Haematology

Question 1

68-year-old male with 1-day history of progressive left leg swelling. Patient’s Well’s score is 1, what is the most appropriate management?

Answer 1

Arrange a D-dimer

Question 2

What biochemical pattern do you see in myeloma?

Answer 2

• High calcium
• Normal phosphate
• Normal alkaline phosphate

Myeloma:
C - elevated calcium 
R - renal failure 
A - anaemia 
B - bone pain

Question 3

What symptom is the most concerning in a transfusion reaction?

Answer 3

Hypotension

Suggests stopping the transfusion

Question 4

What is the transfusion threshold in patients without ACS?

Answer 4

70 g/L

80g/L in patients with ACS

Question 5

8-year-old boy with fatigue and excess sleep. Bloods show microcytic anaemia with raised reticulocytes and bilirubin. What is the most likely diagnosis?

Answer 5

B-thalassaemia

Question 6

How to manage children and young people (0-24y) with unexplained petechiae or hepatosplenomegaly?

Answer 6

Immediate specialist referral for leukaemia

Question 7

What electrolyte imbalance can be caused by large volume transfusions?

Answer 7

Hyperkalaemia

Hypocalcemia

Question 8

Markers seen in tumour lysis syndrome?

Answer 8

Massive destruction of cells

• Hyperkalaemia
• Increased urate
• Renal injury