4

Question 1

function giving folic acid

Answer 1

prevent neural tube defects

support marrow function

Question 2

management haemolytic anaemia

Answer 2

• steroids
• folic acid
• splenectomy
• consider transfusion

Question 3

clinical signs iron deficiency

Answer 3

• beefy red tongue
• koilonychia
• delayed cap refill
• pale pallor
• angular stomatitis

Question 4

causes iron deficiency anaemia

Answer 4

• malabsorption e.g. coeliac
• iron deficient diet
• dyspepsia
• GI bleeding
• menorrhagia
• increased requirement e.g. pregnancy

Question 5

presentation macrocytic anaemia on blood films

Answer 5

• lemon yellow tinge
• increased bilirubin
• red cells friable
• hypersegmented neutrophils
• large RBCs

Question 6

acute leukaemia

Answer 6

cancer of white blood cells that progresses quickly and aggressively

Question 7

myelofibrosis presentation

Answer 7

• weakened bones
• anaemia
• weakness
• fatigue
• weightless
• cytopenia
• leucopenia
• massive splenomegaly

Question 8

management neutropenic sepsis

Answer 8

• Sepsis 6
• ABCD
• IV antibiotics (gentamicin)
  if no response after 72 hours
• IV antifungals

CT chest/ abdo pelvis

Question 9

neutropenic sepsis investigations

Answer 9

• lactate
• blood cultures
• CT chest/ abdo pelvis
• throat swab
• sputum
• FBCs
• RFTs
• LFTs
• coagulation screen

Question 10

what is meant by unconjugated bilirubin

Answer 10

it hasn’t been metabolised by the liver

Question 11

management hereditary spherocytosis

Answer 11

• folic acid
• transfusion
• splenectomy

Question 12

haemolytic anaemia

Answer 12

accelerated red cell destruction

Question 13

define stage C CLL

Answer 13

3 < lymph node areas
AND
thrombocytopenia or anaemia

Question 14

what happens in myeloproliferative neoplasms

Answer 14

blood cancers occurring when bone marrow overproduces one or more type of blood cell

Question 15

management type 4 hypersensitivity

Answer 15

• prevention through avoiding antigens
• anti-inflammatory drugs
• NSAIDs
• corticosteroids
• drugs blocking TNF/ IL-6
• antibodies against B-cells
• immunosuppressive drugs

Question 16

polycythaemia vera

Answer 16

blood cancer. It causes your bone marrow to make too many red blood cells. These excess cells thicken your blood, slowing its flow, which may cause serious problems, such as blood clots.

Question 17

complications HbS

Answer 17

poor perfusion
delayed development 
sickle cell crisis (acute chest syndrome, stroke)
pulmonary hypertension
PE

Question 18

describe haemoglobin in sickle cell disease

Answer 18

haem molecule
2 alpha chains
2 beta sickle chains

Question 19

criteria for myeloma diagnosis

Answer 19

• excessive plasma cells @ bone marrow
• plasmacytoma
• must compromise <10% total bone marrow cell population

Question 20

monoclonal gammopathy of uncertain significance

Answer 20

benign paraproteins present in the body

Question 21

neutrophil function

Answer 21

ingest and destroy pathogens

Question 22

drugs causing altered platelet function

Answer 22

• aspirin
• clopidogrel
• abciximab