Haematology

Question 1

isolated neutropaenia

Answer 1

hereditary, toxic, or immune cause

• Benign ethnic neutropaenia
• myelodysplastic malignancies
• aplastic anemia
• SLE, RA

Question 2

Polycythaemia rubra vera can progress to …

Answer 2

myelofibrosis

AML

Question 3

macrocytic, megaloblastic anaemia causes

Answer 3

vitamin B12 deficiency

folate deficiency

Question 4

macrocytic, normoblastic anaemia causes

Answer 4

alcohol
liver disease
hypothyroidism
pregnancy
reticulocytosis
myelodysplasia
drugs: cytotoxics

Question 5

disseminated intravascular coagulation what?

causes?

Answer 5

clotting factors used in small blood clots
–> purpura & petechia
but bleeding more likely
sepsis, trauma, malignancy

Question 6

disseminated intravascular coagulation

Answer 6

↓ platelets
↓ fibrinogen
↑ PT & APTT
↑ fibrinogen degradation products

Question 7

Aplastic anaemia

Answer 7

Pancytopenia (few all cells)

Hypoplastic bone marrow (nothing there hun)

Question 8

Aplastic anaemia causes

Answer 8

Parvovirus, hepatitis
Radiation
Toxins - benzene
Cytotoxic, chloramphenicol, sulphonamides, phenytoin, gold

Question 9

Autoimmune haemolytic anaemia

Answer 9

Warm/cold depending on antibodies

Can be secondary to lymphoproliferative, infection, drugs

Question 10

Warm AIHA

Answer 10

IgG - haemolysis binds at body temp/37
extravascular sites - spleen

SLE, lymphoma, CLL, methyldopa

Question 11

Warm AIHA treatment

Answer 11

Steroids

Immunosuppression Splenectomy

Question 12

Cold AIHA

Answer 12

IgM - haemolysis - binds at 4 deg
Intravascular
- raynauds
- acrocyanosis

lymphoma, mycoplasma, EBV

Question 13

Microcytic anaemia

Answer 13

Iron deficiency

Thalassaemia

Question 14

Iron def anaemia sings

Answer 14

Koilonychia
Angular stomatitis
Plummer-Vinson

Question 15

Iron def anaemia investigations

Answer 15

low ferritin, transferrin saturation

increased TIBC

Question 16

Thalassaemia

Answer 16

inherited mutation to globing chain

haemolysis by spleen

Question 17

Macrocytic anaemia

Answer 17

B12, folate

Alcohol/liver

Question 18

folate deficiency

Answer 18

green veg, nuts
4 months
absorbed in proximal jejunum
treat w B12 & folate

Question 19

b12 role

Answer 19

meat, fish
absorbed in terminal ileum w IF (from gastric parietal cells)
needed for DNA/myelin synth

Question 20

b12 deficiency

Answer 20

• gastrectomy, ideal resection, chrons, diet
• anaemia
• pallor, mild jaundice
• glossitis
• neuro - paraethesia, neuropathy

Question 21

pernicious anaemia

Answer 21

autoimmune atrophic gastritis
by ABS to parietal cells or IF

assoc w thyroid, vitiligo, addisons

risk of gastric adenocarcinoma

Question 22

Hereditary Spherocytosis

Answer 22

aut dom RBC membrane defect
spherocytes trapped in spleen

• splenomegaly
• pigment gallstones
• jaundice
• aplastic/megalobalstic crisis

Question 23

Sickle cell disease

Answer 23

B globin gene = glu –> val
HbSS (Trait - HbAS)

decreased life span
trapped - thrombosis

Question 24

Sickle cell complications

Answer 24

Sequestration crisis = splenic pooling, shock, severe anaemia

Splenic infarction

Aplastic crisis = Parvo b19

Gall stones

Osteomyelitis infection

Question 25

Haemophilia

Answer 25

A = factor 8 
B = factor 9 

X-linked
increased AAPT, normal P

Question 26

Von Willebrand disease

Answer 26

most common
vWF - binds plats via GpIb to damaged endothelium

increased APTT, bleeding

Question 27

bleeding disorder treatment

Answer 27

desmopressin
tranexamic acid

major & haemophilia rhF8