Haematology

Question 1

For example, do not perform platelet transfusion for any of the following conditions:
CHAT

Answer 1

For example, do not perform platelet transfusion for any of the following conditions:
Chronic bone marrow failure
Autoimmune thrombocytopenia
Heparin-induced thrombocytopenia, or
Thrombotic thrombocytopenic purpura.

Question 2

– can precipitate renal failure in patients with multiple myeloma

Answer 2

NSAIDs can precipitate renal failure in patients with multiple myeloma

Question 3

In chronic myeloid leukaemia there is an increase in – at different stages of maturation +/- –

Answer 3

In chronic myeloid leukaemia there is an increase in granulocytes at different stages of maturation +/- thrombocytosis

Question 4

Irradiated blood products are used as they are depleted in T-lymphocytes

Answer 4

Irradiated blood products are used as they are depleted in T-lymphocytes

Question 5

Situation CMV negative or Irradiated

Granulocyte transfusions
Intra-uterine transfusions
Neonates up to 28 days post expected date of delivery
Pregnancy: Elective transfusions during pregnancy (not during labour or delivery)
Bone marrow / stem cell transplants
Immunocompromised (e.g. chemotherapy or congenital)
Patients with/previous Hodgkins Disease
HIV

Answer 5

Situation CMV negative Irradiated
Granulocyte transfusions ✓ ✓
Intra-uterine transfusions ✓ ✓
Neonates up to 28 days post expected date of delivery ✓ ✓
Pregnancy: Elective transfusions during pregnancy (not during labour or delivery) ✓ CMV negative
Bone marrow / stem cell transplants ✓ Irradiated
Immunocompromised (e.g. chemotherapy or congenital) ✓ Irradiated
Patients with/previous Hodgkins Disease ✓Irradiated
HIV

Question 6

Tamoxifen increases the risk of – + —

Answer 6

Tamoxifen increases the risk of VTE + endometrial cancer

Question 7

Hodgkin’s lymphoma: histological classification and prognosis

Hodgkin’s lymphoma is a malignant proliferation of lymphocytes characterised by the presence of the –
It has a bimodal age distributions being most common in the third and seventh decades

Histological classification

Type Frequency Prognosis Notes
Nodular sclerosing Most common (around 70%) Good prognosis More common in women. Associated with lacunar cells
Mixed cellularity Around 20% Good prognosis Associated with a large number of Reed-Sternberg cells
Lymphocyte predominant A*round 5% Best prognosis
Lymphocyte depleted Rare Worst prognosis

Answer 7

Type Frequency Prognosis Notes

Nodular sclerosing
More common in –. Associated with – cells

Mixed cellularity
Associated with a large number of –cells

Lymphocyte predominant

Lymphocyte depleted

Question 8

Platelet transfusion for thrombocytopenia before surgery or an invasive procedure. 
Aim for plt levels of:
> --×109/L for most patients
--×109/L if high risk of bleeding
>--×109/L if surgery at critical site

Answer 8

Aim for plt levels of:
> 50×109/L for most patients
50-75×109/L if high risk of bleeding
>100×109/L if surgery at critical site

Question 9

Myelofibrosis is associated with –on blood film

Answer 9

‘tear drop’ poikilocytes