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Year 5 MEDICINE Pathology > Past paper corrections hematology > Flashcards

Past paper corrections hematology Flashcards

1
Q

Child with anaemia, blood film shows spherocytes and DAT+(?)

A

autoimmune hemolytic anemia

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2
Q

Child with anaemia, blood film shows spherocytes and DAT+(?) What is the cause?

A

autoimmune hemolytic anemia

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3
Q

Woman has had 2 children, her blood type is A-. Which naturally occurring IgM antibody would be present? (Repeat)

A
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4
Q

Patient presenting with monocular blindness with extremely high neutrophils (140s) , basophils - what is the diagnosis?

A

Chronic myeloid leukemia!!

key signs:
-> spleenomegaly!!!
-> vision loss!!!
-> gouty arthritis!!!

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5
Q

What coagulation factor falls most rapidly after starting warfarin?

A

factor 7

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6
Q

Infants with sickle cell disease (HbSS) may have splenic sequestration. Why does this not occur before 3 months of age?

A

HbF

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7
Q

Venetoclax is a BCL2 inhibitor used in CLL. What cellular process does it affect?

A

apoptosis

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8
Q

75 year old woman has neutropenic sepsis secondary to myelodysplasia. Her blood count is lower than it was 6 weeks ago, with marked panyctopaenia.

Blood film shows numerous large cells of primitive appearance. What is the likely explanation?

A

Progression to AML

M in AML = myelodyplasia

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9
Q

What is the diagnosis, results showed increased IgG lambda but normal kappa lambda ratio, <30g/L -

A

MGUS!!! (As criteria is)

1.. <10% plasma cells
2. Monoclonal protein spike <30 g/L -> this is IMMUNOGLOBULINS/IgG

  1. no CRAB symptoms or organ damage
    * No evidence of other B-cell proliferative disorder
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10
Q

Person with aortic stenosis. Has some blood transfusions for some reason, on the second unit of blood immediately develops SOB, 85% O2 Sats, JVP elevated by 3cm.

A

Transfusion related circulatory overload = symptoms of pulmonary edema/fluid overload. Signs of HF = Increased JVP. increased PCWP

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11
Q

What is raised when a cell undergoes haemolysis?-

A

potassium

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12
Q

Man with positive HTLV1 and other bloods and flower cells, what type of cancer? -

A

Adult T cell lymphoma

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13
Q

What drug would be given to a patient with CLL with p53 deletion?

A

ibrutinib

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14
Q

Patient with multiple myeloma, and lights chains >1000. Most likely kidney manifestation?

A

AL amyloidosis

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15
Q

What is the most common site for a thrombotic event?,

A

deep leg veins

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16
Q

Bleeding patient has prolonged APTT and PT, but normal platelet count and normal fibrinogen. What is the most suitable blood component for treatment?.

A

Fresh frozen plasma as anticoagulant reversal is needed. (cryoprecipitate is only used if fibrinogen is low.). Platelets if abnormal platelet count

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17
Q

At what temperature can platelet transfusions be stored?

A

22 Degrees celsius. Rbcs at 4 degrees.

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18
Q

Lady with macrocytic anemia. Became vegetarian 2 years ago. Most likely cause of patients symptoms?

A

alcohol

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19
Q

40 year old with confusion, and difficulty speaking. Had a fever and a headache and bleeding from the gums for 10 days. On examination, kidney function had deteriorated, had become oliguric. Blood film shows thrombocytopenia and shistyocytes, what is the most likely diagnosis?

A

TTP = triad (thrombocytopenia, MAHA, kidney injury) + fever + neurological symptoms
Contrast to HUS = triad + bloody diarrhea

20
Q

Chronic myeloid leukemia

presentation?

mutation?

A

high WCC with neutrophila!! And basophilia!!

T(9,22). Philadelphia CreaML cheese.

21
Q

Chronic lymphocytic leukemia

which mutation makes worse?

A

TP53

22
Q

markers of myeloid cells seen in AML?

A

CD33, CD13, CD117 = myeloid cells.

mpo+ve

23
Q

Beta thalassemia in a pregnant woman. Most important test to investigate if the future health of fetus is at risk?

A

chorionic villious sampling

24
Q

21 year old with beta Thalessemia has been receiving blood transfusion for 6 years. No presents with congestive cardiac failure and gonadal failure. Most likely explanation?

A

iron overload

25
Q

23 year old. Bilateral cervical lymphadenopathy, night sweats and pain on drinking alcohol -

A

hodkins lymphoma

26
Q

Something about gamma globin chains?

A

learn hemophilias

27
Q

A patient who is known to have chronic lymphocytic leukaemia presents with sudden worsening of fatigue and is found to have had a fall in Hb. His FBC results are reported below. His blood film shows lymphocytosis, smear cells, spherocytes and polychromatic macrocytes. Which is the most likely cause of

A

AIHA - CLL

28
Q

In optimal circumstances, for a 70kg male, transfusion of 1unit RBC and 1 unit of platelet gives a predictable increment in the Hb and platelet count. Which statement is correct?

A

Expected increment, Haemaglobin 10 g/L and Platelets 35 x 10^9/L.

29
Q

A 41 year old woman who is 20 weeks pregnant attends a routine antenatal appointment. She has a past medical hx of venous thromboembolic disease in a previous pregnancy. BMI 31. Mx?

A

low molecular weight heparin

30
Q

Children with Down syndrome have an increased incidence of which type of blood cancer?

A

Acute leukaemia. Especially AML

31
Q

A 55 year old man is being discharged from hospital on long term anticoagulation with Rivaroxaban a direct acting anticoagulant. Which is the correct approach for routine monitoring of his anticoagulation?

A

monitoring not required

32
Q

Woman has chest pain, SOB, persistent swelling in neck. Large mass in supraclavicular fossa is biopsied - malignant cells with reactive fibrosis and high eosinophils [exact pictures below were included in question - bilobed nuclei ]. What is the likely diagnosis? -

A

hodgkin’s lymphoma! (dyspnoea and chest pain = mediastinal involvement)

33
Q

Person had an unprovoked DVT, treated with LMWH for 6 months. What long-term DVT prophylaxis should they take? Aspirin, warfarin, DOAC, none needed

A

LMWH

used for DVT prophylaxis also

34
Q

A 30 year old woman with known ITP gives birth to a healthy full term baby. Which is the correct haematological management of the newborn baby?

A

Check daily FBC for a minimum of five days.

if platelets less than 20, give IVIG to baby and gove intracranial ultrasound

note: early onset thrombocytopenia eg 1st trimester of pregnancy -> high likely hood of ITP

management = IV immunoglobulins, steroids eg azathioprine to increase platelet count

35
Q

what is the leading cause of maternal mortality in the UK

A

venous thromboembolism

36
Q

give one symptom that will make you add the suffix “B” to hodgkins disease

A

fever!

night sweats!

37
Q

Man has fatigue and back pain. Blood results show - high creatinine, low IgG, low IgM, no paraprotein detected (via electrophoresis) , low serum kappa light chains, high lambda light chains, low kappa/lambda ratio. What is the likely diagnosis?.

A

Multiple myeloma!!

regardless of meeting the other criteria, patient has CRAB symptoms and therefore automatically has MM!!!

38
Q

what is the usual prophylaxis for allograft rejection?

A

Basaliximab (anti-CD25)

alemtuzumab Anti CD52

anti thymocyte globulin

39
Q

The wall of vessels expresses anti-thrombotic factors why is this?

A

Because it secrete Thrombomodulin - anticoagulant

40
Q

which blood count finding is characteristic of acute lymphoblastic anaemia (ALL)

A

neutropenia

41
Q

Person who had a DVT many years ago (or recurrent DVTs), presents with recurrent dark bruising, and swelling over the course of 5 years, and now had pain in their leg. What is the possible cause?

A

post thrombotic syndrome

42
Q

A patient has a massive splenomegaly, and JAK2 V617F mutation with a leucoerythroblastic picture and tear-drop poikilocytes. What do they have?

A

myelofibrosis

43
Q

An African man, with Burkitt’s lymphoma is given Rasburicase. He develops haematuria with irregularly contracted cells. What is the cause?

A

– Glucose-6-phosphate dehydrogenase deficiency

44
Q

A man has multiple myeloma, and get amyloidosis. Which type of amyloidosis would it be?

A

amyloid light chain amyloidosis

45
Q

Woman hurt her back lifting something in the garden. Pain persisted for a week. Some blood abnormalities (low Hb, high Ca, high urea/creatinine? …)

What is the best test?

A

serum protein electrophoresis

46
Q

Transfusion level for platelets after trauma?

A

10 bn/litre (10 x 10^9 /L)

higher threshold of 20 in sepsis

For rbcs = 70g/L if asymptomatic, 80g/L if symptomatic

47
Q
A

Year 5 MEDICINE Pathology (11 decks)

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