Haematology

Question 1

causes of microcytic anaemia

Answer 1

Iron deficiency
Thallasaemia
Pregnancy (secondary to iron-def)

Question 2

Causes of macrocytic anaemia

Answer 2

folate
B12
Myeloproliferative disorders
Chronic Liver disease - unable to store folate/B12

Question 3

Normocytic anaemia

Answer 3

chronic inflammation - IBD, bronchiectasis
Renal failure
liver failure
blood loss
rheumatological causes
haemolytic anaemia
malignancy

Question 4

Blood film - what are target cells associated with?

Answer 4

Thalassaemia
Liver disease
Haemoglobin C

Question 5

Pt presents with elevated methylmalonic acid and total homocysteine levels. Do they have cobalamin or folate deficiency?

Answer 5

Cobalamin deficiency - both elevated.

Folate - only homocysteine but normal methylmalonic acid

Question 6

Most cost-effective and sensitive initial screening test for haemochromotosis?

Answer 6

Transferrin saturation -

Question 7

What pretest probability scoring test is used for heparin-induced thrombocytopaenia?

Answer 7

4T score

Question 8

Pt blood results show low plts and clumping on blood film Dx?

Answer 8

Platelet clumping = Pseudothrombocytopaenia - need to retest blood using heparin or citrated tubes.

Question 9

Does a low probability Wells score + negative D-dimer rule out a DVT?

Answer 9

Yes

Question 10

First test for Dx a possible PE in a pregnant woman?

Answer 10

Lower limb US - negates the need for chest imaging if positive

Question 11

Indication for IVC filter?

Answer 11

Pt’s with proximal leg or pelvic DVT that are unable to be anti-coagulated due to high risk of bleeding or active bleeding

Question 12

What is CA125 a marker for and what is its sensitivity for screening?

Answer 12

Tumour marker for ovarian Ca - shit 3% predictive value for screening.
Is used in Pt’s beng treated for ovarian Ca as a measure of disease activity.

Question 13

If the cancer is small volume widely metastatic but Pt assymptomatic, is this a good prognostic sign?

Answer 13

NO. Treat as aggressively as possible

Question 14

What is the appropriate imaging modality for indolent neuroendocrine tumours?

Answer 14

Triple phase contrast-enhanced CT or MRI with gadolinium

Question 15

management for a patient with an incidental

finding of a metastatic low-grade carcinoid tumor that is asymptomatic and hormonally nonfunctional?

Answer 15

Observation w repeat imaging several times a year

Question 16

Which pathogen is gastric MALT cancer associated and initial therapy for it?

Answer 16

H pylori.

2x ABx and PPI

Question 17

How accurate are the tumour markers CA 19-9, 15-3, 125 in identifying cancer of unknown origin?

Answer 17

Very poor. Almost never diagnostic

Question 18

IN which patients are platelet growth factors (thrombopoietin) reserved?

Answer 18

immune-mediated thrombocytopaenia

chemo-mediated Pt’s get plt transfusion