Stage 4 CSIM2 - Blood and Blood Disorders Quiz

Lối Thoát Hiểm

Câu Hỏi 1 of 1

  Thời Gian Còn Lại


0 [{"id":631323,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:56:18","updated_at":"2018-11-30 15:01:20","questionName":"You seen a 63 year old patient who has been referred to haematology with splenomegaly and a very high white cell count. She also reports fatigue, fevers and a 5kg weight loss. You order a new FBC and peripheral blood smear, the results are a moderate normocytic anaemia with very high WCC, on the smear immature cells and early myeloid cells are observed. A bone marrow analysis comes back positive for the Philadelphia chromosome. What is the best option for initial therapy?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":6,"explanation":"Chronic Myeloid Leukaemia (CML) - Treat with tyrosine kinase inhibitors: IMATINIB ","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631318,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:26:32","updated_at":"2018-11-30 15:01:20","questionName":"You are an FY2 in haematology seeing a 75 year old female patient who has a PMH of Polycythaemia vera. She is presenting with some new symptoms of night sweats and on examination she has massive splenomegaly. You order a FBC which shows a cytopenia. What would be the most appropriate next investigation?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":3,"explanation":"\u2022\tPrimary Myelofibrosis\r\no\tBone marrow gets filled with fibrous tissue - malignant\r\no\tAverage survival 5 years from diagnosis \u2013 no cure or real treatment\r\no\tPresent with:\r\n\uf0a7\tSweats, massive splenomegaly, cytopenias\r\n\uf0a7\tLeukoerythroblastic blood film: tear drop poikilocytes (red cells) + primitive white cells - means there\u2019s something INFILTRATING THE MARROW (secondary cancer or myelofibrosis)","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631333,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 11:46:39","updated_at":"2018-11-30 15:01:20","questionName":"Which factors are part of the intrinsic coagulation pathway?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":12,"explanation":"INTRINSIC PATHWAY = VIII, IX, XI, (XII) - 8, 9, 11, (12) \u2013 don\u2019t need factor 12 to generate thrombin","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631314,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:09:36","updated_at":"2018-11-30 15:01:20","questionName":"You're an FY1 and see a 60 year old female patient who has been referred in from GP with an itch and abnormal blood results - Hb 180 (high), WCC 20 (high), Platelets 475 (high). On examination you find hepatosplenomegaly, with some right upper quant rant tenderness and ankle oedema. What is the best diagnostic test?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":1,"explanation":"Polycythaemia Vera \u2013 HIGH HB sometimes with High WCC, High Platelets - Differentiate with history, and genetic test for JAK2 MUTATION (diagnostic of primary polycythaemia).","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631334,"quiz_id":"30871","answer_id":null,"answerType_id":"2","created_at":"2018-11-29 11:48:01","updated_at":"2018-12-06 11:37:59","questionName":"Match these test with the correct coagulation pathway...","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":13,"explanation":"INTRINSIC PATHWAY = VIII, IX, XI, (XII) = 8, 9, 11, (12) \u2013 don\u2019t need factor 12 to generate thrombin - APTT TEST\r\n\r\nEXTRINSIC PATHWAY = VII (only) 7 - PTT\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631326,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 11:03:13","updated_at":"2018-11-30 15:01:20","questionName":"A 55-year-old man complained of tiredness. He gives a history of knee problems and diabetes. His father died of liver cancer and also had diabetes.\r\n\r\nHaemoglobin \t\t165 g\/L \t(130-180)\r\nMCV \t\t\t84.9 fl \t\t(80-96)\r\nWBC \t\t\t6 x 109\/L \t(4.0-11)\r\nPlatelets \t\t398 x 109\/L \t(150-400)\r\n\r\nLFTs abnormal \r\nXrays of knees shows chondrocalcinosis.\r\n\r\nWhat is the most likely diagnosis?\r\n","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":8,"explanation":"Haemochromatosis is an inherited condition in which iron levels in the body slowly build up over many years.\r\nThis build-up of iron, known as iron overload, can cause unpleasant symptoms. If it isn't treated, this can damage parts of the body such as the liver, joints, pancreas and heart.\r\n\r\nSymptoms of haemochromatosis usually start between the ages of 30 and 60.\r\nCommon symptoms include:\r\nfeeling very tired all the time (fatigue)\r\nweight loss\r\nweakness\r\njoint pain\r\nin men, an inability to get or maintain an erection (erectile dysfunction)\r\nin women, irregular periods or absent periods","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631327,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 11:06:35","updated_at":"2018-11-30 15:01:20","questionName":"A 76-year-old woman was tired and gave a 3-month history of pins and needles in feet.\r\n \r\nHaemoglobin\t\t65 g\/L \t\t(130-180)\r\nMCV \t\t\t115.9 fL \t(80-96) \r\nWBC \t\t\t3.4 x 109\/L \t(4.0-11)\r\nPlatelets \t\t140 x 109\/L \t(150-400)\r\n\r\nWhat further investigations would be most appropriate?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":9,"explanation":"\u2022\tInvestigations\r\no\tB12 levels\r\no\tIntrinsic factor (produced by gastric parietal cells)\r\no\tAutoimmune antibodies \u2013 pernicious anaemia (autoimmune condition)\r\no\tFolate levels\r\no\tTFT\u2019s","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631328,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 11:08:02","updated_at":"2018-11-30 15:01:20","questionName":"What is the most common cause of macrocytosis?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":10,"explanation":"The most common cause of MACROCYTOSIS generally is ALCOHOL DEPENDANCY\r\n\r\n(Other rarer causes include myelodysplasia, AI haemolysis with reticulocytes, drugs, liver disease, aplastic anaemia, hypothyroidism)\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631322,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:51:26","updated_at":"2018-11-30 15:01:20","questionName":"You seen a 63 year old patient who has been referred to haematology with splenomegaly and a very high white cell count. She also reports fatigue, fevers and a 5kg weight loss. You order a new FBC and peripheral blood smear, the results are a moderate normocytic anaemia with very high WCC, on the smear immature cells and early myeloid cells are observed. You request a bone marrow analysis, what is the most likely findings?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":5,"explanation":"Chronic Myeloid Leukaemia (CML)\r\n\u2022\tReciprocal 9:22 translocation = Philadelphia chromosome (22 that is shorter than normal)\r\no\tForms a new gene (an oncogene) = BCR\/ABL\r\no\tThis produces the BCR\/ABL protein and upregulates tyrosine kinase \uf0e0 creates too many white cells (and platelets)\r\n\r\no\tBone marrow analysis\r\n\uf0a7\tPhiladelphia chromosome and\/or BCR\/ABL mutation\r\n\uf0a7\tHypercellularity \u2013 expansion of myeloid cell line (neutrophils, basophils, eosinophils)\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631315,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:13:05","updated_at":"2018-11-30 15:01:20","questionName":"You're an FY1 and see a 60 year old female patient who has been referred in from GP with an itch and abnormal blood results - Hb 180 (high), WCC 20 (high), Platelets 475 (high). On examination you find hepatosplenomegaly, with some right upper quant rant tenderness and ankle oedema. What is the best treatment?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":2,"explanation":"Polycythaemia Vera \u2013 HIGH HB sometimes with High WCC, High Platelets - with Budd-Chiari syndrome (clot in hepatic veins that drain the liver)\r\n\r\no\tPrimary\r\n\uf0a7\tNeed to be more aggressive getting Hb back to normal\r\n\u2022\tHydroxycarbamide \u2013 low dose chemotherapy. Can cause pancytopenia, also can cause leg ulcers, need to stop drug\r\n\u2022\tAspirin to stop them clotting\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631332,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 11:44:07","updated_at":"2018-12-06 11:35:45","questionName":"Which one of these statements is correct regarding correction studies if either PT or APTT is prolonged?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":11,"explanation":"\u2022\tCorrection studies (50:50 mix with normal plasma)\r\no\tIf either PT or APTT is prolonged\r\no\t50:50 mix with normal plasma\r\n\uf0a7\tIf it returns the level to normal, it tells you it\u2019s due to a clotting factor deficiency\r\n\uf0a7\tIf it doesn\u2019t correct, it tells you it\u2019s due to something inhibiting it (e.g. lupus anticoagulant, heparin, acquired haemophilia\/immune process)","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631311,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:06:17","updated_at":"2018-11-30 15:01:20","questionName":"You're an FY1 and see a 60 year old female patient who has been referred in from GP with an itch and abnormal blood results - Hb 180 (high), WCC 20 (high), Platelets 475 (high). On examination you find hepatosplenomegaly, with some right upper quant rant tenderness and ankle oedema. What is the most likely diagnosis?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":0,"explanation":"Polycythaemia Vera \u2013 HIGH HB sometimes with High WCC, High Platelets\r\n\u2022\tOften incidental finding\/asymptomatic\r\n\u2022\tItch\r\n\u2022\tSplenomegaly\r\n\u2022\tThrombosis\/CVA \u2013 for example:\r\no\tDVT\r\no\tBudd-Chiari syndrome (clot in hepatic veins that drain the liver - causing her pain, oedema and hepatomegaly)\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631324,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:59:33","updated_at":"2018-11-30 15:01:20","questionName":"A 65-year-old woman complained of tiredness and gave a history of 5 kg weight loss over 3 months. She had been fit and well previously. \r\n\r\nHer FBC was as follows:\r\nHaemoglobin \t\t95 g\/L \t\t(130-180)\r\nMCV \t\t\t64.9 fL \t\t(80-96)\r\nWBC \t\t\t6 x 109\/L\t(4.0-11)\r\nNeutrophil \t\t4 x 109\/L \t(1.5-7.0)\r\nPlatelets \t\t598 x 109\/L \t(150-400)\r\n\r\nWhat is the most likely diagnosis?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":7,"explanation":"Answer is microcytic anaemia due to bleeding - Hx of tiredness and weight loss with microcytic anaemia - think bowel cancer.","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631335,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 11:50:19","updated_at":"2018-11-30 15:01:20","questionName":"What are the vitamin K dependant clotting factors?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":14,"explanation":"Vitamin K dependant clotting factors\u2026 2, 7, 9, 10\r\nA way to remember is 1972 = 10 + 9 (19) then 7 and 2","question_score_id":null,"lang":"","questionAudioPath":null},{"id":631321,"quiz_id":"30871","answer_id":null,"answerType_id":"0","created_at":"2018-11-29 10:47:45","updated_at":"2018-11-30 15:01:20","questionName":"You seen a 63 year old patient who has been referred to haematology with splenomegaly and a very high white cell count. She also reports fatigue, fevers and a 5kg weight loss. You order a new FBC and peripheral blood smear, the results are a moderate normocytic anaemia with very high WCC, on the smear immature cells and early myeloid cells are observed. What is the mostly likely diagnosis?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":4,"explanation":"Chronic Myeloid Leukaemia (CML) \u2013 comes up in EXAMS!!\r\n(in bold need to know for exam)\r\n\u2022\tSplenomegaly and very high white count\r\n\r\n\u2022\tReciprocal 9:22 translocation = Philadelphia chromosome (22 that is shorter than normal)\r\no\tForms a new gene (an oncogene) = BCR\/ABL\r\no\tThis produces the BCR\/ABL protein and upregulates tyrosine kinase \uf0e0 creates too many white cells (and platelets)\r\n\r\n\u2022\tInvestigation:\r\no\tFBC\r\n\uf0a7\tMild-moderate normocytic anaemia\r\no\tPeripheral blood smear\r\n\uf0a7\tImmature cells and early myeloid cells (myeloblasts, nucleated RBCs, etc)\r\no\tBone marrow analysis\r\n\uf0a7\tPhiladelphia chromosome and\/or BCR\/ABL mutation\r\n\uf0a7\tHypercellularity \u2013 expansion of myeloid cell line (neutrophils, basophils, eosinophils)\r\n\r\n\u2022\tTreat with tyrosine kinase inhibitors: IMATINIB \r\no\tSide effects:\r\n\uf0a7\tLots\r\n\uf0a7\tParticularly fluid related, e.g. pleural effusion (don\u2019t need to drain it)\r\n","question_score_id":null,"lang":"","questionAudioPath":null}]
631323
0
120
block

You seen a 63 year old patient who has been referred to haematology with splenomegaly and a very high white cell count. She also reports fatigue, fevers and a 5kg weight loss. You order a new FBC and peripheral blood smear, the results are a moderate normocytic anaemia with very high WCC, on the smear immature cells and early myeloid cells are observed. A bone marrow analysis comes back positive for the Philadelphia chromosome. What is the best option for initial therapy?

Chọn câu trả lời đúng  

(0/0)














631318
0
120
none
631333
0
120
none
631314
0
120
none
631334
0
60
none
631326
0
120
none
631327
0
120
none
631328
0
120
none
631322
0
120
none
631315
0
120
none
631332
0
60
none
631311
0
120
none
631324
0
120
none
631335
0
120
none
631321
0
120
none