Haematology

Question 1

Haemophilia A

Answer 1

Causes hemarthrosis without trauma

Question 2

VTE

Answer 2

Anticoagulate with warfarin for 3 months is provoked and 6 months if unprovoked

Question 3

Burkitt lymphoma

Answer 3

Starry sky appearance on lymph node biopsy

Question 4

Sequestration crisis

Answer 4

Occurs in sickle cell anaemia and causes splenomegaly with abdominal pain

Question 5

Beta-thalassaemia trait

Answer 5

• microcytic anaemia
• raised HbA2
• lethargy

Question 6

C-myc translocation

Answer 6

Genetic change in Burkitt’s lymphoma

Question 7

Antiphospholipid syndrome

Answer 7

• prolonged APTT
• history of VTE, PE and miscarriage
• elevated anticardiolipin antibody

Question 8

Antiphospholipid syndrome (pregnancy)

Answer 8

Anticoagulate with aspirin and enoxaparin

Question 9

Irradiated blood products

Answer 9

Used to avoid transfusion-associated graft vs host disease

Question 10

Tranaxamic acid

Answer 10

When given in major haemorrhage give IV bolus and then slow infusion

Question 11

Blood transfusion

Answer 11

Give if haemodynamically unstable or Hb is less than 70g/L

Question 12

Neutropenic sepsis

Answer 12

Empirical treatment with piperacillin and tazobactam

Question 13

Blood transfusion complications

Answer 13

• iron overload
• ARDS
• hyperkalaemia
• clotting abnormalities
• febrile reaction

Question 14

Multiple myeloma

Answer 14

Rain drop skill or pepperpot skull seen on imaging

Question 15

Disseminated intravascular dissemination

Answer 15

Give fresh frozen plasma

Question 16

Vitamin B12 deficiency

Answer 16

Causes macrocytic anaemia

Question 17

G6PD

Answer 17

• pallor
• jaundice
• haemolytic anaemia
• previous URTI
• Heinz bodies

Question 18

Multiple myeloma

Answer 18

Typically causes hypercalcaemia, pancytopenia and AKI

Question 19

Reed-Sternberg cells

Answer 19

Have mirror image nuclei and are seen in Hodgkin’s lymphoma

Question 20

Stage two Hodgkin’s lymphoma

Answer 20

Tow or more lymph nodes on the same side of the diaphragm

Question 21

Philadelphia chromosome

Answer 21

t(9;22) associated with CML

Question 22

Idarucizumab

Answer 22

Reversible agent for dabigatran

Question 23

Hereditary spherocytosis

Answer 23

-jaundice, fatigue and splenomegaly in haemolytic crisis

Question 24

Cryoprecipitate

Answer 24

Given in major haemorrhage when the fibrinogen level is low

Question 25

Sickle cell anaemia

Answer 25

Normocytic anaemia with Howell-Jolly bodies

Question 26

Autoimmune haemolytic anaemia

Answer 26

Can be caused by SLE

Question 27

DVT in pregnancy

Answer 27

Tend to give subcutaneous low molecular weight heparin

Question 28

Tumour lysis syndrome

Answer 28

Can give allopurinol or rasburicase prior to chemo to reduce the risk

Question 29

Platelet transfusion

Answer 29

High risk of bacterial contamination compared to other blood products

Question 30

Non-haemolytic febrile transfusion syndrome

Answer 30

Pause transfusion and assess for risk and if safe give IV paracetamol and continue

Question 31

Coeliac disease

Answer 31

Can cause target cells and Howell-Jolly bodies due to hyposplenism

Question 32

Polycythaemia rubra vera

Answer 32

Around 5-15% progress to myelofibrosis or AML

Question 33

Beta thalassaemia

Answer 33

Microcytic, hypochromic anaemia - basophilic stippling - occasional target cells

Question 34

Lead poisoning

Answer 34

- gastrointestinal and neuropsychiatric symptoms - anaemia - blue line on gum margin

Question 35

Aplastic crisis

Answer 35

Seen in sickle cell disease often related to parvovirus infection

Question 36

Haemophilia A

Answer 36

Factor VIII associated with 90% of all haemophilia

Question 37

Acute haemolytic transfusion reaction

Answer 37

Combs test | -RBC destruction by IgM

Question 38

Dabigatran

Answer 38

Direct thrombin inhibitor

Question 39

Won willebrands disease

Answer 39

- prolonged bleeding time - normal platelet count - prolonged APTT

Question 40

Factor V Leiden

Answer 40

Also known as activated protein C resistance and the most common inherited thrombophilia

Question 41

Antiphospholipid syndrome

Answer 41

History of clotting and bleeding | -need aspirin and LMWH in pregnancy