Haematology

Question 1

What is the treatment for beta thalassemia major

Answer 1

life long blood transfusions

Question 2

What do we use the direct coombs test for

Answer 2

autoimmune haemolytic anaemia

Question 3

What do we use indirect coombs test for

Answer 3

rhesus haemolytic newborn

Question 4

where would you see koilonychia

Answer 4

severe iron deficiency anaemia

Question 5

how do we manage pregnancies under 6 weeks with no pain but vaginal bleeding

Answer 5

manage conservatively and ask them to repeat pregnancy test after 7 days

Question 6

would you find thrombocytopenia or thrombocytosis in alcoholic liver disease

Answer 6

thrombocytopenia

Question 7

Which lymphoma is a common cause of tumour lysis syndromes

Answer 7

burkitts

Question 8

how often should sickle cell patients have the pneumococcal vaccine

Answer 8

every 5 years

Question 9

what to do if d dimer is positive but ultrasound is negative

Answer 9

stop anticoagulant and repeat scan in 1 week

Question 10

in which patients would you see a raindrop skull

Answer 10

multiple myeloma

Question 11

where are ferritin and haemosiderin found

Answer 11

liver, spleen and bone marrow

Question 12

how much of our dietary iron contains the part for haemoglobin

Answer 12

10-20% of your dietary iron is heme (ferrous) and ferric is non-heme

Question 13

which receptor allows iron to be absorbed into the plasma

Answer 13

ferroportin receptor

Question 14

What regulates iron reabsorption

Answer 14

hepsidin

Question 15

What are the two storage molecules for iron

Answer 15

ferritin and haemosiderin

Question 16

What does iron bind to in the bloodstream

Answer 16

transferrin

Question 17

What happens next to the iron bound to transferrin

Answer 17

transported to the bone marrow to make red blood cells

Question 18

what two things regulate hepcidin

Answer 18

fe concentration in the plasma and liver, erythropoetin demand

Question 19

examples of megaloblastic anaemia and key test result

Answer 19

vitamin B12. folate deficiency and drug related

Question 20

causes of nonmegaloblastic causes of macrocytic anaemia

Answer 20

most common alcoholism, hypothyroidism, liver disease, myelodysplastic syndrome, reticulocytosis

Question 21

where would you see right shifted neutrophils

Answer 21

myelodysplastic syndrome

Question 22

what do macroovalocytes and hypersegmented neutrophils on a blood film suggest

Answer 22

megaloblastic anaemia

Question 23

what presents with high bilirubin, high LDH, low Hb, low platelets high creatinine and MAHA blood film

Answer 23

thrombotic thrombocytic purpura

Question 24

fever, renal failure, confusion, thrombocytopenia, microthrombi and MAHA on the blood film

Answer 24

thrombotic thrombocytopenic purpura

Question 25

reduction in which protein can lead to platelet aggregation in TTP

Answer 25

ADAMTS 13 is a vWF cleaving protease

Question 26

difference between x-line gammaglobulinaemia and CVID.

Answer 26

CVID has low IgG and normal numbers of B and T lymphocytes and x is low IgG and low B lymphocyte numbers x linked is in infants and CVID is in adults

Question 27

what do we use to monitor treatment in haemochromatosis

Answer 27

transferrin saturation and ferritin saturation

Question 28

what causes an isolated rise in APTT:
Haemophilia A
Von willebrand
DIC

Answer 28

Von Willebrand

Question 29

which suggest pancytopenia:

aplastic anaemia
anaemia of chronic disease
AML
ALL

Answer 29

aplastic

Question 30

in which disorder would you see schizocytes:
MAHA
Paroxysmal nocturnal haemoglobinuria
Paroxysmal cold haemoglobinuria

Answer 30

MAHA

Question 31

helmet cells

Answer 31

schizocytes in intravascular haemolysis

Question 32

heinz bodies and target cells

Answer 32

thalassemia

Question 33

what can lead to falsely high and falsely low haemoglobin readings

Answer 33

low: reduced lifespan, anaemia, haemoglobin abnormaitiyes, blood transfusion and ethnicity.
high: b12 deficiency, iron deficiency anaemia, splenectomy, alcoholism