Random

Question 1

> 60 w Iron def. anaemia pathway

Answer 1

2 week wait colonoscopy

Question 2

Causes of IDA

Answer 2

Blood loss
Diet
Malabsorption

Question 3

How to treat IDA

Answer 3

Ferrous sulphate tablets for 4 weeks at least, continue until normal MCV +RBC
Continue for further 3 months

Question 4

When give iral monofer and ferijet in IDA

Answer 4

True intolerance to oral iron
Malabsorption eg IBD

Question 5

What do you look for in severe hypoperfusion?

Answer 5

Deranged LFTs -> ischaemia of liver

Question 6

What bloods do in haemorrhaging

Answer 6

Group and save, crossmathc coag panel, FBC, U+Es

Question 7

Haemorrhaging management

Answer 7

Bloods
ECGs
Transfusion O nrgative RBC - 4 initially
Fresh frozen plasma - 1:1 with bloob
ECG,CXR

Question 8

Causes if thrombocytopenia

Answer 8

AI
Infection - EBV/CMV
Pregnancy
Drugs -> bone marrow failure
ITP
TTP
Chemo
Aplastic anaemia
Deranged clotting + clinically unwell = DIC

Question 9

Rule for platelet transfusions

Answer 9

<10 = transfuse
ITP - dont trasnfuse, steroids instead

Question 10

Prolonged PT causes

Answer 10

Liver disease
Warfarin
Vit K deficiency
Factor deficiency
#DIC
Antiphoph. antibodies
Haemorrhagic stroke

Question 11

INR thin/thick what level

Answer 11

4 = v thin blood
<1 = v thick

Question 12

What is TACO

Answer 12

transfusion acute circulatory overload

Question 13

What is TRALI

Answer 13

TRALI = Transfusion related acute lung injury

Question 14

TACO vs TRALI

Answer 14

TACO -> raised BP
TRALI - hypotnesive

Question 15

Treatment for TACO/TRALI

Answer 15

STOP INFUAION
ocygen
Diuretics, treat HF
ICU

Question 16

Acute chest syndrome in sickle cell treatment

Answer 16

Bronchodilator nebs

Question 17

Management for acute chest syndrome in sickle cell

Answer 17

A-E
Pain control
ABG
Hydroxyalbumide - incentive spirometry
Transfusion

Question 18

Antiphospholipid syndrome

Answer 18

Miscarriages, prolonged APTT with clots

Question 19

What artery would cause speech changes and R sided heiparesis in TIA

Answer 19

LAnterior cerebral artery

Question 20

What bloods would be raised in primary proliferative polycythaemia

Answer 20

Hb, WCC, platelets

Question 21

Why mihgt someone with polycythaemia have IDA

Answer 21

+raised haemotaocrit
Overproducition of RBC exhausts iron stores

Question 22

CML vs primary proliferative polycythaemia

Answer 22

CML - normal Hb, v high WCC w neutrophils and myelocytes

Question 23

myelofibrosis and myeloma affect on Hb

Answer 23

Anaemia - low

Question 24

What causes primary polycythameia

Answer 24

Haemotopoietic stem cell defect Mutation in JAK2 gene

Question 25

How can PCKD, HCC and COPD cause polycythaemia

Answer 25

PCKD ad HCC -> inappropriate EPO production COPD - tissue hypoxia increases EPO

Question 26

What anaemia can hypothyroidism cause

Answer 26

Macrocytic

Question 27

What would an abdominal mass in primary polycythaemia represent

Answer 27

Enlarged spleen - US abdomen, exclude renal carcinomas that can also cause EPO

Question 28

Treatment options polycythaemia

Answer 28

Weekly vensection til Hct 0.45 Aspirin - antiplatelet Cyto-reductive therapy - reduce platelets w interferon or hydroxycarbamide

Question 29

What is an elevated Hct ass with

Answer 29

Cerbro vascular events and MIs

Question 30

Do you need to test for H pylori before treating with duodenal ulcer

Answer 30

no - immediately commence no need for CLO test

Question 31

Non invasice tests for h PYLORI

Answer 31

Stool test Urea breath test

Question 32

What do with gastric ulcer w h.pylori therapy

Answer 32

Recommend test first as less are due to HP - confirm status before treat + biopsy helps rule out malignancy (CLO test invasice)

Question 33

Invasive tests H.pylori

Answer 33

CLO Histolgical exam and culture pH rises above 6.0 with H.pylori due to urea -> ammonia in half na hour

Question 34

Complication of polypectomy casuing rebound tenderness

Answer 34

Colonic perforation

Question 35

What should not be used in sickle cell ciris pain managmenet

Answer 35

Pethidine - only if severly allergic to opioids

Question 36

What monitor opioid patients for

Answer 36

RR, sedation and hypoxia

Question 37

When use transfusion in sickle cell

Answer 37

Symptomatic anaemia, falling Hb or low reticulocyte count 20 Hb below steady state

Question 38

When give IV fluids in sickle cell crisis

Answer 38

When cn no longer tolerate oral 2-3L per day

Question 39

Complications of sickle cell

Answer 39

CVA, seizures, hearing loss Avascular necrosis of hip Renal papillary necrosis - haematuria, rneal tubular defects, difficulty concentrating urine Arthritis Osteomyeltiis Chronic leg ulceration Visual - proliferative retinopathy esp in HbSC disease - retinal screening

Question 40

Is splenic rupture a complication of sickle cell

Answer 40

NO -. hyposlpenism

Question 41

B12 deficiency causes

Answer 41

Crohns Veganism Post fastrecetomy Pernicious anaemia - AI gastritis B12 intrinsic factor. Ass with other AI disorders

Question 42

AI disorders ass with pernicious anameia

Answer 42

s Hashimoto’s hypothyroidism, hypoparathyroidism, Addison’s disease and vitiligo

Question 43

If low in B12 and folate how replace and why

Answer 43

B12 first then folate Risk of Subacute combined degne of spinal cord if folate without B12

Question 44

Polycythaemia signs and symptoms

Answer 44

headaches confusion dizziness blurred vision night sweats itching (pruritis) extreme tiredness (fatigue) unusual bleeding such as nosebleeds, bruising easily or heavy periods red-looking eyes red-looking skin (this may be harder to see on darker skin tones) a swollen spleen, causing a feeling of fullness or pain after eating small amounts gout, causing pain in your joints. Splenomegaly

Question 45

What type of disease is PV

Answer 45

myeloproliferative neoplasms (MPNs).

Question 46

Risk in polycythaemia

Answer 46

Increased blood viscosity - increased incidence of VTE eg stroke, MI, DVT/PE

Question 47

Secondary causes of Polycythaemia vera

Answer 47

hronic lung disease or congenital heart disease, or inappropriate erythropoietin production e.g. from hepatocellular carcinoma.