Malignant Qu 1

You SHO phones you for advice. They have been asked to review a 35 year old man who started his steroid pre-phase for ALL yesterday. The patient complained of palpitations and an ECG shows some T wave abnormalities.


-       What do you suspect and how will you proceed?

-       What are the diagnostic criteria for TLS?

-       Can you give me any examples of risk factors for TLS?

-       Can you tell me how rasburicase works?

-       What is the dose in prophylaxis?


Malignant Qu 2

A GP refers a 57 year old man to you with a Hb 170, Hct 0.53, plt 320, WBC 6.0. How would you approach the investigation of this patient?

-       The patient is positive for the JAK2 V617F mutation. Can you tell me about any diagnostic criteria for PV?

-       How will you manage this patient?

-       Would you not start cytoreduction?

-       Three years later patient is still venesection dependent as he did not tolerate hydroxycarbamide and he is now experiencing early satiety and LUQ discomfort. Would you give him ruxolitinib?


Coag Qu 1

Tell me the principle of preforming an activated partial thromboplastin time

-       Tell me about the method or analyser your lab uses for this

-       What is Quality Assurance and how does your lab ensure that is provides its service users with quality APTT results?

-       Your lab manager phones you and tells you that your most recent NEQAS submission has been returned as outwith consensus. You reported an APTT of 36 seconds, compared to the method median of other labs which reported 43 seconds. What would your initial actions be?