Which one of the following haematological disorders is most associated with gingival hyperplasia?
Correct Answer E: Gingival hyperplasia: phenytoin, cyclosporin, calcium channel blockers and AML.
Gingival hyperplasia:
Drug causes of gingival hyperplasia:
Other causes of gingival hyperplasia include:
Which one of the following is least associated with small cell lung cancer?
Correct Answer C:
Paraneoplastic features of lung cancer:
PTH-related peptide secretion is seen in squamous cell lung cancer.
Lung cancer: small cell: Features:
Management:
*APUD an acronym for:
Each one of the following is associated with hyposplenism, except:
Correct Answer B:
Hyposplenism Causes:
Features:
A 72-year-old man is referred to haematology with a raised haemoglobin. A diagnosis of polycythaemia rubra vera is suspected.
Which other abnormality of the blood would be most consistent with this diagnosis?
Correct Answer E:
Polycythaemia rubra vera: features: Polycythaemia rubra vera (PRV) is a myeloproliferative disorder caused by clonal proliferation of a marrow stem cell leading to an increase in red cell volume, often accompanied by overproduction of neutrophils and platelets.
It has recently been established that a mutation in JAK2 is present in approximately 95% of patients with PRV and this has resulted in significant changes to the diagnostic criteria. The incidence of PRV peaks in the sixth decade.
Following history and examination, the British Committee for Standards in Haematology (BCSH) recommend the following tests are performed:
If the JAK2 mutation is negative and there is no obvious secondary causes the BCSH suggest the following tests:
Other features that may be seen in PRV include a low ESR and a raised leukocyte alkaline phosphotase.
The diagnostic criteria for PRV have recently been updated by the BCSH. This replaces the previous PRV Study Group criteria.
1- JAK2-positive PRV - diagnosis requires both criteria to be present:
2- JAK2-negative PRV - diagnosis requires A1 + A2 + A3 + either another A or two B criteria:
Which of the following factors is associated with a good prognosis in acute myeloid leukaemia?
Correct Answer B: Acute myeloid leukaemia - good prognosis: t(15;17).
A translocation between chromosome 15 and 17 is seen in acute promyelocytic leukaemia, which is known to carry a good prognosis.
Acute myeloid leukaemia: Acute myeloid leukaemia is the more common form of acute leukaemia in adults. It may occur as a primary disease or following a secondary transformation of a myeloproliferative disorder.
Poor prognostic features:
Acute promyelocytic leukaemia M3:
Classification - French-American-British (FAB):
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