Haem/ Onc

Question 1

DVT Ix

Answer 1

Wells <2 = D Dimer
Wells >2 = US leg if within 4 hours. If >4 hours then Tx anticoag

Question 2

Von Willebrand disease clotting profile

Answer 2

mildly elevated APTT

Question 3

Tumour lysis syndrome
risk factors
electrolyte imbalance
prophylaxis

Answer 3

RF - lymphoma/ leukaemia, chemotherapy
hyperKal, hyperPhos, hypoCal
Tx - allopurinol, rasburicase

Question 4

Thrombotic sickle cell crisis (AKA painful/ vaso-occlusive)

Answer 4

painful
precipitated by dehydration, infection

Question 5

Aplastic crisis

Answer 5

caused by parvovirus
sudden fall in haemoglobin

Question 6

sequestration crisis

Answer 6

splenomegaly + abdominal pain

Question 7

Chronic myeloid leukaemia Mx

Answer 7

Imatinib (tyrosine kinase inhibitor)

Question 8

Peutz Jeghers syndrome Fx

Answer 8

pigmented lesions buccal mucosa
gastrointestinal polyps

Question 9

Reed Sternberg cells positive

Answer 9

Hodgkins lymphoma

Question 10

Philadelphia chromosome (T9;22)

Answer 10

chronic myeloid leukaemia

Question 11

Macrocytic anaemia
megaloblastic

Answer 11

B12 def - pernicious anaemia
terminal ileum resection
gastrectomy
folate def - coeliac
drugs - sulphonamide

Question 12

Macrocytic anaemia
Normoblastic

Answer 12

liver disease
alcoholism
HYPOthyroid
myelodysplasia
drugs - anticonvulsants

Question 13

Acute haemolytic transfusion reaction (ABO incompatability)

Answer 13

acute symptoms (bag still running)
burning at IV site
fever, flushing, restless, chest tightness

Question 14

Non haemolytic transfusion reaction

Answer 14

symptoms near end of bag, or 2 hours afterwards
fever, malaise, dyspnoea

Question 15

Chronic myeloid leukaemia Mx

Answer 15

Imatinib

Question 16

Tetanus prone wounds

Answer 16

punture injury in conaminated environment (eg gardening injury)
wounds containing foreign bodies
compound fractures
wounds/ burns with sepsis
animal bite/ scratch

Question 17

Multiple myeloma Ix

Answer 17

Bence Jones Proteins