Haematology
Anaemia, bleeding and clotting disorders, anticoagulation, haematological malignancy and transfusion. Expect questions on iron deficiency, anticoagulant reversal and febrile neutropenia.
High-yield points
Iron deficiency: low ferritin (below about 30 ug/L) is diagnostic; always find the cause, and in men and postmenopausal women investigate the GI tract.
Microcytic anaemia with normal ferritin in someone of South Asian, Mediterranean or Middle Eastern background: consider thalassaemia trait (Hb electrophoresis).
Transfusion: restrictive thresholds (usually Hb below 70 g/L in stable patients); follow Patient Blood Management principles.
Warfarin reversal for major bleeding: IV vitamin K plus prothrombin complex concentrate (Prothrombinex-VF), with FFP if needed.
Febrile neutropenia is an emergency: empirical IV antibiotics (eTG: piperacillin-tazobactam) within 1 hour.
VTE: DOACs are first line for most; provoked DVT/PE treated for 3 months, unprovoked often longer.
Heparin-induced thrombocytopenia: platelet fall 5-10 days after starting heparin with thrombosis; stop all heparin.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Units | Haemoglobin in g/dL (7 g/dL). | Haemoglobin in g/L (70 g/L). |
| Iron deficiency anaemia | Very common and often treated as nutritional; hookworm and thalassaemia trait considered. | Always find the cause. In men and postmenopausal women, investigate for GI blood loss (gastroscopy/colonoscopy) and test for coeliac disease. |
| Warfarin reversal | Vitamin K and fresh frozen plasma. | Prothrombinex-VF plus vitamin K for major bleeding; FFP only if it is unavailable. |
| Blood supply and transfusion | Replacement donation by family is still common. | Unpaid volunteer donors via Lifeblood. Patient blood management: restrictive thresholds, generally Hb below 70 g/L in stable patients. |
Units
India (MBBS)
Haemoglobin in g/dL (7 g/dL).
Australia (AMC): what the exam expects
Haemoglobin in g/L (70 g/L).
Iron deficiency anaemia
India (MBBS)
Very common and often treated as nutritional; hookworm and thalassaemia trait considered.
Australia (AMC): what the exam expects
Always find the cause. In men and postmenopausal women, investigate for GI blood loss (gastroscopy/colonoscopy) and test for coeliac disease.
Warfarin reversal
India (MBBS)
Vitamin K and fresh frozen plasma.
Australia (AMC): what the exam expects
Prothrombinex-VF plus vitamin K for major bleeding; FFP only if it is unavailable.
Blood supply and transfusion
India (MBBS)
Replacement donation by family is still common.
Australia (AMC): what the exam expects
Unpaid volunteer donors via Lifeblood. Patient blood management: restrictive thresholds, generally Hb below 70 g/L in stable patients.
The Australian context
Warfarin reversal in Australia uses Prothrombinex-VF, a local product. Blood products are supplied by Australian Red Cross Lifeblood, and donors are unpaid volunteers. Haemoglobin is reported in g/L (so 70 g/L, not 7 g/dL).