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mrcp 1 > haem/onc > Flashcards

haem/onc Flashcards

1
Q

Prophylaxis in splenectomy?

A

Pen V

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2
Q

Prophylaxis in sickle cell?

A

Hydroxycarbamide

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3
Q

Genotype of mild and severe sickle cell?

A

Mild - HbSC
Severe - HbSS

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4
Q

Differentiating leukaemoid reaction and CML?

A

Leukaemoid reaction - high leucocyte alkaline phosphatase score
CML - low leucocyte alkaline phosphatase score

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5
Q

Hereditary angioedema screening tool between attacks? Acute attack?

A

C4, C1

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6
Q

Skin prick testing and skin patch testing can be read after how much time?

A

15-20 minutes, 48 hours

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7
Q

Myelofibrotic condition progressing to AML?

A

PCV

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8
Q

Investigation for hereditary spherocytosis?

A

EMA binding test

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9
Q

Management of a patient in haemolytic crisis secondary to hereditary spherocytosis?

A

Supportive therapy

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10
Q

Tumour lysis syndrome rx?

A

Rasburicase and IVF

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11
Q

Which electrolyte disturbance most commonly associated with cisplatin?

A

Hypomag

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12
Q

Methaemoglobinaemia

A

Oof Fe2+ in haemoglobin to Fe3+

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13
Q

Thrombophilia associated with resistance to heparin?

A

Antithrombin III def

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14
Q

Headache, fever, seizures and confusion, Parkinsonian features, SE Asia?

A

Japanese encephalitis

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15
Q

Prognostic factor in AML?

A

Cytogenetics

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16
Q

Cyclophosphamide mechanism? Side effects?

A

Cross linking in DNA
Haemorrhagic cystitis, myelosuppression, transitional cell carcinoma

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17
Q

Bleomycin mechanism? Side effects?

A

Degrades preformed DNA
Lung fibrosis

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18
Q

Doxorubicin mechanism? Side effects?

A

Stabilizes DNA-topoisomerase II complex inhibits DNA & RNA synthesis
Cardiomyopathy

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19
Q

Methotrexate mechanism? Side effects?

A

Inhibits dihydrofolate reductase and thymidylate synthesis
Myelosuppresion, mucositis, liver fibrosis, lung fibrosis

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20
Q

5 FU mechanism? Side effects?

A

Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (works during S phase)
Myelosuppression, mucositis, dermatitis

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21
Q

6-mercaptopurine mechanism? Side effects?

A

Purine analogue that is activated by HGPRTase, decreasing purine synthesis
Myelosuppresion

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22
Q

Cytarabine mechanism? Side effects?

A

Pyrimidine antagonist. Interferes with DNA synthesis specifically at the S-phase of the cell cycle and inhibits DNA polymerase
Myelosuppresion, ataxia

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23
Q

Vincristine mechanism? Side effects?

A

Inhibits formation of microtubules
Vincristine: Peripheral neuropathy (reversible) , paralytic ileus
Vinblastine: myelosuppression

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24
Q

Docetaxel mechanism? Side effects?

A

Prevents microtubule depolymerisation & disassembly, decreasing free tubulin
Neutropaenia

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25
Q

Irinotecan mechanism? Side effects?

A

Inhibits topoisomerase I which prevents relaxation of supercoiled DNA
Myelosuppression

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26
Q

Cisplatin mechanism? Side effects?

A

Cross-linking in DNA
Nephrotoxicity (the primary dose-limiting side effect), ototoxicity, peripheral neuropathy, hypomagnesaemia

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27
Q

Hydroxycarbamide mechanism? Side effects?

A

Inhibits ribonucleotide reductase, decreasing DNA synthesis
Myelosuppression

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28
Q

PCV - features?

A

Neutrophilia and raised Hb

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29
Q

Commonest cause of neutropenic sepsis?

A

Staph epidermis

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30
Q

Poor prognostic factors in ALL?

A

Hypoploidy and t(9:22)

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31
Q

APML presentation and rx?

A

Typically presents with disseminated intravascular coagulopathy (DIC), t(15;17) - ATRA

32
Q

TTP presentation?

A

Pentad of fever, neuro signs, thrombocytopenia, haemolytic anaemia and renal failure

33
Q

Antiphospholipid syndrome in pregnancy?

A

Aspirin + LMWH

33
Q

Most common inherited thrombophilia?

A

Activated protein C resistance (Factor V Leiden)

33
Q

Recent URTI, low platelets?

34
Q

PLT < 30 rx, PLT > 30 rx in ITP?

A

<30 - oral pred >30 - observe

35
Q

Sudden drop in Hb associated with which sickle cell complication?

A

Aplastic crisis

36
Q

Rx for TTP?

A

Plasma exchange

37
Q

Raised HbA2, MCV and Hb are usually proportionally decreased?

A

Beta thal trait

38
Q

‘Tear drop’ poikilocytes on blood film?

A

Myelofibrosis

39
Q

Low antibody levels, specifically in immunoglobulin types IgG, IgM and IgA, recurrent infections?

A

Common variable immunodeficiency

40
Q

Indication for cryoprecipitate in bleeding?

A

Low fibrinogen level

41
Q

Most common type of Hodgkin’s?

A

Nodular sclerosing

42
Q

Hodgkin’s best prognosis?

A

Lymphocyte predominant

43
Q

t(9:22) -
t(15:17) -
t(11:14) -
t(14:18) -

A

9/22 - Ph chromosome
15/17 - AML
11/14 - mantle cell lymphoma
14/18 - follicular lymphoma

44
Q

CA125 tumour marker for which cancers?

A

Peritoneal and ovarian cancer

45
Q

Leucocytosis with all stages of granulocyte maturation? Treatment?

A

CML, Imantinib

46
Q

Confusion, low PLT, fragmented red cells, renal impairment?

47
Q

Long term prophylaxis in hereditary angioedema?

A

Anabolic steroids

48
Q

Paroxysmal nocturnal haemoglobinuria investigation?

A

Flow cytometry - CD59 and CD55

49
Q

ET treatment?

A

Hydroxycarbamide

50
Q

Which drug can cause pancytopenia?

A

Trimethoprim

51
Q

Monitor treatment in haemochromatosis?

A

Transferrin and ferritin

52
Q

What can increase risk of pseudogout?

A

Haemochromatosis

53
Q

HLA-B27

A

Ank spond, arthritis - reactive and psoriatic, anterior uveitis

54
Q

HLA-B51

A

Bechet’s

55
Q

HLA-DQ2/DQ8

56
Q

HLA-A3

A

Haemochromatosis

57
Q

HLA-DR2

A

Goodpasture’s and narcolepsy

58
Q

HLA-DR3

A

Sjogren’s, dermatitis herpetiformis, PBC

59
Q

HLA-DR4

60
Q

Cardiomyopathy and skin pigmentation in haemochromo reversible or irreversible?

A

Reversible

61
Q

Microcytosis is often disproportionate to the
anaemia?

A

Beta thal trait

62
Q

What would explain the discrepancy between the HbA1c and fasting glucose levels?

63
Q

Causes of warm AIHA?

A

lymphoma, CLL, SLE

64
Q

Causes of cold AIHA?

A

EBV, lymphoma

65
Q

Common complication of CLL?

A

Hypogammaglobulinaemia

66
Q

Chronic lymphocytic leukaemia is mostly due to proliferation of b or t cells/monoclonal or polyclonal?

A

Monoclonal - B cells

67
Q

AML - deletions of which chromosomes - poor prognosis?

68
Q

Nephrotic syndrome and sensory neuropathy bilaterally in the arms?

69
Q

What does normal short synacthen not exclude?

A

Pituitary dysfunction

69
Q

Combined B- and T-cell disorders?

A

SCID, Wiskott-Aldrich syndrome, ataxic telangiectasia - SCID WAS ATAXIC

69
Q

Von Willebrand causes what clotting abnormality?

A

Slightly elevated APTT and reduced factor VIII activity

70
Q

Management of TTP?

A

The management of management thrombotic thrombocytopenic purpura involves steroids and immunosuppressants. Plasma exchange is also commonly used.

mrcp 1 (18 decks)

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