Haematology

Question 1

risk factors for a DVT/PE

Answer 1

immobility
recent surgery
malignancy
pregnancy
long haul travel
thrombophilia
SLE
polycthaemia
hormone therapy with oestrogen e.g. COCP, HRT

Question 2

what is the bimodal age distribution for Hodgkin’s lymphoma

Answer 2

20 and 75 years

Question 3

risk factors for Hodgkin’s lymphoma

Answer 3

HIV
EBV
Autoimmune conditions e.g. sarcoidosis, RA
FHx

Question 4

presentation of lymphoma

Answer 4

lymphadenopathy (cervical, axillary, inguinal)
systemic = weight loss, night sweats, itchiness, fever (Pel-Ebstein - high-grade fever that keeps rising and falling every 7-10 days or so)
SOB
fatigue
pain in the lymph nodes when they drink alcohol

Question 4

investigations for lymphoma

Answer 4

LDH (lactate dehydrogenase) - raised, but non-specific
Biopsy **Reed-Sternberg cell
CT, MRI, PET scan used for staging

Question 5

what is Ann Arbor staging?

Answer 5

used for Hodgkin’s and Non-Hodgkins lymphoma, based on whether the lymph nodes affected are above/below the diaphragm

stages 1-4

Question 6

management of Hodgkin’s lymphoma

Answer 6

chemotherapy - can cause infertility and leukaemia

radiotherapy - increases risk of cancer, tissue damage, and hypothyroidism

Question 7

examples of non-hodgkin’s lymphoma

Answer 7

burkitt lymphoma (EBV, malaria, HIV)
MALT associated lymphoma (mucosa associated lymphoid tissue - associated with H.pylori infection)
diffuse large B cell lymphoma (rapidly growing painless mass in patients >65)

Question 8

risk factors for non-hodgkins lymphoma

Answer 8

HIV
Epstein-Barr Virus
H. pylori (MALT lymphoma)
Hepatitis B or C infection
Exposure to pesticides and a specific chemical called trichloroethylene used in several industrial processes
Family history

Question 9

what does the bone marrow require to make haemoglobin

Answer 9

iron