Haematology

Question 1

Management of iron overload?

Answer 1

Deferoxamine

Question 2

Why is hydroxyurea used in sickle cell disease?

Answer 2

Promotes the production of HbF as people with sickle cell disease can’t produce normal haemoglobin.

Question 3

What is emicizumab?

Answer 3

A monoclonal antibody that can independently activate Factor 10 by binding it with Factor 9 therefore no need for Factor 8. Given to children with Haemophilia A.

Question 4

Which cell has CD19 and CD20 on them?

Answer 4

B cells

Question 5

Which cells have CD2, CD3, CD4 and/or CD8 on them?

Answer 5

T cells

Question 6

What are considered high risk in ALL?

Answer 6

Initial WCC>50
Hypodiploid
t(9;22) BCR-ABL
t(v;11q23)
Poor response to initial induction chemotherapy (most powerful prognostic factor)

Question 7

Good prognostic features in ALL?

Answer 7

Hyperdiploid
Trisomy 4, 10
t (21;21) ETV6-RUNX1

Question 8

What is the mechanism of imatinib/dasatinib in ALL?

Answer 8

Tyrosine kinase inhibition in Ph+ (t(9,22)) ALL

Question 9

What is the treatment for AML?

Answer 9

High dose cytarabine

Question 10

What is the characteristic feature seen on histology slides in AML?

Answer 10

Auer rods

Question 11

What is acute promyelocytic leukaemia treated with?

Answer 11

ATRA (Retinoic acid - high dose Vitamin A) and arsenic if low risk

Question 12

Which type of leukaemia has the greatest risk of DIC?

Answer 12

APML (FAB M3) - t (15,17)

Question 13

What would a bilobed nucleus on a histology film suspected of leukaemia be suspicious for?

Answer 13

APML

Question 14

Staging for lymphoma?

Answer 14

– Stage I is involvement of a single lymph node region (I) or single extralymphatic site (Ie);
– Stage II is involvement of two or more lymph node regions
on the same side of the diaphragm (II) or of one lymph node region and a contiguous extralymphatic site (IIe);
– Stage III is involvement of lymph node regions on both
sides of the diaphragm, which may include the spleen (IIIs) and/or limited contiguous extralymphatic organ or site (IIIe, IIIes);
– Stage IV is disseminate involvement of one or more extralymphatic organs

Question 15

5 year old girl presents with a 2 day history of abdominal pain and palpable abdominal mass. Previously presented 2 months earlier with intussusception. Small palpable cervical lymph nodes and RLQ mass palpable on examination?

Answer 15

Burkitts Lymphoma

Question 16

What is the target of Rituximab?

Answer 16

CD20 on B cells

Question 17

What is the target of Blinatumomab?

Answer 17

Binds to both CD19 (on tumour B cells) and CD3 (on T cells) - Bispecific T cell engager

Question 18

What is the treatment of cytokine release syndrome?

Answer 18

Tocilizumab (Anti-IL6)

Question 19

What is the target of brentuximab?

Answer 19

Anti-CD30 (Hodgkins lymphoma)

Question 20

What is the treatment in a patient who has just had a stem cell transplant for leukaemia and has presented with weight gain, tender hepatomegaly, jaundice and ascites?

Answer 20

Defibrotide -Sinusoidal Occlusion Syndrome

Question 21

What systems are primarily affected in GVH?

Answer 21

Skin, liver and GIT