Multiple Choice Questions for Haematology and Core Medical Trainees

Contents

Cover

Title Page

Copyright

Preface

Normal Ranges and Abbreviations

Section 1: Single Best Answers Questions 1–50

SBA 1

SBA 2

SBA 3

SBA 4

SBA 5

SBA 6

SBA 7

SBA 8

SBA 9

SBA 10

SBA 11

SBA 12

SBA 13

SBA 14

SBA 15

SBA 16

SBA 17

SBA 18

SBA 19

SBA 20

SBA 21

SBA 22

SBA 23

SBA 24

SBA 25

SBA 26

SBA 27

SBA 28

SBA 29

SBA 30

SBA 31

SBA 32

SBA 33

SBA 34

SBA 35

SBA 36

SBA 37

SBA 38

SBA 39

SBA 40

SBA 41

SBA 42

SBA 43

SBA 44

SBA 45

SBA 46

SBA 47

SBA 48

SBA 49

SBA 50

Section 2: Single Best Answers Questions 51–120

SBA 51

SBA 52

SBA 53

SBA 54

SBA 55

SBA 56

SBA 57

SBA 58

SBA 59

SBA 60

SBA 61

SBA 62

SBA 63

SBA 64

SBA 65

SBA 66

SBA 67

SBA 68

SBA 69

SBA 70

SBA 71

SBA 72

SBA 73

SBA 74

SBA 75

SBA 76

SBA 77

SBA 78

SBA 79

SBA 80

SBA 81

SBA 82

SBA 83

SBA 84

SBA 85

SBA 86

SBA 87

SBA 88

SBA 89

SBA 90

SBA 91

SBA 92

SBA 93

SBA 94

SBA 95

SBA 96

SBA 97

SBA 98

SBA 99

SBA 100

SBA 101

SBA 102

SBA 103

SBA 104

SBA 105

SBA 106

SBA 107

SBA 108

SBA 109

SBA 110

SBA 111

SBA 112

SBA 113

SBA 114

SBA 115

SBA 116

SBA 117

SBA 118

SBA 119

SBA 120

Section 3: Extended Matching Questions 1–30

EMQ 1

EMQ 2

EMQ 3

EMQ 4

EMQ 5

EMQ 6

EMQ 7

EMQ 8

EMQ 9

EMQ 10

EMQ 11

EMQ 12

EMQ 13

EMQ 14

EMQ 15

EMQ 16

EMQ 17

EMQ 18

EMQ 19

EMQ 20

EMQ 21

EMQ 22

EMQ 23

EMQ 24

EMQ 25

EMQ 26

EMQ 27

EMQ 28

EMQ 29

EMQ 30

Section 4: Single Best Answers Answers to Questions 1–120 with Feedback

SBA 1 b Chronic Lymphocytic Leukaemia.

SBA 2 c JC Virus.

SBA 3 b 70 g/l.

SBA 4 c Haematological Features of Anorexia Nervosa.

SBA 5 c Anaemia of Chronic Disease Plus Iron Deficiency.

SBA 6 a Lead Poisoning.

SBA 7 d Plegmasia Caerulea Dolens.

SBA 8 e Ig (Immunoglobulin) A Anti-Tissue Transglutaminase Antibodies.

SBA 9 e Human Immunodeficiency Virus.

SBA 10 b Hepatitis B.

SBA 11 d Hereditary Haemorrhagic Telangiectasia.

SBA 12 e Streptococcus Pneumonia.

SBA 13 e Sinusoidal Obstruction Syndrome.

SBA 14 b Acute Myeloid Leukaemia, Breast Cancer, Hypothyroidism and Coronary Artery Disease.

SBA 15 c She should Take Supplementary Folic Acid.

SBA 16 a Anaemia.

SBA 17 d Wilson's Disease.

SBA 18 e Pure Red Cell Aplasia.

SBA 19 d Henoch–Schönlein Purpura.

SBA 20 b ESR Greater than 40 mm in 1 h.

SBA 21 e Lupus Anticoagulant.

SBA 22 e Vitamin B12 Deficiency.

SBA 23 b β Thalassaemia.

SBA 24 e The Haemoglobin A1c is Likely to be Misleadingly Reduced.

SBA 25 e Vitamin K Malabsorption.

SBA 26 a An Apparently Healthy 70-Year-Old Woman.

SBA 27 b Dengue Fever.

SBA 28 d Schistosomiasis.

SBA 29 d Malaria.

SBA 30 c Anaemia of Chronic Disease.

SBA 31 b Acute Myeloid Leukaemia.

SBA 32 b Intrinsic Factor Antibodies.

SBA 33 c Hypoparathyroidism.

SBA 34 e Primary Myelofibrosis.

SBA 35 d Sickle Cell-Related Intrahepatic Cholestasis.

SBA 36 a Atypical Haemolytic Uraemic Syndrome (aHUS).

SBA 37 d Rasburicase.

SBA 38 a Measure D Dimer.

SBA 39 c Cholesterol Embolisation.

SBA 40 b Fluid Restriction.

SBA 41 b Intravenous Fluids 3 l/m2/d Plus Allopurinol.

SBA 42 e Temporal Artery Biopsy Followed by Prednisolone in a Dose of 40–60 mg Daily.

SBA 43 d Molecular Analysis for JAK2 Mutation.

SBA 44 b Computed Tomography Pulmonary Angiogram.

SBA 45 c Serum Tryptase.

SBA 46 e Warfarin or Non-Vitamin K Antagonist Oral Anticoagulant.

SBA 47 d Rivaroxaban is Relevant and She is Likely to be Fully Anticoagulated.

SBA 48 b Four-Factor Prothrombin Complex Plus Vitamin K.

SBA 49 d Factor XI Deficiency

SBA 50 b No Specific Treatment

SBA 51 d Sézary Syndrome.

SBA 52 b Imatinib 200–300 mg Daily.

SBA 53 b Combination Chemotherapy Followed by Involved Field Radiotherapy.

SBA 54 e Molecular Analysis for a JAK2 Exon 12 Mutation.

SBA 55 a Acquired von Willebrand Disease.

SBA 56 e The Eculizumab Therapy is Unmasking C3 Binding to Red Cells.

SBA 57 d Transfusion of Blood Intended for Another Patient.

SBA 58 a Arrange Molecular Analysis for a CALR Mutation and BCR-ABL1.

SBA 59 d Top-Up Transfusion to Achieve an Hb of 100 g/l.

SBA 60 d Ruxolitinib.

SBA 61 c Juvenile Myelomonocytic Leukaemia.

SBA 62 d Horse Antithymocyte Globulin Plus Ciclosporin.

SBA 63 a Autoimmune Lymphoproliferative Syndrome.

SBA 64 a Blastic Plasmacytoid Dendritic Cell Neoplasm

SBA 65 a Adult T-Cell Leukaemia/Lymphoma.

SBA 66 e Von Willebrand Factor-Containing Plasma-Derived Concentrate.

SBA 67 a B-Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma.

SBA 68 d Rituximab.

SBA 69 c Doxycycline.

SBA 70 a Clusters of CD34-Positive Cells in Biopsy Sections

SBA 71 e Therapy-Related Myeloid Neoplasm.

SBA 72 e Recombinant Factor VIIa OR Activated Prothrombin Complex, Followed by Cyclophosphamide and Corticosteroids.

SBA 73 c Plasma Exchange Followed by Eculizumab.

SBA 74 e Withholding the Second Dose of Desmopressin and no Encouragement of Fluid Intake.

SBA 75 b Chronic Eosinophilic Leukaemia with PDGFRB Rearrangement.

SBA 76 b Ibrutinib.

SBA 77 b Acute Promyelocytic Leukaemia

SBA 78 a Arrange Magnetic Resonance Imaging

SBA 79 a Continuation of Allopurinol.

SBA 80 e Solvent Detergent-Treated Fresh Frozen Plasma.

SBA 81 d Reduced-Intensity Treatment.

SBA 82 b Aspirin Plus Low Molecular Weight Heparin.

SBA 83 c Clostridium Perfringens Sepsis.

SBA 84 d A Normal Thrombin Time.

SBA 85 e Rearrangement of MYC.

SBA 86 e Oral Corticosteroids.

SBA 87 b CD1a

SBA 88 e Iron-Refractory Iron Deficiency Anaemia.

SBA 89 c Phlebotomy to Normalise Iron Stores.

SBA 90 a Cautious Paracentesis and Defibrotide.

SBA 91 e Is Increased Leading to Impaired Release of Iron from Macrophages and Reduced Delivery of Iron into the Plasma by Enterocytes.

SBA 92 b High Dose Methotrexate Followed by Dose-Intensive Consolidation Chemotherapy

SBA 93 b Chromogenic Assay for Anti-Thrombin Activity.

SBA 94 a Copper Deficiency.

SBA 95 d Heterozygosity for Either β Thalassaemia or Haemoglobin S.

SBA 96 b Haemopoietic Stem Cell Transplantation.

SBA 97 b Danazol.

SBA 98 b DNA Analysis for α0 Thalassaemia.

SBA 99 c β Thalassaemia Heterozygosity.

SBA 100 a Intrinsic Factor Antibodies.

SBA 101 c Less than 5 Days Old, CMV-Negative, Taken into Citrate-Phosphate-Dextrose (CPD), Irradiated.

SBA 102 d POEMS Syndrome.

SBA 103 b Aspirin, Venesection and Hydroxycarbamide.

SBA 104 c Observation.

SBA 105 b Normal for Age.

SBA 106 c Intravenous Methylene Blue.

SBA 107 c Commencement of Argatroban and Administration of Vitamin K.

SBA 108 a Compound Heterozygosity for β0 Thalassaemia and δβ Thalassaemia.

SBA 109 c Continue Warfarin at the Same Dose as Long as the INR is in the Therapeutic Range.

SBA 110 b Herpes Zoster.

SBA 111 d Haemoglobin D-Punjab Trait.

SBA 112 e Ruxolitinib.

SBA 113 e Rituximab in a Dose of 375 mg/m2 Weekly for 4 Weeks.

SBA 114 c Hyperdiploidy.

SBA 115 e Hereditary Xerocytosis.

SBA 116 a BCR-ABL1.

SBA 117 e Intensive Combination Chemotherapy Plus Rituximab Plus HAART.

SBA 118 d This Variant Haemoglobin can Interact Adversely with Haemoglobin S and β Thalassaemia.

SBA 119 e Neutrophilic Leukaemoid Reaction.

SBA 120 d Persistent Polyclonal B Lymphocytosis.

Section 5: Extended Matching Questions Answers and Feedback

EMQ 1

EMQ 2

EMQ 3

EMQ 4

EMQ 5

EMQ 6

EMQ 7

EMQ 8

EMQ 9

EMQ 10

EMQ 11

EMQ 12

EMQ 13

EMQ 14

EMQ 15

EMQ 16

EMQ 17

EMQ 18

EMQ 19

EMQ 20

EMQ 21

EMQ 22

EMQ 23

EMQ 24

EMQ 25

EMQ 26

EMQ 27

EMQ 28

EMQ 29

EMQ 30

Index

End User License Agreement

Multiple Choice Questions for Haematology and Core Medical Trainees

Barbara J. Bain

MB BS, FRACP, FRCPath

Professor in Diagnostic Haematology,

Imperial College London and Honorary Consultant Haematologist,

St Mary's Hospital, Praed Street, London.

This edition first published 2016 © 2016 by John Wiley & Sons Ltd.

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Library of Congress Cataloging-in-Publication Data

Names: Bain, Barbara J., author.

Title: Multiple choice questions for haematology and core medical trainees / Barbara J. Bain.

Other titles: Multiple choice questions and extending matching questions for haematology and core medical trainees

Description: Chichester, West Sussex, UK ; Ames, Iowa : John Wiley & Sons, Inc., [2016] | Includes bibliographical references and index.

Identifiers: LCCN 2015044915 (print) | LCCN 2015047076 (ebook) | ISBN 9781119210528 (pbk.) | ISBN 9781119210559 (pdf) | ISBN 9781119210535 (epub)

Subjects: | MESH: Hematologic Diseases—Examination Questions. | Blood Physiological Phenomena—Examination Questions.

Classification: LCC RC633 (print) | LCC RC633 (ebook) | NLM WH 18.2 | DDC 616.1/50076—dc23

LC record available at http://lccn.loc.gov/2015044915

A catalogue record for this book is available from the British Library.

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Preface

This book has been written to help haematology trainees preparing for the part 1 examination of the Royal College of Pathologists. It will also be of use to core medical trainees preparing for the examinations of the Royal College of Physicians and the Royal Australasian College of Physicians and to haematology and general medicine trainees in other countries where methods of examination are similar. There is a considerable paediatric content so the book will also be useful to those preparing for examination of the Royal College of Paediatrics and Child Health. The two formats that are most used by these Royal Colleges have been used, Single Best Answer and Extended Matching Question. Detailed feedback and, when appropriate, relevant references are given for each question so that those who select the wrong answer will understand why another answer is preferred. Because of the detailed feedback and because some of the questions are quite searching, the book is an educational tool as well as a way to prepare for examinations. It will thus be of value also to advanced trainees including those preparing for the part 2 RCPath examination. Since the book incorporates much recent knowledge it may well also be of use to consultant haematologists wanting to update themselves as well as to those who are involved in training and examining.

Barbara J. Bain, 2016

Normal Ranges and Abbreviations

Core abbreviations and normal ranges

Standard abbreviations (not defined in text) and normal ranges for the