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MSRA > Haematology > Flashcards

Haematology Flashcards

1
Q

What is the reversal agent of dabigatran?

A

Idarucizumab

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2
Q

What is the reversal agent for rivaroxiban and apixaban?

A

Andexanet alfa

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3
Q

What is the MOA of dabigatran?

A

Direct thrombin inhibitor

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4
Q

What is the MOA of rivaroxiban/apixaban/edoxaban?

A

Direct factor Xa inhibitor

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5
Q

How is dabigatran excreted?

A

Renally

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6
Q

How is rivaroxiban excreted?

A

Hepatic

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7
Q

How is apixaban excreted?

A

Faecally

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8
Q

How is edoxaban excreted?

A

Faecally

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9
Q

What are the classical symptoms of polycythaemia vera?

A

Intense itching which usually occurs after exposure to hot water or hot and humid weather

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10
Q

The absence of what type of cell indicates a lack of acute leukaemia?

A

Blast cells

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11
Q

What will be seen on an FBC in CML?

A

High white cell count which is due to high numbers of myeloid cells, but anaemia and thrombocytopenia due to bone marrow dysfunction

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12
Q

What is first-line management for CML?

A

The tyrosine kinase inhibitor - Imatinib

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13
Q

What is the first-line management for CLL?

A

Fludarabine and cyclophosphamide

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14
Q

In what type of blood cancers may rituximab be used?

A

Leukaemias and lymphomas of lymphocyte origin, rituximab being a chimeric monoclonal antibody directed at CD20, a lymphocyte marker

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15
Q

How does sequestration crises present in sickle cell anaemia?

A

Sickling within organs such as the spleen or lungs causes pooling of blood with worsening of the anaemia - it is associated with an increased reticulocyte count

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16
Q

What is the most common cause of death in adulthood in sickle cell crisis?

A

Acute chest syndrome

17
Q

How does aplastic crisis occur in sickle cell anaemia?

A

A sudden fall in Hb, with bone marrow suppression causing a reduced reticulocyte count, cause by parvovirus

18
Q

What is the typical blood panel picture in DIC?

A 
Low platelets
Low fibrinogen
Raised PT & APTT
Raised fibrinogen degradation products
Schistocytes due to microangiopathic haemolytic anaemia
19
Q

How would you expect a clotting panel to look in a warfarinised pt?

A 
PT = prolonged
APTT = normal
Bleeding time = normal
Platelet count = normal
20
Q

What are the causes of paraproteinaemia?

A 
Myeloma
Monoclonal gammopathy of uncertain significance (MGUS)
Benign monoclonal gammopathy
Waldenstrom's macroglobulinaemia
Amyloidosis
CLL, lymphoma
Heavy chain disease
POEMS
21
Q

What do you seen on a blood film in CLL?

A

Smudge cells (also called Smear cells)

22
Q

What are the features of CLL?

A

Often none: may be picked up by an incidental finding of lymphocytosis
Constitutional: anorexia, weight loss
Bleeding
Infections
Lymphadenopathy more marked than chronic myeloid leukaemia

23
Q

What is the empirical Abx of choice in suspected neutropenic sepsis?

A

Tazocin

24
Q

How is sickle cell anaemia inherited?

A

Autosomal recessive

25
Q

What is the first-line management for polycythaemia vera?

A

Venesection

26
Q

What is the most common inherited thrombophillia?

A

Activated protein C resistance (Factor V Leiden) is the most common inherited thrombophilia
Prothrombin gene mutation is the second most common cause

27
Q

Which types of transfusion carry the highest risk of bacterial contamination?

A

Platelet transfusion

28
Q

Which ‘B’ symptoms imply a poor prognosis in Hodgkin’s lymphoma?

A
  1. Weight loss > 10% in last 6 months
  2. Fever > 38ºC
  3. Night sweats
29
Q

Presence of what cell type characterise Hodgkin’s lymphoma?

A

Reed-Sternberg cells

30
Q

What are the causes of massive splenomegaly?

A 
Myelofibrosis
CML
Visceral leishmaniasis (kala-azar)
Malaria
Gaucher's syndrome
31
Q

Which is the most common type of haemophilia?

A

Haemophilia A (deficiency in factor VIII)

32
Q

Which factor is deficient in Haemophilia B (Christmas disease)

A

Factor IX

33
Q

Which side of the clotting cascade does PT represent?

A

Extrinsic system - factors V, VII and X, as well as prothrombin and fibrinogen

34
Q

Which side of the clotting cascade does APTT represent?

A

Intrinsic system - factors VII, IX, XI and XII

35
Q

What does a peripheral smear show in thalassaemia?

A
  1. Microcytic, hypochromic red cells

2. Target cells

MSRA (18 decks)

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