Haematology Flashcards
Female aged 39 treated for breast cancer 4 years previously. Recent onset jaundice and hepatomegaly GP bloods: -Hb 87g/l -Reticulocyte 15 x 10^9/L (20-92) -Bilirubin 50 micromol/l conjugated -DAT negative -Nucleated RBCs on blood film What is the most likely explanation for this anaemia? A. Iron deficiency anaemia B. Anaemia of chronic disease C. Bone marrow matastases from breast cancer D. MAHA E. Autoimmune haemolytic anaemia
C. Bone marrow metastases from breast cancer.
45 year old male. 3 weeks history of sore throat Recent episode of shingles EBV igG serology positive FBC: -Lymphocytes raised -Neutrophils normal -Film: reactive lymphocytes no abnormal cells -Monoclonal, kappa only Most likely diagnosis? A. B cell acute lymphoblastic leaukaemia B. Mature B cell lymphoproliferative disorder e.g. CLL C. Infectious mononucleosis D. T cell acute leukaemia lymphoma
B. Mature B cell lymphoproliferative disorder e.g. CLL
Which one of the following about MDS is true?
A. Myelodysplasia has a bi-modal age distribution
B. The primary modality of treatment of MDS is by intensive chemo
C. One third of MDS patients can be expected to die from leukaemic transformation
D. There is no good correlation between the severity of the cytopenias and the overall life expectancy
E. White cell function is frequently well preserved in MDS
C. One third of MDS patients can be expected to die from leukaemic transformation
Regarding aplastic anaemia- which one is true?
A. Immunosuppressive therapy is only used to treat a minority of patients with AA
B. If treated with immunosuppression, then relapse of AA occurs in less than 15% of cases
C. The cure rate of AA treated by sibling related allogeneic SCT in a patient under 40 years old is >70 %
D. Severe AA is differentiated from non-severe AA on the basis of the acquired cytogentic abnormalities in the BM
E. Leucodepletion of cellular blood products is only exceptionally undertaken for patients with AA
C. The cure rate of AA treated by sibling related allogeneic SCT in a patient under 40 years old is >70 %
Which one of the following is true?
A. Telomeric shortening is a feature of both idiopathic AA and dyskeratosis congenita.
B. Development of malignancy is an uncommon complication of Fanconi anaemia
C. Single genetic defect has been identified as the underlying cause for Fanconi anaemia
D. Fanconi anaemia is usually inherited in an autosomal dominant fashion.
E. Telomeric function is considered to be unimportant in the pathophysiology of Dyskeratosis Congenita
A. Telomeric shortening is a feature of both idiopathic AA and dyskeratosis congenita.
Chronic HTLV-1 is associated with an increased risk of which type of lymphoma?
Adult T cell leukaemia lymphoma
Chronic HIV infection is associated with an increased risk of which type of lymphoma?
High grade B cell non Hodgkin Lymphoma
H. pylori is associated with an increased risk of which type of lymphoma?
Gastric MALT lymphoma (marginal cell lymphoma)
If a Blood group O RhD positive patient was transfused A RhD negative red cells, what sort of transfusion reaction would occur?
Acute haemolytic transfusion reaction
What is the probability of finding an HLA donor if the patient has 2 siblings?
44%
The role of conditioning in an allogeneic transplant is to: A. Eradicate the malignancy B. Suppress the patient C. To make space for the incoming cells D. All of the above E. None of the above
D. All of the above
Which of these is a risk factor to develop Graft vs Host disease?
A. Degree of HLA disparity
B. Recipient age
C. Gender combination of recipient and donor
D. Stem cell source
E. All of the above
E. All of the above
Newborn babies, in contrast to adults have: A. A higher Hb B. A lower WBC C. Smaller red blood cells D. The same percentage of HbF
A. A higher Hb
Complications of sickle cell anaemia that are more common in adults than children include: A. Hand-foot syndrome B. Hyposplenism C. Red cell aplasia D. Splenic sequestration E. Stroke
B. Hyposplenism
Siblings with sickle cell anaemia present simultaneously with severe anaemia and a low reticulocyte count - likely diagnosis? A. Splenic sequestration B. Parvovirus B19 infection C. Folic acid deficiency D. Haemolytic crisis E. Vitamin B12 deficiency
B. Parvovirus B19 infection
A 6 year old Afro Caribbean boy presents with chest and abdominal pain; Hb is 63g/l, MCV 85fl and blood film shows sickle cells- likely diagnosis?
A. Sickle cell trait
B. Sickle cell anaemia
C. Sickle cell/beta thalassaemia
B. Sickle cell anaemia
A 1 year old boy present with joint bleeding, Hb, WBC and platelet count are normal, aPTT is prolonged, PT is normal, bleeding time normal-most likely diagnosis? A. Haemophilia A B. Haemophila B C. Von Willebrand disease D. TTP E. Taken his mothers warfarin tablets
A. Haemophilia A
A 5 year old boy of Indian ethnic origin presented with lymphadenopathy and a mediastinal mass on chest radiology.
WBC 180
Hb 93
Platelet 43
1. What is the most likely diagnosis?
2. What is the mediastinal mass?
3. What is the best technique to confirm the diagnosis?
- ALL
- The mediastinal mass is the thymus, which is infiltrated by T lymphoblasts
- Immunophenotyping
N.B very high white blood count in a child = leukaemia
The risk of thrombosis is increased by: A. Reduced prothrombin B. Thrombocytopenia C. Reduced Protein C D. Elevated antithrombin E. Increased fibrinolysis
C. Reduced protein C
Which factor confers the highest risk of thrombosis? A. Factor V Leiden B. Antithrombin deficiency C. Family history of thrombosis D. Reduced Factor VIII level E. 3 hour plane flight
B. Antithrombin deficiency
Which agent has a delayed anti-coagulant effect? A. Vitamin K B. Unfractionated heparin C. Warfarin D. LMWH E. Aspirin
C. Warfarin
How does warfarin achieve its anticoagulant effect?
A. Reduction of plasma protein C and Protein S
B. Blocks phospholipid synthesis
C. Reduction of plasma procoagulant factors
D. Acts as a cofactor for antithrombin
E. Inhibits Factors II, VII, IX and X
C. Reduction of plasma procoagulant factors
Which patient is most likely to benefit from long term anticoagulation after their DVT?
A. 57 year old man after flying to Moscow
B. 27 year old woman during pregnancy
C. 33 year old woman on OCP
D. 77 year old man after hip replacement
E. 30 year old man after a long walk
E. 30 year old man after a long walk
A 32 year old woman developed a DVT after removal of ovarian cyst. Her father and brother had DVTs in the past. What is the next most appropriate step?
A. Test for antithrombin deficiency
B. Recommend HRT
C. Start on long term anticoagulation
A. Test for antithrombin deficiency
A 29 year old man collapsed at work following a PE. No family history. What is the most appropriate next step?
A. Testing for factor V leiden
B. Daily aspirin
C. Continue long term anticoagulation
D. Heparin injections for long haul flights
C. Continue long term anticoagulation
A 38 year old woman had a previous DVT when taking the COCP. She then had a 2nd DVT during her 2nd pregnancy. What is the next most appropriate step? A. Testing for factor V leiden B. HRT C. Continue long term anticoagulation D. Fixed low dose warfarin
A. Testing for factor V Leiden
A 67 year old man present with DVT and weight loss. He is started on LMWH. What is the next most appropriate step?
A. Adbo-pelvic CT scan
B. Switch to DOAC
C. Switch to Warfarin
A. Abdo-pelvic CT scan
The most important cell in the initiation of normal haemostats is: A. Thromboxane A2 B. Erythrocyte C. Cycloxygenase D. t-PA E. Protein C F. Fibrin G. Platelet H. Endothelial Cell I. Antithrombin III J. Megakaryocyte K. Plasmin L. Fibrinogen M. a2 macroglobulin
H. Endothelial cell
The main component involved in stabilising the primary haemostatic plug is: A. Thromboxane A2 B. Erythrocyte C. Cycloxygenase D. t-PA E. Protein C F. Fibrin G. Platelet H. Endothelial Cell I. Antithrombin III J. Megakaryocyte K. Plasmin L. Fibrinogen M. a2 macroglobulin
F. Fibrin
A serine protease which assists in the breakdown of blood clots by binding to the clot and localising agents which break it down is: A. Thromboxane A2 B. Erythrocyte C. Cycloxygenase D. t-PA E. Protein C F. Fibrin G. Platelet H. Endothelial Cell I. Antithrombin III J. Megakaryocyte K. Plasmin L. Fibrinogen M. a2 macroglobulin
D. t-PA
A potent inhibitor of plasmin in the blood is: A. Thromboxane A2 B. Erythrocyte C. Cycloxygenase D. t-PA E. Protein C F. Fibrin G. Platelet H. Endothelial Cell I. Antithrombin III J. Megakaryocyte K. Plasmin L. Fibrinogen M. a2 macroglobulin
M. a2 macroglobulin
A single chain glycoprotein, synthesised by the liver and endothelium, which has strongly anticoagulant action and is important in the mode of action of heparin is: A. Thromboxane A2 B. Erythrocyte C. Cycloxygenase D. t-PA E. Protein C F. Fibrin G. Platelet H. Endothelial Cell I. Antithrombin III J. Megakaryocyte K. Plasmin L. Fibrinogen M. a2 macroglobulin
I. Antithrombin III
This product of the cyclic endoperoxides induces platelet aggregation: A. Megakaryocytes B. Sensitised platelets C. Christmas disease D. Thromboxane A2 E. Ehler-Danlos syndrome F. Vitamin K deficiency G. Haemophilia H. Marfan disease I. Autoimmune thrombocytopenia purpura J. Prostacylcin PGI2 K. Factor VIII deficiency L. Factor XII deficiency M. Von willebran deficiency
D. Thromboxane A2
A 6 foot 7 inch rower presents to his GP complaining of easy skin bruising. On further examination he is found to have pectus excavatum, lax joints and a high-arched palate. A. Megakaryocytes B. Sensitised platelets C. Christmas disease D. Thromboxane A2 E. Ehler-Danlos syndrome F. Vitamin K deficiency G. Haemophilia H. Marfan disease I. Autoimmune thrombocytopenia purpura J. Prostacylcin PGI2 K. Factor VIII deficiency L. Factor XII deficiency M. Von willebran deficiency
E. Ehlers Danlos Syndrome
A 62 year old overweight woman presents to the Emergency Department following a Road Traffic Accident. A full set of investigations is carried out – which shows an increased Activated Partial Thromboplastin Time (APTT) and Prothrombin Time (PT) A. Megakaryocytes B. Sensitised platelets C. Christmas disease D. Thromboxane A2 E. Ehler-Danlos syndrome F. Vitamin K deficiency G. Haemophilia H. Marfan disease I. Autoimmune thrombocytopenia purpura J. Prostacylcin PGI2 K. Factor VIII deficiency L. Factor XII deficiency M. Von willebran deficiency
F. Vitamin K deficiency
A 25 year old man presents to the Emergency Department a day after attending his dentist for a routine check-up. After treatment at the dentists the previous day, his gums had not stopped bleeding. On investigation, his APTT and bleeding time are prolonged but a normal PT. A. Megakaryocytes B. Sensitised platelets C. Christmas disease D. Thromboxane A2 E. Ehler-Danlos syndrome F. Vitamin K deficiency G. Haemophilia H. Marfan disease I. Autoimmune thrombocytopenia purpura J. Prostacylcin PGI2 K. Factor VIII deficiency L. Factor XII deficiency M. Von willebran deficiency
M. Von willebrand deficiency
A 16 year old girl presents to the Haematology Outpatients clinic describing a fluctuating history of easy bruising, epistaxis and menorrhagia. On investigation there is a thrombocytopaenia with increased megakaryocytes on BM examination. A. Megakaryocytes B. Sensitised platelets C. Christmas disease D. Thromboxane A2 E. Ehler-Danlos syndrome F. Vitamin K deficiency G. Haemophilia H. Marfan disease I. Autoimmune thrombocytopenia purpura J. Prostacylcin PGI2 K. Factor VIII deficiency L. Factor XII deficiency M. Von willebran deficiency
I. Autoimmune thrombocytopenia purpura
Which protein, important in haemostasis, is vitamin K dependent but is not a serine protease? A. Tissue factor B. Thrombin C. Arichidonic acid D. Protein S E. Activated factor X F. Protein C G. Vascular subendothelium H. Factor VII I. Vascular endothelium J. Tissue factor pathway inhibitor K. Platelets L. Cyclooxygenase
D. Protein S
Which option is required as a cofactor for protein C activity? A. Tissue factor B. Thrombin C. Arichidonic acid D. Protein S E. Activated factor X F. Protein C G. Vascular subendothelium H. Factor VII I. Vascular endothelium J. Tissue factor pathway inhibitor K. Platelets L. Cyclooxygenase
D. Protein S
Which option synthesises tissue factor, vWF, prostacyclin, plasminogen activator, antithrombin III and thrombomodulin? A. Tissue factor B. Thrombin C. Arichidonic acid D. Protein S E. Activated factor X F. Protein C G. Vascular subendothelium H. Factor VII I. Vascular endothelium J. Tissue factor pathway inhibitor K. Platelets L. Cyclooxygenase
I. Vascular endothelium
Which enzyme, important for platelet aggregation, is irreversibly inhibited by aspirin? A. Tissue factor B. Thrombin C. Arichidonic acid D. Protein S E. Activated factor X F. Protein C G. Vascular subendothelium H. Factor VII I. Vascular endothelium J. Tissue factor pathway inhibitor K. Platelets L. Cyclooxygenase
L. Cyclooxygenase
Which key clotting factor activates both factors V and VIII, and also activates protein C? A. Tissue factor B. Thrombin C. Arichidonic acid D. Protein S E. Activated factor X F. Protein C G. Vascular subendothelium H. Factor VII I. Vascular endothelium J. Tissue factor pathway inhibitor K. Platelets L. Cyclooxygenase
B. Thrombin
A 37 year old mother of 4 children, presents to her GP because of recurrent nose bleeds and feeling tired all the time and heavy periods. A. Antiphospholipid antibody syndrome B. Haemophilia A C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. B-Thalassaemia G. Bile acid malabsorption H. Warfarin overdose I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Malignancy L. Osler-Weber-Rendu Syndrome M. Sickle cell anaemia N. Von Willebrand disease
L. Osler-Weber-Rendu (Hereditary haemorrhage telangiectasia)
A 3 year old boy is brought to see his GP by his mother. A fortnight ago he had been brought along because of cold-like symptoms, unsurprising since it was the middle of winter and he attends nursery. He was therefore sent home with some Calpol, and as expected his symptoms soon resolved. However this morning his mother noticed a rash on his bottom, and he said his tummy ached. A. Antiphospholipid antibody syndrome B. Haemophilia A C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. B-Thalassaemia G. Bile acid malabsorption H. Warfarin overdose I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Malignancy L. Osler-Weber-Rendu Syndrome M. Sickle cell anaemia N. Von Willebrand disease
I. Henoch Schonlein purpura
22 year old Saharawi refugee presents with anaemia, weight loss, loose stools and blood tests reveal an increased PT and slightly increased APTT, with normal thrombin time and platelet count. A. Antiphospholipid antibody syndrome B. Haemophilia A C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. B-Thalassaemia G. Bile acid malabsorption H. Warfarin overdose I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Malignancy L. Osler-Weber-Rendu Syndrome M. Sickle cell anaemia N. Von Willebrand disease
J. Vitamin K deficiency
A 5 year old boy has the following blood results: normal PT, increased APTT, normal platelet count, decreased VIII:C and decreased vWF. A. Antiphospholipid antibody syndrome B. Haemophilia A C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. B-Thalassaemia G. Bile acid malabsorption H. Warfarin overdose I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Malignancy L. Osler-Weber-Rendu Syndrome M. Sickle cell anaemia N. Von Willebrand disease
N. Von Willebrand disease
A 32 week pregnant lady who has gestational diabetes and is epileptic has a caesarean section while on holiday in rural China. Her newborn baby is suffering from bleeding from the umbilical stump, as well as nose and gums. What is wrong with the baby? A. Antiphospholipid antibody syndrome B. Haemophilia A C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. B-Thalassaemia G. Bile acid malabsorption H. Warfarin overdose I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Malignancy L. Osler-Weber-Rendu Syndrome M. Sickle cell anaemia N. Von Willebrand disease
J. Vitamin K deficiency
A fit 48-year-old investment banker presents to A&E with a painful R arm that was present when he woke up that morning. He is otherwise well and there is no history of trauma or abnormalities of any system. On examination there is marked tenderness and mild erythema along the anterolateral aspect of the forearm and cubital fossa, with no abnormality of the upper arm or axilla. A. Varicose veins B. Postphlebitic syndrome C. Inferior vena caval obstruction D. DIC E. Superior vena caval obstruction F. Pulmonary embolism G. Deep vein thrombosis H. Superficial venous thrombosis I. Axillary vein thrombosis J. Thrombophlebitis
H. Superficial venous thrombosis
A 45-year-old lady, known heavy smoker with chronic respiratory problems, presents to her GP with increasing dyspnoea and swelling of her R arm and face. On examination of her chest there is no asymmetry or tracheal deviation, but there are added sounds over the R upper lobe and on bending forward her face becomes congested. A. Varicose veins B. Postphlebitic syndrome C. Inferior vena caval obstruction D. DIC E. Superior vena caval obstruction F. Pulmonary embolism G. Deep vein thrombosis H. Superficial venous thrombosis I. Axillary vein thrombosis J. Thrombophlebitis
E. Superior vena cava obstruction
A 56-year-old woman returns to the Vascular Clinic with recurrence of her L leg ulcer after the area has been knocked by a shopping trolley. On examination the ulcer is situated above the medial malleolus, its dimensions being 6cm x 5cm. The base is filled with yellowish slough and the surrounding area is erythematous, with prominent oedema. A. Varicose veins B. Postphlebitic syndrome C. Inferior vena caval obstruction D. DIC E. Superior vena caval obstruction F. Pulmonary embolism G. Deep vein thrombosis H. Superficial venous thrombosis I. Axillary vein thrombosis J. Thrombophlebitis
B. Postphelbotic syndrome
A 48-year-old man develops R-sided pleuritic chest pain and coughs up a trace of bloodstained sputum 8 days after a R hemicolectomy. He has mild dyspnoea but chest examination and chest radiography are normal. A. Varicose veins B. Postphlebitic syndrome C. Inferior vena caval obstruction D. DIC E. Superior vena caval obstruction F. Pulmonary embolism G. Deep vein thrombosis H. Superficial venous thrombosis I. Axillary vein thrombosis J. Thrombophlebitis
F. Pulmonary embolism
A 32-year-old lady develops acute swelling of her L leg 2 days post-partum. She had bilateral leg swelling during the pregnancy but the delivery was normal. On examination there is tense swelling of the leg and thigh and some deep tenderness over the calf and medial aspect of the thigh. A. Varicose veins B. Postphlebitic syndrome C. Inferior vena caval obstruction D. DIC E. Superior vena caval obstruction F. Pulmonary embolism G. Deep vein thrombosis H. Superficial venous thrombosis I. Axillary vein thrombosis J. Thrombophlebitis
G. Deep vein thrombosis
A drug that is administered intravenously and has a rapid effect by potentiating the action of antithrombin. Action can be reversed quickly which is of relevance in myocardial infarction patients who may require early invasive treatment (ie PTCA). A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
G. Unfractionated heparin (UFH)
Potentiates antithrombin III. Usually given subcutaneously. Can cause osteoporosis and hyperkalaemia. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
K. Dalteparin (LMWH)
Used to monitor patients undergoing warfarin therapy. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
J. Prothrombin time (PT)
Used to monitor patients undergoing unfractionated heparin therapy. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
P. APTT
This anticoagulant drug is directly contraindicated in pregnancy, especially the first 16 and last 4 weeks of a 40 week gestation. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
O. Warfarin
Reflects the amount and activity of fibrinogen. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
H. Thrombin time (TT)
Antiplatelet action. Indicated for primary prophylaxis of stroke in a patient experiencing recurrent retinal TIAs (amaurosis fugax). Ineffective for DVT prophylaxis. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
M. Aspirin
Antiplatelet action. Licensed for secondary prophylaxis of stroke. More effective than aspirin alone. Cheap. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
N. Dipyridamole modified release (MR) and aspirin
Antiplatelet action. Licensed for primary prevention of stroke in aspirin allergic patients, secondary prevention of stroke (but expensive) and in acute myocardial infarction in addition to aspirin. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
E. Clopidogrel
Dangerous combination with no added efficacy and increased GI bleed. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
L. Clopidogrel and aspirin
Old model of starting warfarin A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
F. 10mg, 10mg, 5mg, measure on the 4th day then every 2 days
New (recommended, Tait) model of starting warfarin A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
A. 5mg, 5mg, 5mg, 5mg, measure on the 5th day, 8th day and then every 4 days
In patients with metallic heart valves, this drug is the most effective anticoagulant A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
O. Warfarin
In patients with cancer and acute venous thromboembolism, the most effective drug at reducing the risk of recurrent VTE is \_\_? A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
K. Dalteparin (LMWH)
This drug when given alone initially increases the clotting risk A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
O. Warfarin
Side effects include cutaneous necrosis A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
O. Warfarin
The drug most likely to cause thrombocytopaenia with paradoxical thrombosis A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
G. Unfractionated heparin (UFH)
Indicated as thrombotic prophylaxis in DIC A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
K. Dalteparin (LMWH)
Contra-indicated if recent sore throat, if ever used before, or in the presence of proliferative retinopathy. A. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days B. LMWH and aspirin C. Pentapolysaccharide D. Streptokinase E. Clopidogrel F. 10mg, 10mg, 5mg, measure on 4th day then every 2 days G. Unfractionated heparin (UFH) H. Thrombin time (TT) I. Calciparone J. Prothrombin time (PT) K. Dalteparin (LMWH) L. Clopidogrel and aspirin M. Aspirin N. Dipyridamole modified release (MR) and aspirin O. Warfarin P. APTT
D. Streptokinase
A 65 year old patient presents with hepatosplenomegaly. He is mildly anaemic and thrombocytompenic. A blood monocyte count of 1.2 x 109/l is observed. Bone marrow aspirate reveals ring sideroblasts at 15% of total blasts. Auer rods are observed.
A. Refractory anaemia
B. Refractory Anaemia with excess of Blasts I
C. Myelodysplastic syndrome,unclassifiable
D. Aplastic Anaemia
E. Refractory Anaemia with Ring Sideroblasts
F. Refractory Cytopaenia with Multilineage Dysplasia
G. Myelodysplastic syndrome associated with isolated del(5q) chromosome abnormality (5q syndrome)
H. Refractory Anaemia with excess of Blasts II
I. Secondary Sideroblastic Anaemia
J. Chronic Myelomonocytic Anaemia
K. Acute Myeloid Leukaemia
J. Chronic myelomonocytic anaemia
CMML and JMML. In addition to the 7 MDS subtypes above, chronic myelomonocytic leukemia (CMML) and juvenile myelomonocytic leukemia (JMML) are types of blood cancers that the WHO classifies as “mixed myelodysplastic/myeloproliferative diseases.” Unlike other types of MDS in which blood counts are low, white blood cell counts are higher in these subtypes. Both CMML and JMML begin after a change, or mutation, happens in a type of blood cell called a monocyte. CMML generally occurs in people ages 65 to 75. JMML is most common in children younger than 6. Treatment is similar to MDS and can include chemotherapy and/or stem cell transplantation
An alcoholic presents to your clinic with anaemia. Sideroblasts are observed on morphological examination.
A. Refractory anaemia
B. Refractory Anaemia with excess of Blasts I
C. Myelodysplastic syndrome,unclassifiable
D. Aplastic Anaemia
E. Refractory Anaemia with Ring Sideroblasts
F. Refractory Cytopaenia with Multilineage Dysplasia
G. Myelodysplastic syndrome associated with isolated del(5q) chromosome abnormality (5q syndrome)
H. Refractory Anaemia with excess of Blasts II
I. Secondary Sideroblastic Anaemia
J. Chronic Myelomonocytic Anaemia
K. Acute Myeloid Leukaemia
I. Secondary sideroblastic anemia
A 58 year old lady complains of lethargy and “easy bruising”. She presents with purpura. Her FBC reveals Hb 10.5g/dl; WBCs 2.3x109/l and platelets 8x109/l. Blood film reveals <1% Blasts, and marrow aspirate shows 20% dysplasia in erythroid lineage, 60% dysplasia in platelet lineage, 5% dysplasia in granulocyte lineage, and less than 5% blasts.
A. Refractory anaemia
B. Refractory Anaemia with excess of Blasts I
C. Myelodysplastic syndrome,unclassifiable
D. Aplastic Anaemia
E. Refractory Anaemia with Ring Sideroblasts
F. Refractory Cytopaenia with Multilineage Dysplasia
G. Myelodysplastic syndrome associated with isolated del(5q) chromosome abnormality (5q syndrome)
H. Refractory Anaemia with excess of Blasts II
I. Secondary Sideroblastic Anaemia
J. Chronic Myelomonocytic Anaemia
K. Acute Myeloid Leukaemia
F. Refractory cytopaenia with multilineage dysplasia Refractory cytopenia with multilineage dysplasia (RCMD). In this subtype, people have less than 5% blasts and less than 15% ringed sideroblasts in the bone marrow. The other bone marrow cells look abnormal when viewed under the microscope. At least 2 of the blood cell counts are low. RCMD may eventually turn into AML.
A 78 year old male patient with recurring infections of the face and maxillary sinuses associated with neutropenia. His bloods are: Hb 9.8 g/dl; WBC 1.3x109/l; Neutrophils 0.3x109/l; platelets 38x109/l.The lab informs you that there are Blasts approximately compromise 17% of bone marrow aspirate.
A. Refractory anaemia
B. Refractory Anaemia with excess of Blasts I
C. Myelodysplastic syndrome,unclassifiable
D. Aplastic Anaemia
E. Refractory Anaemia with Ring Sideroblasts
F. Refractory Cytopaenia with Multilineage Dysplasia
G. Myelodysplastic syndrome associated with isolated del(5q) chromosome abnormality (5q syndrome)
H. Refractory Anaemia with excess of Blasts II
I. Secondary Sideroblastic Anaemia
J. Chronic Myelomonocytic Anaemia
K. Acute Myeloid Leukaemia
H. Refractory anaemia with excess of blasts II
Refractory anemia (RA). The primary sign of RA is anemia. White blood cell counts and platelet counts are healthy. There are less than 5% blasts found in the bone marrow. This subtype of MDS does not often turn into AML.
Refractory anemia with ringed sideroblasts (RARS). People with this subtype of MDS have anemia, similar to those with RA, except more than 15% of the red blood cells are sideroblasts. A sideroblast is a red blood cell in which the iron in the cell appears to be in a ring around the center of the cell where the genes are found, called the nucleus. The white blood cell and platelet counts are usually healthy. People diagnosed with RARS have a low risk of developing AML.
Refractory cytopenia with multilineage dysplasia (RCMD). In this subtype, people have less than 5% blasts and less than 15% ringed sideroblasts in the bone marrow. The other bone marrow cells look abnormal when viewed under the microscope. At least 2 of the blood cell counts are low. RCMD may eventually turn into AML.
Refractory anemia with excess blasts (RAEB). People with RAEB can have decreases in all or some of their blood cell counts. There are less than 5% blast cells in the blood and 5% to 20% blasts in the bone marrow. People with more than 20% blasts in the bone marrow are diagnosed with AML. People with RAEB may also have lower white blood cell and platelet counts. About 40% of people diagnosed with RAEB eventually develop AML.
Myelodysplastic syndrome, unclassified (MDS-U). People diagnosed with this subtype have decreased numbers of white blood cells, red blood cells, or platelets, but do not have the specific signs of the other MDS subtypes.
MDS associated with isolated del(5q). People with this subtype have anemia and fewer than 5% blasts, and genetic material is missing from chromosome 5.
You are called to A&E to see a 65 year old man. He is complaining of fever, shortness of breath, and has lost 5Kg in the last few months. His notes say he was previously diagnosed with “Refractory Anaemia with excess Blasts in Transformation” (RAEB-t). His blast cell count is approximately 30% of all nucleated cells.
A. Refractory anaemia
B. Refractory Anaemia with excess of Blasts I
C. Myelodysplastic syndrome,unclassifiable
D. Aplastic Anaemia
E. Refractory Anaemia with Ring Sideroblasts
F. Refractory Cytopaenia with Multilineage Dysplasia
G. Myelodysplastic syndrome associated with isolated del(5q) chromosome abnormality (5q syndrome)
H. Refractory Anaemia with excess of Blasts II
I. Secondary Sideroblastic Anaemia
J. Chronic Myelomonocytic Anaemia
K. Acute Myeloid Leukaemia
K. Acute myeloid leukaemia
A 34 year old man with peripheral cytopenia suffers from bleeding gums. Peripheral blood shows 5% blast cells and bone marrow 42% blast cells.
A. Myelofibrosis
B. 5q syndrome
C. Refractory anaemia with an excess of blasts
D. Inherited aplastic anaemia
E. Refractory cytopenia with multilineage dysplasia
F. Refractory anaemia
G. Secondary aplastic anaemia
H. Idiopathic aplastic anaemia
I. Acute myeloid leukaemia
J. Juvenile myelomonocytic leukaemia
I. Acute myeloid leukaemia
A 74 year old woman with high-normal platelet count. Bone marrow aspirate shows hyperplasia of hypolobulated micromegakaryocytes. Responds well to lenalidomide.
A. Myelofibrosis
B. 5q syndrome
C. Refractory anaemia with an excess of blasts
D. Inherited aplastic anaemia
E. Refractory cytopenia with multilineage dysplasia
F. Refractory anaemia
G. Secondary aplastic anaemia
H. Idiopathic aplastic anaemia
I. Acute myeloid leukaemia
J. Juvenile myelomonocytic leukaemia
B. 5q syndrome
MDS associated with isolated del(5q). People with this subtype have anemia and fewer than 5% blasts, and genetic material is missing from chromosome 5.
A 20 year old man with hepatitis C complains of fatigue and breathlessness and bruises very easily.
A. Myelofibrosis
B. 5q syndrome
C. Refractory anaemia with an excess of blasts
D. Inherited aplastic anaemia
E. Refractory cytopenia with multilineage dysplasia
F. Refractory anaemia
G. Secondary aplastic anaemia
H. Idiopathic aplastic anaemia
I. Acute myeloid leukaemia
J. Juvenile myelomonocytic leukaemia
G. Secondary aplastic anaemia
This patients blood film shows classic Pelger-Huet neutrophils and bone marrow blasts make up 15% of cells.
A. Myelofibrosis B. 5q syndrome C. Refractory anaemia with an excess of blasts D. Inherited aplastic anaemia E. Refractory cytopenia with multilineage dysplasia F. Refractory anaemia G. Secondary aplastic anaemia H. Idiopathic aplastic anaemia I. Acute myeloid leukaemia J. Juvenile myelomonocytic leukaemia
C. Refractory anaemia with an excess of blasts
In this case haemoglobin is normal but there is a reduction in platelets and neutrophils
A. Myelofibrosis
B. 5q syndrome
C. Refractory anaemia with an excess of blasts
D. Inherited aplastic anaemia
E. Refractory cytopenia with multilineage dysplasia
F. Refractory anaemia
G. Secondary aplastic anaemia
H. Idiopathic aplastic anaemia
I. Acute myeloid leukaemia
J. Juvenile myelomonocytic leukaemia
E. Refractory cytopenia with multilineage dysplasia
A 64 year old man complains of headaches, fatigue and itchy skin, particularly evident after a hot bath. He has a long-standing history of alcohol abuse and drug history reveals that he taking thiazide diuretics. On examination, you note that he is thin with sunken eyes. A. Venesection B. Pseudopolycythaemia C. Acute myeloid leukaemia D. Erythropoeitin E. Tear drop poikilocytes F. Idiopathic myelofibrosis G. Melphalan H. Imitanib I. Haematocrit J. Splenomegaly K. Microcytosis L. Hydroxycarbamide M. Essential thrombocythaemia N. Chronic myeloid leukaemia O. Chlorambucil P. Polycythaemia vera
B. Pseudopolycythaemia
A 55 year old female has a past medical history of deep vein thrombosis. She also complains of easy bruising. Her platelet count is 770 x109/L, CRP is 4mg/L. You prescribe aspirin. A. Venesection B. Pseudopolycythaemia C. Acute myeloid leukaemia D. Erythropoeitin E. Tear drop poikilocytes F. Idiopathic myelofibrosis G. Melphalan H. Imitanib I. Haematocrit J. Splenomegaly K. Microcytosis L. Hydroxycarbamide M. Essential thrombocythaemia N. Chronic myeloid leukaemia O. Chlorambucil P. Polycythaemia vera
M. Essential thrombocythaemia
A 53 year old man goes to see his doctor about an embarrassing problem. It seems that his friends have nicknamed him ‘Rudolph’. You seem quite confused, but all becomes apparent when he points to his nose, which appears red. After further questioning, he describes a ‘burning’ sensation on his nose, hands and feet and visual disturbances. You send him for ‘blood tests’. What do you expect to be raised? A. Venesection B. Pseudopolycythaemia C. Acute myeloid leukaemia D. Erythropoeitin E. Tear drop poikilocytes F. Idiopathic myelofibrosis G. Melphalan H. Imitanib I. Haematocrit J. Splenomegaly K. Microcytosis L. Hydroxycarbamide M. Essential thrombocythaemia N. Chronic myeloid leukaemia O. Chlorambucil P. Polycythaemia vera
I Haematocrit
A consultant grills you on a ward round: there is a patient with a WBC of 140 x109/L, Hb 12 g/dL, Platelet count 320 x109/L. She complains of tiredness, night sweats, fever and abdominal pain. Her spleen is markedly enlarged. Blood film shows blasts, neutrophils, basophils. How would you treat her? A. Venesection B. Pseudopolycythaemia C. Acute myeloid leukaemia D. Erythropoeitin E. Tear drop poikilocytes F. Idiopathic myelofibrosis G. Melphalan H. Imitanib I. Haematocrit J. Splenomegaly K. Microcytosis L. Hydroxycarbamide M. Essential thrombocythaemia N. Chronic myeloid leukaemia O. Chlorambucil P. Polycythaemia vera
H. Imatanib
You are asked to see a 76 year old man on the wards, who presented with fatigue, dyspnoea, bleeding gums and nightsweats. His abdomen is massively enlarged. You read his notes and find ‘bone marrow aspirate: ‘dry tap’. What would you expect to see on the blood film? A. Venesection B. Pseudopolycythaemia C. Acute myeloid leukaemia D. Erythropoeitin E. Tear drop poikilocytes F. Idiopathic myelofibrosis G. Melphalan H. Imitanib I. Haematocrit J. Splenomegaly K. Microcytosis L. Hydroxycarbamide M. Essential thrombocythaemia N. Chronic myeloid leukaemia O. Chlorambucil P. Polycythaemia vera
E. Tear drop poikilocytes
A 64-year old woman receiving long-term chemotherapy for lymphoma presents with worsening bone pain, recurrent fever and night sweats. Blood film shows blast cells with Auer rods. A. Chronic lymphocytic leukaemia B. Acute myeloid leukaemia C. Lung fibrosis D. DIC E. Bronchial carcinoma F. Septicaemia G. Chronic myeloid leukaemia H. Acute lymphoblastic leukaemia I. Tumour-lysis syndrome J. Hairy cell leukaemia K. Hypothyroidism L. Acute promyelocytic leukaemia M. Richter's syndrome N. Vincristine poisoning
B. Acute myeloid leukaemia
A 61-year-old man with CLL presents with recurrent pneumonia and haemoptysis. On fibreoptic bronchoscopy, the patient is found to have an endobronchial mass. The biopsy shows anaplastic, large cell lymphoma. A. Chronic lymphocytic leukaemia B. Acute myeloid leukaemia C. Lung fibrosis D. DIC E. Bronchial carcinoma F. Septicaemia G. Chronic myeloid leukaemia H. Acute lymphoblastic leukaemia I. Tumour-lysis syndrome J. Hairy cell leukaemia K. Hypothyroidism L. Acute promyelocytic leukaemia M. Richter's syndrome N. Vincristine poisoning
M. Richter’s syndrome
Richter’s syndrome (RS), also known as Richter’s transformation, is a transformation of B cell chronic lymphocytic leukemia (CLL) or hairy cell leukemia into a fast-growing diffuse large B cell lymphoma.
A newly diagnosed ALL patient complains of tiredness, polyuria, polydipsia, abdominal pain and vomiting on receiving chemotherapy. On examination, BP: 160/100mmHg, temp: 39ºC, and ECG shows tented T waves. Blood test shows serum K+: 6.9mmol/L and phosphate: 7.1 mmol/L. The patient later dies of cardiac arrest. A. Chronic lymphocytic leukaemia B. Acute myeloid leukaemia C. Lung fibrosis D. DIC E. Bronchial carcinoma F. Septicaemia G. Chronic myeloid leukaemia H. Acute lymphoblastic leukaemia I. Tumour-lysis syndrome J. Hairy cell leukaemia K. Hypothyroidism L. Acute promyelocytic leukaemia M. Richter's syndrome N. Vincristine poisoning
I. Tumour lysis syndrome
A routine medical of 33-year-old footballer reveals: Hb = 9.9g/dl and WCC = 130 x 109/L. His blood film shows whole spectrum of myeloid precursors, including a few blast cells. He admits to having frequent night sweats and blurred vision. There is a presence of Ph chromosome t(9;22) on cytogenetic analysis. A. Chronic lymphocytic leukaemia B. Acute myeloid leukaemia C. Lung fibrosis D. DIC E. Bronchial carcinoma F. Septicaemia G. Chronic myeloid leukaemia H. Acute lymphoblastic leukaemia I. Tumour-lysis syndrome J. Hairy cell leukaemia K. Hypothyroidism L. Acute promyelocytic leukaemia M. Richter's syndrome N. Vincristine poisoning
G. Chronic myeloid leukaemia
A 5-year-old girl presents with failure to thrive, recurrent fever and bruising. Immunotyping reveals the presence of CD10. A. Chronic lymphocytic leukaemia B. Acute myeloid leukaemia C. Lung fibrosis D. DIC E. Bronchial carcinoma F. Septicaemia G. Chronic myeloid leukaemia H. Acute lymphoblastic leukaemia I. Tumour-lysis syndrome J. Hairy cell leukaemia K. Hypothyroidism L. Acute promyelocytic leukaemia M. Richter's syndrome N. Vincristine poisoning
H. Acute lymphoblastic leukaemia
A 6-year-old boy presents with bone pain. On examination you notice he looks pale and has many bruises. What is his diagnosis? A. Acute lymphocytic leukaemia B. Marfan’s syndrome C. Chronic lymphocytic leukaemia D. Chronic myeloid leukaemia E. Neutrophils F. Blast cells G. Down’s syndrome H. Sickle cell disease I. Magnesium exposure J. Thalassaemia K. Ionising radiation L. Acute myeloid leukaemia M. Lymphocytes
A. Acute lymphocytic leukaemia
A patient has acute lymphoblastic leukaemia. A bone marrow biopsy will show infiltration by which cells? A. Acute lymphocytic leukaemia B. Marfan’s syndrome C. Chronic lymphocytic leukaemia D. Chronic myeloid leukaemia E. Neutrophils F. Blast cells G. Down’s syndrome H. Sickle cell disease I. Magnesium exposure J. Thalassaemia K. Ionising radiation L. Acute myeloid leukaemia M. Lymphocytes
F. Blast cells
Patients with this inherited disorder have an increased risk of developing acute leukaemia. A. Acute lymphocytic leukaemia B. Marfan’s syndrome C. Chronic lymphocytic leukaemia D. Chronic myeloid leukaemia E. Neutrophils F. Blast cells G. Down’s syndrome H. Sickle cell disease I. Magnesium exposure J. Thalassaemia K. Ionising radiation L. Acute myeloid leukaemia M. Lymphocytes
G. Down’s syndrome
An environmental factor associated with acute leukaemia. A. Acute lymphocytic leukaemia B. Marfan’s syndrome C. Chronic lymphocytic leukaemia D. Chronic myeloid leukaemia E. Neutrophils F. Blast cells G. Down’s syndrome H. Sickle cell disease I. Magnesium exposure J. Thalassaemia K. Ionising radiation L. Acute myeloid leukaemia M. Lymphocytes
K. Ionising radiation
The commonest adult leukaemia. A. Acute lymphocytic leukaemia B. Marfan’s syndrome C. Chronic lymphocytic leukaemia D. Chronic myeloid leukaemia E. Neutrophils F. Blast cells G. Down’s syndrome H. Sickle cell disease I. Magnesium exposure J. Thalassaemia K. Ionising radiation L. Acute myeloid leukaemia M. Lymphocytes
C. Chronic lymphocytic leukaemia
A 50yr old man presents to his GP complaining of weight loss, tiredness, easy bruising and a painful big toe. On examination his spleen is massively enlarged. Investigation shows a raised serum urate. The peripheral blood film is abnormal, showing proliferation of which type of cell? A. Spherocytes B. Auer rods C. Reticulocytes D. Neutrophils E. Blast cells F. Chromosome 11q23 deletion G. Eosinophils H. Pelger-Huet cells I. Clonal B lymphocytes J. Platelets K. Chromosome 9;22 translocation
D. Neutrophils
A 65yr old lady is seen in the haematology clinic where she has been treated for 7 years with Imantinib for chronic myeloid leukaemia. Having been previously well, she is now complaining of shortness of breath and general weakness. Examination reveals splenomegally. Her peripheral blood film has changed from previous appointments and reflects the progression of her disease. Which type of cell is now proliferating? A. Spherocytes B. Auer rods C. Reticulocytes D. Neutrophils E. Blast cells F. Chromosome 11q23 deletion G. Eosinophils H. Pelger-Huet cells I. Clonal B lymphocytes J. Platelets K. Chromosome 9;22 translocation
E. Blast cells
A 70yr old man complains of a year’s history of fatigue, weight loss and recurrent sinusitis. His white cell count is raised with a lymphocytosis of 283x109 /L. Blood film shows features of haemolysis and Coomb’s test is positive. Further investigation show the bone marrow, blood and lymph nodes are infiltrated with which cell population? A. Spherocytes B. Auer rods C. Reticulocytes D. Neutrophils E. Blast cells F. Chromosome 11q23 deletion G. Eosinophils H. Pelger-Huet cells I. Clonal B lymphocytes J. Platelets K. Chromosome 9;22 translocation
I. Clonal B lymphocytes
A routine full blood count on a 62yr old gardener reveals a high white cell count of 154x109 /L, and the differential shows this to be a neutrophilia. The haemoglobin and platelet count are normal. Biopsy shows a hypercellular “packed” bone marrow, and cells show the presence of which chromosomal abnormality? A. Spherocytes B. Auer rods C. Reticulocytes D. Neutrophils E. Blast cells F. Chromosome 11q23 deletion G. Eosinophils H. Pelger-Huet cells I. Clonal B lymphocytes J. Platelets K. Chromosome 9;22 translocation
K. Chromosome 9;22 translocation
A 10 year old boy presenting with tan-to-grey hyperpigmented patches on his upper trunk, neck and face, nail ridges and leukoplakia. A. Hepatitis C infection B. Drug-induced C. Systemic lupus erythematosus D. Myelofibrosis E. Fanconi anaemia F. Acute myeloid leukaemia G. Dyskeratosis congenita H. Aplastic anaemia I. Parvovirus B19 infection J. Radiation-induced
G. Dyskeratosis congenita
A 60 year old female patient with the following blood results: neutrophils 0.4 x 109/l, platelets 19 x 109/l and reticulocytes 50 x109/l. A. Hepatitis C infection B. Drug-induced C. Systemic lupus erythematosus D. Myelofibrosis E. Fanconi anaemia F. Acute myeloid leukaemia G. Dyskeratosis congenita H. Aplastic anaemia I. Parvovirus B19 infection J. Radiation-induced
H. Aplastic anaemia
A 76 year old man presents to his GP with increasing tiredness, weakness and a long-standing cold. The blood results ordered by the GP showed that the gentleman was anaemic and that increased blast cells were present. A. Hepatitis C infection B. Drug-induced C. Systemic lupus erythematosus D. Myelofibrosis E. Fanconi anaemia F. Acute myeloid leukaemia G. Dyskeratosis congenita H. Aplastic anaemia I. Parvovirus B19 infection J. Radiation-induced
F. AML
An 83 year old woman presents to the A&E Departments with severe weakness and shortness of breath on minimal exertion. On examination, masses are felt in both left and right upper quadrants of the abdomen. Blood film show leukoerythroblastic cells and teardrop poikilocytes. A. Hepatitis C infection B. Drug-induced C. Systemic lupus erythematosus D. Myelofibrosis E. Fanconi anaemia F. Acute myeloid leukaemia G. Dyskeratosis congenita H. Aplastic anaemia I. Parvovirus B19 infection J. Radiation-induced
D. Myelofibrosis
A 30 year old woman with a photosensitive rash across her cheeks presents with easy bruising. A. Hepatitis C infection B. Drug-induced C. Systemic lupus erythematosus D. Myelofibrosis E. Fanconi anaemia F. Acute myeloid leukaemia G. Dyskeratosis congenita H. Aplastic anaemia I. Parvovirus B19 infection J. Radiation-induced
C. SLE
A 35 year old women complains of abdominal pain. There is associated pancytopenia, and a Ham’s test is positive. A. Paroxysmal nocturnal haemoglobinuria B. Hereditary spherocytosis C. Sepsis D. Sickle-cell disease E. Drug-induced immune haemolysis F. Spur cell anaemia G. Cardiac haemolysis H. Autoimmune haemolytic anaemia I. Gaucher's disease (glucosylceramide lipidosis) J. Haemolytic uraemic syndrome K. Hereditary elliptocytosis L. Pyruvate kinase deficiency
A. Paroxysmal nocturnal haemoglobinuria
A 62 year old male lorry driver has a blood film that shows polychromasia and macrocytosis. It emerges during consultation with one of your colleges that he had a prosthetic aortic valve fitted 5 years previously. A. Paroxysmal nocturnal haemoglobinuria B. Hereditary spherocytosis C. Sepsis D. Sickle-cell disease E. Drug-induced immune haemolysis F. Spur cell anaemia G. Cardiac haemolysis H. Autoimmune haemolytic anaemia I. Gaucher's disease (glucosylceramide lipidosis) J. Haemolytic uraemic syndrome K. Hereditary elliptocytosis L. Pyruvate kinase deficiency
G. Cardiac haemolysis
A 20 year old male develops intravascular haemolysis while undergoing treatment for syphilis (T. pallidum), which he contracted while visiting the Far East. A. Paroxysmal nocturnal haemoglobinuria B. Hereditary spherocytosis C. Sepsis D. Sickle-cell disease E. Drug-induced immune haemolysis F. Spur cell anaemia G. Cardiac haemolysis H. Autoimmune haemolytic anaemia I. Gaucher's disease (glucosylceramide lipidosis) J. Haemolytic uraemic syndrome K. Hereditary elliptocytosis L. Pyruvate kinase deficiency
E. Drug-induced immune haemolysis
A 19 year old Jewish male presenting with multiple pathological fractures and hypersplenism. A. Paroxysmal nocturnal haemoglobinuria B. Hereditary spherocytosis C. Sepsis D. Sickle-cell disease E. Drug-induced immune haemolysis F. Spur cell anaemia G. Cardiac haemolysis H. Autoimmune haemolytic anaemia I. Gaucher's disease (glucosylceramide lipidosis) J. Haemolytic uraemic syndrome K. Hereditary elliptocytosis L. Pyruvate kinase deficiency
I. Gaucher’s disease (glucosylceramide lipidosis)
A 26 year old primary school teacher presents with chronic anaemia. She has an increased (unconguated) bilirubin, and has had well controlled systemic lupus erythematosus for 7 years. A. Paroxysmal nocturnal haemoglobinuria B. Hereditary spherocytosis C. Sepsis D. Sickle-cell disease E. Drug-induced immune haemolysis F. Spur cell anaemia G. Cardiac haemolysis H. Autoimmune haemolytic anaemia I. Gaucher's disease (glucosylceramide lipidosis) J. Haemolytic uraemic syndrome K. Hereditary elliptocytosis L. Pyruvate kinase deficiency
H. Autoimmune haemolytic anaemia
A woman aged 69 with no past medical history except osteoarthritis suffered acute haemolysis after her right hip was replaced. There was no evidence of splenomegaly or lymphadenopathy and both warm and cold antibody tests were negative. When she had the left hip replaced 2 years later she again developed haemolysis soon after the anaesthetic. She was tested for IgG and IgE antibodies to the anaesthetic. Seven months later she had a revision arthroplasty and haemolysed again. Which condition might she have?
A. Paroxysmal cold haemoglobinuria
B. Autoimmune haemolytic anaemia due to infectious mononucleosis
C. Disseminated intravascular coagulation
D. Hereditary elliptocytosis
E. Primary autoimmune haemolytic anaemia
F. G6PD deficiency
G. Sepsis
H. Cephalosporin-induced haemolytic anaemia
I. Paroxysmal nocturnal haemoglobinuria
J. Hereditary spherocytosis
K. Sickle cell anaemia
H. Cephalosporin-induced haemolytic anaemia
In which condition might the sucrose and Ham acid haemolysis tests be positive?
A. Paroxysmal cold haemoglobinuria
B. Autoimmune haemolytic anaemia due to infectious mononucleosis
C. Disseminated intravascular coagulation
D. Hereditary elliptocytosis
E. Primary autoimmune haemolytic anaemia
F. G6PD deficiency
G. Sepsis
H. Cephalosporin-induced haemolytic anaemia
I. Paroxysmal nocturnal haemoglobinuria
J. Hereditary spherocytosis
K. Sickle cell anaemia
I. Paroxysmal nocturnal haemoglobinuria
Mr RX came to Fulham from Thailand last year. He has inflammatory bowel disease and is taking dapsone for his dermatitis herpetiformis. Which of the above conditions would be likely and clinically relevant?
A. Paroxysmal cold haemoglobinuria
B. Autoimmune haemolytic anaemia due to infectious mononucleosis
C. Disseminated intravascular coagulation
D. Hereditary elliptocytosis
E. Primary autoimmune haemolytic anaemia
F. G6PD deficiency
G. Sepsis
H. Cephalosporin-induced haemolytic anaemia
I. Paroxysmal nocturnal haemoglobinuria
J. Hereditary spherocytosis
K. Sickle cell anaemia
F. G6PD deficiency
A 29 year old man noticed he had yellow eyes and dark urine. He was always tired, and could not take part in sports as he easily became short of breath. There was no itching, fever or bleeding, and he was not taking any drugs. On examination he was anaemic, jaundiced, afebrile and had no palpable lymphadenopathy, hepatosplenomegaly or rash. His blood tests showed Hb 5.4g/Dl and raised WCC (40 x 109/L), bilirubin (47 µmol/l), aspartate transaminase (90iu/L) and lactate dehydrogenase (5721iu/l). The blood film showed polychromic nucleated red cells and spherocytes and the reticulocyte count was 9%. Direct Coombs’ test revealed IgG and C3 on the red cell surfaces. The serum contained a warm non-specific autoantibody (i.e. it reacted with all the red cells in the test panel). Antinuclear antibodies and rheumatoid factor tests were negative and immunoglobulin levels were normal; there were no paraprotein bands in his serum. He failed to respond to high-dose corticosteroids and had a splenectomy three weeks later.
A. Paroxysmal cold haemoglobinuria
B. Autoimmune haemolytic anaemia due to infectious mononucleosis
C. Disseminated intravascular coagulation
D. Hereditary elliptocytosis
E. Primary autoimmune haemolytic anaemia
F. G6PD deficiency
G. Sepsis
H. Cephalosporin-induced haemolytic anaemia
I. Paroxysmal nocturnal haemoglobinuria
J. Hereditary spherocytosis
K. Sickle cell anaemia
E. Primary autoimmune haemolytic anaemia
In which condition might a Donath-Landsteiner be positive?
A. Paroxysmal cold haemoglobinuria
B. Autoimmune haemolytic anaemia due to infectious mononucleosis
C. Disseminated intravascular coagulation
D. Hereditary elliptocytosis
E. Primary autoimmune haemolytic anaemia
F. G6PD deficiency
G. Sepsis
H. Cephalosporin-induced haemolytic anaemia
I. Paroxysmal nocturnal haemoglobinuria
J. Hereditary spherocytosis
K. Sickle cell anaemia
A. Paroxysmal cold haemoglobinuria
A 49 year old female complains of abdominal pain and vomiting a few minutes after the start of transfusion. O.E she is tachycardic and has facial flushing. Urinalysis reveals haemoglobinuria.
A. Viral contamination
B. Graft versus host disease
C. Bacterial contamination
D. Delayed haemolytic transfusion reaction.
E. Anaphylactic reaction
F. Iron overload
G. TRALI
H. Immediate haemolytic transfusion reaction
I. Febrile non haemolytic transfusion reaction
J. Allergic reaction
K. Fluid overload
H. Immediate haemolytic transfusion reaction
A 28 year old female presents with fever < 40 C and rigors approx. 1 ½ hours after transfusion. She has two children and previously had a blood transfusion 7 years ago.
A. Viral contamination
B. Graft versus host disease
C. Bacterial contamination
D. Delayed haemolytic transfusion reaction.
E. Anaphylactic reaction
F. Iron overload
G. TRALI
H. Immediate haemolytic transfusion reaction
I. Febrile non haemolytic transfusion reaction
J. Allergic reaction
K. Fluid overload
I. Febrile non haemolytic transfusion reaction
A 44 year old male develops a pyrexia of >40 C and marked hypotension very shortly after receiving a blood transfusion. He has never had a transfusion before and there is no evidence of ABO blood group / rhesus incompatibility.
A. Viral contamination
B. Graft versus host disease
C. Bacterial contamination
D. Delayed haemolytic transfusion reaction.
E. Anaphylactic reaction
F. Iron overload
G. TRALI
H. Immediate haemolytic transfusion reaction
I. Febrile non haemolytic transfusion reaction
J. Allergic reaction
K. Fluid overload
C. Bacterial contamination
A 78 year old man is found collapsed in his bathroom at home. Tests reveal that he is anaemic and has raised urea and creatinine levels. Over the next 24 hours he receives 3 litres of fluid and a blood transfusion. He then becomes dyspnoeic. Examination reveals a raised JVP, basal crepitations and ankle oedema
A. Viral contamination
B. Graft versus host disease
C. Bacterial contamination
D. Delayed haemolytic transfusion reaction.
E. Anaphylactic reaction
F. Iron overload
G. TRALI
H. Immediate haemolytic transfusion reaction
I. Febrile non haemolytic transfusion reaction
J. Allergic reaction
K. Fluid overload
K. Fluid overload
An 18 year old boy with sickle cell anaemia is observed to have short stature. Further tests reveal poor cardiac function
A. Viral contamination
B. Graft versus host disease
C. Bacterial contamination
D. Delayed haemolytic transfusion reaction.
E. Anaphylactic reaction
F. Iron overload
G. TRALI
H. Immediate haemolytic transfusion reaction
I. Febrile non haemolytic transfusion reaction
J. Allergic reaction
K. Fluid overload
F. Iron overload
An 18 year old African girl known to suffer from sickle cell anaemia develops a fever, sudden lethargy, pallor and arthralgia two months post-transfusion. Investigations reveal bone marrow red cell aplasia and a positive Paul-Bunnell test. A. Reaction to massive transfusion B. Air embolism C. Post-transfusion purpura (PTP) D. Allergic reaction to transfusion E. Non-haemolytic reaction F. B19 parvovirus infection G. Delayed haemolytic transfusion reaction (DHTR) H. CMV infection I. Iron overload J. Immunological haemolytic reaction K. Transfusion-related fluid overload L. Graft vs. Host disease (GvHD) M. Transfusion-related acute lung injury (TRALI)
F. B19 parvovirus infection
A 32 year old Irish man was noted to have a temperature of 36.9ºC and blood electrolyte results of: urea = 5.2 mmol/L, sodium = 144 mmol/L, potassium = 5.5 mmol/L, calcium = 2.5 mmol/L after receiving 10 units of blood over a 24 hour period. A. Reaction to massive transfusion B. Air embolism C. Post-transfusion purpura (PTP) D. Allergic reaction to transfusion E. Non-haemolytic reaction F. B19 parvovirus infection G. Delayed haemolytic transfusion reaction (DHTR) H. CMV infection I. Iron overload J. Immunological haemolytic reaction K. Transfusion-related fluid overload L. Graft vs. Host disease (GvHD) M. Transfusion-related acute lung injury (TRALI)
A. Reaction to massive transfusion
A 55 year old British female developed an itchy, diffuse erythematous rash on both arms fifteen minutes after receiving a blood transfusion. This rash responded well to acrivastine. A. Reaction to massive transfusion B. Air embolism C. Post-transfusion purpura (PTP) D. Allergic reaction to transfusion E. Non-haemolytic reaction F. B19 parvovirus infection G. Delayed haemolytic transfusion reaction (DHTR) H. CMV infection I. Iron overload J. Immunological haemolytic reaction K. Transfusion-related fluid overload L. Graft vs. Host disease (GvHD) M. Transfusion-related acute lung injury (TRALI)
D. Allergic reaction to transfusion
A 36 year old Italian gentleman presented with severe bruising across the dorsal aspect of his left arm one week post-transfusion. FBC results included: Hb = 15g/dL, platelets = 8x109/L and WBC = 5.5x109/L. A. Reaction to massive transfusion B. Air embolism C. Post-transfusion purpura (PTP) D. Allergic reaction to transfusion E. Non-haemolytic reaction F. B19 parvovirus infection G. Delayed haemolytic transfusion reaction (DHTR) H. CMV infection I. Iron overload J. Immunological haemolytic reaction K. Transfusion-related fluid overload L. Graft vs. Host disease (GvHD) M. Transfusion-related acute lung injury (TRALI)
C. Post-transfusion purpura (PTP)
A 72 year old Australian man developed a fever and jaundice five days post-transfusion. FBC revealed Hb = 9g/dL and MCV = 105fL with haemoglobinuria noted on urine dipstick testing. A. Reaction to massive transfusion B. Air embolism C. Post-transfusion purpura (PTP) D. Allergic reaction to transfusion E. Non-haemolytic reaction F. B19 parvovirus infection G. Delayed haemolytic transfusion reaction (DHTR) H. CMV infection I. Iron overload J. Immunological haemolytic reaction K. Transfusion-related fluid overload L. Graft vs. Host disease (GvHD) M. Transfusion-related acute lung injury (TRALI)
G. Delayed haemolytic transfusion reaction (DHTR)
Patient develops increasing restlessness and chest pain during blood transfusion. Haemoglobinuria is also present.
A. FNHTR – Febrile non-haemolytic transfusion reaction
B. ABO incompatible
C. Bacterial infection
D. TRALI – Transfusion related acute lung injury
E. DHTR – Delayed Haemolytic transfusion reaction
F. IgA deficiency
G. TA-GVHD – Transfusion associated graft versus host disease
H. Urticarial rash
I. Iron overload
B. ABO incompatible
Patient develops shortness of breath, dry cough and chills. Donors blood was found to contain anti-leucocyte antibodies with similar specificity to the patient’s white blood cell antigens.
A. FNHTR – Febrile non-haemolytic transfusion reaction
B. ABO incompatible
C. Bacterial infection
D. TRALI – Transfusion related acute lung injury
E. DHTR – Delayed Haemolytic transfusion reaction
F. IgA deficiency
G. TA-GVHD – Transfusion associated graft versus host disease
H. Urticarial rash
I. Iron overload
D. TRALI – Transfusion related acute lung injury
Seven days after a blood transfusion, a patient presents to A&E with jaundice and fever. They are found to have a lowered haemoglobin level.
A. FNHTR – Febrile non-haemolytic transfusion reaction
B. ABO incompatible
C. Bacterial infection
D. TRALI – Transfusion related acute lung injury
E. DHTR – Delayed Haemolytic transfusion reaction
F. IgA deficiency
G. TA-GVHD – Transfusion associated graft versus host disease
H. Urticarial rash
I. Iron overload
E. DHTR – Delayed Haemolytic transfusion reaction
Patient has a severe anaphylactic reaction soon after transfusion. Signs and symptoms include wheeze, raised pulse, low blood pressure and laryngeal oedema.
A. FNHTR – Febrile non-haemolytic transfusion reaction
B. ABO incompatible
C. Bacterial infection
D. TRALI – Transfusion related acute lung injury
E. DHTR – Delayed Haemolytic transfusion reaction
F. IgA deficiency
G. TA-GVHD – Transfusion associated graft versus host disease
H. Urticarial rash
I. Iron overload
F. IgA deficiency
Patient develops mild symptoms of fever and rigors a few days after transfusion, with a rise pulse rate.
A. FNHTR – Febrile non-haemolytic transfusion reaction
B. ABO incompatible
C. Bacterial infection
D. TRALI – Transfusion related acute lung injury
E. DHTR – Delayed Haemolytic transfusion reaction
F. IgA deficiency
G. TA-GVHD – Transfusion associated graft versus host disease
H. Urticarial rash
I. Iron overload
A. FNHTR – Febrile non-haemolytic transfusion reaction
A 21 year old male patient develops a diffuse, erythematous rash on both arms shortly after receiving a blood transfusion. The rash responded well to chlorphenamine. A. Air embolism B. Urticarial rash C. Transfursion related acute lung injury D. CMV infection E. Febrile non-haemolytic transfusion reaction F. Iron overload G. Post-transfusion purpura H. Bacterial infection I. Graft vs host disease J. ABO incompatible K. Delayed transfusion reaction L. Anaphylaxis due to IgA deficiency
B. Urticarial rash
A 28 year old female patient presents to A&E with jaundice and fever. The history revealed she had received a blood transfusion whilst giving birth seven days previously. Blood tests revealed her haemoglobin to be 9g/dL. A. Air embolism B. Urticarial rash C. Transfursion related acute lung injury D. CMV infection E. Febrile non-haemolytic transfusion reaction F. Iron overload G. Post-transfusion purpura H. Bacterial infection I. Graft vs host disease J. ABO incompatible K. Delayed transfusion reaction L. Anaphylaxis due to IgA deficiency
K. Delayed transfusion reaction
A 30 year old female patient develops red/purple spots on both legs after receiving a blood transfusion during a Caesarean section several days previously. A. Air embolism B. Urticarial rash C. Transfursion related acute lung injury D. CMV infection E. Febrile non-haemolytic transfusion reaction F. Iron overload G. Post-transfusion purpura H. Bacterial infection I. Graft vs host disease J. ABO incompatible K. Delayed transfusion reaction L. Anaphylaxis due to IgA deficiency
G. Post-transfusion purpura
A 40 year old male patient with known Sickle-Cell anaemia develops mild symptoms of fever and rigors 3 to 4 days after a transfusion. A. Air embolism B. Urticarial rash C. Transfursion related acute lung injury D. CMV infection E. Febrile non-haemolytic transfusion reaction F. Iron overload G. Post-transfusion purpura H. Bacterial infection I. Graft vs host disease J. ABO incompatible K. Delayed transfusion reaction L. Anaphylaxis due to IgA deficiency
E. Febrile non-haemolytic transfusion reaction
A 36 year old male patient develops severe shortness of breath, laryngeal oedema and hypotension shortly after receiving a blood transfusion. A. Air embolism B. Urticarial rash C. Transfursion related acute lung injury D. CMV infection E. Febrile non-haemolytic transfusion reaction F. Iron overload G. Post-transfusion purpura H. Bacterial infection I. Graft vs host disease J. ABO incompatible K. Delayed transfusion reaction L. Anaphylaxis due to IgA deficiency
L. Anaphylaxis due to IgA deficiency
A 24 year old male who was diagnosed with thalassaemia major at 13 months presents to outpatients clinic complaining of malaise and erectile dysfunction.
A. Transfusion-related acute lung injury (TRALI)
B. Bacterial contamination of transfusion
C. Transfusion haemosiderosis
D. Guthrie test
E. Delayed haemolytic transfusion reaction (DHTR)
F. Pulmonary embolism
G. Kleihauer test
H. Viral contamination of transfusion
I. Allergic reaction to forein protein in donor blood
J. Immediate haemolytic transfusion reaction
C. Transfusion haemosiderosis
