6. Haemotology Flashcards
Myeloma
Malignant disorder of plasma cells
What is found as a diagnosis tool in myeloma?
M spike in protein electrophoresis
Amyloid Light Chain Amylodosis
Whats formed
Creation of missfolded proteins created by Plasma cells
Beta pleated fibrils
Lymphomas
Malignant proliferation of lymphocytes
T (14:18) is a type of what?
Follicular lymphoma
Chronic Lymphocytic leukaemia
Epi?
Malignant disorder of mature B cells
Most common type of leukaemia
Tumnour Lysis Syndrome
What is released
Rapid breakdown of tumour cells
Potassium + phosphate
CAR-T therapy
Genetically modify own T cells towards cancer
Rivaroxaban (apixaban) is a type of direct oral anticoagulants and inhibits what?
Inhibitor of Factor Xa
Dabigatran is a type of direct oral anticoagulants and inhibits what?
Direct thrombin inhibitor
What is a product of VTE that is used as a diagnosis tool?
D dimer
Thrombophilia
familial disorder that leads to predisposure of thrombosis
Factor V Leiden
Most common familial thrombophilia
Prothrombin 20210A is a type of what?
What happens
Thrombophilia
Increased prothrombin levels
LMWH does what to platelet function
DOES NOT inhibit platelet function
Unfractionated does what to platelet function
DOES INHIBIT platelet function
Protamine sulphate is used in what?
Treatment of bleeding with LMWH + Unfractionated heparin
Warfarin reduces production of what?
What is then affected in the cascade production
Vit K
2,7,9,10 C + S
Aspirin inactivates what reducing what?
COX ==> Thromboxane A2
Clopidogrel // Prasugrel // Ticagrelor are all types
P2Y12 => platelet
Disseminated intravascular coagulation (DIC) leads to generation of what?
Generation of thrombin
Iron is absorbed how? How is it excreted?
Absorbed in gut mucosa
Not excreted
How is iron transported?
How is iron stored?
Transferrin
Ferritin
Megaloblastic Anaemia is caused by what? (3)
Impaired DNA synthesis
- -> B12 / Folic acid def
- -> Drugs
- -> Alcohol
What is the regulator of iron absorption?
What is it released from?
Hepcidin
Macrophages
Immune thrombocytopenic purpura (ITP) is what?
Immune disorder that attacks platelets = Thrombocytopenia
Thrombotic Thrombocytopenia Purpura (TTP) is what?
Thrombocytopenia where many clots occur leading to low platelets
Thrombocytopenia
Primitive Cells that are used in haemopoiesis develop from what?
Yolk sac
What type of anaemia is IDA
Microcytic
In Vitamin B12 anaemia, what happens to the neutrophils and macrocytes
Hyper segmented neutrophils + Oval macrocytes
What shape of RBC occurs in IDA?
Pencil Shapes
Leucodepletion?
Removal of WBC to leave RBC alone
Apheresis platelets vs pooled platelets?
Apheresis -> Platelets removed and other parts returned back to donor
Pooled -> Different donors in 1 pack
Fresh frozen plasma contains what?
Clotting factors
Cryoprecipitate is used as what?
Concentrated source of fibrinogen => DIC / Haemorrhage
Febrile non haemolytic transfusion consists of what?
Cytokines that have accumulated in donor transfusion which leads to febrile in recipitant
TACO (transfusion associated circulatory overload) is what?
Volume excess from transfusion = Pulmonary oedema
Acute haemolytic reaction is generally caused by what in transfusion
ABO incompatibility
Delayed haemolytic reaction is generally caused by what in transfusion?
AB forming after exposure
What kind of antigens are affected in delayed haemolytic reaction?
Rhesus / Kell / Duffy / Kidd
Transfusion Related Acute lung Injury?
AB in blood against recipients leucocytes
Donor against host
If the bleeding disorder is congenital, how many defects are present?
Single (one)
If the bleeding disorder is acquired, how many defects are present?
Multiple
vWF is what type of condition?
Epi? Whos affected the most
Autosomal Dominant
Most common bleeding disorder
Group O most common
Haemophilia A =
Factor 8 Def
Haemophilia B =
Factor 9 Def
What type of genetic condition is haemophilia?
X - linked recessive
What inheritance is thalassaemia?
Autosomal recessive
What chromosomes are the globin chains?
11 + 16
Which globin chain is the most predominant form?
Hb - A
Sickle Cell Heterozygote trait electrophoresis characteristic?
Hb S (45%) // Hb A
Sickle Cell Homozygote trait
Hb S / S
Thalassaemia is caused by an imbalance of what?
Alpha - Beta Globin chains
What type of thalassaemia is Hb Barts? What occurs?
Alpha Thalassaemia
No Alpha chains
In HbH, what type of thalassaemia is it? What occurs?
Alpha Thalassaemia
Reduced number of Alpha chains
B thalassemia is caused by an excess of what?
Alpha chains
Which is more severe, B thalassaemia Major or Thalassaemia intermedia?
Major
Giving a transfusion to a thalassaemic patient can lead to what?
Iron Overload
Acute myeloid leukaemia leads to what (pathology)
Accumulation of AML / ALL precursors in bone marrow
What chromosome is usually affected in AML
Chromosome 16
30% of AML patients have what type of mutation
FTL3
What are these all types of? :
Polycythaemia Vera (PV)
Essential Thrombocytosis
Idiopathic myelofibrosis
Chronic Myeloproliferative disorders
In Polycythaemia Vera (PV), what occurs?
Increase in RBC / Neutrophils / Platelets
In Essential Thrombocytosis, what occurs?
Increased platelets
CALR + JAK mutations can lead to what?
Essential Thrombocytosis
JAK tyrosine kinases are important for what?
EPO signalling pathway
T (9:22) Philadelphia is found in what?
CML
CRAB is used in what disease
Myeloma
what type of mutation occurs in alpha thalassaemia
Deletions
what type of mutation occurs in beta thalassaemia
point mutations
what type of deficiency would lead to an increase in thrombotic events
Protein C def
infection of catheters, prostheses and ventriculo-peritoneal shunts bacterial organism
coagulase negative staph
can pernicious anaemia affect fertility
PA => Affect fertility
CN palsy is a complication of what
Acute Lymphoblastic Leukaemia (ALL)
