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AMC MCQ > Haematology > Flashcards

Haematology Flashcards

1
Q

Normal Hb levels

A

Male: 130 - 180 g/L|13.8 to 17.2
Female: 115 - 165 g/L | 12.1 to 15.1

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2
Q

Normal serum ferritin level

A

men: 24 -336 mg/L
women: 11 - 307 mg/L

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3
Q

Mean corpuscular count

A

80 - 100 fL

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4
Q

Platelet count

A

150 - 400 x 10^9/L

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5
Q

Bleeding time

A

2 - 8.5 mins

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6
Q

Prothrombin time (pt)

A

10 - 13 secs

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7
Q

Partial thromboplastin time (aPTT)

A

25 - 35 secs

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8
Q

Autosomal dominant

A
  • spherocytosis
  • hemorrhagic telangiectasia
  • Von Willebrand disease
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9
Q

Autosomal recessive

A
  • Factor 5 diseases
  • Fanconi’s anaemia
  • haemochromatosis
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10
Q

X-linked recessive

A

Haemophilia A
Haemophilia B
- Glucose-6-phosphate dehydrogenase deficiency

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11
Q

rise in platelet count causes

A

– Polycythemia vera.
– Hyposplenism due to splenectomy.
– Iron deficiency anemia.
– Correction of vitamin B12 and folic acid deficiency

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12
Q

microcytic anemia + . Seizures
+ peripheral neuritis + dermatitis

A

Vitamin B6 (pyridoxine) deficiency

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13
Q

vegan vegetarian deficiency

A

B12 deficiency

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14
Q

Vitamin B12 bsorbed by binding to

A

intrinsic factor

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15
Q

B12 deficiency causes what type of anaemia

A

pernicious anaemia

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16
Q

B12 deficiency conditions

A
  • Autoimmune gastritis
  • Terminal ileum disease
  • Gastrectomy
  • Metformin therapy
  • Coeliac disease
  • H.pyelori infection
  • Crohn disease
  • Postgastrectomy
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17
Q

weakness + fatigue + dizziness + palpitations + exercise intolerance + craving of ice/clay

A

Iron deficiency

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18
Q

increased MCV + neutropenia + thrombocytopenia + history of alcohol abuse + hypersegmentation of
the neutrophils

A

Folate deficiency

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19
Q

cheilosis + glossitis+ a variety of ocular problems + hx of biliary atresia/hepatitis

A

Folate deficiency

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20
Q

px around 70 + fatigue + tiredness + macrocytic anaemia

A

myelodysplasia

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21
Q

myelodysplasia investigation

A

Bone marrow biopsy

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22
Q

Causes of macrocytic anemia

A

High MCV

megaloblastic anemias
- Vitamin B12 (cobalamin )
- folate deficiency
- myelodysplasia
vigorous reticulocytosis,
hypothyroidism,
chronic liver disease,
myelodysplastic syndrome

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23
Q

Common causes of microcytic anemia

A

Low MCV

iron deficiency
thalassemia,
anemia of chronic disease
sideroblastic anemia

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24
Q

difference between hemolytic anemia vs anemia of chronic disease

A

Low hepatoglobin

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25
Q

congenital developmental anomalies + progressive pancytopenia

A

Fanconi’s anaemia

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26
Q

Fanconi anaemia investigation

A

Diagnostic: Chromosome fragility test

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27
Q

Fanconi anaemia congenital abnormalities

A
  1. Hand and arm anomalies (misshapen,missing or extra thumbs or abnormalities of
    the radius)
  2. Skeletal anomalies of the hips, spine or ribs
  3. Skin discolouration (café au lait spots, hyper-pigmentation,
  4. Small head or eyes
  5. Low birth weight and subsequent short stature
  6. Missing or horseshoe kidney
  7. Gastrointestinal abnormalities including abnormal development of the
    oesophagus
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28
Q

sudden onset of jaundice + pallor, +
dark urine + with or without abdominal and back pain + fall in the haemoglobin concentration + “bite” cells

A

Glucose-6-phosphate dehydrogenase deficiency

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29
Q

acute haemolysis following ingestion of cotrimoxazole/primaquine

A

Glucose-6-phosphate dehydrogenase deficiency

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30
Q

Glucose-6-phosphate dehydrogenase deficiency dx

A

Heinz Bodies

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31
Q

helmet cells + Artificial (mechanical) valves placemenent

A

schistocytes Hemolytic anemia

32
Q

schistocytes Hemolytic anemia lab findings

A

Decreased serum haptoglobin level

33
Q

spherocytosis clinical features

A

1-Anaemia and jaundice.
2-Splenomegaly.
3-Positive family history of anaemia, jaundice, or gallstones.
4-Spherocytosis with increased reticulocytes.
5-Increased osmotic fragility.
6-Negative direct antiglobulin test (DAT).

34
Q

The outcome of splenectomy in a patient with spherocytosis

A

1- Spherocytosis persists after splenectomy, the cells survive longer in the circulation.
2-Decrease in reticulocytosis.
3- RBC fragility remains high resulting short life span of red blood cells
4- Fall in elevated bilirubin
5- In severely affected patients, life-threatening anaemia

35
Q

Spherocytosis gene defect

A

spectrin
ancyrin
protein 4.1

36
Q

fever + thrombocytopenia + low haemoglobin + acute renal failure + hallucination + haemolytic anaemia

A

Thrombotic thrombocytopenic purpura (TTP)

37
Q

immediate hemolytic reaction
secondary to a blood transfusion invesitgation

A

Positive Coombs test

38
Q

Thrombotic thrombocytopenic purpura (TTP) treatment

A
  • replacement fluid
  • fresh frozen plasma
39
Q

pruritis on hot bath + vertigo + tinnitus + headache + visual disturbances + hypertension + transient ischemic
strokes

A

Polycythaemia vera

40
Q

fever + maculopapular rash+ serum AST, bilirubin and alkaline phosphatase elevation post transplant

A

Graft-versus-host disease

41
Q

decreased serum albumin + hypercalcaemia + anaemia + bony lytic lesions/osteoporosis

A

Multiple myeloma

42
Q

CRAB

A

C - hypercalcaemia 13%
R - renal impairment 20–40%
A - anaemia 70%
B - bony lesions

43
Q

Multiple myeloma investigation

A

Initial: & diagnostic: serum and urinary
electrophoresis

44
Q

poor prognosis of multiple myeloma

A
  1. higher levels of beta-2 microglobulin
  2. lower levels of albumin
45
Q

hepatomegaly + weakness+ hyperpigmentation + atypical
arthritis + diabetes + impotence + unexplained chronic abdominal pain +
cardiomyopathy + Decreased production of FSH and LH + gynaecomastia + 90% are C282Y homozygotes

A

haemochromatosis

46
Q

Most common manifestation of cardiac
involvement in hemochromatosis

A

Congestive cardiac failure

47
Q

most common cause of death in hemochromatosis

A
  1. Liver disease
  2. cardiomypathy
48
Q

haemochromatosis investigation

A

Serum transferrin saturation
- >60% men
- 50$ women

49
Q

haemophilia A in pregnancy

A
  • measure Factor 8 level at 1st antenatal
    visit and at 32 weeks
  • majority develop normal level of factor 8 and do not require replacement
50
Q

-Malaise and pallor + Recurrent infection + Gingival hypertrophy + Fever, night sweats + -Normocytic normochromic anaemia + Thrombocytopenia + myeloblasts more than 20%

A

acute myeloid leukaemia (AML)

51
Q

conditions which can lead to the development of AML

A

-Trisomy 21 noted in Down syndrome.
-Fanconi anaemia.
-Ataxia-telangiectasia.
-Myeloproliferative syndromes.

52
Q

pallor + sweats + weight loss + bilateral axillary lymphadenopathy + massive Spleen and liver megaly

A

Chronic lymphocytic leukaemia (CLL)

53
Q

CLL management

A

1st line: corticosteroids such as prednisolone
chemotherapy if needed

54
Q

urticaria + stridor + hypotension during blood transfusion+ hx of recurrent infections

A

Immunoglobulin A deficiency

55
Q

fatigue and weakness, dyspnea, and pallor + dysplasia + Anaemia with/o f bi- or
pancytopenia+ Macrocytosis + absolute neutropenia

A

Myelodysplasia

56
Q

common feature of autoimmune thrombocytopenia in
childhood

A

Antecedent viral illness

57
Q

microcytic anemia + increased concentration of hemoglobin A2

A

β-Thalassemia

58
Q

β-Thalassemia investigation

A

diagnostic: hemoglobin electrophoresis

59
Q

most profound adverse effect of chronic
transfusional iron overload in children with thalassemia?

A

Progressive hepatic cirrhosis

60
Q

sickle cell anaemia reduce iron overload

A
  • Subcutaneous deferoxamine
  • Splenectomy
  • ## Erythrocytopheresis
61
Q

earliest complication of sickle cell disease

A

Bone infarction

62
Q

decreased red cell, white cell and platelets counts

A

pancytopenia/aplastic anemia

63
Q

aplastic anaemia causes

A

NSAIDs
- Sulfonamides.
– Gold.
– Anti-epileptic drugs (carbamazepine, valproic acid, phenytoin).
– Nifedipine.
– Chloramphenicol.

64
Q

generalised weakness, low-grade fever and sore throat + normal haemoglobin + low neutrophil + low platelets + thyroid medicatiob

A

agranulocytosis

65
Q

Long-standing history of prolonged bleeding after trauma and history of menorrhagia in an otherwise healthy woman

A

Von Willebrand disease

66
Q

fever, night sweats, weight loss + painless generalized lymphadenopathy which becomes painful after alcohol consumption

A

f Hodgkin lymphoma (HL)

67
Q

f Hodgkin lymphoma (HL) highest risk of malignanc

A

Supraclavicular lyphadenopathy

68
Q

Hodgkin lymphoma (HL) diagnostic investigation

A

Lymph node excision biopsy

69
Q

non-Hodgkin lymphoma features

A

GI tract most common site
- 3% of all malignant gastric tumors
- Surgery alone can be considered adequate treatment that does not infiltrate beyond the submucosa
-

70
Q

incidence of thrombosis and bleeding in patients with myeloproliferative neoplasms?

A
  • typically mucocutaneous
  • Bleeding is usually less severe and less frequent than thrombosis
  • Arterial
    thromboses are more common than venous thrombosis
  • Strokes are more frequent followed by myocardial infarction and peripheral arterialocclusion
71
Q

best test to monitor heparin therapy

A

Activated partial thromboplastin time (aPTT)

72
Q

DVT in the presence of thrombocytopenia

A

heparin induced thrombocytopenia

73
Q

types of heparin induced thrombocytopenia

A

Type 1 : first 2 days after exposure, platelet count normalizes with continued heparin therapy. non-immune

Type 2: typically occurs 4-10 days after
exposure, immune-mediated disorder
- Venous limb gangrene
- Bilateral adrenal hemorrhagic infarction
- Skin lesions at injection sites
- Acute systemic reactions following an i- ntravenous heparin bolus

74
Q

heparin induced thrombocytopenia management

A

discontinue and avoid all heparin products immediately

75
Q

Renal failure reflected by oliguria and abdominal pain following invasive diarrhoea

A

hemolytic uremic syndrome (HUS).

AMC MCQ (55 decks)

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