Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
25 Haematology and transfusion medicine MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 8 practice questions
- Sickle-cell disease
- Bleeding disorders and histiocytosis
- Coagulation
- Haemolytic anaemia
- Emergency haematology
- Leukaemia
- Lymphoma and bleeding
- Transfusion reactions
1. A pregnant woman with sickle-cell disease and a child with sickle-cell disease and a stroke are managed. Which statements are correct?
- AFolic acid 5 mg, aspirin 75 mg and thromboprophylaxis after delivery with hydroxycarbamide stopped 3 months before conception, and regular transfusion to keep HbS below 30%
- BACE inhibitors continued, and splenectomy
- CNo treatment, and hydroxycarbamide only
- DHydroxycarbamide continued, and observation
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A. Folic acid 5 mg, aspirin 75 mg and thromboprophylaxis after delivery with hydroxycarbamide stopped 3 months before conception, and regular transfusion to keep HbS below 30% Extended cross-matched CMV-negative blood is used; exchange transfusion is for life-threatening crises or before surgery.
2. A patient has anaemia, raised unconjugated bilirubin, LDH and reticulocytes with low haptoglobin and haemoglobinuria. Which statements are correct?
- AExtravascular haemolysis, and output falls
- BIntravascular haemolysis with marrow output increased six- to eightfold, and anaemia occurs only when destruction outstrips production
- CIron deficiency, and output is unchanged
- DAplastic anaemia, and output rises twofold
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B. Intravascular haemolysis with marrow output increased six- to eightfold, and anaemia occurs only when destruction outstrips production Hallmarks of haemolysis include low haemoglobin, raised unconjugated bilirubin, LDH, reticulocytes and urinary urobilinogen; low haptoglobin marks intravascular haemolysis.
3. A patient has a prolonged APTT with normal PT and platelets, and another on warfarin has life-threatening bleeding. Which statements are correct?
- AAPTT tests factor VII, and warfarin is reversed with idarucizumab
- BAPTT is normal in heparin, and warfarin is reversed with andexanet alfa
- CPT is prolonged by factor VIII deficiency, and warfarin is reversed with protamine
- DAPTT is prolonged by deficiencies of factors VIII, IX, XI, XII, heparin or lupus anticoagulant, and warfarin is reversed with prothrombin complex concentrate and IV vitamin K
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D. APTT is prolonged by deficiencies of factors VIII, IX, XI, XII, heparin or lupus anticoagulant, and warfarin is reversed with prothrombin complex concentrate and IV vitamin K PT is prolonged in deficiencies of II, V, VII or X; protamine reverses heparin, idarucizumab dabigatran and andexanet alfa rivaroxaban and apixaban.
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