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Haematology Flashcards

1
Q

What is the most common inherited bleeding disorder?

A

Von Willebrand’s disease

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2
Q

Inheritance of Von Willebrand disease?

A

Type 1 (80%) is autosomal dominant

Type 3 is autosomal recessive

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3
Q

What does von Willebrand do?

A

Promotes platelet adhesion to damaged epithelium

Binds to factor VIII to prevent its clearance

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4
Q

Presentation of von Willebrand’s disease?

A

Mucosal bleeding - epistaxis, menorrhagia

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5
Q

Investigations for von Willebrand’s disease

A

Prolonged bleeding time
APTT may be prolonged
Factor VIII moderately reduced
Defective platelet aggregation with ristocetin

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6
Q

Management of von Willebrand’s disease

A

Tranexamic acid
Desmopressin
Factor VIII concentrate

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7
Q

How does desmopressin help in von Willebrand’s disease?

A

Increases levels of vWF by inducing vWF release from Weibel-Palade bodies in endothelial cells

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8
Q

Types of von Willebrand’s disease

A

Type 1: partial reduction in vWF
Type 2: abnormal form of vWF
Type 3: total lack of vWF

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9
Q

What should you consider if enlarged lymph nodes + itch?

A

Lymphoma

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10
Q

What is Hodgekin’s Lymphoma?

A

Malignant proliferation of lymphocytes characterised by presence of Reed Sternberg cells

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11
Q

In which condition do you see Reed Sternberg cells?

A

Hodgekin’s lymphoma

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12
Q

Risk factors for Hodgekin’s lymphoma

A

EBV
HIV
Immunosuppression
Smoking

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13
Q

Features of Hodgekin’s lymphoma

A 
Lymphadenopathy - painless, tender, asymmetrical
Fever, weight loss, night sweats
Pruritis
Alcohol induced lymph node pain
Mediastinal mass
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14
Q

What should alcohol induced lymph node pain make you think of?

A

Hodgekin’s lymphoma

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15
Q

Hodgekin’s lymphoma - blood results findings and investigations

A 
Normocytic anaemia, eosinophilia
Raised LDH
Raised ESR
HIV testing
LN biopsy
CXR
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16
Q

Management of Hodgekin’s lymphoma

A

Chemo + radio

If relapse then high dose chemo + autologous stem cell transplant

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17
Q

Prognosis for Hodgekin’s lymphoma

A

80-90% achieve remission

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18
Q

What is the staging system for Hodgekin’s lymphoma called?

A

Ann Arbour

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19
Q

Name three direct oral anticoagulants

A

Dabigatran
Rivaroxaban
Apixaban

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20
Q

How does dabigatran work?

A

Direct thrombin inhibitor

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21
Q

How does rivaroxaban work?

A

Direct factor Xa inhibitor

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22
Q

How does apixaban work?

A

Direct factor Xa inhibitor

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23
Q

Reversal agent for dabigatran

A

Indarucizumab

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24
Q

Reversal agent for rivaroxaban and apixaban

A

Andexanet alfa

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25
Q

Indications for direct oral anticoagulants

A

Prevention of VTE in hip/knee surgery
Treatment of DVT/PE
Preventing stroke in non-valvular AF

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26
Q

What is the most common form of leukaemia in adults?

A

Chronic lymphocytic leukaemia

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27
Q

What is chronic lymphocytic leukaemia?

A

Monoclonal proliferation of well differentiated lymphocytes

almost always B cells

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28
Q

Features of CLL

A 
Often asymptomatic
Reduced appetite, weight loss
Bleeding
Infections
Lymphadenopathy
Splenomegaly, hepatomegaly
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29
Q

Investigations for CLL

A 
Anaemia
Lymphocytosis
Peripheral blood film - smear cells
Increased LDH
BM biopsy
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30
Q

Which chromosomal abnormality is associated with CLL?

A

Philadelphia chromosome

Due to BCR ABL mutation

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31
Q

Management of CLL

A

Tyrosine kinase inhibitor - imatinib

Bone marrow transplant

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32
Q

Stages of CLL

A

1) Chronic
2) Accelerated stage
3) Blastic crisis - quickly fatal

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33
Q

Complications of CLL

A

Anaemia
Hypogammaglobulinaemia
Warm autoimmune haemolytic anaemia
Transformation to high grade lymphoma (Richter’s transformation)

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34
Q

What is Richter’s transformation?

A

When CLL transforms due to high grade lymphoma

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35
Q

Excretion of riveroxaban

A

Liver

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36
Q

Excretion of apixaban

A

Faeces

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37
Q

Excretion of dabigatran

A

Renal

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38
Q

Drug causes of pancytopenia

A 
Cytotoxics
Trimethoprim, chloramphenicol
Anti-rheumatoid: gold, penicillamine
Carbimazole
Carbamazepine
Tolbutamide
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39
Q

Treatment when a patient is both B12 deficient and folate deficient

A

B12 replacement

Start oral folic acid when B12 levels normal

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40
Q

Macrocytic anaemia - megaloblastic causes

A

Vit B12 deficiency

Folate deficiency

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41
Q

Macrocytic anaemia - normoblastic causes

A 
Alcohol
Liver disease
Hypothyroidism
Pregnancy
Reticulocytosis
Myelodysplasia
Cytotoxics
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42
Q

What is antiphospholipid syndrome?

A

Autoimmune disorder characterised by

1) Arterial and venous thromboembolism
2) Recurrent pregnancy loss
3) Thrombocytopenia

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43
Q

Investigations in antiphospholipid disorder

A

Raised aPL antibodies

Thrombocytopenia

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44
Q

Who should be screened for antiphospholipid disorder?

A

Stroke <50 years

3 or more miscarriages before 10 weeks

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45
Q

Conditions associated with antiphospholipid disorder

A

SLE

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46
Q

Management of antiphospholipid disorder

A

Low dose aspirin once positive urinary test

LMWH once fetal heart beat on ultrasound (till 34 weeks)

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47
Q

Pregnancy complications in antiphospholipid disorder

A 
Recurrent miscarriage
IUGR
Pre-eclampsia
Placental abruption
Preterm delivery
Venous VTE
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48
Q

Who should get prophylaxis for neutropenic sepsis?

A

Patients anticipated to have neutrophil count <0.5

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49
Q

What is the prophylaxis for neutropenic sepsis?

A

fluoroquinolone

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50
Q

Empirical antibiotics for neutropenic sepsis

A

Tazocin (piperacillin with tazobactam)

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51
Q

At what time does neutropenic sepsis typically occur?

A

7-14 days after chemotherapy

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52
Q

Inheritance of sick cell haemoglobin

A

Autosomal recessive

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53
Q

When does sickle cell disease present?

A

Age 3 to 6 months after drop in HbF

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54
Q

Presentation of sickle cell disease

A 
Anaemia
Pallor
Jaundice
FTT
Increased infections
Splenomegaly
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55
Q

Types of sickle cell crises

A 
Thrombotic
Sequestration
Acute chest syndrome
Aplastic crises
Haemolytic crises
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56
Q

Sickle cell disease - thrombotic crises

A

Painful/vasoocclusive
Clinical diagnosis
Can infarct organs and bones

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57
Q

What triggers a thrombotic crisis in sickle cell disease?

A

Infection
Dehydration
Deoxygenation

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58
Q

Sickle cell disease - sequestration

A

Sickling in organs causes pooling of blood and worsening anaemia
Raised reticulocyte count

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59
Q

Sickle cell disease - what happens to the reticulocyte in sequestration crises?

A

Increases

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60
Q

Sickle cell disease - acute chest syndrome

A

Dyspnoea
Chest pain
Pulmonary infiltrates
Reduced pO2

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61
Q

Sickle cell disease - aplastic crisis

A

Sudden drop in Hb
Due to parvovirus
Reduced reticulocyte due to bone marrow suppression

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62
Q

What triggers aplastic crisis in sickle cell disease?

A

Parvovirus

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63
Q

Sickle cell disease - what happens to the reticulocyte count in aplastic crisis?

A

Reduces due to bone marrow suppression

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64
Q

Sickle cell disease - haemolytic crisis

A

Fall in Hb due to increased haemolysis

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65
Q

Sickle cell disease - management of crises

A 
Analgesia
Fluids
Oxygen
Antibiotics if infection
Blood transfusion
Exchange infusion if neurological symptoms
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66
Q

Long term management of sickle cell disease

A

Hydroxyurea

Pneumococcal vaccine 5 yearly

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67
Q

What are Heinz bodies?

A

Clumps of damaged haemoglobin attached to red cells

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68
Q

Inheritance of G6PD deficiency

A

X linked recessive

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69
Q

Features of G6PD deficiency

A 
Asymptomatic in most
Neonatal jaundice
Intravascular haemolysis
Gallstones
Splenomegaly
Back/abdo pain
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70
Q

Investigations for G6PD deficiency

A

Blood film - heinz bodies
G6PD enzyme assay
Raised reticulocyte count

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71
Q

When should you do the G6PD enzyme assay?

A

3 months after acute haemolysis to avoid false negative

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72
Q

G6PD deficiency - what is the reticulocyte count?

A

Raised

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73
Q

G6PD deficiency - what are the precipitants of crises?

A 
Infections
Broad (fava) beans
Antimalarials - primaquine
Ciprofloxacin
Sulph-group drugs: sulphonamides, sulphasalazine, sulpfonylurea
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74
Q

What is myeloma?

A

Neoplasm of the bone marrow plasma cells

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75
Q

Features of myeloma

A

Bone pain, osteoporosis, pathological #, osteolytic lesions
lethargy
Infection
Hypercalcaemia
Amyloidosis = cardiac failure, nephrotic syndrome

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76
Q

Investigations to diagnosis myeloma

A 
Anaemia, leukopenia, thrombocytopenia
Raised calcium
Impaired renal function
Serum protein electrophoresis
Urine electrophoresis for Bence Jones protein
IgG, IgA, IgM levels
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77
Q

Investigations to be done once myeloma is diagnosed

A

Bone marrow aspirate

Skeletal survey with whole body MRI

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78
Q

Treatment of myeloma in young patients

A

Autologous stem cell transplant

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79
Q

What is ITP?

A

Immune mediated reduction in platelets

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80
Q

What course does ITP take in adults?

A

Chronic

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81
Q

Presentation of ITP in adults

A

Incidental finding on routine bloods
Petechia, purpura
Bleeding e.g. epistaxis

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82
Q

Management of ITP in adults

A

Oral prednisolone
IVIg
Splenectomy

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83
Q

What is Evan’s syndrome?

A

ITP in association with autoimmune haemolytic anaemia

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84
Q

Investigations for autoimmune haemolytic anaemia

A

Direct antiglobulin test (Coombs) - positive

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85
Q

Antibody responsible in Warm AIHA

A

IgG

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86
Q

Causes of Warm AIHA

A

Autoimmune e.g. SLE
Lymphoma
CLL
Drugs e.g. methyldopa

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87
Q

Where does haemolysis take place in Warm AIHA?

A

Body temperature, haemolysis occurs in extravascular sites such as the spleen

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88
Q

Management of Warm AIHA

A

Steroids
Immunosuppression
Splenectomy

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89
Q

Antibody responsible in Cold AIHA

A

IgM

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90
Q

Causes of Cold AIHA

A

Lymphoma

Infection - mycoplasma, EBV

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91
Q

Where does haemolysis take place in Cold AIHA?

A

At 4 degrees

Occurs in extremities so is generally intravascular

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92
Q

Features of Cold AIHA

A

Raynaulds

Acrocyanosis

93
Q

What should a Heinz body make you think of?

A

G6PD deficiency

94
Q

What is aplastic anaemia?

A

Pancytopenia due to bone marrow failure

95
Q

Features of aplastic anaemia

A

Anaemia = fatigue, pallor

Thrombocytopenia = mucosal bleeding, petechiae

Leukopenia = recurrent infection

96
Q

Investigation results for aplastic anaemia

A

Low RBC, low PLT, low WCC
Raised Epo
Bone marrow biopsy = dry tap

97
Q

Causes of aplastic anaemia

A 
Idiopathic
Congenital - most often Fanconi syndrome
Infections
Toxins
Drugs
98
Q

What is the most common congenital cause of aplastic anaemia?

A

Fanconi syndrome

99
Q

What infections cause aplastic anaemia?

A

EBV
Hepatitis
Parvovirus
HIV

100
Q

What toxins cause aplastic anaemia?

A

Radiation

Benzene

101
Q

What drugs cause aplastic anaemia?

A 
Cytotoxics
Sulfonamides
Chloramphenicol
Phenytoin
Gold
102
Q

Management of aplastic anaemia

A

Haemopoietic stem cell transplant
Immunosuppression
Blood and PLT transfusions

103
Q

Where is vitamin B12 absorbed?

A

terminal ileum once bound to intrinsic factor

104
Q

Where is intrinsic factor released?

A

Parietal cells in the stomach

105
Q

Causes of B12 deficiency

A

Pernicious anaemia
Post gastrectomy
Vegan diet, poor diet
Disorders of terminal ileum e.g. crohns

106
Q

Features of B12 deficiency

A 
Anaemia features
Paraesthesia, numbness
Cognitive changes
Mood disturbance
Glossitis
Oral ulceration
107
Q

B12 deficiency investigations

A

Macrocytic anaemia

Intrinsic factor antibody

108
Q

Management of B12 deficiency

A

1mg IM hydroxocobalamin 3x a week for 2 weeks, then once every 3 months

109
Q

Why is it important to replace B12 before replacing folate?

A

To avoid subacute combined degeneration of the cord

110
Q

What is pernicious anaemia?

A

Autoimmune disorder affecting the gastric mucosa causing B12 deficiency

111
Q

Pathophysiology of pernicious anaemia

A

Intrinsic factor antibodies - block vit B12 binding site

Gastric parietal cell antibodies - cause atrophic gastritis to reduce intrinsic factor production

112
Q

Features of pernicious anaemia

A 
Anaemia = lethargy, pallor, dyspnoea
Peripheral neuropathy
Subacute combined degeneration of the cord
Memory loss
Confusion
Irritable
113
Q

What are the symptoms of subacute combined degeneration of the cord?

A

progressive weakness, ataxia and paresthesias that may progress to spasticity and paraplegia

114
Q

Investigation results for pernicious anaemia

A 
Macrocytic anaemia
Hypersegmented polymorphs on blood film
Vit B12 and folate deficiency
Anti intrinsic factor antibodies
Anti gastric parietal cell antibodies
115
Q

Risk factors for pernicious anaemia

A

Female
Middle/old age
Blood group A
Other autoimmune disorders

116
Q

Management of pernicious anaemia

A

Vit B12 replacement

May also need folate replacement

117
Q

Inheritance of haemophilia

A

X-linked recessive

118
Q

Clotting factor affected in haemophilia A

A

Factor VIII

119
Q

Clotting factor affected in haemophilia B

120
Q

Factor VIII deficiency?

A

haemophilia A

121
Q

Factor IX deficiency?

A

Haemophilia B

122
Q

Which is the most common haemophilia?

123
Q

Presentation of haemophilia

A 
Excessive bleeding
Haemarthrosis
Haematoma
Haematuria
GI bleeding
124
Q

Haemophilia Investigations

A

APTT prolonged

Normal PT, bleeding time and fibrinogen

125
Q

Management of haemophilia

A

Prophylactic VIII in haemophilia A

Prophylactic IX in haemophilia B

126
Q

What is the most common inherited thrombophilia?

A

Factor V leiden

127
Q

What is factor V leiden?

A

Inherited thromophilia

128
Q

Which clotting factor is damaged in factor V leiden?

129
Q

Inheritence of factor V leiden

A

Autosomal dominant

130
Q

Factor V Leiden presentation

A

Thrombophilia screen after VTE or recurrent pregnancy loss

131
Q

Management of factor V leiden

A

Anticoagulation if get a clot

If pregnant + previous VTE then LMWH

132
Q

What is prothrombin gene mutation?

A

Second most common inherited thrombophilia

133
Q

What is protein S deficiency?

A

Inherited or acquired thrombophilia

134
Q

What is protein S?

A

A natural anticoagulant

135
Q

Inheritance of protein S deficiency

A

Autosomal dominant

136
Q

What is protein C deficiency?

A

Inherited or acquired thrombophilia

137
Q

What is protein C?

A

A natural anticoagulant

138
Q

What is antithrombin III deficiency?

A

Inherited or acquired thrombophilia

139
Q

What is antithrombin III?

A

A natural anticoagulant

140
Q

What is hereditary spherocytosis?

A

Haemolytic anaemia caused by abnormal sphere shaped red blood cells

141
Q

Inheritance of hereditary spherocytosis

A

Autosomal dominant

142
Q

Presentation of hereditary spherocytosis

A 
FTT
Jaundice
Gallstones
Splenomegaly
Aplastic crisis due to parvovirus
143
Q

Investigations for hereditary spherocytosis

A

Raised MCHC
Raised reticulocytes
Spherocytes on blood film

144
Q

Definitive investigation for hereditary spherocytosis

A

EMA binding test

145
Q

Hereditary spherocytosis - chronic management

A

Folate replacement

Splenectomy

146
Q

Hereditary spherocytosis - acute haemolytic crisis management

A

Supportive

Transfusion if necessary

147
Q

What is paroxysmal nocturnal haemoglobinuria?

A

Acquired disorder causing haemolysis of haematological cells

Can affect RBC, WCC, PLT or stem cells

148
Q

Features of paroxysmal nocturnal haemoglobinuria

A 
Haemolytic anaemia
Thrombosis
Pancytopenia
Haemoglobinuria - classically in the morning
Aplastic anaemia
149
Q

Investigations for paroxysmal nocturnal haemoglobinuria

A

Flow cytometry

Ham’s test - acid induced haemolysis

150
Q

Treatment for paroxysmal nocturnal haemoglobinuria

A

Blood product replacement
Anticoagulation
Stem cell transplant

151
Q

Relative causes of polycythaemia

A

Dehydration

Stress - Gaisbock syndrome

152
Q

Causes of secondary polycythaemia

A

COPD
Altitude
OSA
Excessive EPO

153
Q

Typical features of polycythaemia vera

A

Hyperviscosity
Pruritis
Splenomegaly

154
Q

What is polycythaemia vera?

A

Myeloproliferative disorder caused by proliferation of marrow stem cells, causing increased red cell volume

155
Q

Features of polycythaemia vera

A 
Hyperviscosity
Pruritis
Splenomegaly
Haemorrhage - due to abnormal PLT
Plethoric appearance
HTN
156
Q

Mutation implicated in polycythaemia vera

157
Q

Investigations for polycythaemia vera

A 
Raised haematocrit
Raised neutrophils, raised basophils
Raised platelets
Low ESR
JAK2 mutations 
Bone marrow biopsy if JAK2 negative
158
Q

Management for polycythaemia vera

A

Aspirin
Venesection
Chemotherapy

159
Q

Prognosis of polycythaemia vera

A

Thrombosis
5-15% progress to myelofibrosis
5-15% progress to acute leukaemia

160
Q

What is myelofibrosis?

A

Bone marrow cancer

Myeloproliferative disorder where the bone marrow is replaced with scar tissue/fibrosis

161
Q

What blood disorder is associated with Ashkenazi Jews?

A

Myelofibrosis

162
Q

Which is the most common acute leukaemia in adults?

A

Acute myeloid leukaemia

163
Q

Drugs causing pancytopenia

A 
Cytotoxics
Trimethoprim, chloramphenicol
Anti-rheumatoid: gold, penicillamine
Aarbimazole
Carbamazepine
Tolbutamide
164
Q

Inheritance of Fanconi anaemia

A

Autosomal recessive

165
Q

Features of Fanconi anaemia

A 
Aplastic anaemia
AML
Short stature
Thumb abnormalities
Cafe au lait spots
166
Q

What is Wiskott-Aldrich syndrome?

A

Primary immunodeficiency with B and T cell dysfunction

167
Q

Genetics of Wiskott-Aldrich syndrome

A

X linked recessive

Mutation in the WASP gene

168
Q

Features of Wiskott-Aldrich syndrome

A

Recurrent bacterial infections
Eczema
Thrombocytopenia
Low IgM

169
Q

What is immune thrombocytopenia?

A

Immune mediated reduction in platelets

170
Q

Immune thrombocytopenia - presentation

A

Incidental finding
Petechia, purpura
Bleeding

171
Q

Immune thrombocytopenia - management

A

Oral prednisolone
IVIg
Splenectomy (rare)

172
Q

What is Evan’s syndrome?

A

immune thrombocytopenia in association with autoimmune haemolytic anaemia

173
Q

Heredtiary spherocytosis - common abdominal complication

A

gallstones

174
Q

Which factor is deficient in haemophilia A?

175
Q

Which factor is deficient in haemophilia B?

176
Q

Ca125 is a tumour marker for which cancers?

A

ovarian cancer

177
Q

Ca19-9 is a tumour marker for which cancers?

A

pancreatic cancer

178
Q

Ca15-3 is a tumour marker for which cancers?

A

breast cancer

179
Q

AFP is a tumour marker for which cancers?

A

HCC

Teratoma (which is a non-seminomatous testicular cancer)

180
Q

CEA is a tumour marker for which cancers?

A

colorectal

181
Q

What drug can cause a false negative PSA?

A

Finasteride

182
Q

What is Meig’s syndrome?

A

ovarian fibroma + pleural effusion + ascites

183
Q

Myelofibrosis - presentation

A

Weight loss, night sweats, low fever

Massive splenomegaly

184
Q

Myelofibrosis - investigations

A

Anaemia
Raised urate
Raised LDH

Tear drop shaped RBC

BM aspirate: dry tap

185
Q

What is essential thrombocythaemia?

A

Megakaryocyte proliferation increases circulating platelets

which increases risk of thrombosis and bleeding

186
Q

Essential thrombocythaemia - presentation

A

Burning pain and dusk discolouration of extremities
Splenomegaly
Livedo reticularis

187
Q

What is haemolytic uraemic syndrome?

A

Triad:

1) Acute renal failure
2) Microangiopathic haemolytic anaemia
3) Thrombocytopenia

188
Q

Haemolytic uraemic syndrome - causes

A 
Dysentry
Tumours
Pregnancy
Ciclosporin
SLE
HIV
oral contraceptive pill
189
Q

Haemolytic uraemic syndrome - typical presentation

A

Diffuse diarrhoea that turns bloody

may have fever, abdo pain, vomiting

190
Q

Haemolytic uraemic syndrome - investigations

A 
Low Hb
Low platelets
Raised LDH
Fragmented blood film
Acute renal failure
191
Q

Haemolytic uraemic syndrome - management

A

IV fluids

Dialysis

192
Q

Acute lymphoblastic leukaemia - presentation

A 
Fever
Fatigue
Lymphadenopathy
Hepatosplenomegaly
Painless unilateral testicular enlargement
Bone pain
193
Q

Acute lymphoblastic leukaemia - investigations

A 
Low Hb
Low platelets
Low or high WCC
Blood film: lymphoblasts
BM biopsy: >30% lymphoblasts
194
Q

Acute myeloid leukaemia - presentation

A 
SOB, pallor, fatigue
Recurrent infection
Muscosal bleeding, petechiae
Hepatosplenomegaly
Lymphadenopathy
Gum hypertrophy
195
Q

Acute myeloid leukaemia - investigations

A

Low Hb
Low or high WCC
Blood film: blasts, Auer rods
BM biopsy: >20% blasts

196
Q

Chronic myeloid leukaemia - pathophysiology

A

Philadelphia Chromosome:

t (9:22)
BCR-ABL gene mutation

197
Q

Chronic myeloid leukaemia - presentation

A

Middle age
Anaemia, weight loss
Splenomegaly
Increased WCC may cause visual changes, priapism, deafness, confusion

198
Q

Chronic myeloid leukaemia - management

A

Imatinib (tyrosine kinase inhibitor)

199
Q

3 most common tumours causing bone metastases

A

Prostate
Breast
Lung

200
Q

Top 5 most common site of bone metastases

A 
Spine
Pelvis
Ribs
Skull 
Long bones
201
Q

Features of bone metastases

A

Pathological fractures
Hypercalcaemia
Raised ALP

202
Q

3 most common cancers in women

A

Breast
Lung
Colorectal

203
Q

5 most common causes of cancer deaths in the UK

A 
Lung
Colorectal
Breast 
Prostate 
Pancreas
204
Q

Risk factors for nausea and vomiting from chemotherapy

A

Anxiety
Age <50
Concurrent opioid use
Type of chemotherapy used

205
Q

First line treatment for nausea for low risk patients getting chemotherapy

A

Metoclopramide

206
Q

First line treatment for nausea for high risk patients getting chemotherapy

A

Ondanestron

can be combined with dexamethasone

207
Q

Side effects of cyclophosphamide

A

Haemorrhagic cystitis - reduced by hydration and mesna
Myelosuppression
Transitional cell carcinoma

208
Q

Main cause of neoplastic spinal cord compression

A

Extradural compression due to vertebral body metastases

209
Q

Features of neoplastic spinal cord compression

A

Back pain
Lower limb weakness
Sensory loss and numbness
Neurological signs

210
Q

Investigations for neoplastic spinal cord compression

A

Urgent MRI

211
Q

Management of neoplastic spinal cod compression

A

High dose oral dexamethasone

Oncology assessment to consider radiotherapy or surgery

212
Q

What is superior vena cava obstruction?

A

Compression of the SVC

Usually by lung cancer

213
Q

SVC obstruction - features

A 
Dyspnoea
Swelling of the face, neck, arms
Headache
Visual disturbance
Pulseless jugular venous distension
214
Q

SVC - causes

A 
Malignancy
Aortic aneurysm
Mediastinal fibrosis
Goitre
SVC thrombosis
215
Q

SVC - management options

A

SVC stent

Radical radio or chemo-radiotherapy

216
Q

S-100 is a tumour marker for which cancers?

A

Melanoma

Schwannoma

217
Q

Bombesin is a tumour marker for which cancers?

A

Small cell lung cancer
Neuroblastoma
Gastric cancer

218
Q

What type of drug is ondanestron?

A

5HT3 receptor antagonist

219
Q

Give an example of a 5HT3 antagonist

A

Ondanestron

220
Q

Side effects of bleomycin

A

Lung fibrosis

221
Q

Side effects of doxorubicin

A

Cardiomyopathy

222
Q

Side effects of fluorouracil

A

Myelosuppression
Mucositis
Dermatitis

223
Q

Side effects of 6-mercaptopurine

A

Myelosuppression

224
Q

Side effects of cytarabine

A

Myelosuppression

Ataxia

225
Q

Side effects of vincristine

A

Peripheral neuropathy

Paralytic ileus

226
Q

Side effects of vinblastine

A

Myelosuppression

227
Q

Side effects of docetaxel

A

Neutropenia

228
Q

Side effects of cisplatin

A

Ototoxicity
Peripheral neuropathy
Hypomagnesaemia

229
Q

3 most common cancers in men

A

Prostate
Lung
Bowel

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