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Haem Flashcards

1
Q

IDA Ferritin

A

LOWERED

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2
Q

IDA TIBC

A

RAISED

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3
Q

IDA Transferrrin

A

RAISED

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4
Q

Aplastic anaemia bloods

A

Pancytopenia

Raised MCV

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5
Q

Anaemia of chronic disease blood film

A

Rouleaux formation

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6
Q

Anaemia of chronic disease TIBC

A

LOWERED

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7
Q

Anaemia of chronic disease Ferritin

A

RAISED

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8
Q

Chronic renal failure anaemia

A

normocytic, normochromic

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9
Q

Lead poisoning blood film

A

Basophilic stippling

Microcytic anaemia

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10
Q

Causes of WARM agglutinin autoimmune haemolytic anaemia

A

Lymphoproliferative diseases

SLE

Drugs (penicillin)

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11
Q

Causes of COLD agglutinin autoimmune haemolytic anaemia

A

Mycoplasma

EBV

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12
Q

G6PD deficiency blood film

A

bite cells

heinz bodies

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13
Q

Causes of MAHA

A

Thrombotic thrombocytopenic purpura

Haemolytic uraemic syndrome

DIC

SLE

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14
Q

MAHA presentation/ blood film

A

Jaundice

Schistocytes

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15
Q

Paroxysmal nocturnal haemoglobinuria

A

Haemolysis, haemoglobinuria, thrombophilia

Positive Ham’s test

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16
Q

Howell-Jolly bodies indicate

A

Hyposplenism

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17
Q

What is anisocytosis

A

Variation in size of circulating erythrocytes

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18
Q

Causes of anisocytosis

A

IDA, thalassemia, megaloblastic anaemia, sideroblastic anaemia

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19
Q

Myelofibrosis diagnostics

A

Tear drop cells (dacrocytes)

Pancytopenia

Hepatosplenomegaly

Bone marrow tap = dry and bloody tap

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20
Q

What do cabot rings indicate

A

Megaloblastic anaemia

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21
Q

Multiple myeloma blood film

A

Rouleaux formation

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22
Q

What do target cells indicate

A

Thalassemia

Asplenia

Liver disease

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23
Q

What do pappenheimer bodies indicate

A

lead poisoning

sideroblastic anaemia

haemolytic anaemia

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24
Q

Haemophilia A APTT

A

Prolonged, (factor 8)

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25
Q

Symptoms of idiopathic TTP

A

MAHA, renal failure, thrombocytopenia, fever, neuro signs

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26
Q

DIC causes

A

Gram negative sepsis, malignancy, trauma, placental abruption, amniotic fluid embolism

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27
Q

vWD symptoms

A

gum bleeding, epistaxis, prolonged bleeding after surgery

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28
Q

vWD clotting studies

A

Prolonged/ normal APTT

normal PT

Reduced fatcor 8

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29
Q

Condition that causes impaired degradation of factor 5 by protein C, causing DVT and miscarriage

A

Factor V Leidan

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30
Q

Patient presents with stroke/ DVT/ miscarriage, bloods show anti-cardiolipin antibodies and lupus anticoagulant

A

Antiphospholipid syndrome

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31
Q

Patient presents with claudication, imaging shows corkscrew appearance of arteries, history of smoking

A

Buerger’s disease

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32
Q

Patient with venous thrombosis, condition resulting in reduced degradation of factors 5a and 8a

A

Protein S deficiency

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33
Q

Patient having a blood transfusion. Becomes short of breath, coughs up pink frothy sputum, has distended neck veins

A

Fluid overload

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34
Q

Patient having a blood transfusion. They are immunosuppressed. Symptoms of diarrhoea, maculopapular rash and skin necrosis soon develop.

A

Graft vs Host Disease

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35
Q

Patient having a blood transfusion. Previous history includes recurrent chest/ gi infections. They soon develop severe anaphylaxis

A

IgA deficiency

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36
Q

Patient having a blood transfusion. Develop dry cough, dyspnoea and fever within 6 horus of transfusion

A

Transfusion related lung injury

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37
Q

Patient having a blood transfusion. 1-2 horus post-transfusion they develop abdo pain, loin pain, vomiting haemoglobinuria. Blood is ABO incompatible

A

Immediate haemlytic transfusion reaction

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38
Q

Patient having a blood transfusion. They show bronzed skin, short stature and heart failure.

A

Iron overload

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39
Q

Patient having a blood transfusion post-pregnancy. Develop a low fever and rigors.

A

Febrile non-haemolytic reaction

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40
Q

Elderly patient shows raised WCC with raised granulocytes. Bone marrow biopsy shows hypercellularity. Chromosomal detection between 9 and 22 present

A

CML

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41
Q

Middle aged patient with splenomegaly, heaptomegaly and pancytopenia. CD25 and CD11c are expressed. Tumour cells express tartrate-resistant acid phosphatase.

A

Hairy cell leukaemia

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42
Q

Down syndrome patient, anaemia, thrombocytopenia, neutropenia. Bone marrow >20% myeloblasts. Blood film shows Auer rods

A

AML

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43
Q

Elderly man with tiredness and weight loss. Lymphocytosis, with smudge cells visible on blood film.

A

CLL

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44
Q

Large lymphocytes in blood stream and bone marrow containing azurophilic granules

A

Large granular pymphocytic leukaemia

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45
Q

African teenager with latent EBV has mandibular (if endemic)/ abdominal mass. Cells show starry sky appearance under microscope.

A

Burkitt lymphoma

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46
Q

Elderly man with generalised lymphadenopathy, heaptomegaly, pancytopenia. Translocation between 11 and 14 causing overexpression of cyclin D1. Agressive b cell lymphoma

A

Mantle cell lymphoma

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47
Q

Middle aged man with painless generalised lymphadenopathy. BCL-2 overexpression leads to centrocytes and centroblasts on blood film

A

Follicular lymphoma

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48
Q

Patient with latent EBV/ HHV8 shows same chromosomal translocation as follicular lymphoma. large lymphocytes with diffuse pattern of growth

A

Diffuse large B-cell lymphoma

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49
Q

Cutaneous T cell lymphoma in elderly man with rash like lesions similar to eczema or psoriasis.

A

Mycosis fungoides

50
Q

Cutaneous masses in nasal area. Tumours with NK cell markers and EBV infection

A

angiocentric lymphoma

51
Q

Essential thrombocythaemia treatment

A

Hydroxyurea or anagrelide

52
Q

Patient with heaptosplenomegaly. Blood counts initially showed raised WCC and platelet counts, now show pancytopenia. Blood film leukoerythroblastic, shows tear-drop cells, circulating megakaryocytes. Bone marrow aspirate is dry/ bloody tap.

A

Myelofibrosis

53
Q

Patient with fever, fatigue, night sweats and hepatosplenomegaly. Bloods show monocytosis and eosinophilia.

A

Chronic myelo-monocytic leukaemia

54
Q

Patient with headcahes/ dizziness/ stroke, pruritis after baths, peptic ulcers, and gout. JAK2 mutation. Raised haemoglobin, WCC and platelets, reduced EPO.

A

Polycythaemia rubra vera

55
Q

Rheumatoid arthritis type of anaemia

A

anaemia of chronic disease

56
Q

Causes of raised ESR

A

Temporal arteritis

Myeloma

AUtoimmune disease

Polymyalgia rheumatica

57
Q

Patient with non-caseating granulomas, bilhilar lymphadenopathy and monocytosis

A

Sarcoidosis

58
Q

Monocytosis causes

A

Sarcoidosis

Brucellosis

Typhoid

Varicella zoster

CMML

59
Q

Secondary polycythaemia causes

A

renal cell carcinoma

chronic hypoxia

solid tumour

renal disease

60
Q

Eosinophilia causes

A

schistosomiasis

allergic disease

neoplasms

NSAIDs

61
Q

leuko-erythroblastic film causes

A

miliary TB

myelofibrosis

cancers

62
Q

neutrophilia causes

A

acute pancreatitis

UC

steroids

63
Q

blood transfusion leading to symptoms of non-cardiogenic pulmonary oedema (SOB, hypoxia, without peripheral oedema, crepitations)

A

transfusion related acute lung injury

64
Q

post transfusion chills, fever, back/ chest pain, hypotension, dark urine, uncontrolled bleeding (DIC)

A

ABO incompatibility

65
Q

when do delayed haemolytic transfusion reactions happen

A

more than 24 hours after transfusion

66
Q

when do febrile haemolytic transfusion reactions happen

A

less than 24 hours after transfusion

67
Q

what does a positive osmotic fragility test show

A

spherocytes are present

68
Q

what is the schilling test used for

A

B12 deficiency - pernicious anaemia

69
Q

when do you get pencil cells

A

iron deficiency anaemia

thalassaemia

pyruvate kinase deficiency

70
Q

when do you get target cells

A

hepatic pathology

hyposplenism

haemglobinopathies

71
Q

what do splenectomy patients require lifelong

A

penicillin V prophylaxis

pneumococcal conjugate vaccine

human influenza B vaccine

meningococcal vaccine

72
Q

acute worsening of a sickle cell patient’s baseline anaemia –> sob, fatigue with a fever

A

aplastic crisis precipitated by parvovirus 19

73
Q

sudden haemoglobinuria and jaundice after exposure to cold temperatures

A

paroxysmal cold haemoglobinuria

74
Q

common anaemia in coeliac

A

iron deficiency anaemia

75
Q

primary cause of aplastic anaemia

A

congenital (Fanconi’s anaemia)

idiopathic

76
Q

secondary causes of aplastic anaemia

A

cytotoxics

carbamezepine

chloramphenicol

anticonvulsants

ionizing radiation

viruses

77
Q

haemochromatosis iron studies

A

RAISED iron

RAISED ferritin

RAISED transferrin

LOW/ NORMAL TIBC

78
Q

TTP features

A

MAHA

Fever

Renal failure

fluctuating CNS signs

haematuria/ proteinuria

low platelet count

79
Q

vitamin k dependent clotting/ anticoagulant factors

A

factor 2, 7, 9 and 10

proteins C, S and Z

80
Q

what can happen in the first few days of starting warfarin

A

a transient HYPERcoagulable state due to impaired protein S and protein C production

81
Q

what can massive blood transfusion cause

A

thrombocytopenia

82
Q

conditions with a raised ESR but NOT CRP

A

SLE

MM

lymphoma

anaemia

pregnancy

83
Q

smokers polycythaemia

A

combined polycythaemia (due to both increased EPO and decreased plasma volume)

84
Q

polycythaemia rubra vera mutation

A

V617F point mutation in exon 14 of JAK2

85
Q

G6PD inheritance

86
Q

what does a positive result for blood on urine dip indicate

A

either

blood

haemoglobinuria

myoglobinuria

87
Q

red cell mass in polycythaemia

88
Q

which blood product contains vWF

A

cryoprecipitate

89
Q

smudge cells

90
Q

haptoglobin concentration in haemolysis

91
Q

beta-thalassemia trait HbA2

92
Q

Burkitt’s lymphoma translocation

93
Q

imatinib MOA

A

tyrasine kinase inhibitor

treats CML

94
Q

what can vWD be treated with

A

desmopressin

95
Q

what percentage of blasts is regarded as leukaemic transformation in myelodysplastic syndrome

96
Q

what is the most likely cause of mortality in myelodysplastic syndrome

A

infection, rather than leukaemic transformation

97
Q

factor V leiden pathology

A

activated protein C resistance

98
Q

mutated protein in hereditary sphereocytosis

99
Q

how is intrinsic pathway activity measured

100
Q

how is extrinsic pathway activity measured

101
Q

first line small molecule inhibitor used in CLL treatment

102
Q

how to urgently reversw LMWH

A

protamine sulfate

103
Q

myelofibrosis erythrocyte description

104
Q

transformation of CLL into a high grade lymphoma

A

richter’s transformation

105
Q

hereditary spherocytosis inheritance

A

autosomal dominant

106
Q

which haemoglobin chain is mutated in sickle cell disease

A

beta globin

107
Q

which drug inhibits fusion protein BCR-ABL and is used in CML treatment

108
Q

myeloproliferative syndromes all carry a risk of transformation into what

109
Q

does haemophilia affect bleeding time

110
Q

what can white cells sometimes be confused with in automated white cell counts

A

reticulocytes

111
Q

skeletal abnormalities (abnormal thumbs), short stature, cafe au lait spots, pancytopenia

A

fanconi anaemia

112
Q

cigar cells

A

iron deficiency anaemia

113
Q

neutropenia, fatty stools, short stature, pancreatic dysfunction

A

schwachman diamond syndrome

114
Q

nail dystrophy, oral leukoplakia, hyperpigmentation of skin creases, pulomary fibrosis, bone marrow failure

A

dyskeratosis congenita

115
Q

heparin induced thrombocytopenia management

A

bivalirudin

or argatroban

116
Q

dic management

A

supportive

117
Q

DVT treatment

118
Q

tumour lysis syndrome prophylaxis

A

rasburicase

119
Q

tumour lysis syndrome bloods

A

HYPERkalaemia

HYPERphosphataemia

HYPOcalcaemia

RAISED urate

120
Q

quickly raise platelet count in ITP

121
Q

profound renal failure in DVT

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