Oncology / Hemat

Question 1

Causes of methaemoglobinaemia

Answer 1

Mnemonic: ‘NAD CANT’
N: Nitrates (e.g., Nitroglycerin, Isosorbide dinitrate)
A: Aniline (e.
g., Aniline dyes)
D: Dapsone
C: Chlorates
A: Antimalarials (e.g., Primaquine, Chloroquine)
N: Nitrobenzene
T: Sulfonamides (e.g., Sulfamethoxazole) Cotrimoxazole

Question 2

In Common variable immunodeficiency which antibody levels are low

Answer 2

specifically in immunoglobulin types IgG, IgM and IgA. → causing recurrent chest and other infections

Question 3

Antiphospholipid syndrome in pregnancy Rx

Answer 3

aspirin + LMWH
low molecular weight heparin once a fetal heart is seen on ultrasound. This is usually discontinued at 34 weeks gestation

Question 4

Which blood product is used for emergency anticoagulation reversal

Answer 4

Prothrombin complex concentrate is used for the emergency reversal of anticoagulation in patients with severe bleeding or a head injury

Question 5

Hemolysis with gallstones/ splenomegaly / splenectomy and Northern European descent.

Answer 5

Hereditary spherocytosis
If African think G6PD deficiency

Question 6

Types of crisis in sickle cell

Answer 6

Thrombotic, acute chest syndrome, aplastic, sequestration

Question 7

Waldenstrom’s macroglobulinaemia characterized by?

Answer 7

lymphoplasmacytoid malignancy characterized by the secretion of a monoclonal IgM paraprotein, complication - hyperviscosity syndrome

Question 8

CKD causes which thrombophilia

Answer 8

Antithrombin III deficiency

Question 9

lymphoma cytogenetics?

Answer 9

All have 14
Follicular (F) : Fourteen (t(14;18))
Burkitt’s : B (looks like 8) (t(8;14))
Mantle Cell : (1\/1antle cell 11 looks like M) (t(11;14))

Question 10

Philadelphia chromosome (BCR - ABL) fusion protein functions as

Answer 10

Abnormally active Tyrosine Kinase, hence rx imatinib - tyrosine kinase inhibitor

Question 11

When does serum tryptase peak in anaphylaxis

Answer 11

One hour, returning to baseline 12-24 hours following the reaction

Question 12

Immunocompromised patients/ current or past hodgkin’s lymphoma / stem cell or marrow transplant need what modification in blood products

Answer 12

Irradiation

Question 13

elevated level of bombesin.

What is the most likely cancer to account for this result?

Answer 13

Bombesin is a tumour marker in small cell lung carcinomas
Bombesin - Small cell lung carcinoma, gastric cancer, neuroblastoma

Question 14

Cytotoxic agents MOA, review mnemonic

Answer 14

Cyclophosphamide, Ciclosporin = Cross linking
Bleomycin = blows DNA = degrades formed DNA
Topotecan, Irenotecan = Topoisomerase inhibition
HydroxyuRea = Ribonucleotide Reductase inhibition

Question 15

Howell Jolly bodies seen in

Answer 15

post splenectomy

Question 16

Screening test for hereditary angioedema

Answer 16

C4

Question 17

Gold standard for Paroxysmal nocturnal haemoglobinuria testing

Answer 17

Flow cytometry for CD59 and CD55

Question 18

Rx of acute intermittent porphyria

Answer 18

IV haematin then IV glucose

Question 19

Warfarin induced skin necrosis associated with which thrombophilia

Answer 19

Protein C deficiency

Question 20

Moa of rasburicase

Answer 20

Is a recombinant urate oxidase - Converts uric acid to allantoin

Question 21

What type of allergy is linked to pollen allergy?

Answer 21

Oral allergy syndrome

Question 22

Breast Ca drug of choice in pre and post menopause for oestrogen positive patients

Answer 22

Pre menopause - tamoxifen
Post menopause- Aromatase inhibitors like anastrozole, letrozole