1. Findings in PRV on bloods?
    • low ESR, raised leucoyte ALP.
    • raised RBCs, and neutrophils/platelets in 50%.
    • JAK 2 mutation.
  2. pt presents with previous gallstones, normocytic anaemia and a family history of splenectomy. Dx?
    • Hereditary spherocytosis is most common genetic haemolytic anaemia.
    • requires osmotic fragility test.
  3. Drugs that predispose to gallstones?
    ceftriaxone, TPN.
  4. Causes of megaloblastic anaemia?
    • vit b12 def
    • folate def (if both, make sure to treat with b12 first due to risk of SACDC)
    • drugs e.g. hydroxyurea.
    • alcohol
    • liver disease
    • hypothyroidism
    • pregnancy
    • reticulocytosis e.g. due to haemolysis
    • aplastic anemia
    • myelodysplasia.
  5. Management of severe thrombocytopenia in ITP?
    • Not pooled platelets as these are only destroyed by antibodies.
    • only managed if patient has other risk factors, or needs surgery etc.

    • oral prednisolone
    • IV Ig
    • pooled platelets (only for acute situation not maintenance)
    • plasmapheresis
  6. Poor prognostic factors in ALL?
    • older age at Dx
    • male
    • B, T cell type
    • philadelphia chromosome (normally present for CML)
    • CNS involvement
    • high white cell count (>100)
  7. large red beefy tongue and lemon yellow tinge to skin?
    • megaloblastic anaemia due to folate or b12 def.
    • (iron def causes painless glossitis and angular stomatitis. May also see koilonychia, pica and dysphagia due to pharyngeal web).
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