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FINALS: Passmed > haem > Flashcards

haem Flashcards

1
Q

blood test results in VWD:
- bleeding time:
- platelet count:
- prolonged APTT:

A
  • bleeding time: increased
  • platelet count: normal
  • prolonged APTT: increased
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2
Q

____________ 1st line imaging in suspected multiple myeloma

A

Whole body MRI

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3
Q

B thalassaemia: ____ reticulocytes and ____ bilirubin

A

raised, raised

bilirubin is normal in iron deficient anaemia

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4
Q

Bleeding on dabigatran? Can use _______ to reverse

A

idarucizumab

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5
Q

_________is used for the reversal of apixaban or rivaroxaban

A

Andexanet alfa

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6
Q

The blood tests show a __________________________, characteristic of DIC. The condition is associated with ___________ on blood film.

A

depletion of platelets and coagulation factors
schistocytes

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7
Q

weight loss, pallor, thrombocytosis, raised neutrophils, low/normal other WBCs, anaemia ‘sense of fullness’ –>

A

CML
splenomegaly

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8
Q

___________ is usually picked up as an incidental finding of lymphocytosis, as it has no symptoms

A

Chronic lymphocytic leukaemia (CLL)

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9
Q

how to diagnose a haem malognancy?

A

Step given by my lecturer (simple yet helpful)
1. Look at lymphocytes
2. Look at WBC
3. Others hint (blast cell/ bands)

Example
1.Low Lymphocytes -> the answer should be AML or CML
2. WBC > 100 -> Chronic causes so Consider CML (rule out AML)
3. Presence of bands cell -> confirm CML

*blast -> Acute
*bands -> Chronic

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10
Q

Deranged coagulation in sepsis ->

A

DIC

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11
Q

DIC bloods (coag screen)

A

low platelets, increased clotting time and raised fibrin degradation products (FDPs), schistocytes

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12
Q

Heparin-induced thrombocytopenia usually happens ________ post-heparin exposure

A

5-14 days

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13
Q
A
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14
Q

B-thalassemia major - when does it present, blood tests, Tx

A

when: within first year of life
blood tests: HBA2 and HbF raised, HbA absent

Mx: repeated transfusion (risk: iron overload)

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15
Q

Blood films: what are the conditions associated with:
1. Target cells:
2. Tear-drop cells:
3. Spherocytes:
4. Basophilic stippling:
5. Howel-Jolly bodies:
6. Heinz bodies:
7. Schistocytes (helmet cells):
8. Burr cells:
9. hypersegmented neutrophils:

A
  1. Target cells: sickle-cell, thalassaemia, iron deficiency, hyposplenism, liver disease
  2. Tear-drop cells: myelofibrosis
  3. Spherocytes: spherocytosis, AIHA
  4. Basophilic stippling: sideroblastic, thalassaemia, lead-poinsoning, myelodysplasia
  5. Howel-Jolly bodies: hyposplenism
  6. Heinz bodies: G6PD deficiency, A-thalassaemia
  7. Schistocytes (helmet cells): haemolysis, mechanical heart valve, DIC
  8. Burr cells: uraemia
  9. hypersegmented neutrophils: megaloblastic anaemia
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16
Q

complications of blood transfusion

A
  1. immunological - acute haemolytic, non-haemolytic febrile, allergic, anaphylaxis
  2. infective
  3. TRALI
  4. TACO
  5. HyperK
  6. HyperFe
  7. clotting
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17
Q

key investigation for CLL (other than bone marrow biopsy)

A

immunotyping

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18
Q

________ is marked in CML

A

splenomegaly

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19
Q

difference in inheritance between two haemolytic anaemias, G6PD and hereditary spherocytosis

A

G6PD: X-linked recessive
spherocytosis: AD

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20
Q

Haematological malignancies: infections

Hodgkin’s and Burkitt’s lymphoma, nasopharyngeal carcinoma:

High-grade B-cell lymphoma:

gastric lymphoma (MALT):

Burkitt’s lymphoma:

A

Hodgkin’s and Burkitt’s lymphoma, nasopharyngeal carcinoma: EBV

High-grade B-cell lymphoma: HIV

gastric lymphoma (MALT): H.Pylori

Burkitt’s lymphoma: Malaria

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21
Q

what is increased in haemophilia?

A

APTT

22
Q

lacunar cells are found in

A

nodular sclerosing Hodgkin’s lymphoma

23
Q

New system of staging Hodgkin’s Lymphoma?

A

Lugano classification

24
Q

ITP - 1st line Tx? Ix result?

A

Isolated thrombocytopenia
Tx: 1st line is predinosolone
2nd line: IVIG

25
Q

what is Evans syndrome

A

ITP in association with AIHA

26
Q

AOCD vs Iron deficient anaemia - serum iron, ferritin, TIBC and transferrin results?

A

Fe-deficient: iron and ferritin low, transferrin low, TIBC high

AOCD: iron low, ferritin high, transferrin low, TIBC low

27
Q

Drainage of the ovaries, uterus and cervix

A

The ovaries drain to the para-aortic lymphatics.

Uterus: iliac lymph nodes

Cervix: internal and external iliac lymph nodes

28
Q

polycthaemia vera Mx

A

aspirin: reduce risk of thrombotic events
venesection

29
Q

_________________ should be suspected in any patient presenting with an acute kidney injury in the presence of a high phosphate and high uric acid level.

A

tumour lysis syndrome

30
Q

vWD pattern of inheritence

A

AD (except type 3 which is AR)

31
Q

Tx for vWD

A

tranexamic acid, desmopressin, factor Vlll concentrate

32
Q

mainstay Tx for Pts undergoing sickle cell vaso-occlusive crisis?

what do you add depending on infection/low Hb?

A

oxygen with IV analgesia and IV fluids.

IV abx, blood transfusion

33
Q

Polycythaemia vera blood results

A

isolated increase in Hb
low ESR
JAK2 mutation

34
Q

Hodgkin’s lymphoma - most common type =

A

nodular sclerosing

35
Q

tricuspid regurg would cause what murmur

A

It would cause a pan-systolic murmur, as, during systole, the blood is ejected from the ventricles which are contracting

36
Q

Poor prognostic factors of ALL

A
  • presenting <2 years or >10 years
  • having B or T cell surface markers
  • having a WCC > 20 * 10^9/l at diagnosis
  • male sex
37
Q

Steroids tend to cause a neutrophilia

A
38
Q

Anaphylaxis - serum tryptase levels _____following an acute episode

A

rise

39
Q

ALL is the most common childhood leukaemia and presents with

A

anaemia, neutropaenia and thrombocytopaenia

40
Q

Acute chest syndrome is defined as

A

new pulmonary infiltrates on chest x-ray along with dyspnoea, chest pain, cough or hypoxia.

41
Q

Burkitt’s lymphoma - ______gene translocation

A

c-myc

42
Q

_______________can present with bone marrow failure, due to ineffective haematopoeisis. Furthermore, bone marrow biopsy may show ring sideroblasts, as described in this patient

A

myelodysplasia

43
Q

Failure to fully recover from abx with swinging fever

A

empyema

44
Q

vast majority of erythema multiforme are due to?

A

herpes simplex virus

45
Q

________________can give a falsely high HbA1c level due to the increased lifespan of RBCs

A

Splenectomy

46
Q

Ix of choice for Non-Hodgkin’s lymphoma?

A

Excisional node biopsy

47
Q

Platelet thresholds for transfusion________________________ for patients with severe bleeding, or bleeding at critical sites, such as the CNS

A

are higher (maximum < 100 x 10 9)

48
Q

which drugs can trigger G6PD?

A

sulph- drugs: sulphonamides, sulphasalazine and sulfonylureas can trigger haemolysis, ciprofloxacin too

49
Q

Platelet transfusion threshold:

A

30 x 109 for patients not bleeding or having an invasive procedure- except where CI or alternative treatments for their condition

50
Q

Platelet transfusion threshold for Pt with severe bleeding?

A

<100 x 10^9

51
Q
A
52
Q
A

FINALS: Passmed (40 decks)

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