Heamtology

Question 1

Signs of anemia

Answer 1

Pallor

Hyperdynamic circulation: severe anemia HB

Question 2

Signs of iron defficancy anemia

Answer 2

Kolioncychia - spoon shaped nails
Angular stomatitis/Chelosis
Post cricoid webs

Question 3

Cause of microcytic anemia

Answer 3

FAST 
fe defficancy 
Anemia of chronic disease 
Siderobalstic anemia - lead poisining 
Thallesemia

Question 4

Cause of normocytic anemia

Answer 4

Acute blood loss, bone marrow failure, renal failure, heamolysis, hypothyroidism, pregnancy

Question 5

Cause of macrocytic anemia

Answer 5

Megoloblastic 
- Vit b12 or folate defficancy 
-anti-folate drugs 
-cytotoxic 
Non - megloblastic 
- reticulocytois - heamolysis 
- alcohol and liver disease 
- hypothyroidism 
- myelodysplasia

Question 6

Cause of iron defficancy anemia

Answer 6

1. Blood loss - GI, gyne, Hookworms, urinary tract
2. Increased utilisation: pregnancy
3. Decreased intake: prem,
4. Decreased absorption: coleiac, chrons, post gastric surgery

Question 7

Clinical features of b12 defficancy

Answer 7

Lemon tinge: pallor and mild jaundice
Glossitis - beefy red tongue
Neuro: paresthesia, peripheral neuropathy, optic atrophy, subacute combined degeneration of the cord

Question 8

What is pernicious anemia

Answer 8

Autoimmune atrophic gastritis caused by auto-antibodies to parietal cells or Intrisic factor

Question 9

APTT

Answer 9

Test intrinsic and common pathway

High - lupus, haemophilia, vWD, unfractionared heparin

Question 10

PT

Answer 10

Test extrinsic and common pathway

Increased in warfin/ Vit k defficancy, hepatic failure, DIC

Question 11

Bleeding time

Answer 11

Platlet function

Question 12

Definition of anemia

Answer 12

HB: men under 13.5g/l, women under 11.5g/L

Question 13

Thrombin time

Answer 13

Finrinogen function

Question 14

Causes of platelet dysfucntion

Answer 14

Decreased production e.g. BM failure
Increased destruction: ITP, SLE
Functional defect: acquired - drugs,

Question 15

Indication for a thrombophillia screen

Answer 15

Aterial thrombosis under 50 
Venous thrombosis under 40 with no risk factors 
Familial VTE 
Unexplained recurrent VTE 
Unsual site of thrombosis 
Recurrent foetal loss

Question 16

What is multiple myeloma

Answer 16

Clonal proliferation of plasma cells

Can produce monoclonal Ig

Question 17

Clinical features of multiple myeloma

Answer 17

Calcium: thirst, groans, moans, stone, bones
Renal failure: Amyloidosis, nephrotic syndrome
Anemia
Bones - bone pain and pathological fracture

Question 18

X-Ray feature of multiple myeloma

Answer 18

Punched out lytic lesions
Pepper pot skull
Vetebral collapse
Fracture

Question 19

What is essential thrombocytopenia

Answer 19

Myeloproflierative disorder where megakaryocytes dominate the bone marrow

Question 20

Amyloidosis

Answer 20

Group of disorder characterised by extra cellular deposits of a protein in a normal fibrillar form that is resistant to degradation