Haematology and Oncology

Question 1

Tumour markers for medullary thyroid cancer

Answer 1

Calcitonin

Question 2

Tumour marker for hepatocellular carcinoma

Answer 2

Alpha fetoprotein

Question 3

Pathological diagnosis of Hogdkin’s Lymphoma

Answer 3

Lymph node biopsy

Question 4

Most common paediatric malignancy

Answer 4

ALL (Hepatosplenomegaly, lymphadeopathy, fatigue, joint pain, infections, bruising)

Question 5

What should be measured to make a diagnosis of haemophilia?

Answer 5

Factor IX activity levels

Question 6

Troisier’s sign

Answer 6

Weight loss, fatigue, palpable left supraclavicular node (Virchow’s node) = Gastric carcinoma

Question 7

Tumours that often metastasise to the bone

Answer 7

Lung, prostate, kidney, thyroid and breast

Question 8

Symptoms assoicated with poor prognosis in lymphoma

Answer 8

B symptoms: night sweats, weight loss, fever

Question 9

Treatment of methotrexate induced folic acid deficiency

Answer 9

Folinic acid

Question 10

80 year old man, tired, megaloblastic anaemia, raised bilirubin

Answer 10

Pernicious anaemia

Question 11

Indications for mastectomy

Answer 11

DCIS, patient request, large tumour in small breast, tumour at nipple

Question 12

Prophylactic management in babies diagnosed with sickle cell

Answer 12

Prophylactic Pen V from 3 months and 5 yearly pneumococcal vaccinations

Question 13

Most likely place of metastasis for the following cancers:
a) Osteosarcoma
b) Colorectal
c) Breast

Answer 13

a) Lung
b) Liver
c) Bone

Question 14

Investigation for spherocytosis

Answer 14

Osmotic fragility

Question 15

Basophilic stippling, a sign of….

Answer 15

Lead poisoning

Question 16

Nausea, vomiting, blackout, dark urine, which ‘hormone’ tumour?

Answer 16

Small cell lung ca

Question 17

Pentad of TTP

Answer 17

Fever, AKI, cerebral dysfunction (confusion etc), thrombocytopenia, microangiopathic haemolytic anaemia

Question 18

Which malignancy is staged on the Clark or Breslow scale?

Answer 18

Melanoma

Question 19

What is considered the single most important factor for predicting survivial and prognosis in MM?

Answer 19

Beta-2 microglobulin (increased levels = poor prognosis)

Question 20

Patient with multiple myeloma. What initial scan to look for osteolytic lesions should be ordered?

Answer 20

Whole body low dose CT scan

Question 21

First line treatment for CLL if there is a 17p deletion or TP53 mutation?

Answer 21

Acalabrutinib
If no 17 p deletion then treat with FCR or BR

Question 22

First line treatment for CML?

Answer 22

Imatinib

Question 23

10 year old with haemophilia A hits head, GCS of 9. Next most important next step in management?

Answer 23

Immediate administration of factor 8

Question 24

Clonal proliferation of immature myeloid cells called blasts?

Answer 24

AML