haematology_flashcards
The risk of thrombosis is increased by:
Reduced protein C
Which factor confers the highest risk of thrombosis?
Factor V Leiden
Which agent has a delayed anticoagulant effect?
Warfarin
How does warfarin achieve its anticoagulant effect?
Reduce plasma procoagulant factors
Which patient is most likely to benefit from long-term anticoagulation after a DVT?
77yo man after hip replacement
What is the most appropriate 1st line treatment for a 33yo man with a PE?
Therapeutic LMWH
What is the most appropriate next step for a 67yo man with DVT and a week history of weight loss on apixaban?
Perform an abdo-pelvic CT
What should you do for a 34yo woman with DVT after removal of ovarian cyst and a family history of DVT?
Continue long term anticoagulation
What should you do for a 29yo man who collapsed at work following a PE with no family history?
Test for Factor V Leiden
What should you do for a 38yo woman who had a previous DVT while taking COCP and a 2nd DVT during her 2nd pregnancy?
Continue long term anticoagulation
What are the most likely lab test results for a 22-year-old male with cyanotic congenital heart disease, Hb 210g/l, Haematocrit 60%, and no splenomegaly?
JAK2 wildtype + raised EPO
Name two haematological cancers causing massive hepato-splenomegaly with no lymphadenopathy
Myelofibrosis, CML
What is the diagnosis for Hb 140 (normal), WCC 120 x10^9 (high), Platelets 300 x10^9 (normal), Neutrophils, basophils, myelocytes in peripheral blood, and 3% blasts in bone marrow?
Chronic phase CML
Ph translocation BCR-ABL1 rearrangement is oncogenic via:
Novel fusion oncoprotein
Regarding lymphoma aetiology, which statement is NOT true?
Chronic EBV infection is linked to adult T cell leukaemia / lymphoma
In certain NHL subtypes, chromosome translocations involving a proto-oncogene are seen. Which statement is NOT true?
Follicular NHL: BCR-ABL1
Lymph node biopsy shows Reed Sternberg cells with a background of chronic inflammatory cells and eosinophils. What is the diagnosis?
Hodgkin lymphoma
What is the most likely subtype of cHL for a 22-year-old female with mediastinal mass?
Nodular sclerosis
What Ann Arbor Stage is cHL with disease involving mediastinum, spleen, and liver?
Stage 4
Which NHL sub type is appropriate for monitoring only in asymptomatic small volume disease?
Follicular lymphoma
What is the immunophenotype of a normal peripheral blood B-lymphocyte?
CD3-, CD5-, CD19+
Who has the worst prognosis in CLL?
IgHV unmutated and TP53 mutated
What does Venetoclax do in CLL treatment?
Blocks BCL2 protein
What sort of transfusion reaction would occur if a blood group O RhD positive patient was transfused A RhD negative red cells?
Delayed haemolytic reaction
Where should you label the blood tube?
Patients bedside
Why is autografting preferred over allografting for treating myeloma?
Transplant related mortality after allografting is unacceptably high in most patients with myeloma
What is the strongest prognostic factor for chronic GvHD?
Prior acute GvHD
Which is true about Cytomegalovirus reactivation?
Is more common in CMV seropositive compared to seronegative
How do newborn babies differ from adults in haematological terms?
A higher Hb
Which complication of sickle cell anaemia is more common in adults than children?
Stroke
What is the likely diagnosis for siblings with sickle cell anaemia presenting simultaneously with severe anaemia and a low reticulocyte count?
Parvovirus B19 infection
What is the likely diagnosis for a 6yo Afro-Caribbean boy with chest and abdominal pain, Hb 63 g/l, MCV 85fl, and blood film showing sickle cells?
Sickle cell anaemia
What is the most likely diagnosis for a 1-year-old boy with joint bleeding, normal Hb, WBC, and platelet count, prolonged aPTT, normal PT, and normal bleeding time?
Haemophilia A
What is the most likely diagnosis for an 83yo man with lymphocytosis, smear cells, normal Hb, and normal platelets?
Chronic lymphocytic leukaemia
What is the most likely diagnosis for a 67yo woman with facial plethora, smoker, high RBC, Hb, PCV, WBC, neutrophil count, basophil count, and platelets?
Polycythaemia vera
What test would you do next to confirm the diagnosis for a 67yo woman with high RBC, Hb, PCV, WBC, neutrophil count, basophil count, and platelets?
Molecular analysis for JAK2 mutation
How would you treat a patient with polycythaemia vera?
Venesection plus hydroxycarbamide
Which result falls within the normal reference range?
Platelet count 273 x 10^9/L
Which statement about MDS is true?
One third of MDS patients can be expected to die from leukaemic transformation
Which statement about Aplastic Anaemia is true?
The cure rate of AA treated by sibling-related allogeneic stem cell transplantation in a patient under 40 years old is > 70%.
Which statement about idiopathic aplastic anaemia and dyskeratosis congenita is true?
Telomeric shortening is a feature of both idiopathic aplastic anaemia and dyskeratosis congenita
What happens to haematological parameters during normal pregnancy?
Platelet count falls
What happens to coagulation during pregnancy?
Result in a leading cause of maternal mortality
What is true about venous thromboembolism during pregnancy?
Is more common in women with high BMI
Which statement is correct about thrombocytopenia during pregnancy?
The platelet count may fall following delivery in baby’s born to mothers with ITP
What has contributed to a reduction in pregnancy associated thrombosis mortality rate?
Improved targeted thromboprophylaxis
Which statement is correct about postpartum haemorrhage (PPH)?
Uterine atony is a common cause of PPH
