Haematological

Question 1

Name 4 myeloproliferative neoplasms

Answer 1

Chronic myeloid leukaemia
Polycythaemia vera
Essential thrombocythemia
Primary myelofibrosis

Question 2

What are the features of bone marrow failure

Answer 2

Neutropenia
Anaemia (normocytic)
Thrombocytopenia

Question 3

Define leukaemia

Answer 3

Abnormal proliferation and differentiation of leucocytes or their precursor cells.

Question 4

What are most cases of leukaemia

Answer 4

De novo (not inherited)

Question 5

Describe acute leukaemia

Answer 5

Result from failure of lymphoid or myeloid progenitor cells to differentiate, with resultant uncontrolled proliferation of these immature blast cells

Question 6

Describe chronic leukaemia

Answer 6

Result from the uncontrolled proliferation of cells at a later stage of differentiation.

Question 7

Define primary haemostasis

Answer 7

Initiation and formation of platelet plug = platelet activation

Question 8

Define secondary haemostasis

Answer 8

Formation of fibrin clot = intrinsic and extrinsic coagulation factors

Question 9

How do NSAIDs affect platelet activation

Answer 9

Inhibits thromboxane formation

Question 10

How does dabigatran affect platelet activation

Answer 10

Inhibits thrombin

Question 11

How does clopidogrel affect platelet activation

Answer 11

P2Y12 inhibitor - antiplatelet

Question 12

Describe the affect of warfarin on the clotting cascade

Answer 12

Blocks vitamin K

1972 - factor 10, 9, 7, 2

Question 13

What is the intrinsic pathway of the coagulation cascade initiated by

Answer 13

Endothelial collagen

Question 14

Summarise the intrinsic pathway

Answer 14

12 - 11 - 9 - 8 - 10 - 10a

Question 15

What is the extrinsic pathway of the coagulation cascade initiated by

Answer 15

Tissue factor expressed by immune cells and endothelium

Question 16

Summarise the extrinsic pathway

Answer 16

7 - 10 - 10a

Question 17

Summarise the common pathway

Answer 17

10a - prothrombin (II) - thrombin (IIa) - fibrinogen - fibrin (factor 13 - reinforces fibrin)

Question 18

How does heparin inhibit the coagulation cascade

Answer 18

Via antithrombin III (prothrombin)

Question 19

How does rivaroxaban inhibit coagulation cascade

Answer 19

Via factor Xa directly

Question 20

Which pathway does APTT show

Answer 20

Intrinsic

Question 21

What pathway does PT show

Answer 21

Extrinsic

Question 22

What pathway does PT and APTT show

Answer 22

Common pathway

Question 23

Describe tranexamic acid

Answer 23

Reduces the conversion of plasminogen to plasmin, preventing fibrin degradation and increasing clot stability

Question 24

What would be seen on a blood film of a patient with iron deficiency anaemia

Answer 24

Hypochromic red cells
Hypochromic microcytosis
Microcytic red cells
Pencil cells
Anisocytosis
Poikilocytosis
Thrombocytosis (raised platelet count)

Question 25

Name features found on a physical examination of someone with iron deficiency anaemia

Answer 25

Pallor
Conjunctiva
Angular stomatitis
Koilonychia/spoon shaped nails/brittle nails
Glossitis
Tachycardia
Postural hypotension
Cold hands and feet

Question 26

What serum protein carriers iron around the body

Answer 26

Transferrin

Question 27

What is blood test to diagnose iron deficiency anaemia

Answer 27

Serum ferritin

Would be low