other

Question 1

what are insoluble protein fibrils

Answer 1

amyloid

Question 2

most common presenting symptom of amyloidosis

Answer 2

weakness and dyspnoea

Question 3

what amyloidosis refers to light chain and what one refers to inflammatory

Answer 3

Light - AL
inflammatory - AA

Question 4

commonest reason doe hereditary haemochromatosis

Answer 4

mutation in HFE gene

Question 5

mx for hereditary haemochromatosis

Answer 5

weekly venesection

Question 6

mx for secondary iron overload

Answer 6

iron chelating agents eg desferrioxamine

Question 7

increased destruction cause of pancytopenia

Answer 7

hypersplenism

Question 8

causes of hypersplenism

Answer 8

portal hypertension, systemic disease eg RA, haematological disease eg splenic lymphoma

Question 9

what pancytopenia has hypocellularity

Answer 9

aplastic anaemia

Question 10

minimum criteria for blood transfusion donor

Answer 10

Hb 125 for women and 135 for men and weight 50kg

Question 11

ABO gene is on chromosome

Answer 11

9

Question 12

O blood can only receive what blood

Answer 12

0 blood

Question 13

what is antisera

Answer 13

using reagents with known antibody specificity to identify antigens present on red cell

Question 14

what does agglutination indicate

Answer 14

presence of an antibody

Question 15

when do you infuse FFP

Answer 15

• Treatment of bleeding in patient with coagulopathy (PT ratio >1.5)
• Prior to surgery or procedure in patient with coagulopathy (PT ratio >1.5)

Question 16

what is febrile non haemolytic transfusion reaction

Answer 16

presents with fever, rigours/chills but patient otherwise well

Question 17

mx of febrile non haemolytic transfusion reaction

Answer 17

slow the transfusion and give paracetamol

Question 18

which protein modulates transferrin uptake (iron overload)

Answer 18

HFE

Question 19

what can lower iron levels in iron overload

Answer 19

desferrioaxamine

Question 20

patients post splenectomy have what

Answer 20

Howell-jolly bodies and Pappenheimer bodies

Question 21

highest risk of infection after splenectomy is when and with what bacteria

Answer 21

2 years after and from pneumococcal

Question 22

lifelong antibiotics prophylaxis post splenectomy is what antibiotic

Answer 22

Phenoxymethylpenicllin also know as penicillin V

Question 23

COX is necessary to produce what

Answer 23

thromboxane 2

Question 24

what should be stopped 7 days prior to elective operations

Answer 24

anti platelet agents

Question 25

what are ADP receptor antagonists

Answer 25

Clopidogrel and Prasugrel

Question 26

what is a phosphodiesterase inhibitor

Answer 26

Dipyridamole

Question 27

what drug is a GP2b/3a inhibitor

Answer 27

abciximab

Question 28

how do you monitor unfractionated heparin

Answer 28

APTT

Question 29

monitoring for LMWH

Answer 29

no usually needed as more predictable response

Question 30

what can reverse heparin in severe bleeding

Answer 30

protamine sulpahte

Question 31

what drug should be taken at the same time every day

Answer 31

warfarin

Question 32

dabigatran MOA

Answer 32

direct thrombin inhibitor

Question 33

moa of edoxaban, rivaroxaban, apixaban)

Answer 33

factor X inhibitors

Question 34

haematopoiesis is the term used

Answer 34

for the production of blood cells

Question 35

adult where is haemopoiesis restricted to a

Answer 35

axial skeleton

Question 36

granulocytes include what

Answer 36

neutrophils, eosinophils and basophils

Question 37

what cell are bi lobed and usually have bright red/ orange granules

Answer 37

eosinophils

Question 38

what do basophils look like

Answer 38

large deep purple granules obscuring nucleus

Question 39

what cell has a large single nucleus, faintly staining granules and are often vacuolated

Answer 39

monocyte

Question 40

small with condensed nucleus and rim of cytoplasm, when activated appear large with plentiful blue cytoplasm extending round neighbouring red cells

Answer 40

lymphocyte

Question 41

what shows lineage of progeny

Answer 41

bioassays

Question 42

how do red cells have a limited lifespan

Answer 42

there is no nucleus so they can't divide or replace damaged proteins

Question 43

adult haemoglobin is

Answer 43

2 alpha and 2 beta chains

Question 44

red cell production is regulated by what and is produced in hypoxia

Answer 44

erythropoietin

Question 45

red cell destruction normally occurs where

Answer 45

Spleen (and liver)

Question 46

the heme group is broken down into what

Answer 46

iron and bilirubin

Question 47

NADPH replenishes what in the hexose monophosphate shunt

Answer 47

glutathione

Question 48

in the hexose monophosphate shunt what is the rate limiting enzyme

Answer 48

Glucose -6 - phosphate dehydrogenase

Question 49

most co2 is transported with

Answer 49

bicarbonate

Question 50

what is increased in chronic anaemia

Answer 50

2-3 DPG

Question 51

where does iron absorption mainly happen

Answer 51

duodenum

Question 52

what decreases iron absorption

Answer 52

tea, calcium, phylates

Question 53

what increases iron absorption

Answer 53

ascoribic acid and alcohol

Question 54

what is the major negative regulator of iron uptake

Answer 54

hepcidin

Question 55

what levels decrease when iron deficient

Answer 55

hepcidin

Question 56

molecule that is spherical and stores iron

Answer 56

ferritin

Question 57

what measures functional iron

Answer 57

haemoglobin conc

Question 58

what also acts as an acute phase protein so goes up with infection, malignancy, liver injury etc

Answer 58

serum ferritin

Question 59

what is secondary haemostasis

Answer 59

formation of fibrin clot

Question 60

von willebrand factor deficiency has what inheritance

Answer 60

autosomal dominant

Question 61

drugs that can reduce platelet function

Answer 61

aspirin or NSAIDs

Question 62

the only really screening test for primary haemostasis

Answer 62

platelet count

Question 63

what converts prothrombin to thrombin

Answer 63

V/Xa

Question 64

What converts fibrinogen to fibrin

Answer 64

thrombin

Question 65

what is a single clotting factor deficiency

Answer 65

haemophilia

Question 66

what has an isolated prolonged APTT

Answer 66

haemophilia

Question 67

examples of what has multiple clotting factor deficiences

Answer 67

DIC, liver failure (as all coagulation factors are synthesises in the liver)

Question 68

prothrombin time relates to what pathway

Answer 68

extrinsic

Question 69

what is used as a measure of overall clotting

Answer 69

prothrombin time

Question 70

APTT measures what factors

Answer 70

8,9,11 and 12

Question 71

most common causes of increased APTT are

Answer 71

haemophilia and possibly von willebrands disease

Question 72

most common reasons for both prothrombin and APTT to be increase

Answer 72

due to multiple clotting factor deficiencies eg liver diease, anticoagulants

Question 73

what breaks down fibrin

Answer 73

plasmin

Question 74

anti- thrombin, protein C and S are

Answer 74

anticoagulant defences

Question 75

what cell only lives for 7-8hrs

Answer 75

neutrophils

Question 76

what are nucleated precursor cells

Answer 76

blasts

Question 77

what are immediate red cell precursor

Answer 77

reticulocytes

Question 78

what means you have more immature red blood cells than what considered normal

Answer 78

polychromasia

Question 79

what is a myelocyte

Answer 79

nucleated precursor between neutrophils and myeloblasts

Question 80

what is used for bone marrow biopsy in a young child

Answer 80

tibia

Question 81

what marrow increases with age

Answer 81

yellow

Question 82

are lymph nodes primary or secondary lymphoid tissues

Answer 82

secondary

Question 83

where does B cell maturation occur

Answer 83

bone marrow

Question 84

where does T cell maturation occur

Answer 84

thymus

Question 85

what things stimulate a predominant T cell response

Answer 85

viral infections, drugs

Question 86

what cell response predominates in autoimmune conditions and infections

Answer 86

B

Question 87

what is troiseries sign

Answer 87

manifestation of metastasis from an abdominal malignancy

Question 88

what is a sentinel lymph node

Answer 88

first lymph node to which cancer cells are more likely to spread

Question 89

where will metastatic cells be identified first

Answer 89

subscapular sinus

Question 90

where is the spleen located

Answer 90

upper left quadrant of the abdomen

Question 91

there can be lack of differentiation or maturation in

Answer 91

malignant haemopoiesis

Question 92

in what there is a proliferation of abnormal progenitors with a block in differentiation/maturation

Answer 92

acute leukaemia. in acute there is a block and in chronic there is no differentiation/ maturation

Question 93

is normal haeompoiesis mono or poly clonal

Answer 93

polyclonal

Question 94

myeloma is malignancy of what cell

Answer 94

plasma

Question 95

CLL affect more what

Answer 95

mature B lymphocytes

Question 96

leukaemia affects blood and lymphoma affects the lymph node. but what is an exception

Answer 96

CLL - can involve both

Question 97

what leukemias are usually more aggressive

Answer 97

acute

Question 98

immunoglobulin are produces by what cells

Answer 98

B and plasma

Question 99

where do B cells encounter the antigen

Answer 99

follicle germinal centre

Question 100

what is a monoclonal immunoglobulin

Answer 100

paraprotein

Question 101

what allows for identification of an abnormal protein band

Answer 101

serum electrophoresis

Question 102

what allows to classify the abnormal protein band

Answer 102

serum immunofixation

Question 103

bence jones protein has immunoglobulin ... chains

Answer 103

light