Haematology

Question 1

When is it reasonable to consider a blood transfusion?

Answer 1

Hb < 8, especially with symptoms

Question 2

What blood will be transfused in the following case:
A large epistaxis which has settled over the last 30 mins with conservative management. Patient light headed and nauseous. Hb 7.1

Answer 2

IV packed red blood cells

Question 3

What is the mechanism of action of aspirin?

Answer 3

Inhibits cyclooxygenase

Question 4

What is the mechanism of action of clopidogrel?

Answer 4

Antagonises adenosine diphosphate receptors on platelets

Question 5

What is the mechanism of action of warfarin?

Answer 5

Inhibits vitamin K epoxide reductase, preventing carboxylation of vitamin K dependent factors

Question 6

What are the vitamin K dependent factors?

Answer 6

II, VII, IX, X

Question 7

What is rouleaux formation?

Answer 7

Red cells will appear stacked like a set of coins

Can be found in reactive process due to acute phase proteins or in plasma cell dyscrasias due to paraproteins

Question 8

What is not an appropriate action in a patient on warfarin presenting with haematemesis and hypotension?

Answer 8

Giving fresh frozen plasma

Does not give sufficient coagulation correction

Question 9

Diagnosis: 18 y/o male, 8 week enlarging lump in neck, night seats, axially lymphadenopathy

Answer 9

Hodgkin’s Disease

Question 10

Which investigation is most likely to give a definitive diagnosis of Hodgkins Disease?

Answer 10

Lymph node biopsy

Question 11

Which test is used to dose heparin?

Answer 11

APTT