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Year 5 > Blood > Flashcards

Blood Flashcards

1
Q

causes of iron deficiency anaemia

A

blood loss (GI incl diverticulitis, menorrhagia) poor diet (vegetarians) malabsorption (coeliac)

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2
Q

features of IDA

A

brittle hair, atrophic glossitis, angular stomatitis, koilonychia

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3
Q

blood results in IDA

A 
low Hb
low MCV
low serum ferritin
low serum iron
high TIBC
film- RBC microcytic hypochromic, anisocytosis (unequal size RBCs)  poikilocytosis (unequal shape)
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4
Q

what helps the absorption of Iron salts

A

vitamin C therefore give it with ascorbic acid + advice drink with OJ

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5
Q

how long should iron salts be continued for

A

check FBC after 4 weeks, then once anaemia resolved stop after 3 months

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6
Q

What is TRALI

A

transfusion related lung injury,

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7
Q

how soon after transfusion would TRALI present?

A

within 6 hours
SOB, hypoxia and fever
CXR-> inflitrates in lower zones/ parahilar nodes

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8
Q

what can occur if RBCs transfused too quickly

A

pulmonary oedema

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9
Q

what is the definition of non-haemolytic febrile reaction

A

rise in temp >1 above baseline

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10
Q

management of non-haemolytic febrile reaction

A

paracetamol and slow rate of transfusion

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11
Q

how would an allergic reaction to a transfusion present

A

in minutes- urticaria

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12
Q

↓serum iron levels
↓ TIBC
↑or normal serum ferritin.

A

anaemia of chronic disease

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13
Q

Causes of microcytic anaemia

A

iron deficiency anaemia
anaemia of chronic disease
thalassaemia
sideroblastic anaemia

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14
Q

name some causes of sideroblastic anaemia

A

any process interfering with heme production
congenital
acquired- alcohol, lead poisoning, TB drugs, malignancy

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15
Q

what would show in blood film of sideroblastic anaemia

A

ringed sideroblasts in BM and increased iron store

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16
Q

causes of macrocytic anaemia

A

normobastic- alcohol/ liver disease, hypothyroid, cytotoxic, myelodysplasia
megaloblastic- B12/ Folate deficiency

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17
Q

target cells on blood film, macrocytic anaemia

A

liver disease

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18
Q

macrocytic anaemia, hypersegmented neutrophil nuclei on blood film

A

b12 deficiency- also causes low WCC/ platelets

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19
Q

name one complication other than anaemia of B12 deficiency

A

dorsal column degenaration-> peripheral neuropathy

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20
Q

what protein is reduced in pernicious anaemia

A

intrinsic factor from gastric mucosa

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21
Q

causes of folate deficiency

A

reduced intake- alcoholics, pverty
malabsorption- coeliac
excess requirement- pregnancy, dialysis

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22
Q

name some causes of normocytic anaemia

A

hypoproliferative- leukaemia, aplastic anaemia

hyperproliferative- haemorrhage, haemolytic anaemia

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23
Q

name some causes of aplastic anaemia

A

congenital
idiopathic acquired
drugs- chemo, chloramphenicol
infections- HIV

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24
Q

causes of congenital haemolytic anaemia

A

membrane: hereditary spherocytosis/elliptocytosis
metabolism: G6PD deficiency
haemoglobinopathies: sickle cell, thalassaemia

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25
what might indicate a haemolytic anaemia?
``` evidence of breakdown (increased bilirubin) evidence of RBC production -reticulocytosis, -polychromasia, -macrocytosis, ```
26
which test identifies immune causes of haemolytic anaemia
Coombs test (direct antiglobulin test)
27
some causes of acquired haemolytic anaemia
immune: transfusion reaction, penecillin | non-immune: DIC, HUS, prosthetic valves, malaria
28
how is B thalassaemia inherited
AR
29
how is sickle-cell anaemia inherited?
AR
30
What causes a sickle cell crisis
trigger causing increased O2 demand-> cells sickle and haemolyse, blocking small blood vessels and causing infarction
31
what cells form from a common myeloid progenitor?
megakaryocyte-> thronbocyte erythrocyte mast cell myelobast-> basophil, eosinophil, neutrophil, monocyte-> macrophage
32
what cells form from a common lymphoid progenitor?
natural killer cell t cell B cell-> plasma cell
33
function of neutrophils
made in BM | phagocytose bacteria
34
function of eosinophils
made in BM | antiparasitic
35
function of basophils
help mast cells in inflammation contain histamine allergic reactions
36
function of mast cells
produced in BM surround BVs and nerves. inflammation initiator histamine release
37
function of macrophages
made in BM phagocytosis antigen presenting cells
38
B cell function
membrane bound antibodies, binding of pathogen and antigen presenting + helper T cell stimulation-> activation -> plasma cells via IL4 (make ABs) / memory cells
39
CD4+ T cell function
helper T cells MHC II complex activate B cells and release cytokines
40
CD8+ T cell function
cytotoxic cell to viral infected/ cancerous cells | MHC I complex
41
IL1, TNF-a
fever and cachexia, vasodilation. TNF produced by mast cells/ macrophages
42
IL2
T cell activation
43
IL3
BM stimulant
44
IL5
eosinophil activator
45
IL8
neutrophil recruiter
46
IFN-G
granuloma activator
47
RFs for Hodgkin's lymphoma
EBV (infectious mononucleosis) | HIV
48
Reed-Sternberg cells
HL, these are B cells that no longer express surface antigens/ do not undergo apoptosis
49
assymetrical painless lymph nodes above diaphragm, fever, weight loss,
HL (NHL can be tender)
50
Staging system for HL
Ann Arbor
51
peak age HL
30s/70s
52
NHL peak age
55-60
53
most common NHL
diffuse large B cell
54
definitive diagnosis investigation for HL
lymph node biopsy
55
what are B symptoms of HL
drenching night sweats WL fever
56
first stage management for HL
radio +/- chemo
57
spread of HL vs NHL
continguous in HL meaning spreads via lymph to adjacent nodes/ structures. NHL can arise in several unlinked structures
58
which has worse prognosis HL/ NHL
NHL
59
back pain, impaired renal function, normochromic normocytic anaemia hypercalcaemia
myeloma
60
most effective analgesia for bone pain
steroid
61
peak age for myeloma
60-70 men
62
investigations in suspected myeloma
``` monoclonal proteins (IgG/ IgA) in serum and Bence-Jones proteins in urine increased plasma cells in BM ```
63
what is DIC?
Cytokine mediated activation of extrinsic coagulation cascade. caused by sepsis/ major trauma
64
how is haemophilia inherited?
X linked recessive
65
which clotting factor is affected in haemophilia A/ B
VIII/ IX
66
features of haemophilia
haemoarthroses, haematomas prolonged bleeding after surgery or trauma prolonged APTT, normal PT, Bleeding time
67
most common cause of thrombophilia
Factor V leiden deficiency
68
causes of thrombocytopenia
``` DIC haem malignancies heparin induced drug induced (diuretics, aspirin) alcohol B12 deficiency ```
69
pancytopenia
congenital | acquired- reduced BM production (myeloma, megaloblastic anaemia)/ increased destruction (liver disease)
70
causes of neutropenia
infections drugs- agranulocytosis megaloblastic anaemia
71
most common malignancy of childhood
acute lymphoblastic leukaemia
72
presentation of acute leukaemias
Anaemia Bleeding and bruising – as a result of thrombocytopaenia Infection – as a result of leukopaenia Bone pain – as a result of bone marrow infiltration
73
difference between acute and chronic leukaemia
the malignant clones are themselves able to differentiate, and the accumulated cell population in the bone marrow is made up of a more mature variety of cells, and not just blast cells.
74
which factor changes prothrombin to thrombin
X, which in turn changes fibrinogen to fibrin
75
extrinsic pathway
Trauma-> tissue factor-> | VII-> x
76
Intrinsic pathway
trauma to blood cells directly | XII, XI, IX VIII
77
vitamin K dependant factors
VII, IX, X prothrombin
78
APTT measures what
intrinsic pathway
79
PT/INR measures what
extrinsic pathway

Year 5 (12 decks)

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