Haematology

Question 1

Criteria for starting treatment in CLL (5)

Answer 1

Thrombocytopaenia
Marrow failure
Lymphadenopathy
Splenomegaly
(both of these have to be widespread/massive)
Systemic symptoms - >10% weight loss in 6 months

Question 2

Management of genetic methahaemaglobinaemia

Answer 2

Asorbic acid

Question 3

2nd line agent in CLL

Answer 3

Ibrutinib

Question 4

Burkitt’s Lymphoma
- association
- genetics

Answer 4

HIV
t8:14

Question 5

What qualifies as progressive lymphocytosis in CLL requiring treatmetnt?

Answer 5

Doubling over 2 months

Question 6

MDS vs AML - blood film findings

Answer 6

AML >20% blasts in peripheral blood

MDS = hypogranular, hypo lobulated neutrophils

Question 7

ADAMST13

Answer 7

Can be low in HUS
Not as low as in TTP

Question 8

Platelet refractoriness
- definition
- management

Answer 8

= PLT rise <10
Check anti-HLA or anti-platelet antibodies

Question 9

Wells Score for DVT
- pathway

Answer 9

< 2 = d-dimer
>= 2 = leg US

Question 10

Haemophilia A
vs
vWF

Answer 10

Both have low factor VIII

vWF = prolonged bleeding time, platelet aggregation impaired

Question 11

Investigation of choice in CLL

Answer 11

Immunophenotyping
Cytogenetics used for prognostication

Question 12

Anticoagulation in HIT

Answer 12

Bivalirudin (direct thrombin inhibitor)
Cannot use warfarin - doesn’t help with the risk of thrombus and increased risk of skin gangrene

Question 13

Hairy cell leukaemia
- what is the associated mutation?

Answer 13

BRAF mutation

Question 14

Blood product of use in DIC

Answer 14

Fresh frozen plasma

Question 15

Investigation of choice in multiple myeloma

Answer 15

Whole body MRI

Question 16

Need to raise platelets quickly in ITP

Answer 16

IV immunoglobulin