Haematology

Question 1

Heinz bodies

Answer 1

G6PD def, a thalassaemia

Question 2

Howell Jones bodies

Answer 2

Hyposplenism

Question 3

Target Cells

Answer 3

sickle cell
thalassaemia
IDA
hyposplenism
liver diseaese

Question 4

Tear drop

Answer 4

Myelofibrosis

Question 5

Basophilic stippling

Answer 5

lead poisoning
thalassaemia
sideroblastic anaemia
myelodysplasia

Question 6

Helmet cells

Answer 6

schistocytosis
intravascular haemolysis
mechanical heart valve

Question 7

Burr cells

Answer 7

uraemia

pyruvate kinase disease

Question 8

polikilocytes

Answer 8

pencil

IDA

Question 9

hypersegmented neutrophils

Answer 9

megaloblastic anaemia

Question 10

Sideroblastic anaemia

Answer 10

x linked/ acquired
iron accumulation in mitochondria > bad haem synthesis > ring of iron around nucleas > Perls reaction
|> hyperchromic cells
Tx pyridoxine (B6)

Question 11

sickle cell tx

Answer 11

hydroxycarbamide

Question 12

thalassaemia tx

Answer 12

folate supplements
desferrioximine/ ascorbic acid (iron chelators)
Blood transfusion 2-4 weeks
splenectomy
cure - marrow transplant

Question 13

subacute combined degeneration of the cord

Answer 13

posterior (dorsal) column loss
Extensor plantars (UMN) • Absent
knee and ankle jerks (LMN)
ataxia, joint position and vibration sensing

Question 14

LMWH

Answer 14

factor Xa I
heparininduced
thrombocytopenia (HIT), osteoporosis with long-term use, hyperkalaemia.

Question 15

Heparin overdose

Answer 15

protamine sulphate

Question 16

more common form of acute leukaemia in adults

Answer 16

AML

Question 17

80% of childhood leukaemias

Answer 17

ALL

Question 18

Poor prognostic factors ALL

Answer 18

boys
adult
ph chromosome

Question 19

ph chromosome

Answer 19

CML

Question 20

Tx CML

Answer 20

imatinib

inhibitor of the tyrosine kinase associated with the BCR-ABL defect

Question 21

most common adult leukemia

Answer 21

CLL

Question 22

Richter’s transformation

Answer 22

transformation CLL > high grade lymphoma

Question 23

smudge cells/ smear cells

Answer 23

CLL

Question 24

Reed sternberg cells

Answer 24

mirror image nuclei

Hodgkins

Question 25

c-myc gene translocation

Answer 25

Burkitt's lymphoma | starry sky'

Question 26

dx amyloidosis

Answer 26

congo red stain with red green bi refringence

Question 27

dx paraproteinaemia

Answer 27

monoclonal band electrophoresis

Question 28

myeloma

Answer 28

``` bone marrow tumour proliferation of plasma cells > bone marrow failure increased of a ig > G Bence Jones proteins - urine serum electrophoresis - monoclonal band 70 yrs Tx - bisphosphonates ```

Question 29

protein electrophoresis > 50, back pain

Answer 29

myeloma

Question 30

Tamm Hors fall protein -

Answer 30

light chain deposits kidneys in myeloma

Question 31

Jak 2

Answer 31

Essential polycythaemia

Question 32

Polycythaemia vera: management

Answer 32

aspirin venesection - first line treatment hydroxyurea -slight increased risk of secondary leukaemia phosphorus-32 therapy

Question 33

Essential thrombocytosis

Answer 33

overlaps with CML, polycythaemia rubra vera and myelofibrosis. Megakaryocyte proliferation > overproduction of platelets. burning sensation in the hands JAK2 mutation ~ 50%

Question 34

Essential thrombocytosis Management

Answer 34

hydroxyurea (hydroxycarbamide) - reduce platelet count interferon-α - younger patients low-dose aspirin may be used to reduce the thrombotic risk

Question 35

Hyposplenism

Answer 35

Howell Jones bodies Pappenheimer bodies Target cells

Question 36

Haemophilia

Answer 36

A- 8 B-9 Increased APTT Give factor 8. 15% develop antibodies.

Question 37

Hodgkin's Lymphoma

Answer 37

Reed sternberg cells Alcohol painful nodes Staging ann arbour AVBD

Question 38

Haemophilia A

Answer 38

Factor 8 Prolonged APTT X linked recessive Haemarthrosis,

Question 39

VWD

Answer 39

3 types: 1 - 80%, AD 3 - AR Prolonged bleeding time, sometimes APTT tranexamic acid for mild bleeding desmopressin (DDAVP): raises levels of vWF