Formative assessment

Question 1

A blood film contains macrovalocytes and hypersegmented neutrophils.

Which type of anaemia is these buzzwords referring to?

What is the cause?

Answer 1

Megaloblastic anaemia (a type of macrocytic anaemia)

Vitamin B12 / Folate deficiency

Question 2

Which autoimmune disease can cause B12 / Folate malabsorption?

Answer 2

Pernicious anaemia

Question 3

What are two blood film buzzwords for B12 / Folate deficiency?

Answer 3

Macrovalocytes

Hypersegmented neutrophils

Question 4

What is a blood film finding specific to acute myeloid leukaemia?

Answer 4

Auer rods

Question 5

A patient’s blood film contains Auer rods.

Which haematological malignancy is this referring to?

Answer 5

Acute myeloid leukaemia (AML)

Remember CML has its own buzzwords: Philadelphia chromosome (22) mutation, BCR-ABL1 positive, treated with imatinib

Question 6

What does a monocyte look like under the microscope?

Answer 6

Horseshoe nucleus

White vacuoles

Question 7

In which situations would you give a patient

a) iron tablets

b) iron injections?

Answer 7

a) Mild iron deficiency anaemia

b) Severe iron deficiency anaemia

Question 8

How do you treat autoimmune haemolytic anaemia?

Answer 8

Steroids

Question 9

How do you treat Waldenstrom’s (IgM) disease?

Answer 9

Cytotoxic drugs

Plasma electropharesis

Question 10

Which anticoagulant drugs target Factor Xa?

Answer 10

Rivaroxaban

Apixaban

Edoxaban

i.e all the novel anticoagulants with -xa- in their name

Question 11

Which type of blood cells express CD20 antigens?

Answer 11

B cells

Question 12

Which type of blood cells express CD30 antigens?

Answer 12

T cells

Question 13

Which drug targets CD20 and can therefore be used to target B cell lymphomas?

Answer 13

Rituximab

Question 14

Which drug targets BCR-ABL1 tyrosine kinase?

Which haematological malignancy is this enzyme associated with?

Answer 14

Imatinib

CML

Question 15

Which drug targets Factors II, VII, IX and X?

Answer 15

Warfarin

Question 16

Which disease is JAK2 mutation associated with?

Answer 16

Polycythaemia rubra vera

Question 17

Which drug potentiates the action of antithrombin?

Which types of this drug potentiate antithrombin’s action against

a) thrombin
b) factor Xa?

Answer 17

Heparin

a) Unfractionated heparin

b) LMWH e.g dalteparin

Question 18

Which drug inhibits platelet activation by inactivating cycloxygenase enzymes?

Answer 18

Aspirin

Question 19

Which drug inhibits primary haemostasis by antagonising ADP?

Answer 19

Clopidogrel

Ticagrelor

Question 20

Which NOAC directly inhibits thrombin?

Answer 20

Dabigatran

Question 21

Bence Jones proteins (light chains found in a urine sample) indicates which haematological malignancy?

Answer 21

Multiple myeloma

Question 22

Which drugs tend to cause a prolonged

a) PT / INR

b) APTT?

Answer 22

a) Warfarin

b) Heparin

Question 23

Which disease causes a drop in platelets and fibrinogen, plus prolonged clotting times?

Answer 23

Disseminated intravascular coagulation (DIC)

Treat with platelet transfusions and fresh frozen plasma

Treat underlying cause

Question 24

Which disease are you testing for with a JAK2 gene analysis?

Answer 24

Polycythaemia rubra vera

i.e primary polycythaemia

Question 25

What is the purpose of a Coombs test?

Answer 25

To differentiate between an autoimmune and non-autoimmune cause of haemolytic anaemia

(Autoimmune HA is Coombs positive, other causes e.g Sickle cell are Coombs negative)

Question 26

What disease is associated with a raised serum caeruloplasmin?

Answer 26

Wilson’s disease

Question 27

Immunophenotyping is used to differentiate between different kinds of ___.

Answer 27

lymphoma

Question 28

What is a Kleihauer test used to detect?

Answer 28

Antepartum haemorrhage

Question 29

Name two tests which can be used to detect thalassaemia.

Answer 29

Osmotic fragility analysis

Haemoglobin analysis

because this is a disease affecting globin chains

Question 30

Name a cause of single factor deficiency.

Answer 30

Haemophilia A/B

Question 31

Name some causes of multiple factor deficiency.

Answer 31

DIC

Liver failure

Question 32

If an investigation references the red cell membrane, which disease does it likely involve?

Answer 32

Hereditary spherocytosis

but you’d see this on a blood film???

Question 33

What is the (really simple) pathophysiology of sickle cell anaemia?

Answer 33

Point mutation in globin gene producing HbS instead of HbA

Question 34

Transfusions can acutely injure which organs?

Answer 34

Lungs

Question 35

Loss of central pallor is a buzzword for which disease?

Answer 35

Spherocytosis

Question 36

What is a sickle crisis?

Answer 36

Episodes of ischaemia (pain) caused by blockage of capillaries by sickle cells

Question 37

Antiphospholipid syndrome is an (inherited / acquired) cause of thrombophilia.

Answer 37

acquired

others, like Factor V Leiden & antithrombin, protein C & S deficiencies are usually INHERITED