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MRCP Part 2 > Haem > Flashcards

Haem Flashcards

1
Q

Management of Heparin-Induced Thrombocytopenia (HIT)

A

Switch to argatroban or danaparoid

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2
Q

Indication for treatment in CLL

A

Constitutional symptoms

Bone marrow failure

Symptoms due to LN/spleen/liver elargement

Weight loss > 10% in 6 months

AI anaemia/ thrombocytopenia not responding to prednisolone

Lymphocyte doubling in <6m, or 50% increase in 2m

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3
Q

Indication for use of Ibrutinib (BTK inhibitor) in CLL

A

TP53 mutation

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4
Q

Pentad of features in TTP (Thrombotic Thrombocytopenic Purpura)

A
  1. Thrombocytopenia
  2. MAHA (anaemia + schistocytes)
  3. Fever
  4. Fluctuating neuro signs
  5. Renal impairment
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5
Q

Causes of MAHA (schistocytes seen on film)

A

TTP
HUS
DIC
Pre-eclampsia

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6
Q

Presentation of HUS

A

Haemolytic anaemia (MAHA)
Thrombocytopenia
Severe AKI
Following bloody diarrhoea

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7
Q

AL amyloidosis presents as

A 
Nephrotic syndrome
Cardiomyopathy
Peri-orbital purpura
(Macroglossia)
(Urine free light chains)
Without features of MM
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8
Q

Waldenstrom’s macroglobulinaemia (lymphoplasmacytoid malignancy) presents as

A

Monoclonal IgM paraproteinaemia
Hyperviscosity
Systemic upset

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9
Q

Commonest initial treatment for CLL

A

Fludarabine + cyclophosphamide + rituximab (FCR)

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10
Q

Other options for CLL treamtent, when FCR not appropriate

A

Bendamustine
Chlorambucil
Anti-CD20 (obinutuzumab)

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11
Q

Management of AI anaemia/thrombocytopenia in CLL

A

Prednisolone

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12
Q

Treatment of Waldenstrom macrogolubulinaemia

A

Cyclophosphamide + dexamethasone + rituximab

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13
Q

Features of monoclonal gammopathy of unknown significance (MGUS)

A

Paraproteinaemia
Asymptomatic/neuropathy
Normal immune function
No bone lesions/renal impact

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14
Q

Schnitzler’s syndrome

A

Chronic urticaria

Monoclonal raised IgM

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15
Q

Features of methaemoglobinaemia

A

Cyanosis
Low O2 sats with normal PaO2
Ischaemia

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16
Q

R-CHOP is

A 
Rituximab
Cyclophosphamide
Doxorubicin
Vincristine
Prednisolone
17
Q

Management of NHL - low-grade and asymptomatic

A

Watch and wait

Vaccinate (flu, haemophilus, pneumococcus, meningococcus)

18
Q

Chemo options for NHL

A

R-CHOP

FCR

19
Q

Management of primary CNS lymphoma

A

High-dose methotrexate + dexamethasone

20
Q

Imatinib is chemotherapy agent used in

A

CML
MALT-lymphoma
c-kit melanoma

21
Q

Non-Hodgkins Lymphoma with CNS involvement

A

R-CHOP + intrathecal methotrexate

22
Q

Curative treatment for myelofibrosis

A

Allogenic stem-cell transplant

23
Q

Drugs used in control of myelofibrosis

A

Hydroxyurea
IFN-a
JAK inhibitors

24
Q

Diagnostic criteria for HHT (Osler-Weber-Rendu)

Need 3 for definite diagnosis.

A

Epistaxis
Telangiectasia
AVMs or GI telangiectasia
1st-degree family history

25
Q

Impaired platelet aggregation with Ristocetin, suggests

A

von Willebrand’s disease

26
Q

BCR-ABL mutation is diagnostic for

A

CML

27
Q

BCL2 mutation seen in

A

Diffuse large B cell lymphoma

28
Q

TP53 mutation seen in

A

Diffuse large B cell lymphoma

29
Q

C-MYC mutation seen in

A

Burkitt’s lymphoma

30
Q

Commonest mutation seen in myelofibrosis

A

JAK2

31
Q

Lysosomal storage disorder which causes massive splenomegaly

A

Gaucher disease

32
Q

Lysosomal storage disorder which causes massive splenomegaly

A

Gaucher disease

33
Q

Causes of warm AIHA

A

Autoimmune (eg SLE)
CLL, lymphoma
Methyldopa

34
Q

Causes of cold AIHA

A

Mycoplasma
EBV
Lymphoma

35
Q

Prophylactic antimicrobials given when starting chemotherapy (FCR)

A

Co-trimoxazole
Aciclovir
Fluconazole

36
Q

CLL - Poor prognostic factors (median survival 3-5 years)

A 
Male
>70yo
Lymphocyte count >50
Polymorphs >10%
Doubling time <12m
Raised LDH
CD38 positive
TP53 mutation

MRCP Part 2 (15 decks)

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