Haematology

Question 1

What is the genetic change associated with Burkitts lymphoma?

Answer 1

c-myc gene translocation

Question 2

Complications of tumour lysis syndrome

Answer 2

hyperkalaemia
hyperphosphataemia
hypocalcaemia
hyperuricaemia
acute renal failure

Question 3

What is Burkitts lymphoma

Answer 3

high-grade B-cell neoplasm

endemic (African) form: typically involves maxilla or mandible
sporadic form: abdominal (e.g. ileo-caecal) tumours are the most common form. More common in patients with HIV

Microscopy findings
‘starry sky’ appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

Question 4

What can Polycythaemia vera progress to?

Answer 4

AML or myelofibrosis (Bone marrow biopsy will demonstrate fibrosis)

Question 5

AML findings

Answer 5

• low neutrophils
• thrombocytopenia
• disseminated intravascular coagulation
• bone marrow failure (pancytopenia) with circulating blast cells in the peripheral blood

Question 6

Key Ix in MM

Answer 6

monoclonal proteins (usually IgG or IgA) in the serum and urine (Bence Jones proteins)
increased plasma cells in the bone marrow

Question 7

Haemolytic anaemias

- Types (2)

Answer 7

Hereditary

Acquired

Question 8

Hereditary haemolytic anaemia causes

Answer 8

Membrane: hereditary spherocytosis/elliptocytosis

metabolism: G6PD deficiency
haemoglobinopathies: sickle cell, thalassaemia

Question 9

Acquired haemolytic anaemia causes

Answer 9

Acquired: immune causes

autoimmune: warm/cold antibody type
alloimmune: transfusion reaction, haemolytic disease newborn
drug: methyldopa, penicillin

Acquired: non-immune causes
microangiopathic haemolytic anaemia (MAHA): TTP/HUS, DIC, malignancy, pre-eclampsia
prosthetic heart valves
paroxysmal nocturnal haemoglobinuria
infections: malaria
drug: dapsone

Question 10

Immune thrombocytopenic purpura

Answer 10

• ## presents with bruising and bleeding with an isolated low platelet count.

Question 11

Chronic lymphocytic leukaemia

Answer 11

white count raised, the elevation in white count is due to an increase in lymphocytes.

Question 12

Chronic myeloid leukaemia

Answer 12

increase in white cells t due to mature neutrophils and myelocytes

Question 13

Disseminated intravascular coagulation

Answer 13

Prolonged PT, prolonged APTT, reduced fibrinogen

(activation of the coagulation pathway