Transmission of which type of infection is most likely to occur following a platelet transfusion?
Correct Answer D: As platelet concentrates are generally stored at room temperature they provide a more favourable environment for bacterial contamination than other blood products.
Blood product transfusion complications:
Complications:
Immediate haemolytic reaction:
Febrile reactions:
Causes a degree of immunosuppression:
Patients with Sjogren's syndrome are at an increased risk of which one of the following malignancies?
Correct Answer E: Patients with Sjogren's syndrome have an increased risk of lymphoid malignancies.
Sjogren's syndrome:
Sjogren's syndrome is an autoimmune disorder affecting exocrine glands resulting in dry mucosal surfaces. It may be primary (PSS) or secondary to rheumatoid arthritis or other connective tissue disorders, where it usually develops around 10 years after the initial onset. Sjogren's syndrome is much more common in females (ratio 9:1). There is a marked increased risk of lymphoid malignancy (40-60 fold).
Features:
Investigation:
Management:
A 77-year-old man with a history of chronic lymphocytic leukaemia is admitted to the Acute Medical Unit with pneumonia. This is his fourth admission for pneumonia in the past six months.
Which one of the following factors is most likely to be responsible?
Correct Answer C:
Chronic lymphocytic leukaemia: Chronic lymphocytic leukaemia (CLL) is caused by a monoclonal proliferation of well-differentiated lymphocytes which are almost always B-cells (99%).
Investigations:
Burkitt's lymphoma is associated with which one of the following genetic changes:
Correct Answer D: Burkitt's lymphoma - c-myc gene translocation.
Burkitt's lymphoma:
Burkitt's lymphoma is a high-grade B-cell neoplasm. There are two major forms:
Burkitt's lymphoma is associated with the c-myc gene translocation, usually t(8:14). The Epstein-Barr virus (EBV) is strongly implicated in the development of the African form of Burkitt's lymphoma and to a lesser extent the sporadic form.
Management is with chemotherapy. This tends to produce a rapid response which may cause 'tumour lysis syndrome'.
Complications of tumour lysis syndrome include:
A 34-year-old man is reviewed four years after having an orchidectomy for a testicular teratoma.
What are the most useful follow-up investigation(s) to detect disease recurrence?
Correct Answer D:
Tumour markers: Tumour markers may be divided into:
It should be noted that tumour markers usually have a low specificity.
Monoclonal antibodies:
Tumour marker Association:
Tumour antigens: Tumour marker Association:
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