Haematology

Question 1

clopidogrel and bleeding

Answer 1

platelet tranfusion

Question 2

minutes after transfusion
fever, abdo pain, chest pain, agitation and hypotension

Answer 2

acute haemolytic transfusion reaction
stop, resus with saline and inform lab

Question 3

acute chest syndrome with SOB, chest pain, cough, hypoxia and new pulmonary infiltrates

Answer 3

sickle cell anaemia

Question 4

low platelets and bleeding

Answer 4

give platelets (under 30) but not FFP because this is for low INR and low coags

Question 5

what can CLL transform into

Answer 5

non-Hodgkin’s lymphoma

Question 6

rare side effect of heparin

Answer 6

thrombocytopenia with a prothrombotic state so increased risk of venous and arterial thromboembolism

Question 7

ALL

Answer 7

acute lymphocyte proliferation
blast cells
Downs syndrome/children
Philadelphia chromosome t(9:22)

Question 8

CLL

Answer 8

chronic lymphocyte proliferation
can transform into high-grade lymphoma
smear or smudge cells
associated with warm haemolytic anaemia

Question 9

CML

Answer 9

chronic phase, accelerated phase and blast phase
Philadelphia chromosome t(9:22)

Question 10

AML

Answer 10

can be transformation of myeloproliferative disorder eg polycythaemia rubra vera/myelofibrosis
Auer rods and blast cells

Question 11

anaemia, jaundice and splenomegaly

Answer 11

haemolytic anaemia

Question 12

investigations for haemolytic anaemia

Answer 12

FBC for normocytic anaemia
blood film for schistocytes
direct coombs test/ antiglobulin test

Question 13

what type of Ig in haemolytic disease of the newborn

Answer 13

IgG

Question 14

definitive sickle cell disease diagnosis

Answer 14

haemoglobin electrophoresis

Question 15

reversal agent for dabigatran

Answer 15

idarucizumab

Question 16

what can apixaban and rivaroxaban be reversed by

Answer 16

andexanet alfa