Haem Flashcards

1
Q

Microcytic anaemia causes

A

Low iron, thalassaemia, sideroblastic
Sometimes chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Macrocytic anaemia causes

A

B12/folate deficiency, chronic liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normocytic anaemia - low retics

A

Diamond-Blackfann anaemia, Fanconi’s anaemia, TEC (transient erythroblastosis of childhood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normocytic anaemia - high retics

A

Bleeding, haemolysis, bone marrow infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs of thalassaemia

A

o Chipmunk facies
o Bony deformities (frontal bossing)
o Dental malocclusion
o Jaundice
o HSM
o Desferroxamine signs (scars, retinopathy, cataracts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of iron deficiency

A

Pallor in skin and conjunctiva
Pale atrophic tongue
Angular cheilosis/stomatitis
Leuconychia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Features of bleeding

A
  • Bruises
  • Petechiae
  • CNS, joints, sputum, urine, stool blood loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of clotting defects

A

o Congenital - haemophilia; vWD
o Acquired - liver disease; DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of low platelets - congenital

A

 Trisomies
 Short statures → Noonan, Turner’s
 Abnormal thumbs → TAR, Fanconi’s
 Abnormal skin → Wiskott Aldrich
 Bernard Soulier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of low platelets - acquired

A

Marrow infiltration (leukaemia, lymphoma)
Immune (ITP, SLE, alloimune)
Drugs (PHT, valproate, sulphonamides)
Infective (EBV, CMV, HIV)
Metabolic
Consumption (hypersplenism, haemangiomas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Eczema and lots of bruising

A

Wiskott Aldrich

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Evidence of CLD

A

Spider naevi, pruritus, jaundice, oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sickle cell anaemia features

A

Anaemia
Haemolysis → bone, HSM, lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sickle cell complications

A

Vaso-occlusive disease (VOD) -> neuro, resp, CVS, abdo, joints, renal
Aplastic crisis -> increased pallor, URTIs, splenic sequestation, hypotension, generally unwell
Haemolysis -> lymphadenopathy, hepatosplenomegaly, bone expansion +- compression +- fractures, RUQ pain
Anaemia -> cognitive decline, CHF, SOBOE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of thalassaemia

A
  • Growth → impaired height, increased HC
  • Puberty → delayed
  • Dysmorphology → chip-munk facies, protrusion of teeth, frontal bossing
  • Hands → pale, periungal pigmentation
  • Eyes → jaundice
  • Abdomen → HSM, gallstones
  • Urinalysis → ↑ urobilinogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complications of thalassaemia

A
  • Anaemia → high output failure, impaired cognition
  • Haemolysis → folate ↓, RUQ pain with gallstones, jaundice
  • Extra-medullary expansion
    –> Facial bones: impaired hearing
    –> Spine: bone pain, fractures, spinal cord compression, cortical thinning, high risk #’s
    –> HSM
    –> Lymphadenopathy (especially mediastinal)
17
Q

Complications of desferroxamine

A
  • Local irritation
  • Hypotension
  • Vision – pigmentary retinopathy, Cataracts, night blindness, decreased visual fields and acuity
  • Hearing impairment (SNL of CNVIII)
  • Bone – pseudorickets, metaphyseal changes, flat vertebral bodies
  • Altered renal function
18
Q

Complications of recurrent blood transfusions

A
  • Infective → HBV, HCV with CLD
  • Fe overload:
    o Pituitary/gonadal = delayed puberty, oestrogen/testosterone def, hypogonadism
    o Hypothyroidism
    o Hypoparathyroidism↓ Ca+2
    o Cardiomyopathy, arrhythmias, pericarditis, CCF
    o Diabetes mellitus
    o Liver cirrhosis and hepatic failure (risk after 7 years)
    o Arthritis
    o Bronzed skin
    o Infection: iron loving organisms such as Yersinia