

Transfusion reaction
in HOURS <6 hrs

dry cough, SOB, fever, tachy
bilateral lung infiltrates/oedema

No HF (↑JVP)
cause = dont anti-HLA Abs
A

Transfusion-related acute lung injury

TRALI

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13
Q 
Diarrhoea, liver failure, skin desquamation and bone marrow failure
DAYS later (>24hr)

Donor WBCs recognise recipient’s HLA as foreign and attack gut, liver, skin, BM
Prevent by irradiating blood components for immunosuppressed recipients

A

GvHD

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14
Q

SCD/thalassaemia blood transfusions

bronze skin, HF, short stature

A

Transfusion associated haemosiderosis

/ Fe overload

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15
Q

African lady
requests a sickle cell solubility test
low Hb, normal MCV?]
clouding of the tested blood

A

Sickle cell trait

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16
Q

African child
low Hb,normal MCV
Electrophoresis - high HbS and low HbF

A

SCD

Normal = HbA =~99.99%, HbF, HbA2 = ~0.01% each or none.

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17
Q

Haemolysis after antimalarials / malaria treatment

A

G6PD

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18
Q

spherocytes
polychromasia
reticulocytosis on blood film

A

hereditary spherocytosis

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19
Q

Coeliac disease
poor compliance with diet
macrocytosis
cause?

A

folate deficiency

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20
Q

high HbF

low Hb

A

B thalassaemia

21
Q

high HbS, low HbF

A

SCD

sickle cell train 50% HbS

22
Q

high IgG paraprotein (32- 40) g/dl
back pain
loss of sensation in legs

A

multiple myeloma

23
Q

IgM paraprotein and visual disturbances

A

Lymphoplasmocytic lymphoma
(Waldenstrom’s macroglobinaemia)

NHL low-grade, get hyperviscosity Sx

24
Q

German lady
asymptomatic
low neutrophils, but no abnormal cells on film

A

Chronic idiopathic neutropenia

25
Q

injured playing sports
pancytopenia
immature myeloid cells on blood film
WCC normal.

A

AML

26
Q 
overweight, diabetes 
longstanding bone/back pain. 
paraprotein IgA ~8g/dl
GFR 55mls/min/1.73m^2
FBC normal and albumin normal.
A

MGUS

  • IgG/A <30
    <10% clonal plasma cells
    no CRAB
27
Q

IgA 31
12% plasma clonal cells
no other Sx

A

Smouldering MM

28
Q

IgG 51
clonal cells 9%
Constipation, GFR 50, low Hb, fracture

A

multiple myeloma

IgG/A must be >30
plasma cell % anything
CRAB Sx

29
Q

IgG/A <30
<10% plasma cells in BM
no CRAB or organ damage

A

MGUS

no Tx needed

30
Q

IgG/A>30g/l
>10% plasma cells in BM
borderline CRAB

A

smouldering MM

no Tx needed, higher transformation rate

31
Q

normal Ca levels

A

2.2-2.6

32
Q

IgG/A >30
clonal plasma cell % any

1+ CRAB Sx
Calcium 2.75, Renal Failure 177, Anaemia 100

Organ damage - hypogammaglobulinaemia, bone disease, cytopenia, hyperviscosity

A

MM

need Tx

33
Q

most common cause of thrombocytopenia/low platelets in Pregnancy

A

Gestational thrombocytopenia

then pre-eclampsia

34
Q

Causes DIC in pregnancy

A

Amniotic fluid embolism

placental abruption

35
Q

Normal change in pregnancy

A

increased fibrinogen

36
Q

Cause of Neonatal thrombocytopenia

A

neonatal alloimmune thrombocytopenia (NAIT). ?

37
Q

minor illness (cold, fever) a week ago
now abnormal bruising
otherwise well

A

idiopathic thrombocytopenia

38
Q

viral infection

Donath-Landsteiner Abs

A

Paroxysmal cold Hburia

39
Q

morning dark urine
thrombosis
Budd-Chiari
Ham’s test

A

Paroxysmal nocturnal Hburia

40
Q

Thrombocytopenia + Anaemia + Renal Failure + Child + Fever

A

HUS

41
Q

Thrombocytopenia + Anaemia + Renal Failure + Adult + Fever

A

TTP

Ab to ADAMTS13 -> vwF strands cut up RBCs

42
Q 
normal physiological changes in pregnancy
ALP
fibrinogen
systemic vascular resistance
creatinine clearance
A

ALP increases
fibrinogen increases
SVR decreases
creatinine clearance increases

43
Q

young adult
translocation(9:22)
cells are positive for TdT

A

ALL

44
Q

Low serum iron, Low ferritin

high TIBC

A

IDA

45
Q

Low serum iron, normal or high Ferritin

high/low TIBC

A

ACD

high TIBC - poorly nourished
low TIBC - well nourished

46
Q

Dad and brother of dead individual disagree over having an autopsy. The Dad was the main carer but no mention of Standing order or special status assigned to dad by the dead individual. Can do autopsy?

A

autopsy can be done but to settle the disagreement it goes to a special court

47
Q

Next of kin is identified for a woman who is estranged from her family, and found at home unresponsive with needles, and is a drug addict. When they get her to hospital she dies.

A

Refer to coroner (for advice) as cause of death is unknown

48
Q

A man presents with history of heart disease, left ventricular hypertrophy, has a facial basal cell carcinoma and type 2 diabetes. Investigations from one year ago showed critical aortic stenosis.
How should you fill out the MCCD (Medical Certificate of Causes of Death)?

A

1a = aortic stenosis

1b must cause 1a
Ic must cause 1b
2 = other causes related to 1a e.g. T2DM and MI

Year 5 Pathology (13 decks)

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