MLA Haematology

Question 1

Which medication is the first line treatment for DVT?

Answer 1

DOAC
1st line: apixaban or rivaroxaban
If unsuitable, use LMWH

Question 2

What is a thrombophilia screen?

Answer 2

Includes tests for:
- Deficiencies in antithrombin, protein c, and protein s
- Factor V Leiden and prothrombin gene mutations
- Lupus anticoagulant/ antiphospholipid

Question 3

How is anaemia managed?

Answer 3

Test ferritin levels and determine underlying cause of anaemia
- Refer urgently if cancer is suspected
- Treat with OD ferrous sulphate, ferrous fumarate, or ferrous gluconate for 3 months after deficiency is corrected

Question 4

What is disseminated intravascular coagulation?

Answer 4

Abnormal clotting throughout the body
- Causes clot formations and bleeding causing long-term organ damage

Happens due to sepsis, cancer, pancreatitis

Question 5

What are the complications of haemochromatosis?

Answer 5

• Liver cirrhosis
• Diabetes due to pancreas damage
• Cardiac congestions and arrhythmias
• Arthritis
• Erectile dysfunction and menstrual changes
• Bronze/grey skin
• Osteoporosis
• Increased risk of infection

Question 6

What causes haemochromatosis?

Answer 6

A recessive gene

Question 7

What is a haemoglobinopathy?

Answer 7

Diseases that affect the structure of haemoglobin

Eg. Sickle cell anaemia, thalassaemia

Most common type of genetic defect because they protect against malaria

Question 8

What are the different types of haemophilia?

Answer 8

A: most common. Factor 8 deficiency
B: Factor 9 deficiency
C: Very rare. Factor 11 deficiency

Treated with factor replacement, prophylactic medications, antifibrinolytics, infusions

Question 9

What are the complications of a splenectomy?

Answer 9

• Increased risk of clots
• High risk of severe infections like streptococcus pneumoniae and neisseria meningitidis

Question 10

What are the subtypes of lymphoma?

Answer 10

B-cell lymphomas:
- Diffuse large B-cell (most common)
- Follicular
- Mantle cell (aggressive)
- Burkitt (most aggressive)

T-cell lymphomas:
- Peripheral T-cell (aggressive)
- Anaplastic (Aggressive)
- Hepatosplenic
- Extra nodal

Question 11

What’s a myeloproliferative disorder?

Answer 11

Disorders of bone marrow that increase the number of blood cells

Eg.
- Chronic myeloid leukaemia (CML)
- Polycythaemia vera
- Essential thrombocythemia
- Primary myelofibrosis

Question 12

What are the causes of pancytopenia?

Answer 12

• Bone marrow issues
• Infections like Epstein-Barr, CMV, HIV
• Haematological cancers
• nutritional deficiencies
• Meds that suppress the bone marrow eg. chemotherapy, NSAID’s, antibiotics, diuretics, antipsychotics
• Toxins
• Pregnancy

Question 13

What is the difference between anticoagulant and antiplatelet therapy?

Answer 13

• Anticoagulants slow down process of blood clot formation Eg. heparin or warfarin
• Antiplatelet prevent platelet clumping which prevents clots eg. aspirin or clopidogrel

Question 14

What’s the pathophysiology of polycythaemia vera?

Answer 14

AKA erythrotosis

Primary
- Genetic mutation of defect in the bone marrow

Secondary
- Natural response to low oxygen levels due to high altitudes, COPD, congenital heart disease, cancers

Question 15

What is the clinical presentations of a PE?

Answer 15

SOB, chest pain, dizziness, cough, cyanosis, sweating

Non-specific ECG: sinus tachycardia, t wave inversions, axis deviations

Question 16

What is the management post PE?

Answer 16

Long-term DOAC
Pulmonary exercises
Risk evaluations

Question 17

What is prescribed as prophylaxis for sickles cell patients?

Answer 17

Penicillin prophylaxis
Hydroxycarbamide (increases foetal Hb)
Offer elective blood transfusions

Stem cell transplant for children