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Step 1 > Haematology and Oncology > Flashcards

Haematology and Oncology Flashcards

1
Q

Source of energy in RBC

A

Glucose

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2
Q

How glucose is used in RBCs

A

90% glycolysis, 10% HMP shunt

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3
Q

How do RBCs transport CO2?

A

Use Cl/HCO3 transporter

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4
Q

Anisocytosis

A

varying sizes

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5
Q

Poikilocytosis

A

varying shapes

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6
Q

Lifespan of thrombocyte

A

8-10 days

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7
Q

Dense granules of thrombocytes

A

ADP, Ca

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8
Q

alpha granules of thrombocytes

A

vWF, fibrinogen, fibronectin

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9
Q

What proportion of platelets are stored in the spleen?

A

1/3

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10
Q

vWB receptor

A

GpIb

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11
Q

Fibrinogen receptor

A

GpIIb/IIIa

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12
Q

Granulocytes

A

neutrophil, eosinophil, basophil (BEN)

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13
Q

Mononuclear cells

A

Monocytes, lymphocytes

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14
Q

Order of WBCs from most to least pneumonic

A

Neutrophils Like Making Everything Better

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15
Q

Multilobed nucleus, leukocyte alkaline phosphatase, lysozyme, lactoferrin

A

Neutrophil

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16
Q

Lysosome =

A

azurophilic granules

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17
Q

lysosomes in neutrophils contain

A

proteinases, acid phosphatase, myeloperoxidase, B-glucuronidase

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18
Q

Hypersegmented neutrophil

A

B12/ folate deficiency

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19
Q

Band cell

A

immature neutrophil

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20
Q

Neutrophil chemotaxis agents

A

C5a, IL-8, LTB4, kallikrein, PAF

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21
Q

Frosted glass cytoplasm

A

monocyte

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22
Q

Activation of monocyte –> mpg

A

gamma-interferon

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23
Q

Mpg as antigen presenting

A

MHC II

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24
Q

Initiation of septic shock

A

Lipid A from bacterial LPS binds CD14

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25
Q

bilobate nucleus

A

eosinophil

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26
Q

what are eosinophils good for?

A

antigen-antibody complexes

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27
Q

produes histaminase + major basic protein

A

eosinophils

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28
Q

Causes of eosinophilia

A

NAACP

Neoplasia, asthma, allergy, chronic adrenal insufficiency, parasites

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29
Q

Mediates allergic reaction

A

basophil

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30
Q

WBC containing heparin and histamine

A

basophil

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31
Q

leukotrienes

A

basophils

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32
Q

job of mast cells

A

allergic reaction in local tissues

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33
Q

what do mast cells contain?

A

basophilic granules

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34
Q

Binds Fc of IgE to membrane

A

Mast cell

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35
Q

WBC involved in type I hypersensitivity

A

Mast cell

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36
Q

What prevents mast cell degranulation?

A

cromolyn sodium

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37
Q

What does mast cell degranulation release?

A

histamine, heparin, tryptase, eosinophil chemotactic factors

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38
Q

Link between innate and adaptive immune systems

A

dendritic cell

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39
Q

Dendritic cells express

A

MHC class II

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40
Q

Dendritic cell on the skin

A

Langerhans cells

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41
Q

Adaptive immunity

A

B and T cells

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42
Q

NK cells as part of the

A

innate immune presonse

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43
Q

round densely staining nucleus with small amount of pale cytoplasm

A

lymphocyte

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44
Q

Antigen presenting using B cell

A

MHC II

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45
Q

cytotoxic T cells

A

express CD8, MHC I

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46
Q

helper T cells

A

express CD4, MHC II

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47
Q

Regulatory T cells express

A

CD28

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48
Q

clock face refers to

A

plasma cell chromatin

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49
Q

eccentric nucleus, abundant RER, well developed golgi

A

plasma cells

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50
Q

erythropoesis yolk sac

A

yolk sac - 3 - 8 weeks
liver - 6 weeks-birth
spleen - 10-28 weeks
marrow - 18 weeks on

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51
Q

embryonic globin

A

zeta and epsilon

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52
Q

HbF

A

a2y2

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53
Q

Why does HbF have a higher affinity for O2?

A

less avid binding of 2,3-BPG

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54
Q

Universal RBC recipient

A

AB

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55
Q

Universal RBC donor

A

O

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56
Q

Rh hemolytic disease of the newborn

A

Maternal anti-D Rh IgG molecules

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57
Q

erythroblastosis fetalis

A

haemolytic disease of the newborn

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58
Q

Why would a woman have anti-D IgG?

A

previously exposed to Rh+ve blood

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59
Q

Rx haemolytic disease of the newborn

A

anti-D IgG in 3rd trimester

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60
Q

ABO hemolytic disease of the newborn presents as

A

Early jaundice

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61
Q

When does ABO haemolytic disease of the newborn occur?

A

Type O mother with type A, B or AB fetus

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62
Q

Hb electrophoresis direction

A

+ve to -ve

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63
Q

Hb electrophoresis positions

A

Animal food seems classy

Adult, fetus, sickle, HbC

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64
Q

action of bradykinin

A

vasodilation, permeability, pain

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65
Q

stimulation of bradykinin

A

HMWK from factor XII activation

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66
Q

extrinsic pathway

A

VII

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67
Q

Intrinsic pathway

A

XII, XI, IX, VIII

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68
Q

Factor I

A

fibrinogen

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69
Q

Factor II

A

prothrombin

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70
Q

active vitamin K

A

reduced

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71
Q

vitamin K deficiency

A

II, VII, IX, X, protein C, protein S

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72
Q

what does activated protien C do?

A

cleaves and inactivates Va and VIIIa

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73
Q

what does plasminogen do?

A

fibrinolysis

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74
Q

How does factor V leiden work?

A

factor V is resistant to protein C

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75
Q

how does heparin work?

A

enhances the activity of antithrombin

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76
Q

weibel-palade bodies of endothelial cells

A

vWF (also a-granules of platelets)

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77
Q

what coagulation factor is released by platelets?

A

TXA2

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78
Q

how does aspirin work?

A

inhibits TXA2 synthesis by inhibiting cyclooxygenase

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79
Q

how to clopidogrel, prasugrel and ticlopidine work?

A

inhibit ADP-induced expression of GpIIb, IIIa

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80
Q

How do abciximab, eptifibatide and tirofiban work?

A

Inhibit GpIIb/IIIa

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81
Q

Ristocetin failure

A

vWF disease, Bernard-Soulier syndrome

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82
Q

spur cell

A

liver disease, abetalipoproteinemia

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83
Q

basophilic stippling

A

lead poisoning, sideroblastic anaemia, myelodysplastic syndromes

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84
Q

teardrop cell =

A

dacrocyte

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85
Q

bite cell =

A

degmacyte

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86
Q

Burr cell/ echinocyte

A

end stage renal disease, liver disease, pyruvate kinase deficiency

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87
Q

heireditary elliptocytosis

A

mutation in RBC membrane proteins

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88
Q

macro-ovalocyte

A

megaloblastic anaemia, marrow failure

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89
Q

Ring sideroblast from

A

excess iron in mt

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90
Q

schistocyte

A

think shit has hit the fan

DIC, TTP/HUS, HELLP, mechanical haemolysis

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91
Q

spherocyte

A

drug and infection induced haemolytic anaemia

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92
Q

target cell

A

HALT

HbC disease, asplenia, liver disease, thalasaemia

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93
Q

Heinz bodies due to

A

oxidation of -SH to S-S

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94
Q

Howell-Jolly bodies

A

asplenia/ hyposplenia

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95
Q

what are howell-jolly bodies?

A

basophilic nuclear remnants

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96
Q

Microcytic anaemia

A

Iron deficiency, ACD, thalassemia, lead poisoning, sideroblastic anaemia

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97
Q

Normocytic anaemia - non haemolytic

A

iron deficiency, ACD, aplastic, CKD

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98
Q

Normocytic anaemia - haemolytic, intrinsic

A

RBC membrane defect, enzyme deficiency, HbC disease, paroxysmal nocturnal haemoglobinuria, sickle cell

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99
Q

Normocytic anaemia - haemolytic, extrinsic

A

autoimmune, microangiopathic, macroangiopathic, infection

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100
Q

macrocytic anaemia - megaloblastic

A

folate, B12, orotic aciduria

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101
Q

macrocytic anaemia - non-megaloblastic

A

liver disaese, alcohol, diamond-blackfan anaemia

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102
Q

hydrops fetalis

A

Hb Barts (4 gamma chains)

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103
Q

inhibits ferrochelatase and ALA dehydratase

A

Lead

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104
Q

symptoms of Lead poisoning

A

Lead lines
Encephalopathy, erythrocyte basophilic stippling
Abdo colic, sideroblastic anaemia
Drop of wrist and foot

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105
Q

Rx lead poisoning

A

dimercaprol

EDTA

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106
Q

X linked defect delta-ALA gene

A

sideroblastic anaemia

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107
Q

sideroblastic anaemia

A

defect in haem synthesis

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108
Q

acquired sideroblastic anaemia

A

alcohol, lead, B6 deficiency, copper deficiency, isoniazid

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109
Q

Rx sideroblastic anaemia

A

B6

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110
Q

cause of megaloblastic anaemia

A

impaired DNA synthesis - nucleus and cytoplasm mature at different rates

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111
Q

drugs causing folate deficiency

A

methotrexate, trimethoprim, phenytoin

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112
Q

diphyllobothrium lactum

A

fish tapeworm

B12 deficiency

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113
Q

Schilling test

A

B12 deficiency

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114
Q

raised homocysteine, methylmalonic acid

A

B12 deficiency

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115
Q

Orotic aciduria

A

can’t convert orotic acid to UMP

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116
Q

Rx orotic aciduria

A

uridine monophosphate

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117
Q

Diamod-Blackfan anaemia

A

defect in erythroid progenitor cell

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118
Q

triphalangeal thumbs

A

Diamond-Blackfan anaemia

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119
Q

Difference between megaloblastic and non megaloblastic

A

nonmegaloblastic will have NO hypersegmented neutrophils

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120
Q

how to tell if hemolysis is intra or extra vascular

A

only intravascular decreases haptoglobins

121
Q

anaemia of chronic disease

A

hepcidin binds ferroportin inhibiting iron transport

122
Q

where is ferroportin found?

A

mucosal cells, mpgs

123
Q

decreased iron + TIBC, increased ferritin

A

anaemia of chronic disease

124
Q

aplastic anaemia

A

destruction/ failure of myeloid stem cells

125
Q

viruses causing aplastic anaemia

A

B19, EBV, HIV, hepatitis

126
Q

Fanconi anaemia

A

DNA repair defect –> marrow failure

127
Q

cafe-au-lait spots, short, thumb/ radial defects

A

Fanconi anaemia

128
Q

splenomegaly, aplastic crisis

A

hereditary spherocytosis

129
Q

back pain, hemoglobulinuria after stress

A

G6PDH deficiency

130
Q

hemolytic anaemia in the newborn

A

pyruvate kinase deficiency

131
Q

HbC mutation

A

glutamic acid –> lysine

132
Q

complement mediated intravascular RBC lysis

A

Paroxysmal nocturnal haemoglobulinuria (PNH)

133
Q

coombs negative haemolytic anaemia, pancytopaenia, venous thrombosis

A

PNH

134
Q

Rx PNH

A

eculizumab

135
Q

proportion of african americans carrying HbS allele

A

8%

136
Q

Warm autoimmune hemolytic anaemia

A

IgG

137
Q

Warm anaemia causes

A

SLE, CLL, methyldopa

138
Q

Cold autoimmune haemolytic anaemia

A

IgM and complement

139
Q

Cold anaemia causes

A

CLL, m.pneumoniae infections, mono

140
Q

Coombs +ve

A

autoimmune hemolytic anaemia

141
Q

Microangiopathic anemia is

A

damaged RBCs from passing through obstructed/ narrow vessel

142
Q

causes of microangiopathic anaemia

A

DIC, TTP/HUS, SLE, malignant htn

143
Q

macroangiopathic anemia

A

mechanical RBC destruction

144
Q

TIBC

A

Transferrin

145
Q

Ferritin

A

primary iron storage protein

146
Q

neutropenia value

A

< 1500

147
Q

severe neutropenia

A

< 500

148
Q

lymphopenia

A

<1500

< 3000 kids

149
Q

eosinopenia

A

< 30

150
Q

lymphopaenia

A

HIV, DiGeorge, SCID, SLE, GCs, radiation, sepsis, post-op

151
Q

neutropenia

A

sepsis, chemo, aplastic anaemia, SLE, radiation

152
Q

eosinopenia

A

cushing syndrome, GCs

153
Q

leukoerythroblastic reaction

A

more immature RBCs due to severe anaemia, marrow response

154
Q

porphyrias

A

condition of defective heme synthesis

155
Q

Porphobilinogen deaminase

A

Acute intermittent porphyria

156
Q

Abdo pain, port wine urine, polyneuropathy, psych disturbance

A

acute intermittent porphyria

157
Q

drugs precipitating acute intermittent porphyria

A

cytochrome p-450 inducers, alcohol starvation

158
Q

Rx acute intermittent porphyria

A

glucose + heme

159
Q

uroporphyrinogen decarboxylase

A

porphyria cutanea tarda

160
Q

tea coloured urine

A

porphyria cutanea tarda

161
Q

blistering cutaneous photosensitivity

A

porphyria cutanea tarda

162
Q

nausea, vomiting, gastric bleed, lethargy, scarring –> GI obstruction

A

Fe poisoning

163
Q

Iron chelation agents

A

Deforoxamine, defasirox

164
Q

PT

A

extrinsic

165
Q

INR calculated from

A

PT

166
Q

Haemophilia B

A

IX

167
Q

Rx haemophilia

A

desmopressin + factor concentrate

168
Q

low GpIIb/IIIa

A

Glanzmann thrombasthenia

169
Q

Bernard-Soulier syndrome

A

large plt, low GpIb, platelets don’t bind to vWF

170
Q

thrombocytopenia, microangiopathic hemolytic anemia, acute renal failure

A

HUS

171
Q

Rx HUS

A

plasmaphoresis

172
Q

Immune thrombocytopenia

A

anti-GpIIb/IIIa

viral

173
Q

Rx immune thrombocytopenia

A

steroids, IVIG, splenectomy

174
Q

inhibition of ADAMTS 13

A

TTP

175
Q

neuro and renal symptoms, fever, thrombocytopenia, microangiopathic hemolytic anemia

A

TTP

176
Q

Rx TTP

A

plasmapheresis, steroids

177
Q

how does desmopression affect coagulation?

A

releases vWF from endothelial stores

178
Q

Causes of DIC

A

Sepsis, trauma, obstetric, pancreatitis, malignancy, nephrotic syndrome, transfusion

179
Q

Protein C/S deficiency

A

can’t inactivate Va and VIIIa (vWB)

180
Q

antithrombin

A

inhibits factors IIa and Xa

181
Q

acquired antithrombin deficiency

A

renal failure, nephrotic syndrome

182
Q

Reed-Sternberg cells

origin

A

Hodgkins
Owl eyes/ avocado
CD15 + CD30 + B cell

183
Q

lymphoma > 55yr male

A

Hodgkin

184
Q

lymphoma associated with EBV

A

Hodgkins, Burkitt’s

185
Q

which lymphomas have B symptoms?

A

Hodgkins

186
Q

lymphoma associated with HIV and autoimmune

A

Non-Hodgkins

187
Q

t(8:14)

A

Burkitt’s

188
Q

starry sky, tingible body mpg

A

Burkitt’s

189
Q

lymphoma endemic in Africa

A

Burkitt’s

190
Q

Most common adult NHL

A

Diffuse large B cell

191
Q

t(14:18) is, affects

A

Follicular

Bcl-2

192
Q

waxing and waning lymphadenopathy

A

follicular lymphoma

193
Q

t(11:14) - called, is, affects

A

mantle cell, cyclin D1 Ig heavy chain, adult males

194
Q

Lymphoma associated with HIV/AIDS

A

primary central nervous system lymphoma

195
Q

HTLV

A

T cell lymphoma

196
Q

HTLV populations

A

Japan, West Africa, Caribbean

197
Q

T cell lymphoma presentation

A

lytic bone lesions, hypercalcaemia

198
Q

skin plaques in adults

A

Mycosis fungoides

199
Q

Multiple myeloma normally procudes

A

IgG or IgA

200
Q

Multiple myeloma epectrophoresis

A

M spike at Beta and gamma

201
Q

Rouleaux

A

Myeloma

202
Q

hypercalcaemia, renal issue, anaemia, bone lytic lesions

A

myeloma

203
Q

What apart from myeloma has an M spike?

A

Waldenstrom macroglobulinaemia

204
Q

Pseudo-Pelger-Huet anomaly

when is it seen?

A

neutrophils with biolbed nuclei

post chemo

205
Q

T cell ALL presentation

A

medaistinal mass

206
Q

ALL associated with

A

Down’s syndrome

207
Q

TdT

A

pre-T and B cells

208
Q

CD10

A

pre-B cells

209
Q

t(12;21)

A

good in ALL

210
Q

CLL think

A

crushed little lymphocytes

211
Q

Richter transformation

A

CLL –> diffuse large b cell lymphoma

212
Q

Hairy cell leukaemia is, who gets it

A

mature B cell tumour

adult males

213
Q

Rx Hairy cell leukaemia

A

cladribine, pentostatin

214
Q

Auer rods

A

AML

215
Q

myeloperoxidase +ve

A

AML

216
Q

RF for AML

A

chemo, radiation, myeloproliferative disorders, Down’s syndome

217
Q

t(15:17)

A

AML associated with Down’s syndrome

218
Q

t(9:22)

A

CML

219
Q

blast crisis

A

CML –> AML/ALL

220
Q

Rx CML

A

tyrosine kinase inhibitors - imatinib

221
Q

child with lytic bone lesions, skin rash, recurring otitis media

A

langerhans cell histiocytosis

222
Q

S-100 expression, CD1a

A

Langerhans cell histiocytosis

223
Q

Birbeck granules

A

Langerhans cell histiocytosis

224
Q

JAK2 mutation

A

chronic myeloproliferative disorders

225
Q

polycythaemia

A

increased hematocrit

226
Q

severe itching after warm water

A

polycythaemia rubra vera

227
Q

polycythaemia Rx

A

aspirin

228
Q

proliferation of megakaryocytes and platelets

A

essential thrombocythemia

229
Q

mechanism of heparin

A

lowers activity of thrombin and factor Xa

230
Q

S.E heparin

A

bleeding, thrombocytopaenia, osteoporosis, drug-drug interactions

231
Q

protamine sulfate

A

heparin antidote

232
Q

LMW-heparin

A

enoxaparin, fondaparinux

233
Q

enoxaparin benefit

A

longer half life, better bioavailability

234
Q

heparin induced thrombocytopenia

A

IgG antibodies against Plt factor 4

235
Q

Bivalirudin

is, use, s.e

A

direct thrombin inhibitor
AF, VTE
bleeding

236
Q

S.E Warfarin

A

bleeding, tetarogenic, tissue necrosis, drug inteactions,

237
Q

Rivaroxaban

A

Bind directly to Xa

238
Q

Alteplase, streptokinase

A

conversion of plasminogen to plasmin

239
Q

reversal of thrombolytics

A

aminocaproic acid

240
Q

clopidogrel, ticagrelor, riclopidine

A

Block ADP receptors, prevent GpIIb/IIIa expression

241
Q

Cilostazol, dipyridamole is, use, s.e

A

phosphodiesterase III inhibitor, inhibits plt addregation
intermittent claudication, angina, stroke/TIA prevention
headache, facial flushing, hOtn, abdo pain

242
Q

S.E. ticlopidine

A

neutropenia

243
Q

s.e. abciximab

A

bleeding, thrombocytopaenia

244
Q

Azathioprine is

A

purine analog

245
Q

metabolite of azathioprine

A

6-MP

246
Q

Azathioprine use

A

preventing organ rejection, RA, IBD, SLE

247
Q

Careful when prescribing azahtioprine with

A

allopurinol or febuxostat (xanthine oxidase)

248
Q

Cladribine is, use, s.e

A

purine analog - inhibits DNA polymerase, DNA strand breaks
ahiry cell
myelosupression, nephrotoxicity, neurotoxicity

249
Q

Cytarbine

A

pyramidine analog

inhibits DNA polymerase

250
Q

Rx with cytarabine

A

AML, lymphoma

s.e myelosuppession with megaloblastic anaemia

251
Q

use of 5-flurouracil

A

colcon ca, oancreatic ca, basal cell ca

252
Q

careful use of 5-flurouracil

A

leucovorin (folinic acid)

253
Q

methotrexate

A

folic acid analog

254
Q

use of methotrexate

A

ALL, lymphoma, choriocarcinoma, sarcoma, ectopic pregnancy, abortion, RA, psoriasis, IBD, vasculitis

255
Q

s.e. methotrexate

A

myelosupression, hepatotoxicity, mucositis, pulmoary fibrosis

256
Q

reversal of methotrexate myelosupressoin

A

leucovorin

257
Q

bleomycin is, use, s.e

A

breaks DNA strands
testicular ca., HL
pulmonary fibrosis, skin hyperpigmentation

258
Q

dactinomycin is, use

A

intercalates in DNA

wilms tumour, ewing sarcoma, rhabdomyosarcoma

259
Q

doxorubicin use, s.e

A

generates free radicals breaking DNA
solid tumours, leukaemia, lymphoma
dilated cardiomyopathy, alopecia

260
Q

how can cardiotoxicity with doxorubicin be stopped?

A

dexrazozane - iron chelation

261
Q

busulfan is, use, s.e.

A

cross links DNA
CML, ablates bone marrow
pumlonary fibrosis, hyperpigmentation, myelosupression

262
Q

Cyclophosphamide, ifosfamide

A

gross links DNA at guanine N-7

263
Q

use ifosfamide s.e

A

solid tumours, leukaemia, lymphoma

haemorrhagic cystitis

264
Q

how to prevent haemorrhagic cystitis

A

mensa

265
Q

nitrosoureas

A

carmustine, lomustine, semustine, streptozocin

266
Q

what is different about nitrosoureas?

A

cross link DNA in the CNS

267
Q

S.E nitrosoureas

A

cns toxicity

268
Q

paclitaxel is, use, s.e

A

stops anaphase
ovarian + breast ca
neuropathy, hypersensitivity

269
Q

vincristine, vinblastine

A

prevent mitotic spindles

270
Q

use vincristine

A

solid tumours, leukaemia, NHL

271
Q

vinblastine

A

solid tumours, leukaemia, HL

272
Q

vincristine s.e.

A

neurotoxicity, constipation

273
Q

cisplatin is, use, s.e.

A

cross links DNA
testicular, bladder, ovary ,lung carcinoma
nephrotoxicity, peripheral neuropathy, ototoxicity

274
Q

give with cisplatin

A

amifostine, chloride

275
Q

etoposide is, use, s.e

A

inhibits topoisomerase II
solid tumours - testicular, small cell, leukaemia, lymphoma
alopecia

276
Q

irinotecan, is, use, s.e.

A

inhibit topoisomerase I
colon ca., ovarian, small cell
diarrhoea

277
Q

hydroxyurea does, for

A

inhibits ribonucleotide reductase

melanoma, CML, sickle cell

278
Q

general s.e. of cancer drugs

A

myelosupression

279
Q

bevacizumab

A

mab against VEGF

280
Q

use bevacizumab, s.e

A

colorectal, renal carcinoma

hemorrhage, blood clots, impaired wound healing

281
Q

erlotinib is, use, s.e

A

EGFR tyrosine kinase inhibitor
non-small cell
rash

282
Q

cetuximab, is, use, s.e

A

ECGF
IV colon ca (KRAS), head and neck ca
rash, elevated LFTs, diarrhoea

283
Q

imatinib use, s.e

A

CML, GI stromal tumours

fluid retention

284
Q

rituximab is, use, s.e.

A

against CD20
NHL, CLL, ITP, RA
multifocal leukoencephalopathy

285
Q

Tamoxifen, raloxifene

A

E R modulator

286
Q

use raolxifene

A

prevent OP, breast ca

287
Q

tamoxifen s.e.

A

risk of endometrial ca, hot flashes, PE, DVT

288
Q

raolxefine s.e.

A

PE, DVT

289
Q

Herceptin is, use, s.e.

A

trastuzumab
breast/gastric ca
cardiotoxicity

290
Q

vemurafenib, is, use

A

inhibits BRAF oncogene

metastatic melanoma

291
Q

hydroxyurea in sickle cell

A

increases HbF

used in a crisis

292
Q

sickle cell increases infection from

A

encapsulated organisms - s.pneumoniae

293
Q

salmonella osteomyelitis

A

sickle cell

294
Q

cerebriform nuclei

A

Mycosis fungoides

295
Q

Mycosis fungoides

A

cutaneous T cell lymphoma from CD4+ cells

296
Q

nosebleeds + petichiae

A

immune thrombocytopaenic purpura

297
Q

venous thrombosis + anaemia + pancytopaenia

A

Paroxysmal nocturnal haematuria

298
Q

what type of anaemia is seen in paroxysmal nocturnal haematuria?

A

coombs negative autoimmune haemolytic anaemia

299
Q

deficiency in CD59 and CD55

A

PNH - haemolysis by complement

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