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J Haem > Conditions summary > Flashcards

Conditions summary Flashcards

1
Q

tired
low Hb
low MCV
pencil cells on blood film

what investigation do you want to do
for what

A

serum ferritin - for iron deficiency anaemia

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2
Q

young girl
tired
low Hb
low MCV

A

microcytic anaemia caused by iron deficiency (probs dietary)

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3
Q

rheumatoid arthritis
tired
low Hb
low MCV

A

microcytic anaemia caused by anaemia of chronic disease (chronic inflammation in RA)

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4
Q

management of iron deficiency anaemia

A

ferrous fumarate

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5
Q 
tired 
low Hb 
high MCV 
hypothyroidism 
Fx autoimmune
A

macrocytic anaemia caused by pernicious anaemia

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6
Q

macrocytic anaemia management

A 
folic acid 5mg 
IM hydroxycobulamin (B12)
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7
Q 
tired
low Hb
spherocytes and reticulocytes on blood film 
coombs test positive 
IgG mediated (more common)
A

warm autoimmune haemolytic anaemia

coombs +ve = immune problem

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8
Q

mechanical heart valve
dark urine
tired
low Hb

A

microangiopathic haemolytic anaeamia

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9
Q

Fx
child
jaundice, splenomegaly, tired
spherocytes and reticulocytes on blood film

A

hereditary spherocytosis

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10
Q

transferrin stores >50%

Fx

A

hereditary haemochromatosis (iron overload)

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11
Q

hereditary haemochromatosis (iron overload) management

A

weekly venesection for life

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12
Q

management of iron overload from repeated FBC transfusion (eg thalassaemia)

A

iron chelating drugs

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13
Q

pancytopenia in child - infections, fatigue, bleeding

MSK problems

A

fanconis anaemia

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14
Q

infections fatigue, bleeding

autoimmune PMH

A

idiopathic aplastic anaemia

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15
Q

management of panyctopaenia

A

blood transfusion - if symptomatic anaemia <70
platelet transfusion - if bleeding
antibiotics - for everyone (bc risk of infection)

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16
Q

<5mins of transfusion
fever
flush
feeling of impending doom

A

acute haemolytic transfusion reaction - ABO incompatibility or bacterial contamination

IgM (bc immediate), intravascular

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17
Q

management of acute haemolytic transfusion reaction (3)

A

STOP transfusion
ABCDE
blood cultures for sepsis (bacterial contamination)

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18
Q 
30 mins into transfusion 
elderly 
raised JVP
SOB 
pitting oedema
A

transfusion associated circulatory overload (TACO)

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19
Q

management of transfusion associated circulatory overload (TACO) (2)

A

diuretics (furosemide)

transfuse slower

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20
Q

current transfusion
fever
rash

A

febrile non haemolytic transfusion reaction (mild, acute)

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21
Q

management of febrile non hemolytic transfusion reaction (2)

A

paracetamol for fever

transfuse slower

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22
Q

PMH allergy
current transfusion
mild urticarial rash
SOB

A

allergic transfusion reaction

can also present as severe anaphylaxis

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23
Q

FFP transfusion

SOB but normal JVP

A

transfusion associated lung injury

no fluid overload like TACO
anti-leukocyte reaction to FFP

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24
Q

management of allergic transfusion reaction (4)

A

adrenaline
anti histamine (chlorampheniramine)
salbutamol (for SOB bronchoconstriction)
steroids

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25
Q

5-10 days after transfusion

jaundice

A

delayed haemolytic transfusion reaction

IgG, extravascular haemolysis

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26
Q

splenomegaly
jaundice
HbH haemoglobin present

A

HbH disease (type of alpha thalassaemia)

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27
Q

electrophoresis with increased HbA2

A

beta thalassaemia

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28
Q

management of beta thalassaemia

A

transfusion dependent

lifelong if beta thalassaemia major (with iron chelating drugs)

29
Q

6 months old
thrive
pallor
bony deformities - cortical thinning, hair on end bone appearance
blood film - target cells, nucleated RBCs

A

beta thalassemia major

up until 6 months HbF will compensate for missing HbA

30
Q

dactylitis - v v painful
priapism
electrophoresis with HbS

A

sickle cell anaemia

31
Q

management of acute sickle cell crisis

A

hydration
opiate analgesia
transfusion

32
Q

chronic treatment of sickle cell disease

A

folic acid and hydroxocobalamin

33
Q

young boy
haemarthrosis in knee
factor VIII deficiency
prolonged APTT normal PT

A

haemophilia A

34
Q

young boy
haemarthrosis in knee
factor IX deficiency
prolonged APTT normal PT

A

haemophilia B

35
Q

‘bleeding form everywhere’ - venflon sites etc
bruising
purpura
prolonged APTT and PT

A

DIC

36
Q

haemophilia management

A

IV factor VIII/IX

37
Q

DIC management

A 
platelets 
FFB 
fibrinogen 
blood transfusion 
cryoprecipitate
38
Q

arterial thrombosis management

A

aspirin - anti platelet

39
Q

venous thrombosis management

A

warfarin/NOAC/heparin - anti coagulant

40
Q

puerperium

unilateral red hot swollen leg

A

DVT

41
Q

recurrent DVTs

Fx thrombosis

A

thrombophilia

42
Q

autoimmune condition

arterial and venous thrombosis

A

anti phospholipid syndrome

43
Q

anti phospholipid syndrome management

A

aspirin (anti platelet) and warfarin (anti coag)

44
Q 
young female 
CD30+ 
reed Sternberg cells 
night sweats
lymphadenopathy 
fatigue 
alcohol induced pain (sip of wine)
A

hodgkins lymphoma

45
Q 
night sweats
lymphadenopathy 
fatigue
African kid with EBV PMH 
tumour in jaw 
translocation 8;14
A

burkitts lymphoma

46
Q 
night sweats
lymphadenopathy 
fatigue 
slow onset 
incurable 
CD20+
A

low grade B cell non hodgkins lymphoma

47
Q 
night sweats
lymphadenopathy 
fatigue 
fast onset - aggressive 
curable 
CD20+
A

high grade B cell non hodgkins lymphoma

48
Q

management of all non hodgkins lymphoma

A

rituximab

49
Q

management of hodgkins lymphoma

A

chemo (not rituximab bc not CD20+)

50
Q 
60yo 
anaemia - fatigue 
bleeding from gums 
infections 
auer rod cells 
myeloblasts
A

AML (granda)

51
Q 
child 
anaemia - tired 
bleeding 
infections 
lymphoblasts
A

ALL

52
Q 
anaemia - tired 
bleeding 
infections 
philidelphia chromosome 
9;22 translocation 
BCR-ABL gene 
increased granulocytes, abnormal
A

CML

53
Q

CML treatment

what type of drug is it

A

imatinib (tyrosine kinase inhibitor)

54
Q

AML and ALL treatment

A

chemo

55
Q 
anaemia - tired 
bleeding 
infections 
increase lymphoma risk 
abnormal B cells = smudge cells on blood film
A

CLL

56
Q 
monoclonal rise in IgG
abdo pain 
renal impairment 
thirsty 
bone pain - 'punched out lytic lesions'
pathological fracture

what electrolyte imbalance causes symptoms

A

myeloma

hypercalcemia causes symptoms
note monoclonal rise in Ig = paraprotein

57
Q

management of myeloma (4)

A

analgesia (not NSAIDs bc renal impairment)
chemo
steroids
bisphosphonates

58
Q

increased para protein (monoclonal rise in Ig) but asymptomatic

A

monoclonal gammopathy of undetermined significance (MGUS)

59
Q

paraprotein formation = organ damage

congo red stain with ‘apple green bifringence’

A

AL amyloidosis

60
Q 
type of non hodgkins lymphoma - night sweats, fatigue, weight loss
hyperviscosity 
IgM paraprotein (seen on electrophoresis)
A

waldenstroms macroglobinaemia

61
Q

waldenstroms macroglobinaemia management

A

plasmaphoresis (remove IgM paraprotein plasma with donor plasma)
chemo

62
Q

itch after bath
thrombosis
gout

JAK2 mutation

A

polycythaemia rubra vera (PRV) (type of MPD)

63
Q

arterial thrombosis
gout
fatigue
digital ishcaemia

JAK2 mutation

A

essential thrombocytopaenia (type of MPD)

64
Q

polycythaemia rubra vera (PRV) management

A

venesection and aspirin

65
Q

essential thrombocytopaenia management

A

anti platelets (aspirin)

66
Q

increased RBC platelets and granulocytes after surgery

A

normal reactive changes (not MPD!)

67
Q

leukoerythroblasts - immature RBCs and neutrophils
blood film - tear drop RBCs
bone marrow biopsy - dense collagen
JAK2 mutation positive

A

idiopathic myelofibrosis (caused by PRV or essential thrombocytopaenia)

68
Q

investigation for isolated high RBC

A

JAK2 mutation for polycythaemia rubra vera

J Haem (12 decks)

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