10/4

Question 1

What ages do people present with certain leukaemia?

Answer 1

ALL CeLLmates have CoMmon AMbitions

ALL <5 + >45
CLL >55
CML >65
AML >75

Question 2

Describe what acute leukaemia is

Why is it so bad?

Answer 2

Rapid proliferative of partially developed cells

• myeloid - affects differentiation/maturation of RBC, platletes and granulocytes
• lymphoid - affects lymphoid precusors

increased non-functioning cells, stop others from developing and reside in liver/spleen/thymus/lymph - causing mealy

Question 3

Match the following buzzwords to the haematological malignancy:
- Auer rods
- Smear cells
- Reed-sternberg cells (look like owl eyes)
- lymph node painful if drinking alcohol
- philadelphia chromosome
- JAK2 mutation
- rouleaux formation

Answer 3

1. AML
2. CLL
3. Hodgkin lymphoma
4. Hodgkin lymphoma
5. CML
6. Polycthaemia vera
7. Multiple myeloma

Question 4

To diagnose leukaemia they do
1. Blood count and film
2. Coag screen
3. Bone marrow aspiration

Where do they take the aspiration from?

Answer 4

Kids - tibia
Adults - Post iliac crest

Question 5

How is acute leukemia treated?

Answer 5

Multi-agent chemo (normally administered via central (Hickman) line)

Question 6

What is CLL?

It is only treated if B symptoms are present - what are these?

Answer 6

Progressive accumulation of functionally incompetent B cells

• weight loss
• night sweats
• fevers

Question 7

What is Burkitt lymphoma?

What viruses is it assoc. with?

Answer 7

A type of Non-Hodgkin lymphoma
Fastest growing human tumour

EBV and HIV

Question 8

What virus is associated with lymphoma?

Answer 8

Previous EBV infection

Question 9

How is CML managed?

Answer 9

1. Tyrosine kinase inhibitor (Imatinib)
2. Bone marrow transplant

Question 10

What is polycythaemia vera?

Answer 10

A cancer causing uncontrolled proliferation of RBC

Question 11

How is acute epistaxis managed from first aid to theatre - what are the steps?

What is applied if first aid management is successful?

Answer 11

1. First aid - Pinch the nostrils and lean forward for 20ish mins
   - if successful apply Naseptin cream - reduces crusting and risk of vestibulitis
2. Cautery - if can see bleeding point OR anterior packing
3. Posterior packing + urgent referral to ENT
4. Admit to ED for spehopalatine ligation in theare