Haem Flashcards
Anaemia + painless jaundice
Haemolytic anaemia
Features of haemolytic uraemic syndrome (triad)
- MAHA
- Thrombocytopenia
- Renal impairment
Vitamin B12 deficiency features
- Symmetric paraesthesia/numbness
- Gait problems
IgA Vasculitis (Henoch-Schonlein purpura) features
- Purpuric rash
- Raised ESR
- joint and abdo pain
Disseminated intravascular coagulation features
- Thrombocytopaenia
- Prolonged PT and aPTT
- Low plasma fibrinogen
- Elevated plasma D-dimer
Chronic lymphocytic leukaemia blood film
Increased lymphocytes with sparse cytoplasm
ALL v CLL features
ALL more common in children + YA, and more syx - fatigue/fever/bleeding.
Hodgkin’s lymphoma features
- Painless lymphadenopathy, often in neck/ supraclavicular region (may be painful when drinking alc)
- Lymph nodes may feel rubbery/moveable
- Lymph nodes spread to adjacent ones
Non Hodgkin’s lymphoma features
- Lymphadenopathy may be painless
- Lymph nodes feel firm and fixed
- May spread in non-contiguous pattern
HL v NHL blood films
- HL: Reed- sternberg cells; large, atypical cells w multiple nuclei surrounded by inflamm infiltrate
- NHL: may show variety of different lymphoid cells
Acute lymphoblastic leukaemia presentation
- Over weeks-months
- Petechial rash
- Hepatomegaly
- Anaemia/fatigue
- CHild
Causes of macrocytic anaemia
Folate and vitamin B12 deficiency
Causes of microcytic anaemia
IDA
Hodgkin’s lymphoma mx
Chemotherapy
Initial ix for MM
Urine and serum protein electrophoresis
Sickle cell pt with pain ++ Mx
IV morphine
Myelofibrosis and features
Blood ca where bone’s ability to make blood cells affected
- Pancytopaenia
- Splenomegaly
-Purpura
Causes of microcytic anaemia (<80)
IDA
THalassaemia
Normocytic anaemia (80-100)
Anaemia chronic disease
CKD
Macrocytic anaemia (>100)
Megaloblastic
- B12
- Folate
Non-megaloblastic
- Alcohol
IDA & >= 60
2WW colonoscopy
IDA >=50-59 + rectal bleeding
2 WW colonscopy
IDA >=50-59 + no rectal bleeding
Faecal occult test
IDA >=40-49 + B syx + rectal bleed
2 WW colonoscopy
Microcytic anaemia + disproportionately low MCV
thalassaemia
Normocytic anaemia + reduced renal function
CKD related anaemia
Macrocytic anaemia + mixed upper/lower signs
B12 deficiency
HSP mx
Analgesia ± steroids
Immune thrombocytopenic purpura features
- purpuric rash legs and buttocks ± oral mucosa
- reduced platelets
ITP mx
Steroids ± IVIg
Acute presentation bruises over limbs + DIC
acute promyelocytic leukaemia
Which translocation is associated with acute promyelocytic leukaemia?
t(15; 17) PML-RARA
Which haem ca associated w philadelphia chromosome t(9;22)
CML
CML first line mx
Imatinib (tyrosine kinase inhib)
- if no response -> stem cell transplant
Auer rods haem ca
AML
Haemophilia first line Ix
Factor XIII assay level
severe, life-threatening bleeding haemophilia A mx
Factor VIII
Most common presentation haemophilia
haemarthrosis
Mx of acute SCD
- IV Morphine
- IV fluids
- High flow O2
± blood transfusion
±abx
SCD complications
- Acute chest syndrome (vaso-occlusion within the pulmonary vasculature of patients with sickle cell disease)
- Acute splenic sequestration (acute drop Hb and splenomegaly ->
Repeated sickling in the spleen causes scarring, making the spleen not work very well) - Cerebrovascular disease/stroke
