GeriQBank · Topic
Anaemia, haematological disorders, cancer and cancer screening.
Set 3 or more times
Exceptionally well covered: Pathy's Ch. 26/27, Tables 26.1–26.4 and 27.1 — directly quotable. Subtype Dysplastic lineages Ring sideroblasts Blasts MDS-SLD 1 <15% (<5% if SF3B1+) PB<1%, BM<5% MDS-RS 1–3 ≥15% (≥5% if SF3B1+) PB<1%, BM<5%…
Myelodysplastic Syndrome Describe the WHO classification and diagnostic criteria of myelodysplastic syndrome. Discuss its differential diagnosis. (15 marks) Definition. Myelodysplastic syndromes are clonal disorders of the…
Primary source: Pathy's, 6th ed. — "Preventive Geriatrics"; Essentials of Clinical Geriatrics, 7th ed. — "Prevention". Screening is secondary prevention — detection of disease in the preclinical phase. Essentials states that the value…
Primary source: Pathy's, 6th ed.; Essentials of Clinical Geriatrics, 7th ed. The prevalence of carcinogenesis increases along the entire gastrointestinal tract with age, driven by mucosal irritation, inflammation, impaired antioxidant…
Primary source: Pathy's, 6th ed. — "Preventive Geriatrics"; Essentials of Clinical Geriatrics, 7th ed. — "Prevention". Mammography is the mainstay of breast cancer screening. Research has shown mammography to be effective up to age 84 —…
Well covered: Pathy's Ch. 26 ("Myelodysplasia") and Ch. 27 ("Management of MDS and AML in the Elderly") cover this topic in genuine depth — this answer is largely textbook-derived. Heterogeneous clonal haematopoietic stem cell disorders…
Set twice
Note on sources: Pathy's 6th edition does not carry a single dedicated chapter on the ageing immune system. The textbook content below is assembled from the chapters where it is covered — Cancer and Ageing, Geriatric Dermatology, Modern…
Set once
Definition. Remote, non-metastatic effects of malignancy mediated by tumour-secreted hormones, cytokines or cross-reacting onconeural antibodies — not by tumour mass, local invasion or metastasis. They are important because they are…
Definition and mechanism. An oncological emergency caused by massive lysis of tumour cells, spontaneously or after cytotoxic therapy, releasing intracellular contents into the circulation faster than the kidney can clear them. This…
Well covered: Pathy's Ch. 22, under "Inflammatory Anaemias", with Figures 22.3 and 22.5. Anaemia from inflammation with excess cytokine production — a functional iron deficiency (stores normal/high, but unavailable for erythropoiesis).…
Well covered: Pathy's Ch. 24 ("Disorders of Platelet Number"), supplemented by Ch. 23 (DIC). Definition: platelet count <1,50,000/µL. Platelet count does NOT change with normal ageing — a low count always signifies disease. Haemostasis…
Textbook gap: No Hodgkin lymphoma chapter. Only link: Ch. 26 — actuarial risk of therapy-related MDS/AML is 6–9% after Hodgkin's treatment (vs 17% after myeloma treatment). Geriatric-oncology philosophy from Ch. 26/27 transfers…
Textbook gap: No NHL chapter. Only links: Ch. 24 (lymphoma causing marrow infiltration/thrombocytopenia, acquired FVIII inhibitors); Ch. 26 (lymphoma treatment as MDS/AML risk). Geriatric-oncology philosophy transfers directly — median…
Well covered: Pathy's Ch. 22, dedicated CKD section with Figure 22.3. Normocytic, normochromic, HYPOPROLIFERATIVE anaemia — reticulocytes low for the degree of anaemia. 45–70% of adults over 75 meet CKD criteria (GFR<90); 51–60% of CKD…
Covered briefly: Pathy's Ch. 24 gives the two-mechanism framework and HIT in detail; the six-antibody subdivision below is externally sourced. Pathy's rule: "Prescription drugs should ALWAYS be considered as a possible cause in any case…
Partial coverage: No dedicated transfusion chapter, but elderly-specific PRACTICE is discussed substantially across Ch. 22 (CKD), Ch. 23 (DIC), Ch. 24 (platelet thresholds) and Ch. 26/27 (MDS transfusion support — the most detailed…
No standalone chapter, but Ch. 27 discusses allogeneic HSCT in real depth, framed around age eligibility — directly quotable. Definition: conditioning regimen + infusion of HLA-compatible stem cells. Allogeneic (curative, immune…
Complete textbook gap. Only tangential link: the standard peripheral neuropathy work-up algorithm (Essentials of Clinical Geriatrics, Fig. 13-3) includes SPEP/UPEP/IPEP for any acquired demyelinating neuropathy — the pathway that would…
Bone Marrow Transplantation Discuss the types, indications, procedure and complications of bone marrow transplantation, with emphasis on the older patient. Definition. Bone marrow transplantation — more accurately haematopoietic stem…
POEMS Syndrome Describe the clinical features, laboratory investigations and treatment of POEMS syndrome. (15 marks) Definition. POEMS syndrome is a rare multisystem paraneoplastic disorder caused by an underlying clonal plasma cell…
Hormone Therapy in Malignancy Discuss the principles, agents, indications and adverse effects of hormone therapy in malignancy, with emphasis on the older patient. (15 marks) The governing statement. A number of cancers prevalent in the…
A periprocedural checklist for an older adult has five headings — appropriateness, antithrombotic management, organ-system optimisation, geriatric syndromes, and post-procedure care. Appropriateness first: confirm the indication, the…
Pallor with breathlessness and signs of heart failure in an older man suggests anaemia that is causing or worsening heart failure. Anaemia itself can present with breathlessness, fatigue and heart failure. Work on two fronts at once:…
Molecules that show the presence of cancer or give information about how it will behave, for example its likelihood of progressing or responding to treatment. An ideal marker would have high positive and negative predictive values; be…
Confirm the diagnosis fully, then match treatment to fitness, frailty and the woman's wishes rather than to her age. Age-related variation in treatment is common, and many older women receive primary endocrine therapy, which may worsen…
Not set in 2009–2025 papers
Textbook gap: Pathy's has no dedicated chapter on plasma cell dyscrasias. Only incidental mentions exist in Ch. 24 (paraproteins as a cause of acquired coagulation defects — myeloma, MGUS, amyloid; inhibition of fibrin polymerisation;…
Textbook gap: No dedicated Pathy's content. Relevant fragments: Ch. 24 (paraprotein-related coagulation defects), Anaemia chapter (MGUS as clonal anaemia), Ch. 59 (chronic pain red flags — weight loss, fever, prior malignancy,…
Textbook gap: No myeloma chapter in Pathy's. Transferable content: Ch. 24 (paraprotein coagulopathy), Anaemia chapter (clonal anaemia), Ch. 59 (spinal red flags), and — most valuably — Ch. 26/27's geriatric-oncology philosophy (CGA is…
Textbook gap: Pathy's mentions CML only once — Ch. 24, Table 24.2 — as a myeloproliferative disorder causing acquired platelet dysfunction (bleeding paradoxically more common when platelets >10,00,000/µL). Everything else is externally…
Alkylating agents attach an alkyl group directly to DNA (usually N7 of guanine), causing intra- and inter-strand cross-linking that blocks replication/transcription → apoptosis. Cell-cycle non-specific — kill dividing and resting cells;…
No university frequency data yet
Definition and magnitude. Anaemia is defined by WHO as haemoglobin below 13 g/dL in men and below 12 g/dL in women. Prevalence rises steeply with age — about 10% over 65 years and over 20–25% beyond 85 years, and higher still in nursing…
Definition. Anaemia (WHO: Hb <13 g/dL in men, <12 g/dL in women) resulting from depleted body iron stores. It is the commonest anaemia worldwide and the commonest nutritional anaemia in Indian elderly. In an older adult, iron deficiency…
Definition. A macrocytic anaemia caused by impaired DNA synthesis from vitamin B (cobalamin) or folate 12 deficiency, producing nuclear-cytoplasmic asynchrony and ineffective erythropoiesis. Physiology of B absorption. Dietary B binds…
Definition. Also called anaemia of inflammation — a mild to moderate, usually normocytic normochromic anaemia occurring in chronic infection, inflammation or malignancy. It is the second commonest anaemia worldwide and the commonest…
Guiding principle. Transfuse for symptoms and physiology, not for a number. Give a single unit and then reassess ("why give two when one will do"), and always consider treating the cause — iron, B , folate or 12 erythropoietin — instead…
Definition and bleeding risk. Platelet count below 150 × 109/L. Spontaneous bleeding is unusual above 50, purpura and mucosal bleeding appear below 30, and the risk of spontaneous serious or intracranial bleeding rises below 10–20 ×…
Definition. An acquired syndrome of widespread intravascular activation of coagulation with loss of localisation, causing microvascular thrombosis with organ dysfunction and simultaneous consumption of platelets and clotting factors…
Definition. Myelodysplastic syndromes are clonal haematopoietic stem cell disorders characterised by ineffective haematopoiesis — a hypercellular or normocellular marrow with peripheral cytopenias — morphological dysplasia, and a…
Definition and cytogenetics. A myeloproliferative neoplasm defined by the Philadelphia chromosome — t(9;22) (q34;q11) — producing the BCR::ABL1 fusion gene, which encodes a constitutively active tyrosine kinase. Median age at diagnosis…
Definition. A monoclonal proliferation of mature B lymphocytes, defined by ≥5 × 109/L clonal B lymphocytes in peripheral blood persisting for at least 3 months with a characteristic immunophenotype. It is the commonest leukaemia of…
Definition and classification. Myeloproliferative neoplasms are clonal haematopoietic stem cell disorders with effective but dysregulated proliferation of one or more myeloid lineages. Philadelphia-negative: polycythaemia vera (PV),…
treatment 15 MARKS Answer — Textbook Core (10 points) Definition and the spectrum. Plasma cell dyscrasias (monoclonal gammopathies) are clonal proliferations of plasma cells or lymphoplasmacytic cells producing a monoclonal…
Definition and epidemiology. A malignant clonal proliferation of bone marrow plasma cells producing a monoclonal immunoglobulin, with resultant lytic bone disease, marrow failure and renal impairment. It accounts for about 10% of…
Types. Autologous transplantation uses the patient's own stem cells after high-dose chemotherapy (myeloma, relapsed lymphoma) — no graft-versus-host disease and lower transplant-related mortality. Allogeneic transplantation uses donor…
Epidemiology and risk factors. The commonest non-cutaneous cancer in men; incidence rises steeply with age, with median age at diagnosis around 66–70 years and latent histological cancer present in over 70% of men above 80 at autopsy.…
Clinical recognition. Suspect metastatic disease in any older patient with back pain that is progressive, unremitting, worse at night or at rest, associated with weight loss or a known cancer, or accompanied by neurological signs. Red…
Principles of screening (Wilson and Jungner). Screening is justified when the condition is an important health problem with a recognisable latent or early symptomatic stage, the natural history is understood, there is an acceptable,…
Breast cancer — target population and guidelines. Women aged 40–74 (USPSTF 2024), biennial mammography; the American Cancer Society advises annual screening from 45 and biennial from 55, continuing while life expectancy exceeds 10…
Principle. PET is a functional (metabolic) imaging technique using a positron-emitting radionuclide attached to a biologically active molecule. The emitted positron annihilates with an electron to release two 511 keV gamma photons at…
Well covered: Pathy's Ch. 22 (Figures 22.1, 22.3, 22.4) — largely textbook-derived. Definition: Hb <13 g/dL men, <12 g/dL women — but also track the trend from the patient's own baseline. Anaemia is NOT normal ageing — signifies…