Haematology

Question 1

What are blood film findings suggesting of iron deficiency anaemia?

Answer 1

Poikilocytosis - target cells and pencil cells

Question 2

What is common cause of B12 deficiency in < 3 yr old?

Answer 2

Goat’s milk diet

Question 3

What are the clinical features of Fanconi Anaemia?

Answer 3

Short stature, thumb/forearm abnormalities, Micropthalmia

Question 4

What is the test for Fanconi Anaemia?

Answer 4

Chromosome breakage test

Question 5

What are the clincal features of Diamond Blackfan Anaemia?

Answer 5

Widely spaced eyes, snub nose, thumb abnormlaity, short.

Question 6

For what presentation should you consider Schwachman-Diamond Anaemia as cause?

Answer 6

Loose, foul smelling stool and anaemia
(pancreas dysfunction)

Question 7

What medications can cause bone marrow failure?

Answer 7

Chloramphenicol, Sulfonamides (trimethoprim), carbimazole, anti-cancer drugs

Question 8

What test differentiates between anaemia due to consumption or bone marrow suppresion?

Answer 8

Reticulocyte counts

Question 9

What feature on what type of x-ray suggests transfusion dependent beta thalassaemia

Answer 9

Skull x-ray
Hair on end appearance

Question 10

What is the test to confirm thalassaemia?

Answer 10

Hb electrophoresis
Genetic testing

Question 11

What treatment MUST transfusion dependent thalassaemia patients have to avoid cardiac failure?

Answer 11

Iron chelating agents
Deferoxamine

Question 12

After what age would you consider splenectomy in hereditary spherocytosis patients?

Answer 12

> 6 years of age

Question 13

What type and proprotion of each type of Hb would you expect to see in normal patient?

Answer 13

HbA 90%, HbA₂ <3.5 %

Question 14

What type and proprotion of each type of Hb would you expect to see in a person with thalassaemia trait?

Answer 14

HbA 90%, HbA₂ >3.5 %

Question 15

What is the inheritence pattern of hereditary spherocytosis?

Answer 15

AD

Question 16

What type and proprotion of each type of Hb would you expect to see in a person with sickle trait?

Answer 16

HbS (25%–40%); HbA (50%–60%)

Question 17

What type and proportion of each type of Hb would you expect to see in a person with sickle disease?

Answer 17

HbS (80%–95%); HbF (5%–10%)

Question 18

What is the inheritance of G6PD?

Answer 18

X-linked recessive

Question 19

What are the triggers for G6PD haemolytic crisis?

Answer 19

Acute illness, fava beans
Nitrofurantoin, salicylates, sulfonamides

Question 20

What can cause prolonged PT?

Answer 20

Vit K deficiency, Warfarin therapy, liver disease, DIC,

Question 21

What can cause prolonged APPT?

Answer 21

Haemophilia A+B, Von Willebrand disease, Unfractionated heparin, DIC

Question 22

What conditions can cause thrombophilia?

Answer 22

Protein C + S deficiency
Factor V leiden

Question 23

When treat ITP?

Answer 23

If any mucosal/ GI bleeding or uncontrolled bleeding from nose/skin

Question 24

What is prophylactic medicine of choice for patient with Von willebrand disease about to have surgical procedure?

Answer 24

Desmopressin

Question 25

What does basophilic stippling on blood film + evidence of haemolysis suggest?

Answer 25

Lead poisoning