haematology

Question 1

what is acute lymphibalstic leukaemia

Answer 1

most common malignancy

• 2-5 years of age
• boys>girls

features

1. anaemia: lethargy and pallor
2. neutropaenia: frequent or severe infections
3. thrombocytopenia: easy bruising, petechiae

other features

• bone pain (secondary to bone marrow infiltration)
• splenomegaly
• hepatomegaly
• fever is present in up to 50% of new cases (representing infection or constitutional symptom)
• testicular swelling

poor prognostic factors 
age < 2 years or > 10 years
WBC > 20 * 109/l at diagnosis
T or B cell surface markers
non-Caucasian
male sex

Question 2

features of wilms tumour

Answer 2

abdominal mass (most common presenting feature)
painless haematuria
flank pain
other features: anorexia, fever
unilateral 
metastases

Mx
nephrectomy
chemotherapy
radiotherapy if advanced disease
prognosis: good, 80% cure rate

Question 3

haemophilia A inheritance

Answer 3

x linked recessive - factor VIII

features -> haemarthroses

blood tests

• prolonged APTT
• BLEEDING, THROMBIN, PROTHROMBIN time normal

Question 4

difference between VWB and haem A

Answer 4

prolonged bleeding time specific in VWB