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haem Flashcards

1
Q

reed-sternberg

A

hodgkins lymphoma

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2
Q

enlarged non painful lymph nodes (cervical rubbery)
painful with alcohol
fever night sweats wt loss itch fatigue

A

hodgkins / NHL (both present with B symptoms and similar lymph nodes)

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3
Q

hodgkins blood results with poor prognosis

A

raised ESR

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4
Q

key diagnostic test for lymphoma

A

excisional lymph node biopsy

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5
Q

how is CLL confirmed

A

immunophenotyping

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6
Q

what is an indication to start treatment in CLL

A

B symptoms
rapidly progressing lymphadenopathy/hepatosplenomegaly

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7
Q

how do you confirm lymphoma

A

immunohistochemisty

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8
Q

smudge cells

A

CLL

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9
Q

once bloods returns to normal after anti-leukaemia treatment how do you proceed?

A

one more round of chemo

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10
Q

confirm AML

A

immunophenotyping

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11
Q

neuropenic sepsis Tx

A

tazocin (piperacillin / tazobactam)

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12
Q

hodgkins Tx

A

multi agent chemo (ABVD: adriamycin, bleomycin, vinblastine, dacarbazine) +/- radio

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13
Q

NHL Tx

A

multiagent chemo (R-CHOP: rituximab,cyclophosphamide,hydroxydaunorubicin, vincristine andprednisolone)

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14
Q

common childhood cancer assoc with downs syndrome

A

ALL

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15
Q

what cancer can occur in lymph and blood

A

CLL or myeloma

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16
Q

acute leukaemia affect what kind of cell

A

primitive progenitors

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17
Q

chronic leukaemias affect what type of cell

A

mature

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18
Q

what leukaemia affect bone marrow and blood

A

Chronic myeloid leukaemia/ chronic myeloproliferative disorders
Acute myeloid leukaemia
Acute lymphoblastic leukaemia

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19
Q

what leukaemia is common in elderly

A

AML

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20
Q

auer rod

A

AML

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21
Q

prevent tumour lysis syndrome in ALL

A

allopurinol

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22
Q

characteristics of blast cells

A

high nuclear:cytoplasmic ratio

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23
Q

philadelphia chromosome translocation t(9:22) resulting in new gene BCR-ABL1 and how do u find this cytogenic abnormality

A

CML

FISH

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24
Q

in what condition do you get renal impairment, bone pain and hypercalcaemia

A

multiple myeloma

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25
what condition do u get gout
CML
26
Tx CML
tyrosine kinase inhibitor - imatinib and stem cell/bone marrow transplant
27
cancer of plasma cells
myeloma
28
bence jone protein
myeloma
29
what immunoglobulin is abundant in myeloma and how do you investigate this
IgG - serum protein electrophoresis
30
Tx myeloma
chemo (thalidomide) + alkylating agent (melphalan) + steroid (dexamethasone)
31
what leukaemia can polycythaemia vera transform to
AML
32
JAK2 mutation
polycythaemia vera
33
aquagenic puritis
polycythaemia vera
34
bloods: very high Hb and erythropoietin levels
PCV
35
Tx PCV
venesect to haematocrit <0.45 aspirin cytotoxic oral chemo eg hydroxycarbamide
36
dry aspirate fibrosis of trrephine biopsy
myelofibrosis
37
tear drop RBC (poikilocytes)
myelofibrosis
38
Tx myelofibrosis
JAK2 inhibitor - ruxolitinib
39
iron chelating agents
desferrioxamine, deferiprone etc
40
arterial thrombosis Tx
antiplatelets aspirin
41
venous thrombosis Tx
anticoagulants DOAC - apixaban 1st line massive PE - thrombolysis secondary prevention - LMWH (pregnancy) or warfarin (first line in antiphospholipid syndrome)
42
hereditary thrombophilias
factor V leiden prothombin20210 mutation antithrombin def protein C and S def
43
where does extravascular haemolysis occur
majority in spleen
44
name some types of extravascular haemolysis
sickle, thalassaemia, here sphero, haem disease of new born, WARM AIHA
45
name some intravascular haemolysis
mismatch, G6PD, cold AIHA
46
what drug inhibits prolactin
cabergoline (dopamine agonist)
47
what leads to burkitts lyphoma and what is it caused by
NHL, EBV virus
48
smudge cells
CLL
49
where is EPO produced from
kidneys
49
where is EPO produced from
kidneys
50
foetal Hb contents
2 alpha 2 gamma
51
in what form is iron stored as ferritin/transferrin
fe3+
52
where are clotting factors produced
liver
53
what does the common pathway produce
thrombin
54
what is the measure of the common pathway
thrombin time
55
vitamin K dependent clotting factors
II, VII, IX, X
56
embryology sites of haemopoesis: yolk sac
week 10
57
embryology sites of haemopoiesis: liver
week 6
58
embryology sites of haemopoiesis: bone marrow
week 16
59
bone marrow biopsy in child
tibia
60
bone marrow biopsy in adult
posterior iliac crest
61
cell?
normal
62
neutrophil
63
monocyte
64
eosinophil
65
basophil
66
lymphocyte
67
plasma cell
68
NK cell
69
megakaryocyte
70
cell?
megaloblast
71
cell and condition it is seen in
target cells iron deficiency, post-splenectomy, liver disease, thalassaemia
72
cell and condition it is seen in
heinz bodies G6PD, alpha thalassaemia, chronic liver disease
73
cell and condition it is seen in
howell-jolly bodies post splenectomy, sickle, anything with hyposplenism
74
cell and condition it is seen in
reticulocytes haemolytic anaemia major bleed
75
cell and condition it is seen in
schistocytes HUS, DIC, TTP, heart valves
76
cell and condition it is seen in
sideroblasts myelodysplasia
77
cell and condition it is seen in
smudge cells CLL
78
cell and condition it is seen in
spherocytes AIHA, hereditary spherocytosis
79
cell and condition it is seen in
rouleaux multiple myeloma Waldenstroms
80
cell and condition it is seen in
myeloblast AML
81
cell and condition it is seen in
lymphoblast ALL
82
cell and condition it is seen in
auer rod AML
83
cell and condition it is seen in
tear drop RBC marrow fibrosis conditions
84
how do you treat shock
synthetic colloids ASAP
85
if alloantibody is identified in patient blood what do you need to make sure in the donor blood
negative for that antigen
86
indirect coombs test looking for ?
alloantibodies
87
what causes megaloblastic anaemia
defects in DNA synthesis and nuclear maturation
88
what is B12 rich in
meat, eggs etc
89
folate is rich in
leafy greens
90
positive blood CANNOT be given to negative patients T/F
T
91
where is b12 absorbed
terminal ilium
92
where is folate absorbed
duodenum and jejunum
93
why do you not give folate before fixing B12 levels
subacute combined degeneration of the cord (affecting dorsal and lateral columns)
94
blood film of B12/folate def
hypersegmented nucleus macrovalocytes
95
blood film of B12/folate def
hypersegmented nucleus macrovalocytes
96
causes of nonmegaloblastic anaemia
alcohol liver hypothyroidism marrow failure
97
in blood transfusion what happens if anti-A and group A are put together
intravascular haemolysis
98
what can all blood groups recieve
donor O group
99
what can recipient group A and AB recieve
A
100
what antibodies are present in group A plasma
anti-B
101
patient is AB what blood can they recieve
all !!!
102
group O what plasma is safe to recieve
any - dont have A or B antigen
103
vit K inhibitor that target fibrin clot
warfarin
104
what potentiates warfarin - inc INR - risk of bleed
hepatic enzyme inhibitors - alcohol, metronidazole, clarithromycin
105
what antagonises warfarin - dec INR
hepatic enzyme inducers - carbamazepine, phenytoin
106
what drug potentiates antithrombin and switches off factor X
heparin
107
reversal of heparin
protamine sulphate
108
monitor of LMWH
anti-Xa assay
109
unfractionated heparin monitor
APTT
110
how are DOACs excreted and what can it cause
via kidneys can accumulate in renal failure
111
thrombin inhibitor
dabigatran
112
blocks COX preventing platelet aggregation
aspirin
113
ADP receptor antagonist
clopidogrel (antiplatelet)
114
phosphodiesterase inhibitor
dipyridamole
114
phosphodiesterase inhibitor
dipyridamole
115
thalassaemia inheritance
AR
116
HbAS
sickle trait
117
HbSS
sickle anaemia
118
Tx sickle crisis
hyposplenism - penicillin, vaccines folic acid hydroxycarbamide - induce HbF production
119
TTP Tx
plasmapheresis steroids splenectomy
120
ITP Tx
steroids splenectomy immunosupression - azathrioprine
121
vWD tx
desmopressin
122
isolated inc aPTT
haemophilia blood test
123
high HbA2
beta thalassaemia trait/major
124
Tx of pernicous anaemia
hydroxocobalamin for life
125
IgM haemolysis
cold AIHA due to infection EBV
126
IgG haemolysis
warm AIHA
127
JAK2 inhibitor for myeofibrosis
ruxolitinib
128
only acquired thrombophilia
antiphospholipid syndrome

y3 summary (7 decks)

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