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MRCP 1 > Clinical Haematology/Oncology > Flashcards

Clinical Haematology/Oncology Flashcards

1
Q

Features of G6PD deficency

A 
Neonatal jaundice
Intravascular haemolysis
Gallstones
Splenomegaly
Heinz bodies
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2
Q

Drugs inducing haemolysis in G6PD

A

Anti-malarials: primaquine
Ciprofloxacin
Sulphonamides, sulphasalzine, sulfonylureas

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3
Q

Raised leucocyte alkaline phosphatase

A 
Myelofibrosis
Leakaemoid reactions 
Polycythaemia rubra vera
Infections 
Steroids
Pregnancy 
OCP
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4
Q

Cyclophosphamide; MoA

A

Causes cross linking in DNA

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5
Q

Cyclophosphamide: SE

A

Haemorrhagic cystitis
Myelosuppression
Transitional cell carcnioma

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6
Q

Bleomycin: MoA

A

Degrades performed DNA

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7
Q

Bleomycin; SE

A

Lung fibrosis

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8
Q

Anthracyclines; MoA

A

Stabilises DNA complex

Inhibits DNA and RNA synthesis

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9
Q

Anthracyclines; SE

A

Cardiomyopathy

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10
Q

Methotrexate: MoA

A

Inhibits dihydrofolate reductase

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11
Q

Methotrexate: SE

A

Myelosuppression, mucositis, liver fibrosis, lung fibrosis

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12
Q

Flurouracil; MoA

A

Pyrimidine analogue inducing cell cycle arrest and apoptosis

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13
Q

Flurouracil; SE

A

Myelosuppression, mucositis, dermatitis

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14
Q

Vincristine, vinblastine; MoA

A

Inhibits microtubule formation

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15
Q

Vincristine; SE

A

Reversible peripheral neuropathy, paralytic ileus

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16
Q

Vinlastine; SE

A

Myelpsuppression

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17
Q

Cisplastin; MoA

A

cross linking in DNA

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18
Q

Cistplastin; SE

A

Ototoxicity, peripheral neuropathy, hypo Mg

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19
Q

Hereditary angioedema; causes

A

AD condition assoicated with low plasma levels of C1 inhibitor

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20
Q

Hereditary angioedema; screening

A

Serum C4

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21
Q

Hereditary angioedema; features

A

Painful macular rash

Painless, non-pruritic swelling of SC tissues

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22
Q

Hereditary angioedema; acute Mx

A

IV C1-inhibitor concentrate, FFP

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23
Q

TTP; what?

A

Abnormally larger and sticky multimers of VWB factor causing platelet aggregation

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24
Q

TTP; features

A

Fever, neuro signs, microangiopathic haemolytic anaemia, thrombocytopenia, renal failure

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25
Q

Methaemoglobinaemia; what?

A

Haemoglobin which has been oxidised from Fe2+ to Fe3+

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26
Q

Methaemoglobinaemia; acquired causes

A

Drugs; sulphonamides, nitrates, dapsone, sodium nitroprusside, primaquine

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27
Q

Methaemoglobinaemia; features

A

‘chocolate’ cyanosis, dyspnoea, anxiety, headache, acidosis, arrhythmias, seizures, coma, normal pO2 but decreased saturations

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28
Q

CML; genetic associations

A

Philadelphia chromosome

Translocation between long arm of chromosome 9 and 22 (t9:22)(q34; q11)

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29
Q

CML; managment

A

Imatinib

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30
Q

Imatinib; MoA

A

Tyrosine kinase inhibitor

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31
Q

Acute promyelocytic leukaemia M3; what?

A

associated with t(15;17)

Fusions of PML and RAR-alpha genes

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32
Q

AML; film

A

Auer rods

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33
Q

Cryoglobulinaemia; Type 1

A

Monoclonal; IgG or IgM

Associations; MM, Waldenstrom macroglobulinaemia, Raynauds

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34
Q

Cryoglobulinaemia; Type 2grens

A

Mixed monoclonal and polyclonal
Usually with Rh factor
Associations; HCV, RA, Sjogren’s, lymphoma

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35
Q

Cryoglobulinaemia; Type 3

A

Polyclonal

Associations; RA, Sjo

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36
Q

vWB; what?

A

AD bleeding disorder

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37
Q

vWB; Ix

A

Prolonged bleeding time
APPT
Reduced VIII

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38
Q

vWB; Mx

A

Tranexamic acid

Desmopressin

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39
Q

Paroxysmal nocturnal haemoglobinuria; what?

A

Acquired disorder leading to intravascular haemolysis

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40
Q

Paroxysmal nocturnal haemoglobinuria; features

A

Haemolytic anameia
Pancytopenia
Haemoglobinuria
Thrombosis

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41
Q

Paroxysmal nocturnal haemoglobinuria; Ix

A

Flow cytometry of blood to detect CD59 and CD55

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42
Q

MGUS; what?

A

Common condition causes paraproteinaemia

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43
Q

MGUS; difference from myeloma

A

Normal immune function
Normal beta-2 levels
Lower and stable paraproteinaemia
No CF of myeloma

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44
Q

B Cell deficinecy

A

Shitty B Cells

  • selective IgA deficinecy
  • Burton’s
  • CVID
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45
Q

Combined B & T cell deficnecy

A

WASH your Bs and Ts

  • Wiskott Aldrichs
  • Ataxic telangectasia
  • SCID
  • Hyper IgM
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46
Q

Selective Oestrogen Receptor Modulators

A

Tamoxifen

Used is oestrogen +ve breast ca

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47
Q

Aromatase inhibitors

A

Reduce peiperhal oestrogen synthesis
Anastrozole and letrozole
Used in ER + breast ca

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48
Q

Waldenstrom’s macroglobulinaemia; features

A 
Monoclonal IgM paraproteinaemia
Hyperviscosity 
HSM
LN
Cryoglobulinaemia
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49
Q

Tumour lysis syndrome; Rx

A

Rasburicase

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50
Q

Rasburicase; MoA

A

Metabolises uric acid to allantoin

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51
Q

Intravascular haemolysis

A 
Mismatched blood transfusion 
G6PD deficiency 
Red cell fragmentation 
PNH
Cold autoimmune haemolysis
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52
Q

Extravascular haemolysis

A

Haemoglobinopathies
Hereditary spherocytosis
Haemolysis disease of newborn
Warm autoimmune haemolysis

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53
Q

Sickle cell disease: thrombotic crisis precipitant

A

Infection, dehydration, deoxygenation

54
Q

Sickle cell disease: thrombotic crisis features

A

Pain

55
Q

Sickle cell disease: sequestration crises

A

Sickling within organs causing pooling of blood with worsening anaemia
Associated with high reticulocyte count

56
Q

Sickle cell disease: acute chest syndrome

A

Dyspnoea, chest pain, pulmonary infiltrates, low pO2

57
Q

Sickle cell disease: aplastic crises

A

Sudden infection with parvovirus
Sudden fall in Hb
Bone marrow suppression and reduced reticulocyte count

58
Q

Hogdkins Lymphoma: Staging I

A

single LN

59
Q

Hogdkins Lymphoma: Staging II

A

2+ LN on same side of diaphragm

60
Q

Hogdkins Lymphoma: Staging III

A

nodes on both sides of diaphragm

61
Q

Hogdkins Lymphoma: Staging IV

A

Beyond LN

62
Q

Hogdkins Lymphoma: Staging A

A

No systemic symptoms

63
Q

Hogdkins Lymphoma: Staging B

A

B symptoms

64
Q

Polycythaemia Vera; cause

A

JAK2 mutations

65
Q

Polycythaemia Vera; features

A

Hyperviscosity, pruritus, splenomegaly, haemorrhage, plethoric appearance, low ESR

66
Q

Polycythaemia Vera; Mx

A

Aspirin, venesection, chemotherapy

67
Q

Wiskott-Aldrich Sx; features

A

Recurrent bacterial infections
Eczema
Thrombocytopenia
Low IgM

68
Q

What is acute intermittent porphyria?

A

Rare AD condition

Results in accumulation of breakdown of haem produtcts

69
Q

Acute intermittent porphyria: features

A 
Abdo pain, vomiting
Neuro
Psychiatric
HTN
Tachycardia
70
Q

Acute intermittent porphyria: Mx

A

Deep red urine

Raised urinary porphobilinogen

71
Q

Skin prick test

A

Most common

Used for food allergies and pollen

72
Q

RAST

A

Used for food allergies, pollen and wasp venom

73
Q

Skin patch testing

A

Contact dermatitis

74
Q

Target cells

A 
Sickle cell
Thalassaemia
IDA
Hyposplenism
Liver disease
75
Q

Tear drop

Poikilocytes

A

Myelofibrosis

76
Q

Spherocytes

A

Hereditary spherocytosis

Autoimmune haemolytic anaemia

77
Q

Basophilic stippling

A

Lead poisoning
Thalassaemia
Sideroblastic anaemia
Myelodysplasia

78
Q

Howell-Jolly bodies

A

Hyposplenism

79
Q

Heinz Bodies

A

G6PD deficiency

Alpha thalassaemia

80
Q

Schistocytes

‘Helmet cells’

A

Intravascular haemolysis
Mechanical heart valve
DIC

81
Q

Pencil pikilocytes

A

IDA

82
Q

Burr cells

A

Uraemia

Pyruvate kinase deficiency

83
Q

SERM e.g.

A

tamoxifen

84
Q

SERM: SE

A

menstrual disturbance
hot flushes
VTE
endometrial Ca

85
Q

Aromatase inhibitors e.g.

A

anastrazole

letrozole

86
Q

Aromastase inhibitors: SE

A 
OP
Hot flushes
Arthralgia
Myalgia
Insomnia
87
Q

Aplastic anaemia: Mx

A 
Blood products
Prevention and treatment of infection 
Anti-thymocyte globulin (ATG)
Anti-lymphocyte globulin (ALG)
Stem cell transplant
88
Q

CLL: features

A 
Lymphocytosis 
Anorexia
Weight loss
Bleeding, infections 
LN
89
Q

CLL: blood film

A

smudge cells

90
Q

CLL: Ix

A

immunophenotyping

91
Q

Hereditary spherocytosis: features

A

failure to thrive
jaundic, gallstones
Splenomegaly
Aplastic crisis

92
Q

Hereditary sphereocytosis: Ix

A

EMA binding test

93
Q

Leukaemoid reaction: causes

A

Severe infection / haemolysis
Massive haemorrhage
Metastatic cancer

94
Q

Leaukaemoid reaction: features

A

High leucocyte alkaline phosphatase score
Dohle bodies in WC
Left shift of neutrophils

95
Q

What is sideroblastic anaemia?

A

Deposition of iron in mitochrondira due to failure of RC incompletely forming haem

96
Q

Sideroblastic anaemia: Blood film

A

Basophilic striping of RBCs

97
Q

Sideroblastic anaemia: bone marrow

A

Prussian blue staining

98
Q

Thymoma associations

A 
Myasthenia gravis
red cell aplasia
dermatomyositis
SLE
SIADH
99
Q

CA 15-3

A

Breast cancer

100
Q

S-100

A

Melanoma

Schwannonmas

101
Q

Bombesin

A

Small cell LC
Gastric Ca
Neuroblastoma

102
Q

What is warm haemolytic anaemia?

A

Haemolysis at body temperature

Tends to be extra vascular

103
Q

What is cold haemolytic anaemia?

A

Haemolysis at 4oC and is complement mediated

104
Q

Warm haemolytic anaemia e.g.

A

SLE
Lymphoma, CLL
Methyldopa

105
Q

Cold haemolytic anaemia e.g.

A

Lymphoma
Mycoplasma
EBV

106
Q

t(9;22)

A

Philadelphia chromosome

CML

107
Q

t(15;17)

A

Acute promyelocytic leukaemia

108
Q

t(8;14)

A

Burkitt’s lymphoma

109
Q

t(11;14)

A

Mantle cell lymphoma

110
Q

t(14;18)

A

Follicular lymphoma

111
Q

Hairy cell leukaemia; features

A

Pancytopenia
Splenomegaly
Vasculitis
TRAP stain positive

112
Q

Lead poisoning; features

A 
Abdo pain
Peripheral neuropathy
Fatigue 
Constipation 
Blue lines on gum margin
113
Q

Lead poisoning; FBC

A

Basophilic stripping and clover leaf

114
Q

Polycythaemia; causes

A 
Dehydration
Stress
Rubra vera
COPD
Altitude
OSA
115
Q

What is factor v leiden?

A

Resistance to protein C

116
Q

CLL: Indications for Rx

A 
Progressive marrow failure
Massive LN or splenomegaly
Progressive lymphocytosis
B symptoms
Autoimmune cytopaenias
117
Q

Universal Donor

A

AB RhD negative

118
Q

Aflatoxin

A

HCC

119
Q

Aninline dyes

A

TCC

120
Q

Asbestos

A

Mesothelioma and bronchial carcinoma

121
Q

Nitrosamines

A

Oesophageal and gastric cancer

122
Q

Vinyl chloride

A

Hepatic angiosarcoma

123
Q

AML: features

A 
Anaemia
Neutropenia
Thrombocytopenia
Splenomegaly 
Bone pain
124
Q

AML: poor prognostic features

A

> 60 years
20% blasts after chemo
Deletions of chromosome 5 or 7

125
Q

Blood products - Non-haemolytic febrile reaction: features

A

Fever / chills

RBC 1-2%, platelets 10-30%

126
Q

Blood products - Non-haemolytic febrile reaction: Mx

A

Stop / slow transfusion
Paracetamol
Monitor

127
Q

Blood products - Minor allergic reaction: features

A

Prutitus

Uriticaria

128
Q

Blood products - Minor allergic reaction: Mx

A

Temporarily stop
Antihistamine
Monitor

129
Q

Blood products - acute haemolytic reaction: features

A

Fever, abdo pain, hypotension

130
Q

Blood products - acute haemolytic reaction: Mx

A

Stop transfusion
Confirm diagnosis (identity, send blood back)
Supportive care

131
Q

Eosinophilia: pulmonary causes

A 
Asthma
Allergic bronchopulmonary aspergillosis
Churg-Strauss
Loffler's
Tropical pulmonary eosinophilia
Eosinophilic pneumonia
Hyperesoinophilic syndrome
132
Q

Eosinophilia: infective

A

Schistosomiasis
Nematodes
Cestodes

MRCP 1 (16 decks)

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