A 48-year-old man of Irish ancestry is referred to the haematology clinic after abnormal liver function tests are noted during investigation of fatigue. He reports worsening pain in both hands over the past 5 years and states that handshakes have become increasingly uncomfortable. His father died from liver cancer aged 68 years. He drinks less than 10 units of alcohol weekly. Examination reveals mild skin hyperpigmentation and tenderness over the second and third metacarpopha

A 42-year-old man of Ashkenazi Jewish ancestry is referred to the haematology clinic for investigation of longstanding thrombocytopenia and splenomegaly. Over the preceding five years, he has developed worsening fatigue, intermittent severe pain affecting both femora and hips, and progressive limitation in exercise tolerance. He reports that several episodes of bone pain were initially diagnosed as "sports injuries" despite occurring without significant trauma. He also descri

A 54-year-old man of Northern European ancestry is referred to the haematology clinic after abnormal liver function tests were identified during an insurance medical examination. He reports progressive fatigue over the last 5 years, reduced libido, and worsening pain affecting the second and third metacarpophalangeal joints bilaterally. His father died from "liver disease" in his sixties. Investigations demonstrate: Test Result Hb 162 g/L WBC 6.4 × 10⁹/L Platelets 220 × 10⁹/L

A 51-year-old man is referred to the haematology clinic with a 9-month history of fatigue, night sweats, intermittent diarrhoea, and a 7-kg weight loss. Examination reveals moderate splenomegaly but no lymphadenopathy. Full blood count shows: Hb 118 g/L WBC 28.5 ×10⁹/L Neutrophils 10.2 ×10⁹/L Eosinophils 11.8 ×10⁹/L Platelets 520 ×10⁹/L Blood film confirms marked eosinophilia without significant dysplasia. Bone marrow examination demonstrates a hypercellular marrow with eosin

A 76-year-old woman is referred to the haematology clinic with a 9-month history of progressive gait disturbance, numbness of both feet, memory impairment and fatigue. She has a history of autoimmune hypothyroidism, type 2 diabetes mellitus treated with metformin for 12 years, and gastro-oesophageal reflux disease treated with omeprazole for many years. Examination reveals: Loss of vibration sense to the knees Absent ankle jerks Mild glossitis Investigations: Test Result Refe

A 58-year-old man with a 5-year history of primary cold haemagglutinin disease is referred for urgent coronary artery bypass grafting (CABG) following angiography demonstrating severe triple-vessel coronary artery disease. Pre-operative investigations reveal: Haemoglobin: 94 g/L Reticulocyte count: 180 × 10⁹/L DAT: strongly positive for C3d only Cold agglutinin titre: 1:4096 The cardiac surgeon discusses the planned procedure with the haematology team. Which of the following

Theme: Paediatric & Neonatal Transfusion Medicine Options A. Delayed cord clamping B. Exchange blood transfusion (EBT) C. Fetal blood sampling (FBS) D. Intrauterine red cell transfusion (IUT) E. Intrauterine platelet transfusion F. Neonatal red cell transfusion 15 mL/kg G. Neonatal platelet transfusion threshold 25 × 10⁹/L H. IVIg and maternal steroids during pregnancy I. Fresh (<5 day old) irradiated red cells transfused through a blood warmer J. Paedipack red cell transfus

Theme: Management of Relapsed Acute Lymphoblastic Leukaemia (ALL) Option List Each option may be used once, more than once, or not at all. A. Blinatumomab followed by HSCT B. CAR-T cell therapy assessment C. Standard-risk chemotherapy pathway without HSCT D. Imatinib in addition to relapse therapy E. Cranial radiotherapy during maintenance F. National MDT discussion only G. Bilateral orchidectomy H. Second cycle of blinatumomab I. Proceed directly to HSCT J. Continue inductio

Theme: ALL Risk Stratification and Management Decisions Options A. Continue allocated induction and commence Imatinib from Day 15 B. Transfer to Induction C on Day 15 C. Proceed directly to Blinatumomab consolidation at Week 6 D. Proceed to Extended Induction (Hemi-1B) E. Allocate to Standard-Risk pathway following Blinatumomab F. Allocate to High-Risk pathway following Blinatumomab G. Classify as Blinatumomab Failure H. Consider allogeneic stem cell transplantation I. Manage

Instructions For Questions 1–10, select the single BEST answer from the option list below. Each option may be used once, more than once, or not at all. Option List A. Acyclovir B. Co-trimoxazole C. Ciprofloxacin D. Meropenem E. Omeprazole F. Trimethoprim G. Sodium bicarbonate hydration and urine alkalinisation H. Calcium folinate (folinic acid) rescue I. Glucarpidase J. Monitoring methotrexate plasma concentrations K. NSAIDs L. Delaying methotrexate administration pending con

Theme Jehovah's Witness Option List Choose the single best answer for each scenario. A. Proceed with blood transfusion immediately B. Respect the patient's refusal and continue bloodless management C. Seek consent from relatives before transfusing D. Refer to the High Court for a specific issue order E. Review and follow the patient's Advance Decision document F. Administer transfusion because refusal may result in death G. Optimize haemoglobin with iron and/or erythropoietin

Theme For each clinical scenario, select the single most appropriate treatment from the option list below. Each option may be used once, more than once, or not at all. Options A. Prothrombin Complex Concentrate (PCC) B. Recombinant activated factor VII (NovoSeven®) C. FEIBA® (Activated Prothrombin Complex Concentrate) D. Fresh Frozen Plasma (FFP) E. Vitamin K F. Obizur® (Recombinant Porcine FVIII) and Steroids G. Voncento® (VWF/FVIII concentrate) H. Factor VIII concentrate I.

Theme: Diagnosis and investigation of haemoglobinopathies. Options A. β-thalassaemia trait B. α⁰-thalassaemia trait C. Homozygous α⁺-thalassaemia D. δβ-thalassaemia trait E. Hereditary persistence of fetal haemoglobin (HPFH) F. Hb E trait G. Hb Lepore trait H. Hb S/β⁰-thalassaemia I. Hb SC disease J. Further DNA analysis required K. Repeat testing after iron repletion L. Test biological father immediately M. Newborn likely to have β-thalassaemia major/TDT N. Emergency sickle