Theme: TLS Options Each option may be used once, more than once, or not at all. A. Oral allopurinol (standard dose) B. High-dose allopurinol (up to 800 mg/day) C. Febuxostat D. Aggressive IV hydration alone E. Fixed-dose rasburicase (3 mg stat) F. Weight-based rasburicase (0.2 mg/kg daily) G. Stop allopurinol and commence rasburicase H. Continue allopurinol and add rasburicase I. Emergency hyperkalaemia protocol J. IV calcium gluconate K. Withhold calcium replacement L. Initi

Theme: Cytogenetics & Molecular Abnormalities Options (Each option may be used once, more than once, or not at all) A. t(8;21) – RUNX1-RUNX1T1 B. inv(16) / t(16;16) – CBFB-MYH11 C. t(15;17) – PML-RARA D. t(9;22) – BCR-ABL1 E. t(11;14) – CCND1-IGH F. t(14;18) – IGH-BCL2 G. t(8;14) – MYC-IGH H. t(11;17) – PLZF-RARA I. t(5;14) – IL3-IGH J. t(4;14) – FGFR3-MMSET 📘 Questions Q1 A 32-year-old woman presents with fatigue, bruising, and gum bleeding. Blood film shows abnormal promye

Options A. APL B. BPDCN C. CMML D. T-PLL E. ATLL F. T-LGL G. NK-LGL H. Hairy Cell Leukaemia I. CLL J. Mantle Cell Lymphoma K. Follicular Lymphoma L. Burkitt Lymphoma M. DLBCL N. Classical Hodgkin Lymphoma O. Nodular Lymphocyte Predominant Hodgkin Lymphoma P. Waldenström Macroglobulinaemia Q. Splenic Marginal Zone Lymphoma R. ALCL S. PTCL-NOS T. Sézary Syndrome 🔬 Questions Q1 A 36-year-old woman presents with fatigue, spontaneous bruising, and gum bleeding. Blood tests show p

Theme: Inherited Platelet Disorders A. May–Hegglin anomaly B. Sebastian syndrome C. Fechtner syndrome D. Epstein syndrome E. Eckstein syndrome F. Bernard–Soulier syndrome G. Grey platelet syndrome H. Giant platelet syndrome with velocardiofacial syndrome (22q11.2 deletion) Questions (Select ONE best option for each scenario): Q1. A 24-year-old man is incidentally found to have thrombocytopenia on routine blood tests. Blood film shows giant platelets and Döhle-like leukocyte i

Theme: Perioperative Anticoagulation Options A. Continue warfarin without interruption B. Stop warfarin 5 days pre-op, no bridging C. Stop warfarin 5 days pre-op + therapeutic LMWH bridging D. Stop warfarin 5 days pre-op + prophylactic LMWH E. Continue DOAC without interruption F. Stop DOAC 24 hours pre-op G. Stop DOAC 48–72 hours pre-op H. Delay surgery I. Warfarin reversal by PCC and Vitamin K J. Restart anticoagulation 6–12 hours post-op at therapeutic dose Questions Q1 A

Theme: Haemoglobinopathies Options (use once, more than once, or not at all): A. Sickle cell trait (HbAS) B. Sickle cell disease (HbSS) C. HbSC disease D. β-thalassaemia trait E. β-thalassaemia major F. δβ-thalassaemia G. Hereditary persistence of fetal haemoglobin (HPFH) H. HbE traitI. HbE disease J. HbD Punjab trait K. HbC trait L. HbH disease (α-thalassaemia) M. Recent transfusion effect N. Iron deficiency affecting HbA₂ interpretation Questions Q1 A 25-year-old man of Wes

Options (each used once, more than once, or not at all): A. Pyruvate kinase deficiency B. Glucose-6-phosphate dehydrogenase deficiency C. Increased 2,3-bisphosphoglycerate D. Decreased oxygen affinity of haemoglobin E. Reticulocytosis masking enzyme deficiency F. Heinz body formation G. Echinocyte (burr cell) formation H. Oxidative stress–induced hemolysis I. ATP depletion in red cells J. X-linked inheritance Questions Q1 A 24-year-old man of African ancestry presents with da

Theme: AML Options A. PML::RARA B. RUNX1::RUNX1T1 C. CBFB::MYH11 D. KMT2A::MLLT3 E. DEK::NUP214 F. t(3;3) G. AML with mutated NPM1 H. AML with CEBPA I. AML with mutated TP53 J. AML with BCR::ABL1 Questions Q1 A 34-year-old woman presents with menorrhagia, and rapidly worsening fatigue over 10 days. Examination reveals ecchymoses and mild fever but no significant lymphadenopathy. Laboratory tests show Hb 82 g/L, platelets 18 ×10⁹/L, WBC 4.2 ×10⁹/L, fibrinogen markedly reduced,

Theme: Haemorrhage Options A. Immediate issue O D negative red cells B. Immediate issue O D positive red cells C. Take crossmatch sample before first emergency unit D. Tranexamic acid (TXA) should not be used in GI Bleed E. Second dose TXA 1 g if bleeding persists after 30 min F. Early fibrinogen monitoring and replacement G. Intraoperative cell salvage (ICS) H. ABO-incompatible platelets (low titre) I. Anti-D immunoglobulin 1500 IU J. Switch rapidly to group-specific blood K

Options-Fractionated Products (Blood Essential Book-NHSBT Website) A. Anti-D immunoglobulin within 72 hours B. Anti-D immunoglobulin 1500 IU after intraoperative cell salvage C. Additional anti-D dosing guided by fetomaternal haemorrhage estimation D. 20% Human Albumin Solution (HAS) E. 4.5% / 5% Human Albumin Solution (HAS) F. Intravenous Immunoglobulin (IVIg) replacement therapy G. High-dose IVIg as immune modulation H. Disease-specific immunoglobulin I. No Albumin replacem

Theme: Blood Donation, Donor Eligibility, Component Processing and Blood Safety Options A. Whole blood donation every 12 weeks B. Whole blood donation every 16 weeks C. Platelet donation every 2–4 weeks D. Plasma donation every 2 weeks E. Minimum donor age 17 years F. Minimum donor weight 50 kg G. Female donor under 65 kg requires estimated blood volume calculation H. Diversion pouch of first 20–30 mL I. Male-only donor policy for FFP production J. Platelet storage at 22°C wi

Theme: HIT Options A. Proceed with intraoperative unfractionated heparin (UFH) only, with non-heparin anticoagulation before and after surgery B. Use bivalirudin C. Delay surgery until PF4-heparin antibodies become negative D. Use argatroban E. Use citrate anticoagulation F. Use danaparoid G. Use plasma exchange (PEx) ± IVIG before essential heparin exposure H. Use low molecular weight heparin (LMWH) I. Perform a functional platelet activation assay for PF4-heparin antibodies

Theme: Diagnosis and Management of HIT Options A. Stop heparin and start argatroban B. Stop heparin and start fondaparinux C. Start warfarin immediately D. Perform PF4 IgG ELISA only E. Perform platelet activation assay with high-dose heparin inhibition and Fc receptor blockade F. Give IVIG 1 g/kg for 2 days G. Continue LMWH and repeat platelet count H. Therapeutic anticoagulation for 3 months I. Therapeutic anticoagulation for 4 weeks J. Provide HIT alert card and clearly do

Theme: Laboratory Diagnosis of HIT Options A. HIT excluded; no further testing required B. Stop heparin and start alternative anticoagulation immediately C. Perform high-sensitivity IgG-specific anti-PF4 ELISA D. Perform serotonin release assay (functional platelet activation assay) E. Repeat sample using a fresh specimen for lateral flow assay F. Do not use PIFA alone for diagnosis G. Interpret positive ELISA result with 4Ts pretest probability score H. Report optical densit

Theme: Heparin-Induced Thrombocytopenia (HIT) Options A. Continue heparin and no further investigation required B. Stop heparin immediately and start alternative therapeutic anticoagulation C. Send PF4/heparin antibody test only and continue heparin D. Give prophylactic platelet transfusion E. Start warfarin immediately F. Calculate 4Ts pretest probability score G. Routine platelet monitoring not required H. Repeat platelet count 24 hours after starting heparinI. Switch from

Theme: Diagnosis and Initial Management of Rare Aggressive T-cell Lymphomas Options A. CHOP chemotherapy followed by consideration of autologous HSCT consolidation B. Intensive non-cross-resistant chemotherapy (e.g. NCRI/SNLG protocol) followed by BEAM-conditioned auto-HSCT C. Intensive non-anthracycline-based chemotherapy such as IVAC/ICE with early referral for allo-HSCT D. Immediate allogeneic HSCT without induction chemotherapy E. Brentuximab vedotin + CHP F. Watchful wai

Theme: Mature T Cell Leukaemia/Lymphoma Options A. CNS prophylaxis using DLBCL risk assessment B. PET-CT staging C. EBER in situ hybridization D. EBV DNA qPCR monitoring E. Non-cross-resistant multiagent chemotherapy F. Anthracycline-based therapy G. Immediate radiotherapy alone H. Brentuximab monotherapy I. Observation only J. Intrathecal methotrexate for all patients Questions 1. A 52-year-old woman presents with advanced-stage ENKTL involving the nasal cavity, skin, liver,

Theme: Mature T/NK Cell Lymphomas Options A. CHOP chemotherapy alone B. CHOP followed by involved-site radiotherapy (ISRT) C. CHOP followed by autologous stem cell transplant consolidation D. SMILE regimen + radiotherapy E. DDGP regimen F. Allogeneic stem cell transplant in first remission G. Allogeneic stem cell transplant in second remission H. High-dose methotrexate CNS prophylaxis I. Brentuximab vedotin + CHP J. AspaMetDex Questions 1. A 58-year-old man presents with gene

Theme: Complex Management of Peripheral T-cell Lymphomas Options (Each option may be used once, more than once, or not at all) A. AZT + interferon-α B. High-dose AZT + interferon-α C. CHOP-like chemotherapy D. CHOP-like chemotherapy + AZT/IFN-α E. CHP + brentuximab vedotin (CHP-BV) F. Allogeneic HSCT G. Autologous HSCTH. Brentuximab vedotin monotherapy I. Multiagent salvage chemotherapy (non–cross-resistant) J. CNS prophylaxis K. Treat Strongyloides infection L. AZT/IFN-α mai

Theme: Management of Mature T-cell Leukaemia’s Options (Each option may be used once, more than once, or not at all) A. Watch-and-wait (observation only) B. Intravenous alemtuzumab C. Alemtuzumab + purine analogue D. Alemtuzumab re-treatment E. Allogeneic HSCT F. Autologous HSCT G. Methotrexate (low-dose weekly) H. Ciclosporin I. Cyclophosphamide J. Supportive therapy (G-CSF ± erythropoietin ± short steroids) K. Alemtuzumab (for refractory LGLL) L. Purine analogue (e.g. pento