Haematology & Oncology

Question 1

Causes of iron deficiency

Answer 1

Poor intake
Malabsorption
Blood loss

Question 2

Anaemia range

Answer 2

Neonate <140
>12 mnth <100
1-12<110

Question 3

Main forms of sickle cell

Answer 3

HbSS-Homozygous for HbS - SIckle cell
HbSC
Sickle cell b-thalassaemia

Question 4

Brain tumours in children

Answer 4

Astrocytoma (~40%) – varies from benign to highly malignant (glioblastoma multiforme).
• Medulloblastoma (~20%) – arises in the midline of the posterior fossa. May seed through the CNS via the CSF and up to 20% have spinal metastases at diagnosis.
• Ependymoma (~8%) – mostly in posterior fossa where it behaves like medulloblastoma.
• Brainstem glioma (6%) – malignant tumours associated with a very poor prognosis.
• Craniopharyngioma (4%) – a developmental tumour arising from the squamous remnant of Rathke pouch. It is not truly malignant but is locally invasive and grows slowly in the suprasellar region.
• Atypical teratoid/rhabdoid tumour – a rare type of aggressive tumour that most commonly occurs in young children.

Question 5

Hodgkin Lymphoma clinical features

Answer 5

Painless lymphdenopathy

Symptoms are for months and can be systemic

Question 6

Tx of hodgkin lymphoma

Answer 6

Chemotherapy with or without radiotherapy

Question 7

Non hodgkin lymphoma clinical features

Answer 7

Presents like hodgkin or all

May have mediastinal mass or intestinal obstruction if abdomen involved.

Question 8

Neuroblastoma clinical features

Answer 8

Abdominal mass
Over 2 years symptoms like metastatic diseases
ie. bone pain, bone marrow suppression causing weight pain and malaise

Question 9

Wilms Tumour CF

Answer 9

Nephroblastoma w/ abdominal mass before 5 years

Haematuria

Question 10

Haemophilia

Answer 10

A bleeding disorder, usually inherited, characterised by the deficiency of coagulation factor VIII or IX.

Occurs almost exclusively in males due to an X-linked pattern of inheritance.

Graded as mild, moderate, or severe, based on factor VIII or IX level.

Musculoskeletal bleeding is the most common type of haemorrhage.

Treatment consists of coagulation factor VIII or IX replacement.

Question 11

Haemophilia A vs B

Answer 11

Factor VIII (A), Factor IX (B)

Question 12

Tx of Haemophilia

Answer 12

A- Recombinant FVIII
B-Recombinant FVIX
For whenever there is a bleed

Question 13

Complications of haemophilia

Answer 13

Reduce or inhibit effect of tx due to Ab treatment

Risk of infection: HIV, Hep A,B,C, Prions

Question 14

Von Willebrand disease CF

Answer 14

Bruising
Excessive bleeding after surgery
Mucosal bleeding such as epistaxis and menorrhagia

Question 15

vWD treatment

Answer 15

Type 1 -DDVAP (caution for under 1 risk of hyponatraemia and water retention)
More severe types of vWD have to be treated with plasma-derived FVIII concentrate

Question 16

Thrombocytopenia

Answer 16

Platelet count <150
Mild 50-150
Moderate 20-50
Severe <20

Question 17

ITP

Answer 17

Most common cause of thrombocytopenia in children (Aged 2-10 years). Diagnosis of exclusion

Question 18

Febrile neutropenia

Answer 18

Febrile neutropenia is defined as a fever >38°C (>101°F) for 1 hour, with neutrophil less than 1x10*9

Question 19

common people to have febrile neutropenia

Answer 19

Children who have had chemotherapy for malignancy