Haematology

Question 1

isolated thrombocytopenia and previous viral URTI

Answer 1

Idiopathic Thrombocytopenic Purpura

Question 2

Lymphocytosis in 70 year old, unremarkable clinical examination, lethargic for 2 weeks

Answer 2

CLL

Question 3

Drug that can cause aplastic anaemia

Answer 3

Phenytoin

Question 4

Management for isolated pyrexia during blood transfusion

Answer 4

Regular (15min) obs, needs no Rx in itself but requires monitoring for more serious complications

Question 5

The transfusion threshold (Hb) for patients with ACS

Answer 5

80g/l

Question 6

transfusion of unirradiated blood in immunosupressed patients can cause

Answer 6

Graft Versus Host Disease (Can occur 4-30 DAYS after transfusion)

Question 7

Platelet transfusion threshold

Answer 7

10 x 10^9 for patients not bleeding or having an invasive procedure- except where CI or alternative treatments for their condition

Question 8

Contraindications for platelet transfusion

Answer 8

TTP (give corticosteroids or other immune modulators)

Question 9

combination of low platelet counts and raised FDP (fibrin degradation products)

Answer 9

DIC

Question 10

What is the mechanism of action of Dabigatran?

Answer 10

Direct thrombin inhibitor

Question 11

PT/APTT in VwD

Answer 11

PT is normal, APTT is prolonged

Question 12

major criteria determining the use of cryoprecipitate in bleeding

Answer 12

low fibrinogen level

Question 13

no.1 test to confirm haemolytic transfusion reaction

Answer 13

Direct Coombe’s test

Question 14

lymphoma (lymphoplasmacytic lymphoma) producing excess IgM

Answer 14

Waldenstrom’s macroglobulinaemia

Question 15

How long before operation should oral contraceptive be stopped

Answer 15

4 weeks

Question 16

Mechanism of action of anti-coagulants

Answer 16

Rivaroxaban is a direct factor Xa inhibitor. Apixaban is also a direct factor Xa inhibitor.

Dabigatran is a direct thrombin inhibitor.

Heparin activates antithrombin III.

Warfarin inhibits clotting factors II, VII, IX and X.

Question 17

the most common form of lymphoma in the UK

Answer 17

Diffuse large B cell lymphoma

Question 18

used for the emergency reversal of anticoagulation in patients with severe bleeding or a head injury

Answer 18

prothrombin comlpex concentrate

Question 19

recommended treatment for post-thrombotic syndrome

Answer 19

compression stockings

Question 20

raised ESR and osteoporosis

Answer 20

multiple myeloma until proven otherwise

Question 21

Myelodysplasia may progress to

Answer 21

AML

Question 22

Acute haemolytic transfusion reaction should be treated with…

Answer 22

Permanent transfusion termination, generous saline resusitation and inform the lab

Question 23

First line treatment for neutropenic sepsis

Answer 23

Tazocin IV

Question 24

Haemarthrosis without trauma

Answer 24

Haemophilia A or B

Question 25

A ‘rouleaux formation’

Answer 25

a stacking of red blood cells seen in a blood film. It is characteristic of a myeloma.