Haem Flashcards
1
Q
IDA Ferritin
A
LOWERED
2
Q
IDA TIBC
A
RAISED
3
Q
IDA Transferrrin
A
RAISED
4
Q
Aplastic anaemia bloods
A
Pancytopenia
Raised MCV
5
Q
Anaemia of chronic disease blood film
A
Rouleaux formation
6
Q
Anaemia of chronic disease TIBC
A
LOWERED
7
Q
Anaemia of chronic disease Ferritin
A
RAISED
8
Q
Chronic renal failure anaemia
A
normocytic, normochromic
9
Q
Lead poisoning blood film
A
Basophilic stippling
Microcytic anaemia
10
Q
Causes of WARM agglutinin autoimmune haemolytic anaemia
A
Lymphoproliferative diseases
SLE
Drugs (penicillin)
11
Q
Causes of COLD agglutinin autoimmune haemolytic anaemia
A
Mycoplasma
EBV
12
Q
G6PD deficiency blood film
A
bite cells
heinz bodies
13
Q
Causes of MAHA
A
Thrombotic thrombocytopenic purpura
Haemolytic uraemic syndrome
DIC
SLE
14
Q
MAHA presentation/ blood film
A
Jaundice
Schistocytes
15
Q
Paroxysmal nocturnal haemoglobinuria
A
Haemolysis, haemoglobinuria, thrombophilia
Positive Ham’s test
16
Q
Howell-Jolly bodies indicate
A
Hyposplenism
17
Q
What is anisocytosis
A
Variation in size of circulating erythrocytes
18
Q
Causes of anisocytosis
A
IDA, thalassemia, megaloblastic anaemia, sideroblastic anaemia
19
Q
Myelofibrosis diagnostics
A
Tear drop cells (dacrocytes)
Pancytopenia
Hepatosplenomegaly
Bone marrow tap = dry and bloody tap
20
Q
What do cabot rings indicate
A
Megaloblastic anaemia
21
Q
Multiple myeloma blood film
A
Rouleaux formation
22
Q
What do target cells indicate
A
Thalassemia
Asplenia
Liver disease
23
Q
What do pappenheimer bodies indicate
A
lead poisoning
sideroblastic anaemia
haemolytic anaemia
24
Q
Haemophilia A APTT
A
Prolonged, (factor 8)
25
Symptoms of idiopathic TTP
MAHA, renal failure, thrombocytopenia, fever, neuro signs
26
DIC causes
Gram negative sepsis, malignancy, trauma, placental abruption, amniotic fluid embolism
27
vWD symptoms
gum bleeding, epistaxis, prolonged bleeding after surgery
28
vWD clotting studies
Prolonged/ normal APTT
normal PT
Reduced fatcor 8
29
Condition that causes impaired degradation of factor 5 by protein C, causing DVT and miscarriage
Factor V Leidan
30
Patient presents with stroke/ DVT/ miscarriage, bloods show anti-cardiolipin antibodies and lupus anticoagulant
Antiphospholipid syndrome
31
Patient presents with claudication, imaging shows corkscrew appearance of arteries, history of smoking
Buerger's disease
32
Patient with venous thrombosis, condition resulting in reduced degradation of factors 5a and 8a
Protein S deficiency
33
Patient having a blood transfusion. Becomes short of breath, coughs up pink frothy sputum, has distended neck veins
Fluid overload
34
Patient having a blood transfusion. They are immunosuppressed. Symptoms of diarrhoea, maculopapular rash and skin necrosis soon develop.
Graft vs Host Disease
35
Patient having a blood transfusion. Previous history includes recurrent chest/ gi infections. They soon develop severe anaphylaxis
IgA deficiency
36
Patient having a blood transfusion. Develop dry cough, dyspnoea and fever within 6 horus of transfusion
Transfusion related lung injury
37
Patient having a blood transfusion. 1-2 horus post-transfusion they develop abdo pain, loin pain, vomiting haemoglobinuria. Blood is ABO incompatible
Immediate haemlytic transfusion reaction
38
Patient having a blood transfusion. They show bronzed skin, short stature and heart failure.
Iron overload
39
Patient having a blood transfusion post-pregnancy. Develop a low fever and rigors.
Febrile non-haemolytic reaction
40
Elderly patient shows raised WCC with raised granulocytes. Bone marrow biopsy shows hypercellularity. Chromosomal detection between 9 and 22 present
CML
41
Middle aged patient with splenomegaly, heaptomegaly and pancytopenia. CD25 and CD11c are expressed. Tumour cells express tartrate-resistant acid phosphatase.
Hairy cell leukaemia
42
Down syndrome patient, anaemia, thrombocytopenia, neutropenia. Bone marrow >20% myeloblasts. Blood film shows Auer rods
AML
43
Elderly man with tiredness and weight loss. Lymphocytosis, with smudge cells visible on blood film.
CLL
44
Large lymphocytes in blood stream and bone marrow containing azurophilic granules
Large granular pymphocytic leukaemia
45
African teenager with latent EBV has mandibular (if endemic)/ abdominal mass. Cells show starry sky appearance under microscope.
Burkitt lymphoma
46
Elderly man with generalised lymphadenopathy, heaptomegaly, pancytopenia. Translocation between 11 and 14 causing overexpression of cyclin D1. Agressive b cell lymphoma
Mantle cell lymphoma
47
Middle aged man with painless generalised lymphadenopathy. BCL-2 overexpression leads to centrocytes and centroblasts on blood film
Follicular lymphoma
48
Patient with latent EBV/ HHV8 shows same chromosomal translocation as follicular lymphoma. large lymphocytes with diffuse pattern of growth
Diffuse large B-cell lymphoma
49
Cutaneous T cell lymphoma in elderly man with rash like lesions similar to eczema or psoriasis.
Mycosis fungoides
50
Cutaneous masses in nasal area. Tumours with NK cell markers and EBV infection
angiocentric lymphoma
51
Essential thrombocythaemia treatment
Hydroxyurea or anagrelide
52
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.
Myelofibrosis
53
Patient with fever, fatigue, night sweats and hepatosplenomegaly. Bloods show monocytosis and eosinophilia.
Chronic myelo-monocytic leukaemia
54
Patient with headcahes/ dizziness/ stroke, pruritis after baths, peptic ulcers, and gout. JAK2 mutation. Raised haemoglobin, WCC and platelets, reduced EPO.
Polycythaemia rubra vera
55
Rheumatoid arthritis type of anaemia
anaemia of chronic disease
56
Causes of raised ESR
Temporal arteritis
Myeloma
AUtoimmune disease
Polymyalgia rheumatica
57
Patient with non-caseating granulomas, bilhilar lymphadenopathy and monocytosis
Sarcoidosis
58
Monocytosis causes
Sarcoidosis
Brucellosis
Typhoid
Varicella zoster
CMML
59
Secondary polycythaemia causes
renal cell carcinoma
chronic hypoxia
solid tumour
renal disease
60
Eosinophilia causes
schistosomiasis
allergic disease
neoplasms
NSAIDs
61
leuko-erythroblastic film causes
miliary TB
myelofibrosis
cancers
62
neutrophilia causes
acute pancreatitis
UC
steroids
63
blood transfusion leading to symptoms of non-cardiogenic pulmonary oedema (SOB, hypoxia, without peripheral oedema, crepitations)
transfusion related acute lung injury
64
post transfusion chills, fever, back/ chest pain, hypotension, dark urine, uncontrolled bleeding (DIC)
ABO incompatibility
65
when do delayed haemolytic transfusion reactions happen
more than 24 hours after transfusion
66
when do febrile haemolytic transfusion reactions happen
less than 24 hours after transfusion
67
what does a positive osmotic fragility test show
spherocytes are present
68
what is the schilling test used for
B12 deficiency - pernicious anaemia
69
when do you get pencil cells
iron deficiency anaemia
thalassaemia
pyruvate kinase deficiency
70
when do you get target cells
hepatic pathology
hyposplenism
haemglobinopathies
71
what do splenectomy patients require lifelong
penicillin V prophylaxis
pneumococcal conjugate vaccine
human influenza B vaccine
meningococcal vaccine
72
acute worsening of a sickle cell patient's baseline anaemia --> sob, fatigue with a fever
aplastic crisis precipitated by parvovirus 19
73
sudden haemoglobinuria and jaundice after exposure to cold temperatures
paroxysmal cold haemoglobinuria
74
common anaemia in coeliac
iron deficiency anaemia
75
primary cause of aplastic anaemia
congenital (Fanconi's anaemia)
idiopathic
76
secondary causes of aplastic anaemia
cytotoxics
carbamezepine
chloramphenicol
anticonvulsants
ionizing radiation
viruses
77
haemochromatosis iron studies
RAISED iron
RAISED ferritin
RAISED transferrin
LOW/ NORMAL TIBC
78
TTP features
MAHA
Fever
Renal failure
fluctuating CNS signs
haematuria/ proteinuria
low platelet count
79
vitamin k dependent clotting/ anticoagulant factors
factor 2, 7, 9 and 10
proteins C, S and Z
80
what can happen in the first few days of starting warfarin
a transient HYPERcoagulable state due to impaired protein S and protein C production
81
what can massive blood transfusion cause
thrombocytopenia
82
conditions with a raised ESR but NOT CRP
SLE
MM
lymphoma
anaemia
pregnancy
83
smokers polycythaemia
combined polycythaemia (due to both increased EPO and decreased plasma volume)
84
polycythaemia rubra vera mutation
V617F point mutation in exon 14 of JAK2
85
G6PD inheritance
X-linked
86
what does a positive result for blood on urine dip indicate
either
blood
haemoglobinuria
myoglobinuria
87
red cell mass in polycythaemia
INCREASED
88
which blood product contains vWF
cryoprecipitate
89
smudge cells
CLL
90
haptoglobin concentration in haemolysis
decreased
91
beta-thalassemia trait HbA2
increased
92
Burkitt's lymphoma translocation
8;14
93
imatinib MOA
tyrasine kinase inhibitor
treats CML
94
what can vWD be treated with
desmopressin
95
what percentage of blasts is regarded as leukaemic transformation in myelodysplastic syndrome
>20%
96
what is the most likely cause of mortality in myelodysplastic syndrome
infection, rather than leukaemic transformation
97
factor V leiden pathology
activated protein C resistance
98
mutated protein in hereditary sphereocytosis
spectrin
99
how is intrinsic pathway activity measured
APTT
100
how is extrinsic pathway activity measured
PT
101
first line small molecule inhibitor used in CLL treatment
Ibrutinib
102
how to urgently reversw LMWH
protamine sulfate
103
myelofibrosis erythrocyte description
dacrocyte
104
transformation of CLL into a high grade lymphoma
richter's transformation
105
hereditary spherocytosis inheritance
autosomal dominant
106
which haemoglobin chain is mutated in sickle cell disease
beta globin
107
which drug inhibits fusion protein BCR-ABL and is used in CML treatment
imatinib
108
myeloproliferative syndromes all carry a risk of transformation into what
AML
109
does haemophilia affect bleeding time
NO
110
what can white cells sometimes be confused with in automated white cell counts
reticulocytes
111
skeletal abnormalities (abnormal thumbs), short stature, cafe au lait spots, pancytopenia
fanconi anaemia
112
cigar cells
iron deficiency anaemia
113
neutropenia, fatty stools, short stature, pancreatic dysfunction
schwachman diamond syndrome
114
nail dystrophy, oral leukoplakia, hyperpigmentation of skin creases, pulomary fibrosis, bone marrow failure
dyskeratosis congenita
115
heparin induced thrombocytopenia management
bivalirudin
or argatroban
116
dic management
supportive
117
DVT treatment
DOAC
118
tumour lysis syndrome prophylaxis
rasburicase
119
tumour lysis syndrome bloods
HYPERkalaemia
HYPERphosphataemia
HYPOcalcaemia
RAISED urate
120
quickly raise platelet count in ITP
IV Ig
121
profound renal failure in DVT
warfarin
