Haematology

Question 1

Asymmetrical spreading lymphadenopathy + large multinucleate cells with prominent eosinophilic nucleoli = ?

Answer 1

Hodgkin’s lymphoma

These cells are Reed-Sternberg cells (owl cells)

Question 2

Management of acute haemolytic reaction?

Answer 2

Stop transfusion, give IV fluids

Question 3

Most common cause of thrombophilia?

Answer 3

Factor V Leiden (activated protein C resistance)

Question 4

What cells would you see on a blood film suggestive of myelofibrosis?

Answer 4

‘Tear drop’ poikilocytes

Will also get high WBC and low Hb in early disease

Question 5

Prophylaxis and treatment for neutropenic sepsis and neutropenia

Answer 5

Prophylaxis of infection = fluoroquinolone (give to pts at high risk of neutropenia)

Neutropenia, but not septic = GCSF (filgrastim)

Neutropenic sepsis = tazocin

Still septic after 48h of tazocin = + meropenem +/- vancomycin

Still unwell after 4-6d = investigate for fungal infection

Question 6

Raised APTT, PT, D-dimer. Low platelets.

What is the diagnosis?

Answer 6

Disseminated intravascular coagulation

Question 7

First line tx for autoimmune haemolytic anaemia?

What test would differentiate between autoimmune and non-autoimmune haemolytic anaemia?

Answer 7

Corticosteroids

Direct Coombs test (positive = autoimmune)