Haematology

Question 1

Features of an anaphylactic reaction to blood transfusion (e.g. FFP, cyroprecipitate and platelets) and how should it be treated?

Answer 1

Features of anaphylactic shock (acute wheeze and hypotension in absence of fever) with acute onset.
Immediately treated with IM adrenaline and transfusion terminated.

Question 2

Most common cause of an isolated thrombocytopenia?

Answer 2

Immune (idiopathic) thrombocytopenic purpura (ITP)

Question 3

Most common inherited bleeding disorder?

Answer 3

Von Willebrand’s disease

Question 4

What type of cells are seen on the blood film of G6PD deficiency?

Answer 4

Heinz bodies mainly
Bite and blister cells also sometimes.

Question 5

What organism is the most common cause of neutropenic sepsis?

Answer 5

Coagulase negative, gram positive bacteria such as Staphylococcus epidermis

Question 6

Most common form of non-hodgkin/any lymphoma in the UK?

Answer 6

Diffuse large B cell lymphoma

Question 7

What type of drugs can cause haemolytic anaemia (i.e. haemolysis) in people with G6PD deficiency?

Answer 7

Anti-malarials (e.g. primaquine)
Ciprofloxacin
Sulph group drugs

Question 8

How would you differentiate Haemophillia and Von Willebrand’s disease?

Answer 8

Bleeding time is prolonged in VW while normal in haemophillia.
(APTT is prolonged in both though)

Question 9

What is the empirical antibiotic choice for neutropenic sepsis?

Answer 9

Piperacillin with tazobactam (Tazocin)

Question 10

Common feature of graft versus host disease in a pt with recent hx of allogenic bone marrow transplant?

Answer 10

Painful maculopapular rash (often neck palms and sole)

Question 11

What is Burkitt lymphoma associated with? Appearance on blood film?

Answer 11

Epstein barr virus- pt gets sever throat pain if contracted in adulthood .
Starry sky appearance

Question 12

What do thymomas present as?

Answer 12

Anterior mediastinal mass and symptoms of myasthenia gravis (fatiguability)

Question 13

Blood film associated with myelofibrosis?

Answer 13

Tear drop poikilocytes

Question 14

Deficiency in which immunoglobulin increases the risk of anaphylactic blood transfusion reactions?

Answer 14

IgA defeciency

Question 15

What can chronic lymphocytic leukaemia (CLL) transform into, making pts suddenly unwell?

Answer 15

High-grade (non-hodgkin’s) lymphoma (Richter’s transformation)

Question 16

If a patient with suspected DVT post-op has renal impairment, what is the most appropriate management for this pt?

Answer 16

LMWH followed by warfarin for 3 months

Question 17

What is the tranfusion threshold for patients with ACS? And without ACS?

Answer 17

With acs-80 g/L
Without acs- 70 g/L

Question 18

What type of crisis in sickle cell disease is associated with a sudden drop in haemoglobin?

Answer 18

Aplastic crisis (sudden drop of haemoglobin w/low reticulocyte count)

Question 19

What is given to pts with polycythaemia vera to reduce the risk of thrombotic events?

Answer 19

Aspirin

Question 20

What medications increased risk of VTE?

Answer 20

• Combined oral contraceptive pill
• Hormone replacement therapy
• Raloxifene and tamoxifen
• Antipsychotics (especially olanzapine)

selective estrogen receptor modulators (SERMs) used in breast cancer

Question 21

What drugs cause haemolysis in patients with G6PD deficiency?

Answer 21

• Anti-malarials- primaquine
• Ciprofloxacin
• Sulph group drugs- sulphonamides, sulphasalazine, sulfonylureas