Quiz Haematology

Front 1

What are the normal haemoglobin levels in men and women?

Back 1

M : 13.5-17.5
F : 10.5-15.5

Front 2

Which drug's common side effect is a syndrome of inappropriate ADH

Back 2

carbamezapine

Front 3

Normal values for MCV?

Back 3

80-95 fL

Front 4

What's the pathology behind a microcytic anaemia

Back 4

When inadequate levels of haemoglobin available the RBC division increases leading to smaller cells (MCV <80)

Front 5

What 4 causes of a microcytic anaemia do you know?

Back 5

<Iron - iron deficiency anaemia
Odd Globin chains - thalassaemia
odd haem ring - Congenital sideroblastic anaemia
poor iron utilisation - chronic disease

Front 6

What's the pathology behind a megaloblastic anaemia?

Back 6

An inabilit to synthesise new DNA bases or rasied plasma lipids results in fewer divisions and larger RBCs

Front 7

What 4 causes do you know for a Megaloblastic anaemia?

Back 7

B12/Folate deficiency
Cytotoxic drugs
Myelodysplasia
High plasma lipids (liver disease, hypothyroid, alcohol, pregnancy)

Front 8

Max Fe possibly absorbed /day

Back 8

3.5mg / day

Front 9

How is Fe transported in blood

Back 9

Transferrin

Front 10

How is iron stored in the body (3)

Back 10

65% haemoglobin
29% ferritin
3% myoglobin

Front 11

What two specific signs do you know that identifies the anaemia as iron deficient?

Back 11

Atrophic glossitis
Koilonychia

Front 12

What 3 categorial causes of iron deficiency are there?

Back 12

Malabsorption - Post-gastrectomy, coeliac disease
>Blood loss - GI, renal, uterine
>Demand - pregnancy, growth

Front 13

How would you resolve someone's iron deficiency (4)

Back 13

Treat cause
FeSO4 tablets
Fe Sorbital IM
Blood transfusion

Front 14

What foods contain Vit B12

Back 14

Animal liver, fish, dairy
(Vegans)

Front 15

How does Vit B12 get from your fork to your marrow? (3phases)

Back 15

Binds to IF from gastric parietal cells
IF binds to terminal ileal cells, B12 absorbed
B12 bound to transcobalanin II in serum

Front 16

Is there much storage of Vit B12 to keep you going?

Back 16

Liver - 3yrs

Front 17

What makes up 80% of the causes of Vit B12 deficiency?

Back 17

Pernicious Anaemia

Front 18

What's the age/sex distribution of Pernicious anaemia

Back 18

45-65 yrs
M=F

Front 19

What antibodies are present?

Back 19

Anti-parietal cell
Anti-IF

Front 20

What's the test for pernicious anaemia?

Back 20

Schilling test

Front 21

What is Schilling test?

Back 21

Radio B12 orally with Norm B12 IM - measure urine B12 radio

Radio B12 orally + IF with B12 IM - if much increased radio urine = +ve

Front 22

How is sickle cell trait inherited?

Back 22

recessive - blacks

Front 23

What sickle crises (4) do you know and what are their main features?

Back 23

Vaso-occlusive - small vessel plugging (acute bone pain, fever, tachycardia)

Sickle chest - bone marrow infarction leads to pulmonary fat emboli, fatal.

Sequestrian crises - venous outflow thrombosis spleen/liver

Aplastic crisis - follows erythrovirus 19 infection leads to severe self-limiting red cell aplasia.

Front 24

How do you investigate a suspected sickler? (2)

Back 24

Blood film - sickle cells
Electrophoresis - HbS/HbC bands

Front 25

How do you manage a sickler? (4)

Back 25

Prophylaxis - folic acid, pen V, vaccination (hyposplenism)
Rehydration, O2, Analgesisa, Antibiotics
Transfusion (top-up/exchange)
BM transplant

Front 26

What is the pathology of Thalassaemia?

Back 26

Partial/Complete failure to produce a/b globins

Front 27

What are is the geographical distributions of the Thalassaemias (2)?

Back 27

a = mediterranean
b = south-east asia

Front 28

What is hereditary spherocytosis?

Back 28

A autosomal dominant condition where the RBC's are spherical not donuts and therefore haemolyse more rapidly.

Front 29

What is a hepatic complication of haemolytic anaemias?

Back 29

pigmented gallstones

Front 30

What is the physiology behind G6PDH deficiency causing a haemolytic anaemia

Back 30

Unable to produce NADPH in RBCs thus reduced coping to oxidative stress, so periodic haemolysis

Front 31

whose affected with this fascinating G6PDH deficiency you've mentioned?

Back 31

10% of the world population!
mainly in malaria belt (provides some protection)
males affected while females carry

Front 32

What do doctors give to cause the stresses bringing on the haemolysis (3)

Back 32

3A's

Analgesia (aspirin)
Antimalarials (chloroquine, quinine)
Antibiotic (sulphonamides, nitrofurantoin)

Front 33

Which haemolytic anaemia is caused by reduced ATP production in the RBC

Back 33

Pyruvate Kinase deficiency - chronic non-periodic haemolysis

Front 34

What is the test for Autoimmune Haemolytic anaemias?

Back 34

Comb's test - complement binding reagent binds to RBC and causes agglutination

Front 35

50% of autoimmune haemolysis have no precipitating cause. What about the other 50%(4)

Back 35

Malignancy - lymphoma, solid
SLE/RA
Drugs - quinine, methyldopa
UC HIV

Front 36

Treatment for autoimmune haemolysis (4)

Back 36

Prednisolone
Transfusion
Splenectomy
Immune suppression

Front 37

What 3 causes are there for a non-immune haemolytic anaemia

Back 37

Physical trauma (burn, march, heart valve)
Infection (falciparum, clostridium)
Chemical (arsenic, dapsone)

Front 38

Other than infection, inflammation and malignancy, what can cause a Neutrophilia (3)

Back 38

Trauma (surgery, burns)
Infarction (MI, PE)
Physiological (Exercise, Preg)

Front 39

What are eosinophils primarily involved with (3)?

Back 39

These puppies with their peroxidase granules are aimed at taking out parasites.
Their also induced by allergy (hayfever/asthma) and hypersensitivity (gold/sulphonamides)

Front 40

What are basophils about?

Back 40

Granules contain histamine and primarily induced by acute hypersensitivity and myeloproliferation

Front 41

Which acute leukaemia is commonest in children

Back 41

ALL

(AML is 4x in adults)

Front 42

What blood results would you expect from ALL

Back 42

FBC - normal? raised/low/norm WCC, thrombocytopaenia
Blood film - blasts
Marrow - >30% blasts
>Uric Acid, >LDH

Front 43

Which leukaemia is this?

Philadelphia chromosomal abnormality, 55yrs old, Massive smooth painless spleen

Back 43

CML

Front 44

Which leukaemia is this?

Commonest leukaemia in westerners. Male 70yr old.

Back 44

CLL

Front 45

Which leukaemia is this?

Philadelphia chromosomal abnormality, 55yrs old, Massive smooth painless spleen

Back 45

CML

Front 46

Which leukaemia is this?

Commonest leukaemia in westerners. Male 70yr old.

Back 46

CLL

Front 47

What's the pathology of multiple myeloma?

Back 47

Malignant plasma cell proliferation resulting in a monoclonal paraproteinaemia with hypercalcaemia and Bence Jones Proteinuria

Front 48

In Hodgkin's Lymphoma (with Reed-Sternberg cells) what is the age distribution

Back 48

Bimodal
20-35 & 50-70

Front 49

LIST THE P450 INHIBITORS

Back 49

Omeprazole
Fluoxetine/Fluconazole
Disulfiram
Erythromycin/Clarithromycin
Valproate
Isoniazid
Cimetidine/Ciprofloxacin
EtOH acute
Sulphonamides

Front 50

LIST P450 INDUCERS

Back 50

Phenytoin
Carbamezapine

Barbituates
Rifampicin
Alcohol
Sulphonylureas/St John's Wort