Anaemia

Question 1

What is anaemia?

Answer 1

A reduction in the haemoglobin concentration of the blood

Question 2

What are the symptoms of anaemia?

Answer 2

Shortness of breath on exercise
Weakness and lethargy
Palpitations and headaches
Cardiac failure, angina, intermittent claudication and confusion
Visual disturbances due to retinal haemorrhage

Question 3

What are the signs of anaemia?

Answer 3

Pallor
Hyperdynamic circulation, tachycardia, bounding pulse, cardiomegaly
Congestive cardiac failure
Retinal haemorrhages

Question 4

What are the causes of anaemia?

Answer 4

Lack of ingredients to make haemoglobin (iron, B12 or folic acid)
Failure of the blood marrow to make red cell (aplastic anaemia or replacement of the bone marrow by tumour)
Loss of blood
Destruction of red cells

Question 5

What are the classifications of anaemia?

Answer 5

Microcytic (MCV <80, MCH <27- iron deficiency)
Normocytic (MCV 80-100, MCH >36- after acute blood loss, renal disease)
Macrocytic (MCV >100- megaloblastic- vitamin B12 or folate deficiency, non-megaloblastic- alcohol, liver disease)

Question 6

What is the treatment for iron deficiency anaemia?

Answer 6

Oral iron supplement- ferrous sulphate 200mg 3x a day

Question 7

What is pernicious anaemia?

Answer 7

A deficiency in the production of red blood cells through a lack of vitamin B12

Question 8

What is the treatment for macrocytic anaemia?

Answer 8

Vitamin B12 injections

Folic acid

Question 9

What is leukaemia?

Answer 9

Cancer of the blood cells

Question 10

What is the classification of leukaemia?

Answer 10

Acute myeloid leukaemia M0-M7
Acute lymphoblastic L1-L3
Chronic myeloid leukaemia
Chronic lymphoid leukaemia

Question 11

What is the classification of acute myeloid leukaemia?

Answer 11

M0- differentiated
M1- without maturation 
M2- with granulocytic maturation 
M3- acute promyelocyctic 
M4- granulocyctic with monocyctic maturation 
M5- monoblastic
M6- erythroblastic
M7- megakaryoblastic

Question 12

What is the classification of acute lymphoblastic leukaemia?

Answer 12

L1- small blasts with high nuclear cytoplasmic ratio
L2- larger heterogenous blasts
L3- vacuolated, basophilic blasts

Question 13

What are the signs of leukaemia?

Answer 13

Tissue infiltration 
Bone marrow failure 
Anaemia 
Infection 
Thrombocytopenia 
Skin infection 
Gum infiltration 
Oral candidiasis

Question 14

What is lymphoma?

Answer 14

Lymphoma is a type of cancer that affects the lymphatic system where malignant lymphocytes accumulate in lymph nodes

Question 15

What are the two types of lymphoma?

Answer 15

Hodgkin’s lymphoma (Reed Sternberg cells)

Non-Hodgkin’s lymphoma

Question 16

What are the constitutional symptoms of Hodgkin’s lymphoma?

Answer 16

Fever 
Weight loss
Anorexia 
Pruritis 
Night sweats 
Fatigue

Question 17

What are the clinical findings of Hodgkin’s lymphoma?

Answer 17

Cervical lymphadenopathy 
Mediastinal mass 
Painless, firm, discrete lymph nodes 
Hepatosplenomegaly 
Superior venacaval obstruction

Question 18

What is the treatment of Hodgkin’s lymphoma?

Answer 18

Combination therapy (MOPP, ABVD, Stanford V)
Autologous stem cell transplantation
Targeted immunotherapy

Question 19

What are the clinical symptoms of Non-Hodgkin’s lymphoma?

Answer 19

Lymphadenopathy
Constitutional symptoms
Oropharyngeal involvement
Abdominal disease

Question 20

What is the treatment of Non-Hodgkin’s lymphoma?

Answer 20

High grade- aggressive treatment with possibility of cue

Low grade- treatment controls disease, may have long survival

Question 21

What is multiple myeloma?

Answer 21

Clinical proliferation of plasma cells

Question 22

What are the signs of multiple myeloma?

Answer 22

Bone marrow failure 
Bone disease
Paraprotein 
Renal failure 
Hypercalcaemia

Question 23

What is the treatment of multiple myeloma?

Answer 23

Resuscitation (steroids, fluid, renal support, transfusion)
Oral chemotherapy
Thalidomide, bortizimab
Autologous stem cell transplantation
Relapse- lenalidomide, pomolidamide, carfilzomib
Daratumab