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Haematology > First year cards > Flashcards

First year cards Flashcards

1
Q

What can a myeloblast become?

A

Basophil
Promyeloblast -> neutrophils
Eosinophil
Promonocyte -> monocyte -> macrophage

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2
Q

Thalassaemia

A
  • Decrease in Hb chain
  • Abnormal tetramers that causes premature destruction
  • Microcytic, hypochromic anaemia
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3
Q

What are pappenheimer bodies?

A

Abnormal granules of iron found inside RBCs on routine blood stain

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4
Q

What conditions are pappenheimer bodies observed?

A

Sideroblastic anemia
Hemolytic anemia
Sickle cell disease.

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5
Q

Features of iron deficiency anaemia

A
  • Hypochromic, microcytic
  • Anisocytosis
  • Pokilocytosis
  • Serum ferritin reduced
  • Serum iron low
  • Raised transferrin
  • Raised unsaturated iron binding capacity
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6
Q

NOAC

A

New/novel oral anticoagulants

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7
Q

Pernicious anaemia

A

Autoimmune gastritis -> reduced gastric secretion of intrinsic factor

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8
Q

WAIHA

A

Warm antibody autoimmune haemolytic anaemia

  • happens at body temperature
  • IgG
  • antibody attaches to RBC -> monocytes and macrophages in the spleen ‘take a bite’ -> spherocytes -> destroyed

SLE, rheumatoid arthritis, CLL

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9
Q

Jaundice sclera

A

Icterus

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10
Q

Fibrolytic agents

A
  • tPA (tissue plasminogen activator) binds fibrin and converts plasmingen to plasmin
  • Plasmin (fibrin -> FDPs)
  • Protein C stimulates tPA
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11
Q

Pica

A

Desire for non nutrient rich food

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12
Q

Thrombocytopenia

A

Deficiency of platelets

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13
Q

HbA

A

α2β2 98%

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14
Q

Cold agglutin disease

A
  • high levels of IgM
  • direct against RBC
  • only bind at low temperatures 28-31°C
  • haemolytic anaemia
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15
Q

Shift binding curve to right

A
  • Carbon dioxide
  • Increase H+ concentration
  • Increase temp
  • Increase 2,3 bisphosphoglycerate
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16
Q

Virchow’s triad

A

Causes of thrombi

  1. Endothelial damage
  2. Abnormal blood flow
  3. Hypercoagulability
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17
Q

Factors involved in haemophilia A, B, C

A

A VIII
B IX
C XI

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18
Q

Erythropoiesis in the foetus

A

Up to around 6 weeks Yolk sac

6 weeks- 6 months Liver and spleen

From 7 months bone marrow

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19
Q

What’s it called when erythropoiesis occurs not in the bone marrow?

A

Extramedullary erythropoiesis

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20
Q

Lab features of B12 and folate deficiency

A
  • Macrocytic
  • Hypersegmented neutrophils
  • Slightly reduced leukocyte and platelet counts
  • Raised bilirubin
  • BM hypercellular
  • Megaloblastic
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21
Q

HbA1c

A

α2β2glucose
<5%

Glycated hemoglobin- measures 3 month average plasma glucose

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22
Q

Cause of increase APTT

A

(activated partial prothrombin time)

  • Heparin treatment
  • Haemophilia
  • DIC
  • Liver disease
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23
Q

Biochemical tests for blood

A
  • bilirubin
  • LDH
  • haptoglobin
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24
Q

Mechanical haemolytic anaemias

A
  • microangiopathic haemolytic anaemia (red cells travel through damaged vessels and are cut by thrombin)
  • valve prosthesis
  • march haemoglobinuria
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25
Q

HbA2

A

α2δ2

<3.5%

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26
Q

MCV

A

Mean corpuscular volume

Normal 80-96 fL

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27
Q

Reticulocytes

A
  • young non-nucleated RBCs
  • retain RNA
  • nucleus condenses on maturation of cell and is extruded prior to release in circulation
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28
Q

EPO

A
  • erythropoietin
  • released from kidney when oxygen low
  • inhibit RBC apoptosis
29
Q

Mechanism of factor V Leiden

A

Patients have a mutated factor V so protein C can’t cleave it. Coagulation continues unchecked.

30
Q

Inhibitor of IIa (thrombin)

A

Dabigatran

Idarucizumab for reversal

31
Q

Increase in D-dimers

A
  • DIC
  • DVT
  • PE
32
Q

Characteristic of platelet defects

A
  • bleeding but lack of joint swelling/pain
  • superficial bleeding
  • nose bleeds
  • takes a whle to stop but does stop
  • enlarged spleen
  • petechia
33
Q

TIBC

A

total iron binding capacity

34
Q

Normal platelet count

A

150-450 x 10^9/L

35
Q

Intermittent claudication

A

Obstruction of arteries during exercise -> leg cramps

36
Q

Causes of normocytic anaemias

A 
Acute blood loss
Anaemia of chronic disease
Bone marrow failure
Haemolysis
(Hypothyroidism)
Renal failure
Pregnancy
37
Q

Mechanism of LMWH

A

Inactivates Xa

38
Q

B12

A
  • stored in liver
  • 2-4 years
  • intrinsic factor (gastric parietal cells)
  • B12/IF bind transcobalamin II to be taken into the cells
  • absorbed in the terminal ileum
39
Q

DNA bodies

A

Howell Jolly bodies

40
Q

Signs of factor bleeding

A
  • subtle
  • delayed
  • into joints
  • no splenomegaly
  • presents early in life
41
Q

Sickle cell anaemia

A
  • abnormal Hb shape

- releases oxygen and aggregates -> burst in small blood vessels

42
Q

Sickle cell anaemia inheritance pattern

A

autosomal recessive

gene on chromosome 11

43
Q

Coombs test

A

Detects antibody or complement bound to surface of RBCs

44
Q

Mutations in EPO cascade that leads to increase RBC production

A

Polycythaemia rubavera

45
Q

Action of heparin

A

Glyccosaminoglycan which binds antithrombin and makes it a better inhibitor of thrombin, Xa and IXa

46
Q

Causes of increased INR (normalised prothrombin time)

A

International normalised ratio

Extrinsic

  • warfarin
  • vitamin k deficiency
  • liver disease
  • DIC
47
Q

DIC

A

Disseminated intravascular coagulation

48
Q

Proteins that control coagulation cascade

A
  • TFPI tissue factor pathway inhibitor (inhibits VIIIa)
  • Antithrombin III
  • Protein C (protease targets Va and VIIIa)
  • Protein S is a cofactor that helps C
49
Q

Inhibitors of Xa

A

Betrixaban
Edoxaban
Apixaban *
Rivaroxaban *

50
Q

Signs of anaemia

A
  • pallor
  • jaundice
  • gallstones or splenomegaly
  • koilonychia (spoon shaped nails)
51
Q

MCHC

A

Mean corpuscular haemogloin concentration

- measure of Hb in a given volume of RBC

52
Q

Causes of increased thrombin time

A
  • heparin treatment
  • DIC
  • dysfibrinogenaemia
53
Q

Abnormal shape of RBC

A

Poikilocytosis

54
Q

Causes of macrocytic anaemia

A 
Hypothyroidism
Myelodysplastic syndrome
Marrow infiltration
Alcohol excess/liver disease
Cytotoxics
Reticulocytosis
Antifolate drugs
B12/folate deficiency
55
Q

Signs of Von Willelbrand disease

A
  • increase APTT
  • increase bleeding time
  • decrease factor VIIIc
  • INR and platelets normalish
56
Q

Thrombin activities

A

+ 5, 7, 8, 11, 13

- plasmin, antithrombin (targets thrombin, X, 7, 9, 11)

57
Q

Clinical features of B12 or folate deficiency

A
  • glossitis

- angular cheilitis

58
Q

Infectious agents at risk of if had splenectomy

A

Neisseria meningitidis
Haemophilus influenza type B (Hib)
Streptococcus pneumoniae

59
Q

HBF

A

α2γ2
< 2%
switch to adult up to months

60
Q

Formation of a clot

A
  • collagen exposed
  • vWF binds
  • vWF binds GP1b receptor on platelet
  • platelet integrin α2β1 and GPVI to collagen
  • increase intracellular calcium
  • pseudopodia and TXA2
  • platelet dense granules released
61
Q

Intravascular haemolysis

A
  • decrease haptoglobins
  • haemoglobinuria
  • urine haemosiderin
62
Q

Causes of microcytic anaemia

A

Sideroblastic
Iron deficiency
Thalassaemia

63
Q

Exit of bilirubin through gut

A
  • bilirubin
  • urobininogen -> urobilin -> urine
  • stercobilin -> feces
64
Q

Lysed RBCs

A

Schistocytes

65
Q

RBCs different size

A

Anisocytosis

66
Q

PCV/haematocrit

A

Packed cell volume
Most cells in blood are RBC so reflects RBC

Normal
M 0.45 +/- 0.05 Abnormal >0.52
M 0.41 +/- 0.05 Abnormal >0.48

67
Q

Normal white cell count

A

4-11 x 10^9/L

68
Q

Flat broad nails

A

Plantonychia

69
Q

Erythropoiesis in adults

A

Central skeleton and proximal ends of long bones

Haematology (5 decks)

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