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Haematology

Haemopoiesis |Red cell disorders |Anaemias |Polycythaemias-primary and secondary |Thalassaemias |Haemoglobinopathies |White cell disorders|Leukaemias |Lymphomas-Hodgkin's disease and the non Hodgkin lymphomas | Myeloproliferative disorders | Myeloma and other plasma cell disorders |Platelet disorders |Thrombocytopenia |Thrombocytosis |Thrombosis |Coagulation |DIC | haemophilia and von Willebrand's disease. |Transfusion |Transplantation |General haematological problems| haematological emergencies (neutropenic fever, massive haemorrhage, abnormal bleeding, thromboembolism, hypercalcaemia )| Principles of laboratory haematology | The social and ethical issues of treatment

 

  • An understanding of haemopoiesis and how the cellular elements of blood are made.

    Exam Questions

    2001 paper one question 21 T cell development

    References


    • Red cell disorders-mechanisms, investigation and therapy:
    • Anaemias

     

    Exam Questions

    2001 paper one question 31 laboratory tests in microcytic anaemia

    2001 paper two question 6 Differential diagnosis blood film Pancytopenia, with macrocytosis, anisocytosis and hypersegmented neutrophils

    2001 paper two question 16 Diagnosis of acquired haemolytic anaemia

    2001 paper two question 35 Differentials for anaemia with reticulocytosis / haemolysis

      2002 paper two question 70 Aplastic Anaemia and Treatment

      2003 paper one question 25 Treatment of acquired siderablastic anaemia

      2003 paper two question 38Sickle cell crisis: acute presentation, anaemia and blood film

      2003 paper two question 65 Macrocytic anaemia of liver disease

      2003 paper two question 82 Diagnosing Pernicious anaemia
      question repeated 2005 paper one question 32

      2003 paper two question 93 Differentials for hypochromic microcytic anaema repeat question 2001 paper two question 72

      2004 paper one question 59 Megaloblastosis in Transcobalamin I deficiency

      2004 paper two question 48 Investigating Iron deficiency anaemia

      2004 paper two question 66 Diagnosing mechanism of anaemia

      2004 paper two question 93 Diagnosing aneamia on blood film

      2005 paper one question 18 Aneamia post op

      2005 paper two question 51 Aneamia and use of EPO in ESRD question repeated 2003 paper two question 40

      References

      Anaemia of Chronic Disease
      Weiss G and Goodnough LT
      NEJM 352;10 March 10 2005 pp 1011-23

      Red cells I: Inherited anaemias
      Weatherall D and Provan D
      The Lancet Vol 355 April 1 2000 pp 1169-75

      Red cells II: acquired anaemias and polycythaemia
      Provan D and Weatherall D
      The Lancet Vol 355 April 8 2000 pp 1260-8

      The Pathophysiology of Acquired Aplastic Anaemia
      Young NS and Maciejewski J
      NEJM Vol 336, No 19 May 8 1997 pp 1365-71

      Pure Red-Cell Aplasia and Epoetin Therapy
      Bennett CL et al
      NEJM 351;14 September 30, 2004, pp1403-8

      Polycythaemias-primary and secondary
    • 2003 paper two question 51 Distinguishing between primary and secondary causes of polycythaemia

      2004 paper two question 33 Distinguishing between primary and secondary causes of polycythaemia

      2005 paper two question 70 Distinguishing between primary and secondary causes of polycythaemia

      • Thalassaemias


      Exam question

      2003 paper two question 93 Differentials for hypochromic microcytic anaema repeat question 2001 paper two question 72

      References

      • Haemoglobinopathies.

       

      exam questions

      2002 paper two question 2 Genetic counselling for haemoglbinopathies. Repeat question2001 paper two question 65

      references

    • White cell disorders-pathophysiology, investigation and therapy:

      Exam Questions

      2002 paper two question 96Waldenstrom’s Macroglobulinaemia (WM)

      References

      Leukaemias-acute and chronic, myeloid and lymphoid

       

      exam questions

      2002 paper two question 20 Diagnosing APML on BMAT and appropriate therapy

      2004 paper one question 3 Lymphadenopathy, blood film and CD19 immunophenotype

      2004 paper one question 44 Diagnosing CML on blood film (philidelphia chromosome t(9;22))

      2004 paper two question 20 CML best treatment for complete cytogenic response

      References

      ALL

      Mechanisms of Disease: Acute Lymphoblastic Leukemia
      C.-H. Pui, M. V. Relling, and J. R. Downing
      New England Journal of Medicine Volume 350:1535-1548, April 8, 2004 No15

      Drug Therapy: Treatment of Acute Lymphoblastic Leukemia
      Pui C.-H., Evans W. E.
      N Engl J Med 2006; 354:166-178, Jan 12, 2006. Review Articles

      AML

      Adult Acute Myeloid Leukemia
      ELIAS J. JABBOUR, MD; ELIHU ESTEY, MD; AND HAGOP M. KANTARJIAN, MD
      Mayo Clin Proc. • February 2006;81(2):247-260 • www.mayoclinicproceedings.com

      CLL

      Chronic Lymphocytic Leukemia: Diagnosis and Treatment
      KAREN W. L. YEE, MD, AND SUSAN M. O’BRIEN, MD
      Mayo Clin Proc. • August 2006;81(8):1105-1129 • www.mayoclinicproceedings.com

      Mechanisms of Disease: Acute Lymphoblastic Leukemia
      Pui C.-H., Relling M. V., Downing J. R.
      N Engl J Med 2004; 350:1535-1548, Apr 8, 2004. Review Articles

      Mechanisms of Disease: Chronic Lymphocytic Leukemia
      Chiorazzi N., Rai K. R., Ferrarini M.
      N Engl J Med 2005; 352:804-815, Feb 24, 2005. Review Articles

      CML

      Chronic Myeloid Leukemia: Diagnosis and Treatment
      ALFONSO QUINTÁS-CARDAMA, MD, AND JORGE E. CORTES, MD
      Mayo Clin Proc. • July 2006;81(7):973-988 • www.mayoclinicproceedings.com

      BCR-ABL Tyrosine Kinase Inhibitors for Chronic Myelogenous Leukemia
      Schiffer C. A.
      N Engl J Med 2007; 357:258-265, Jul 19, 2007. Clinical Therapeutics

      Chronic myeloid leukaemia
      Rüdiger Hehlmann, Andreas Hochhaus, Michele Baccarani on behalf of the European LeukemiaNet
      Lancet 2007; 370: 342–50

      Mechanisms of Disease: Chronic Myeloid Leukemia — Advances in Biology and New Approaches to Treatment
      Goldman J. M., Melo J. V.
      N Engl J Med 2003; 349:1451-1464, Oct 9, 2003. Review Articles

      Lymphomas-Hodgkin's disease and the non Hodgkin lymphomas

      exam questions

      2003 paper two question 10 Diagnosing Burkkitts Lymphoma on blood smear and karyotypic abnormality

    2005 paper one question 39 Mechanism of hypercalcaemia in lymphoma is Increased 1,25(OH)2-vitamin D synthesis.

    2005 paper one question 48 Cancer risk following mantle radiotherapy treatment of hodgkins lymphoma

    reference

    Management of Hodgkin Lymphoma
    Stephen M. Ansell, James O. Armitage
    Mayo Clin Proc. • March 2006;81(3):419-426 • www.mayoclinicproceedings.com

    Non-Hodgkin Lymphoma: Diagnosis and Treatment
    STEPHEN M. ANSELL, MD, PHD, AND JAMES ARMITAGE, MD
    Mayo Clin Proc. • August 2005;80(8):1087-1097 •www.mayoclinicproceedings.com

    Treatment of Non-Hodgkin's Lymphoma
    Armitage JO
    N Engl J Med 328:1023, April 8, 1993 Review Article

    Part I: Hodgkin's lymphoma—molecular biology of Hodgkin and Reed-Sternberg cells Roman K Thomas, Daniel Re, Jürgen Wolf and Volker Diehl
    Lancet Oncol 2004; 5: 11–18

    Part II: Hodgkin's lymphoma—diagnosis and treatment
    Volker Diehl, Roman K Thomas and Daniel Re
     Lancet Oncol 2004; 5: 19–26


    Myeloproliferative disorders

    Exam Questions

    2002 paper two question 45 Blood film in myelofibrosis, tear drop cells

     

    references

    The Myelodysplastic Syndromes: Diagnosis and Treatment
    DAVID P. STEENSMA, MD, AND JOHN M. BENNETT, MD
    Mayo Clin Proc. • January 2006;81(1):104-130 •www.mayoclinicproceedings.com

    Myeloma and other plasma cell disorders.

    Exam Questions

    2002 paper two question 18 abnormal spine xray and protein on dipstick

    • 2003 paper two question 25 Diagnosing multiple myeloma on bone marrow aspirate and presentation

      References

      Multiple Myeloma: Diagnosis and Treatment
      S. VINCENT RAJKUMAR, MD, AND ROBERT A. KYLE, MD
      Mayo Clin Proc. • October 2005;80(10):1371-1382 •www.mayoclinicproceedings.com

      Monoclonal Gammopathy of Undetermined Significance,
      Waldenström Macroglobulinemia, AL Amyloidosis,
      and Related Plasma Cell Disorders: Diagnosis and Treatment
      S. VINCENT RAJKUMAR, MD; ANGELA DISPENZIERI, MD; AND ROBERT A. KYLE, MD
      Mayo Clin Proc. • May 2006;81(5):693-703 • www.mayoclinicproceedings.com

      Multiple Myeloma
      Kyle RA, Rajkumar SV
      N Engl J Med 351:1860, October 28, 2004 Review Article

       

      Platelet disorders-pathophysiology, investigation and therapy:

      Exam Questions

      2005 paper two question 9 differentials for thrombocythemia with blood film

      References

      Thrombocytopenia

      Exam questions

      2005 paper two question 36 Management of throbocytopenia in ITP

      2005 paper two question 78

      References

      Drug-Induced Immune Thrombocytopenia
      Aster RH, Bougie DW
      N Engl J Med 357:580, August 9, 2007 Review Article


      Thrombocytosis.

      Thrombosis:

      Exam questions

      2003 paper one question 64 Problems with investigations for an underlying hypercoagulable state in DVT Repeat question 2001 paper one question 19

      Reference

      An understanding of the general area of thrombophilia, its prevalence, investigation and management; indications for treatment with heparin, warfarin, thrombolytic therapy and the monitoring of patients receiving these drugs.

      Coagulation:

      Exam question

      2001 paper two question 52 Causes of prolonged APTT and APTT 1:1 mix, with normal INR

      2002 paper two question 58 Wafarin reversal and hypercoagulation

      2004 paper two question 84 Causes of raised APTT

      2005 paper one question 41 Role of von Willebrand's factor in normal coagulation

      2005 paper two question 20 Causes of raised APTT and increased thrombin time

       

      Reference

      Diagnosis and management of acquired disorders of haemostasis,

         

        including disseminated intravascular coagulation,

      as well as inherited disorders such as haemophilia and von Willebrand's disease.

      Exam Questions

      2003 paper one question 52 Treatment of haemophilia A and a high titre factor VIII inhibitor

    • 2004 paper one question 31 treatment with Aspirin and low molecular weight heparin to achieve pregnancy in womean with antiphospholipid syndrome

       

      References

      Transfusion:

      Indications for transfusion of red cells, platelets, fresh frozen plasma, cryoprecipitate, albumin and immunoglobulin concentrates. The principles of cross matching and assessment of transfusion reactions and of the obstetric patient.

      Exam questions

      2002 paper one question 57 Blood transfusion reaction Question repeated 2001 paper one question 45

      2002 paper one question 70 Leucodepletion

      2002 paper two question 77 Use of FFP during plasma exchange

      2003 paper one question 35 The use of Cryoprecipitate

      2004 paper two question 46 prevention of recurrent febrile non-haemolytic transfusion reactions

      2005 paper one question 18 Aneamia post op

      2005 paper one question 60 Blood components and risk of septic transfusion reaction

      References

       

    Australian Red Cross Blood service (Clinical Professional Information) www.transfusion.com.au NHMRC / ASBT (Aust and NZ society of Blood Transfusions) www.anzsbt.org.au Blood Safe Transusion Administration Check list www.safetyandquality.sa.gov.au/bloodsafe

    Red blood cell transfusion in clinical practice
    The LancetVolume 370, Issue 95854 August 2007-10 August 2007Pages 415-426 Harvey G Klein, Donat R Spahn and Jeffrey L Carson

    Platelet transfusions
    The LancetVolume 370, Issue 95854 August 2007-10 August 2007Pages 427-438 David F Stroncek and Paolo Rebulla

    Coagulation factor concentrates: past, present, and future
    The LancetVolume 370, Issue 95854 August 2007-10 August 2007Pages 439-448 Nigel S Key and Claude Negrier

    Transplantation:
    Principles of autologous and allogeneic haemopoietic stem cell tranplantation, including tissue typing, high dose therapy and graft-versus-host disease.

    Exam Questions

    2001 paper one question 7 Graft versus host disease 2003 paper two question 100 Complications of graft versus host disease References
    Interface with general medicine:
    General haematological problems, especially those associated with special units, e.g. intensive care, obstetrics and accident and emergency
    Assessment and management of haematological emergencies, e.g. neutropenic fever, massive haemorrhage, abnormal bleeding, thromboembolism, hypercalcaemia, nausea, vomiting and pain relief Principles of laboratory haematology: blood counting and morphology, immunophenotyping, cytogenetic analysis, simple tests of haemostasis and blood cross matching
    The social and ethical consequences of choosing not to institute or not to continue treatment and understanding the use of ICU severity scoring systems.


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