CBL - Haematology notes

Question 1

What is Haemolytic uraemic syndrome and its causes?

Answer 1

It occurs when small thrombosis occur in small BVs of the body. Usually caused by shiga toxin produced by E.coli (main one to think of) or shigella.

Question 2

What is the classic triad of HUs?

Answer 2

• Microangiopathic haemolytic anaemia,
• Thrombocytopenia,
• Acute kidney injury

Question 3

Describe the presentation of HUS

Answer 3

• Brief gastroenteritis with bloody diarrhoea followed by:
• Reduced urine output,
• Haematureia,
• Abdominal pain,
• Lethargy and irritability,
• Confusion,
• Hypertension,
• Bruising
• High urea and creatinine (indicates kidney damage)

Question 4

What is the management of HUS?

Answer 4

• Do not give antibiotics or antimotility drugs as this increases risk of HUS.
• Instead give antihypertenisves, blood transfusions and haemodialysis.

Question 5

Describe the cause of immune thrombocytopenic purpura in adults and children

Answer 5

Children - Usually occurs post viral infection as antibody-viral antigen complexes bind to platelets resulting in removal of platelets by macrophages.

Adults - Not associated with viral infection but autoimmune diseases, IgG antibodies bind to platelet glycoproteins. Resulting complexes are removed by liver or splenic macrophages

Question 6

What excludes the diagnosis of ITP?

Answer 6

Splenomegaly

Question 7

What is the treatment of ITP?

Answer 7

• In children it is usually self limiting.
• In adults you treat with immunosupression or IV immunoglobulin (to saturate macrophages to reduce their destruction of platelets) Prednisolone, ritixmab and immunoglobulins

Question 8

What is the presentation of glandular fever?

Answer 8

• Most common in adults age 15-24.
• Presents with fever,
• Lymphadenopathy,
• Tonsillitis with a whitewash exudate,
• Prodromal symptoms,
• Non-specific rash,
• Splenomegaly,
• Hepatomegaly

Question 9

What are the investigations for glandular fever?

Answer 9

• EBV viral serology,
• FBC with heterophile antibodies

Question 10

Describe symptoms of Lupus

Answer 10

• Most common is SLE (autoimmune) presents with:
• Muscle and joint pain,
• Butterfly rash,
• Pyrexia,
• Photophobia,
• Lupus nephritis,
• Development of antiphospholipid syndrome (lupus anticoagulant)

Question 11

What is Henoch Schonlein purpura?

Answer 11

Purpuric rash with normal platelets. IgA vasculitis most common in children under 10. Usually self limiting.

Question 12

What are the symptoms of pernicious anaemia

Answer 12

• Often associated with other autoimmune diseases. It is a vitamin B12 deficiency which presents with:
• Pale yellow tinge,
• Sore/red tongue (glossitis)
• Paraesthesia.
• Loss of JPS,
• Irritability.
• Disturbed vision