Haematology COPY

Question 1

t(9;22) translocation

1. Name of resultant chromosome
2. Associated Disease
3. Resultant Protein

Answer 1

t(9;22) - Philadelphia chromosome

present in > 95% of patients with CML

BCR-ABL gene

Treat with tyrosine kinase inhibitors such as Imatinib!

Question 2

t(15;17) translocation

Answer 2

Seen in APML (Acute ProMyelocitic Leukaemia)

Question 3

t(8;14) translocation

Answer 3

Burkitt’s Lymphoma

Question 4

t(11;14) translocation

Answer 4

Mantle Cell Lymphoma

Question 5

Massive Splenomegaly = ? (Haem answer)

Answer 5

CML or Myelofibrosis

Non Haem:

Visceral Leishmaniasis (Kala-azar)

Malaria

Question 6

Post Splenectomy pathogens = ?

Answer 6

Encapsulated bacteria:

Haemophilus Influenzae

Streptococcus pneumoniae

Meningococcus

Question 7

DVT scoring system = ?

Answer 7

Wells score

Question 8

Polycythaemia Rubra Vera mutation = ?

Answer 8

JAK2 - also first line test

Question 9

Bence Jones Protein (BJP) in the urine = ?

Answer 9

Multiple Myeloma - symptoms = CRAB

(Can be Waldenström’s macroglobulinemia - Signs and symptoms of WM include LYMPHADENOPATHY + SPLENOMEGALY, weakness, fatigue, weight loss and chronic oozing of blood from the nose and gums.)

Question 10

Heinz bodies on blood film (inclusions within RBCs) = ?

Answer 10

G6PD

Question 11

Howell - Jolly bodies (purple spot of nuclear remnants in RBC)

Answer 11

Post-splenectomy or severe hyposplenism (e.g. sickle cell)

Also megaloblastic anaemia

Question 12

Donath-Landsteiner antibodies

Answer 12

Paroxysmal cold haemoglobinuria

Question 13

APTT monitors heparin or warfarin?

Answer 13

Heparin - Intrinsic Pathway

Question 14

PT monitors heparin or warfarin?

Answer 14

Warfarin - Extrinsic Pathway

Question 15

Heparin antidote?

Answer 15

Protamine Sulphate

Question 16

Auer Rods = ?

Answer 16

AML

Question 17

“Starry Sky” appearance - histology = ?

Answer 17

Burkitt’s Lymphoma

Question 18

JAK2 mutation = ?

Answer 18

Polycythaemia rubra vera

Question 19

Aquagenic pruritus

Answer 19

Polycythaemia rubra vera

Question 20

Smear cell

Answer 20

CLL

Question 21

Teardrop dacrocyte

Answer 21

Myelofibrosis

Question 22

Osmotic fragility

Answer 22

Hereditary spherocytosis

Question 23

Ham’s test

Answer 23

Paroxysmal nocturnal haemoglobinuria

Question 24

Hypersegmented neutrophils

Answer 24

Megaloblastic Anaemia

Question 25

Cabot rings

Answer 25

Megaloblastic Anaemia

Question 26

Schistocytes

Answer 26

Microangiopathic haemolytic anaemia (MAHA)

Question 27

'Dry' / 'Bloody tap' on BM aspirate

Answer 27

Myelofibrosis

Question 28

Low FVIII with nosebleeds / gum bleeding

Answer 28

VwD

Question 29

Maculopapular rash after transfusion

Answer 29

GVHD

Question 30

Tartrate-resistant acid phosphatase (TRAP)

Answer 30

Hairy cell leukaemia

Question 31

Reed-Sternberg cells

Answer 31

Hodgkin's lymphoma

Question 32

Centrocytes + Centroblasts on blood film

Answer 32

Follicular lymphoma (14;18)

Question 33

Monocytosis of >1000/mm3

Answer 33

Chronic myelo-monocytic leukaemia

Question 34

Severe headache + ESR >60

Answer 34

Temporal arteritis

Question 35

Test for Hereditary Spherocytosis

Answer 35

Osmotic fragility test

Question 36

MAHA Fever Renal Failure CNS Signs (hallucinations / headaches etc) Haematuria Low platelets

Answer 36

TTP (MARCH with low platelets)

Question 37

Non classical hodgkins lymphoma

Answer 37

Nodular lymphocytic leukaemia

Question 38

Drug to treat CML

Answer 38

Imatinib

Question 39

Mech of action of imatinib

Answer 39

Tyrosine Kinase inhibitor

Question 40

Prolonged bleeding post dental surgery

Answer 40

VwD

Question 41

Most common type of Hodgkin's lymphoma

Answer 41

Nodular Sclerosing (70%) Good prognosis

Question 42

Felty's syndrome =

Answer 42

Neutropenia + splenomegaly with underlying long-standing rhuematoid arthritis

Question 43

How long should warfarin therapy be continued? 1. Provoked (e.g. recent surgery) 2. Unprovoked

Answer 43

1. 3 months | 2. 6 months

Question 44

Management of DVT

Answer 44

1. Low molecular weight heparin (LMWH) or fondaparinux should be given ASAP after a DVT is diagnosed 2. a vitamin K antagonist (i.e. warfarin) should be given within 24 hours of the diagnosis 3. Continue LMWH for 5 days 4. Continue warfarin for 3 - 6 months

Question 45

Investigation of DVT

Answer 45

If a DVT is 'likely' (2 points or more) a proximal leg vein ultrasound scan should be carried out within 4 hours and, if the result is negative, a D-dimer test if a proximal leg vein ultrasound scan cannot be carried out within 4 hours a D-dimer test should be performed and low-molecular weight heparin administered whilst waiting for the proximal leg vein ultrasound scan (which should be performed within 24 hours) If a DVT is 'unlikely' (1 point or less) perform a D-dimer test and if it is positive arrange: a proximal leg vein ultrasound scan within 4 hours if a proximal leg vein ultrasound scan cannot be carried out within 4 hours low-molecular weight heparin should be administered whilst waiting for the proximal leg vein ultrasound scan (which should be performed within 24 hours)

Question 46

anti-Cardiolipin antibody

Answer 46

antiphospholipid syndrome

Question 47

Warfarin target INR

Answer 47

VTE = 2.5, if recurrent 3.5 | Atrial fib = 2.5

Question 48

Genetic translation associated with Burkitt's lymphoma

Answer 48

C-myc gene

Question 49

Most common inherited thrombophilia

Answer 49

FV Leiden

Question 50

Most common inherited bleeding disorder

Answer 50

VwD

Question 51

Rate limiting enzyme in haem synthesis

Answer 51

ALA synthase