MRCP Haematology

Question 1

Microcytic anaemia, raised HbA2 (>3.5%)

Answer 1

Beta thalassaemia trait

Question 2

Two main complications of polycythaemia vera

Answer 2

Thrombosis and bleeding

Question 3

Bleeding prophylaxis in patient with vWD

Answer 3

DDAVP (desmopressin) and tranexamic acid

Question 4

Two commonest causes of gross splenomegaly

Answer 4

CML, myelofibrosis

Question 5

Blood film seen in myelofibrosis

Answer 5

Leucoerythroblastic cells, tear drop cells

Question 6

Anaemia & marrow biopsy showing fatty bone marrow

Answer 6

Aplastic anaemia

AI attack against haematopoietic stem cells

Question 7

Intensity and duration of anticoagulation in antiphospholipid syndrome?

Answer 7

INR 2-3, lifelong

Question 8

What vitamin helps with the absorption of oral iron?

Answer 8

Vitamin C

Reduces iron from ferric to ferrous form

Question 9

Empirical treatment of neutropaenic sepsis

Answer 9

Tazocin (piperacillin & tazobactam)

Question 10

Red cells showing osmotic fragility

Answer 10

Hereditary spherocytosis

Question 11

Underlying cause of haemolysis in G6PD deficiency

Answer 11

Reduced levels of NADPH

Question 12

APTT & PT in anti-phospholipid syndrome

Answer 12

APTT prolonged

PT NORMAL

Question 13

Tissue sampling required to make diagnosis of lymphoma

Answer 13

Lymph node extraction & biopsy.

FNA not adequate!

Question 14

Tests for determining prognosis in myeloma

Answer 14

Albumin and B2-microglobulin

Question 15

What surface receptor is the target for immunotherapy in lymphoma?

Answer 15

CD20

Question 16

Best test to confirm invasive aspergillosis

Answer 16

Galactomannan

Question 17

Translocation in acute promyelocytic leukaemia

Answer 17

t(15;17)

Question 18

Anaemia + gallstones = ?genetic condition

Answer 18

Hereditary spherocytosis

Question 19

Bleeding prophylaxis in vWD pre dental procedure

Answer 19

Desmopressin

Question 20

Treatment of APML (often presents with DIC)

Answer 20

All-trans-retinoic acid (vitamin A derivative)

Question 21

Infection prophylaxis for people taking fludarabine

Answer 21

Co-trimoxazole

fludarabine is treatment for CLL

Question 22

Pathophysiology behind warfarin induced skin necrosis

Answer 22

Protein C deficiency (it is vit K dependent and rapidly falls on commencing warfarin leading to paradoxical prothrombotic state)

Question 23

Peripheral blood film blast cells, gum hypertrophy, splenomegaly

Answer 23

AML (Auer rods also)

Question 24

Lymphadenopathy, anaemia, smudge/smear cells on blood film. What investigation? Whats the diagnosis?

Answer 24

Diagnosis: CLL
Investigation: Immunophenotyping

Question 25

Acute treatment of hyperviscosity syndrome

Answer 25

Plasmapheresis

Question 26

Bone marrow aspiration showing lymphoplasmacytoid cells

Answer 26

Waldestrom's macroglobulinaemia

Question 27

Dry bone marrow aspirate, bone marrow biopsy - fried egg appearance, TRAP stain positive

Answer 27

Hairy cell leukaemia

Question 28

Bone marrow stain positive for Sudan black, myeloperoxidase and non-specific esterase ++

Answer 28

Acute monocytic leukaemia (type of AML)

Question 29

Ligamentous laxity, thromboembolic events and short-sightedness suggest which diagnosis?

Answer 29

Homocystinuria

Question 30

First line treatment for ITP?

Answer 30

HIGH dose steroids

Question 31

Treatment for HELLP syndrome

Answer 31

Delivery of baby/placenta

Question 32

Only clotting factor unique to PT

Answer 32

Factor VII

Question 33

Leucocytes expressing CD5 when stained (immunophenotyping)

Answer 33

CLL

Question 34

Absent CD55 and CD59 on red cell surface

Answer 34

Paroxysmal noctural haemoglobinuria (PNH)

Question 35

Haemophilia B is associated with which clotting factor deficiency?

Answer 35

Factor IX (9)

Question 36

Translocation t(15;17)

Answer 36

Acute promyelocytic leukaemia

Question 37

Pancytopenia and bone marrow biopsy showing increased cellularity

Answer 37

Myelodysplasia

Question 38

Translocation of chromosomes 9 and 22

Answer 38

Philadelphia chromosome | CML