Misc

Question 1

What blood film changes are most frequently seen after splenectomy (5)?

Answer 1

1) Howell Jolly bodies (nuclear remnant)
2) Target cells
3) Heinz Bodies (Denatured haemoglobin)
4) Pappenheimer bodies (Iron deposits)
5) Spurr cells (Acanthocytes)

Reticulocytosis

Question 2

What are the types of Necrotisng fasciitis?

Answer 2

Type 1 - polymicrobial
Type 2 (15%) - Isolated pathogen, mostly Strep pyogenes
Type 3 - gas gangrene - clostridium perfringens

Question 3

What are the metabolic manifestations of Refeeding syndrome (4)?

Answer 3

Hypophosphataemia
Hypokalaemia
Hypomangesaemia
Abnormal fluid balance

Question 4

How is Hodkins Lymphoma staged?

Answer 4

Ann Arbor staging system
1 - single lymph node region
2 - 2+ same side of diaphragm
3 - both sides of diaphragm
4 - extra nodal sites

Question 5

What are the characteristic histology findings of Actinomycetaceae infections?

Answer 5

• Gram positive anaerobe

- ‘Suphur granules’ - colonies appearing as round or oval basophilic masses

Question 6

What are the serology findings of acute and chronic Hep B infections?

Answer 6

Acute = HBsAg+ve  Anti-HBs -ve, AntiHBc IgM+
Chronic = HBsAg+ve  Anti-HBs -ve, AntiHBc IgG+

Question 7

Which anaesthetic agent characteristically causes adrenal suppression?

Answer 7

Etomidate

Question 8

How should patients at risk of refeeding syndrome be managed?

Answer 8

Start at 10kcal/kg/day build up over 4-7 days

Coadminister Oral thiamine, Vit B Co Strong and supplements
Give additional K+ (2-4mmol/kg), Phosphate (0.3-0.6mmol/kg) and Magnesium (0.2-0,4mmol/kg)

Question 9

Which subtypes of Hodgkins lymphoma carry the worst and best progosis?

Answer 9

Lymphocyte rich classical (Best)
Lymphocyte depleted (Worst)

Others - Nodular sclerosing, mixed cellularity