HAEM Flashcards
How is sickle cell disease inherited?
Autosomal recessive
If both parents had sickle cell trait, what is the odds of them having a child with sickle cell anaemia?
25%
If one parent had sickle cell anaemia and the other parent was not a carrier for sickle cell, what are the chances of them having a child with sickle cell anaemia AND sickle cell trait?
All of the children will have sickle cell trait
What does it mean to have sickle cell trait?
You carry the gene for sickle cell anaemia and could pass it on to your children, it very rarely causes any actual symptoms
What is the management for sickle cell crisis?
- analgesia (IV morphine)
- vigorous IV rehydration
- O2
- warming
- broad spectrum antibiotics
What is the management for chronic sickle cell disease? (4)
- Hydroxycarbamide
- penicillin prophylaxis
+ vaccine propylaxis due to hyposplenia
- 5 yearly pneumococcal vaccination
- single dose meningitis vaccination
How is thalassaemia inherited?
autosomal recessive
What is chronic lymphocytic leukaemia?
monoclonal proliferation of B cells
How does CLL present?
Often asymptomatic
- anorexia/ weight loss
- bleeding/ infections
- lymphadenopathy
What blood results would you see in FBC of someone with CLL? (3)
- lymphocytosis
- anaemia
- thrombocytopenia
What diagnosis would a finding of smear cells on blood film suggest?
CLL
What are 3 complications of CLL?
- hypogammaglobulinemia
- warm autoimmune haemolytic anaemia
- high grade lymphoma (Richters)
When does Chronic Myeloid Leukaemia typically present?
Age 60-70
Presence of the Philadelphia chromosome indicates which condition?
CML
What does the Philadelphia chromosome do?
Increases tyrosine kinase activity which increases cell proliferation
Which haematological condition is associated with down’s syndrome?
ALL
What findings would you see on FBC of someone with CML?
increased eosinophils, basophils and neutrophils
How is CML treated?
Imatinib
Who is most often affected by non-Hodgkin’s lymphoma?
Over 75, Caucasian, FH
Talk through the Ann Arbour Staging
I - single lymph node
II - 2+ lymph nodes
III - lymph nodes on BOTH sides of diaphragm
IV - spread beyond lymph nodes
What would you see on histology of someone with Hodgkin’s lymphoma?
Reed Sternberg cells
What age range are most affected by Hodgkin’s lymphoma?
bimodal - 3rd and 7th decade
What are risk factors for developing Hodgkin’s lymphoma?
HIV/EBV
What are 3 signs/symptoms of Hodgkin’s lymphoma?
- painless asymmetrical lymphadenopathy
- pain worsens on drinking alcohol
B symptoms - weight loss/night sweats/fever
What would a FBC of someone with Hodgkin’s lymphomas show?
- normocytic anaemia
- eosinophilia
- raised Lactate dehydrogenase
What is the treatment for Hodgkin’s lymphoma?
chemo/radiotherapy
What is multiple myeloma?
Proliferation of plasma cells (play a role in immunity)
What would you see on blood film of someone with multiple myeloma?
Rouleaux formation
What are the symptoms of multiple myeloma?
CRAB
C-hypercalcaemia
R-renal insufficiency
A-anaemia
B-lytic bone lesions
(+bleeding/bruising/infection)
What would you see on protein electrophoresis of blood/urine of someone with multiple myeloma?
Serum - monoclonal antibody band
Urine- Bence Jones proteins
How is multiple myeloma treated? (3)
Chemo
bone marrow transplant
bisphosphonates
What is Acute Lymphoblastic Leukaemia?
Malignant proliferation of B lymphocytes in bone marrow causing pancytopenia.
What is Acute Lymphoblastic Leukaemia?
Malignant proliferation of B lymphocytes in bone marrow causing pancytopenia.
Give 5 differential diagnoses for a petechial rash
- leukaemia
- meningococcal septicaemia
- vasculitis
- idiopathic thrombocytopaenia
- non-accidental injury
What would a blood film show for ALL?
Blast cells
What would you see on blood film of someone with AML?
Auer rods
