Passmed haem

Question 1

Which is affected in haemophilia
APTT
PT
Bleeding time

Answer 1

APPT - increased

Question 2

Reversal of:
Warfarin 
Heparin 
dabigatran
Other NOACs

Answer 2

Warfarin - Vit K + FFP

Hep - protamine

Dab- Indarucizumab

beriplex

Question 3

What is the indicator of cell lysis in haemolytic anaemia

Answer 3

LDH

[bilirubin too]

Question 4

Common class of drug causing haemolytic anaemia

Answer 4

NSAIDS

Question 5

Coombs with hereditary spherocytosis

Answer 5

negative

therefore if +ve and sphereocytes = autoimmune

Question 6

Cleareance of
Dabigatran
Rivaroxaban
Apixaban

Answer 6

Dabigatran -= renal
Rivaroxaban - liver
Apixaban - poo

Question 7

which NOAC for people with renal impairment ?

Answer 7

apixibam

Question 8

Cause of aplastic crisis in sickle cell?

Answer 8

parovirus

-> fsudden fall in Hb

Question 9

What is a sequestration crisis in sickle cell?

Answer 9

sickling within organs such as the spleen or lungs causes pooling of blood with worsening of the anaemia

Question 10

What condition can malaria prophylaxis cause haemolytic anaemia in ?

Answer 10

G6PD deficiency

Question 11

Seen on blood film G6PD deficiency

Answer 11

Heinz bodies

Question 12

Anaemia / thrombocytes in alcoholic ?

Answer 12

Macrocytic (lose folate)

thombocytopenic

Question 13

Hb 9.2 g/l (Low)

Platelets 701 * 109/ (raised)

WBC 9.8 * 109/ (normal)

Neuts 77% (raised)

Lymphs 17% (low)
Eosin 2.4% (normal)

What you thinking? why?

Answer 13

CML (Thrombocytosis + raised neutrophils )

Question 14

What drug used to reduce platelets in CML

Answer 14

hydroxyurea (hydroxycarbamide)

Question 15

blood film of myeloma? urine?

Answer 15

‘rouleaux formation’
-stacking of RBCs

bence jones in urine

Question 16

After DVT what is this describing ?
painful, heavy calves
pruritus
swelling
varicose veins
venous ulceration

Answer 16

post thrombotic syndrome

-> compression stockings

Question 17

DIC - pt?aptt?bleeding time? platelets?

Answer 17

Low platelets

High everything else

Question 18

What is the main factor in bleeding time?

Answer 18

platelets - eg asprin increases

Warfarin/noac/heparin - will be normal

Question 19

Heparin affects what bleeding study?

Answer 19

APTT

PT also sometimes longer

Question 20

Warfarin affects what bleeding study?

Answer 20

PT

Question 21

Most common cause of increased VTE risk? name 1 aquired

Answer 21

Factor V leiden - Activated protein C resistance

[protein c/s deficiency are others]

Antiphospholipid syndrome

Question 22

Raised ESR + Osteoperosis =

Answer 22

Myeloma

Question 23

abdominal pain and a motor periperal neuropathy

Answer 23

lead poisoning

Question 24

Bleeding time in
VWD
Haemophilia
vit K def

Answer 24

VWD - prolonged

Normal in others

Question 25

Acute haemolytic Transfusion reaction mx

Answer 25

Iv fluids + stop transfusion

Question 26

blood film with target cells

Howell-Jolly bodies

Answer 26

Hyposplenism eg. splenectomy

Question 27

‘tear drop’ cells on blood film

Answer 27

myelofibrosis

Question 28

normocytic anaemia, gallstones and family history

Answer 28

Hereditary spherocytosis

Question 29

‘starry sky’ appearance on lymph node biopsy

Answer 29

burkitt lymphoma

Question 30

tamoxifen increases risk of?

Answer 30

VTE + endometrial cancer

Question 31

enlarged lymph nodes become painful on alcohol consumption

Answer 31

Hodgkin

Question 32

what is seen in blood film of hyposplenism

Answer 32

target cells, Howell-jolly bodies