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J3 > 3 > Flashcards

3 Flashcards

1
Q

characteristic features of haemolytic anaemia

A
  • Low haemoglobin
  • High reticulocytes
  • High bilirubin
  • Palpable spleen
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2
Q

Features of the compensated haemolytic state

A
  • Normal haemoglobin
  • Elevated bilirubin (unconjugated)
  • Increased reticulocyte count
  • jaundice
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3
Q

Hereditary spherocytosis

A
  • Autosomal dominant (structural defect)
  • RBCs are spherocytic & polychromatic (increased reticulocytes)
  • Jaundice – often presents in the neonatal period
  • Splenomegaly
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4
Q

Abnormalities of RBC enzymes

A

1) Pyruvate Kinase Deficiency Anaemia (autosomal recessive)

2) Glucose 6 phosphate dehydrogenase deficiency (X-linked recessive)

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5
Q

Causes of Congenital Haemolytic Anaemia

A

1) Haemoglobinopathies
2) Cell membrane defects - Hereditary spherocytosis
3) Enzyme defects - Pyruvate Kinase Deficiency Anaemia and G6PD deficiency

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6
Q

Causes of Acquired Haemolytic Anaemia

A

1) Isoimmune - HDN
2) Autoimmune - AIHA
3) Non-immune - Drug induced
4) Non-immune - fragmentation haemolysis (e.g. HUS, mechanical heart valve malfunction)

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7
Q

Drug Induced AIHA

A

1) Acting as a hapten
2) Immune Complex (Innocent Bystander)
3) Autoimmune

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8
Q

Which conditions will elicit a positive Direct Coombs Test?

A

1) AIHI

2) HDN

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9
Q

Uses of the Indirect Coombs Test

A

Forms the basis of the CROSSMATCH/ Group and Save tests

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10
Q

Hypochromic microcytic

A

poorly haemoglobinised and small RBC (low MCH and low MCV)

Seen in:

  • IDA
  • ACD
  • thalassaemia trai
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11
Q

MCV

A

mean corpuscular volume

= RBC size

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12
Q

MCH

A

Mean corpuscular Hb content

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13
Q

Reticulocytes

A

Immature RBCs.
Normally form <2% of RBCs.
No nucleus but some persisting RNA
Polychromatic (blue-purple) appearance in the blood film

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14
Q

Rouleaux

A

RBC columns

seen in samples with raised globulin or raised fibrinogen levels

e.g. myeloma, chronic inflammation/infection

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15
Q

Spherocytes

A

erythrocytes that are sphere-shaped rather than bi-concave disc shaped

seen in haemolysis particularly
autoimmune haemolytic anaemia (AIHA) and hereditary
spherocytosis

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16
Q

Howell-Jolly Bodies

A

Nuclear fragments in RBC

Seen in hyposplenic patients

17
Q

Macrocytes

A

large RBC (increased MCV)

Seen in B12/folate deficiency, hepatic disease, hypothyroidism.

18
Q

Anisopoiklocytosis

A

variance in size (anisocytosis) and shape (poikilocytosis) of a red blood cell

seen in B12/folate deficiency

19
Q

When would you see RBC fragmentation?

A

in mechanical haemolytic anaemias

eg prosthetic valve malfunction

20
Q

Megaloblasts

A

abnormal nucleated RBC precursors seen in B12 or Folate deficiency

21
Q

Bone marrow Trephine Biopsy

A

Removal of core of Bone and Marrow

provides detail on architecture and infiltration

22
Q

Leukaemic Blasts

A

abnormal primitive blast cells that are found in the bone
marrow (and often also in the peripheral blood )

Seen in Acute leukaemia and poor prognosis Myelodysplastic syndromes

23
Q

Name 3 Myeloproliferative disorders

A

Essential thrombocythaemia
Polycythaemia vera
myelofibrosis

24
Q

Myeloma

A

Malignant proliferation of Plasma Cells in the Bone Marrow.

NB: this is a Lymphoproliferative disease NOT a
Myeloproliferative Disease

25
Q

PT

A

Prothrombin time

Test of extrinsic pathway of coagulation

sensitive to Warfarin and liver disease

26
Q

INR

A

International normalised ratio.

Measure of Warfarin activity

27
Q

(A)PTT

A

Partial Thromboplasm Time (activated
PTT)

Measure of Intrinsic pathway

sensitive to IV Heparin

28
Q

Purpura/Petechiae

A

Pin point bleeding on skin and mucous membranes.

Usually due to thrombocytopenia or less commonly vasculitis.

29
Q

Ecchymoses

A

bruises

30
Q

Beriplex:

A

Freeze dried coagulation factors for Warfarin reversal.
Can be prepared from donated plasma

contains factors II, VII, IX, X

31
Q

Group and screen

A

Determine ABO and Rh group.

Screen plasma for immune RBC antibodies (crossmatch)

32
Q

Cryoprecipitate

A

Prepared from donated plasma.

Rich in Factor VIII and fibrinogen

33
Q

Where does haemopoiesis take place in the embryo and foetus?

A

first occurs in the yolk sac of an embryo

later in the liver, spleen, thymus, and lymph nodes of a foetus.

J3 (18 decks)

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