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Haematology > Passmedicine > Flashcards

Passmedicine Flashcards

1
Q

Treatment for chronic myeloid leukaemia?

A

Imatinib

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2
Q

Treatment for chronic lymphocytic leukaemia (requiring treatment)

A

Fludarabine, cyclophosphamide and rituximab (FCR)

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3
Q

Which drugs could cause thrombocytopenia?

A 
Heparin
Sodium valproate
Thiazides
Valproic acid
Quinidine
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4
Q

Which drugs could cause pancreatitis?

A

Corticosteroids
Sodium valproate
Thiazides
Valproic acid

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5
Q

What condition would you see smudge/smear cells?

A

Chronic lymphocytic leukaemia

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6
Q

How would Von Willebrand’s disease present?

A
  • Bleeding problems
  • Normal platelets
  • Raised bleeding time
  • Slightly raised APTT
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7
Q

Which drug can cause nasal congestion?

A

Sildenafil

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8
Q

Which drugs are associated with hyperkalaemia?

A 
ACE inhibitors
Spironolactone
ARBs
Heparin
Ciclosporin
Amiloride
Succinylcholine
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9
Q

What is the underlying pathology of polycythemia rubra vera?

A

Mutation in JAK2

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10
Q

What is the underlying pathology in lead poisoning?

A

Defective ferratochelatase and ALA dehdratase function

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11
Q

Age group affected in multiple myeloma?

A

Age 60-70

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12
Q

Why do you get hypercalcemia in myeloma?

A

Primarily this is due to increased osteoclastic bon resorption caused by local cytokines (e.g. IL-1. TNF) released by the myeloma cells
Much less common contributing factors: impaired renal function, increased renal tubular calcium reabsorption and elevated PTH-rP levels)

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13
Q

Treatment for restless legs syndrome

A

Ropinirole

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14
Q

Treatment for polycythemia rubra vera

A

Venesection

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15
Q

Which condition would you find Auer rods in?

A

Acute myeloid leukaemia

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16
Q

Features of Cryoglobulinaemia?

A

Purpuric rash

Hepatitis C positive

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17
Q

HER2/neu receptor antagonist

A

Imatinib

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18
Q

Inhibitor of the tyrosine kinase associated with the BCR-ABL defect

A

Imatinib

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19
Q

Which drugs can cause osteoporosis?

A

Corticosteroids
Heparin
Pioglitazone

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20
Q

Which drugs could cause epistaxis?

A

Isotretinoin

Warfarin

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21
Q

Hereditary haemorrhagic telangiectasia inheritance pattern?

A

Autosomal dominant

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22
Q

Features of hereditary haemorrhagic telangiectasia?

A

Epistaxis
Spider Naevi
Arteriovenous malformations

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23
Q

“A 60 year old woman presents with cold peripheries. Investigations show a normocytic anaemia and a positive direct antiglobulin test”

A

Autoimmune haemolytic anaemia

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24
Q

“A 15 year old Greek boy develops pallor and jaundice after having a lower respiratory tract infection. He has a history of neonatal jaundice. The blood film shows Heinz bodies”

A

G6PD deficiency

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25
Q

G6PD inheritence

A

X-linked recessive

-so you’re going to see it in males

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26
Q

Why is a decreased level of G6PD bad?

A

It means there will be a reduced level of glutathione, and this increases red cell susceptibility to oxidative stress

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27
Q

Diagnostic test for hereditary spherocyosis?

A

Osmotic fragility test

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28
Q

Which stupid food can precipitate a crisis in G6PD deficiency?

A

Broad beans

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29
Q

How do you diagnose G6PD deficiency?

A

G6PD enzyme assay

30
Q

Drugs which can cause haemolysis?

A

Anti-malarials: primaquine
Ciprofloxacin
Sulph-group drugs: sulphonamides, sulphasalazine, sulfonylureas

31
Q

What type of haemolysis in G6PD deficiency?

A

Intravascular

32
Q

What type of haemolysis in hereditary spherocytosis?

A

Extravascular (so spleen etc)

33
Q

How does standard heparin work?

A

Activates anti-thrombin III

Forms a complex that inhibits thrombin, factors Xa, IXa, XIa and XIIa

34
Q

How does LMWH work?

A

Activates anti-thrombin III.

Forms a complex that inhibits factor Xa

35
Q

How do you monitor standard heparin?

A

APTT

36
Q

How do you monitor LMWH?

A

Anti-factor Xa (although routine monitoring is not required)

37
Q

Why can heparin and LMWH cause hyperkalaemia?

A

It is thought to be due to inhibition of aldosterone secretion

38
Q

Causes of normocytic anaemia?

A

Anaemia of chronic disease
Chronic kidney disease
Aplastic anaemia
Haemolytic anaemia

39
Q

Activated protein C resistance

A

Factor V leiden

40
Q

C1-1NH deficiency

A

Hereditary angioedmea

41
Q

What is tumour lysis syndrome associated with?

A

Burkitt’s lymphoma (treated with chemotherapy)

42
Q

What is hypogammaglobulinaemia associated with?

A

Chronic lymphocytic leukaemia

43
Q

Macrocytic (normoblastic)

A

Reticulocytosis

44
Q

Macrocytic (megaloblastic)

A

Vitamin B12 deficiency

45
Q

“a 10 year old child with a history of neonatal jaundice develops pallor and jaundice after an upper respiratory tract infection associated with erythematous cheeks. Splenomegaly is noted on examination”

A

Hereditary spherocytosis

(the clue is in the splenomegaly!! –> hereditary spherocytosis = extravascular haemolysis = the spleen is going to be working overtime = splenomegaly! Although you can sometimes get splenomegaly with G6PD)

46
Q

Management of hereditary spherocytosis?

A

Folate replacement

Splenectomy

47
Q

Which medication can cause a slate-grey appearance?

A

Amiodarone

48
Q

Which medication can cause skin necrosis?

A

Warfarin

49
Q

Factors that may potentiate warfarin?

A
  • Liver disease
  • P450 enzyme inhibitors (e.g. amiodarone, ciprofloxacin)
  • Cranberry juice
  • Drugs which displace warfarin from plasma alubmin (e.g. NSAIDS)
  • Inhibit platelet function: NSAIDS
50
Q

Dark coloured urine, haemolytic anaemia and thrombosis are features of which disease?

A

Paroxysmal nocturnal haemoglobulinuria

51
Q

Treatment of essential thrombocytosis?

A

Hydroxyuria

52
Q

The philadelphia chromosome is present in more than 95% of people with this condition?

A

Chronic myeloid leukaemia

53
Q

Imatinib method of action

A

Inhibitor of the tyrosine kinase associated with BCR-ABL defect
-Very high response rate in chronic phase CML

54
Q

This type of hodgkins lymphoma is associated with lacunar cells

A

Nodular sclerosing hodgkins lymphoma (the most common type)

55
Q

This condition is characterised by the presence of Reed-Sternberg cells

A

Hodgkins lymphoma

56
Q

Hodgkins lymphoma with the best prognosis

A

Lymphocyte predominant

57
Q

Hodgkins lymphoma with the worst prognosis

A

Lymphocyte depletes

58
Q

Hodgkins lymphoma symptoms which imply poor prognosis

A

Weight loss more than 10% in the last 6 months
Fever greater than 38 degrees C
Night sweats

59
Q

Common cause of tumour lysis syndrome

A

Burkitts lymphoma

60
Q

What is felty’s syndrome?

A

Splenomegaly and neutropenia in a patient with Rheumatoid arthritis

61
Q

t (9,22)

A

Philadelphia chromosome:
Present in >95% of patients with CML
-also a poor prognostic factor in ALL

62
Q

t(15,17)

A

Seen in acute promyelocytic leukaemia

63
Q

t(8,14)

A

Burkitt’s lymphoma

64
Q

t(11,14)

A

Mantle cell lymphoma

65
Q

How can you reverse heparin?

A

Protamine sulphate (although this only partially reverses effects of LMWH)

66
Q

How do you monitor heparin?

A

APTT

67
Q

How could you monitor LMWH?

A

Anti-factor Xa (although routine monitoring is not required)

68
Q

How do you give heparin?

A

IV

69
Q

Treatment for DVT

A

LMWH or fondaparinux should be given initially after a DVT is diagnosed

-a vitamin K antagonist (e.g. warfarin) should be given within 24 hours of the diagnosis

70
Q

How long should you continue LMWH/fondaparinux after DVT?

A

Continue for at least 5 days of until the INR is 2.0 or above for at least 24 hours

Haematology (25 decks)

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