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!!Path Past Papers (COPY) > Haem > Flashcards

Haem Flashcards

1
Q

Smear cells

A

CLL

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2
Q

Philadelphia chromosome

A

9:22
BCR-ABL
CML (but can be associated with AML/ALL)
Imatinib (TK inhibitor)

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3
Q

Auer rods

A

AML

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4
Q

Tear drop poikilocytes and JAK2

A

Myelofibrosis

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5
Q

pruritis and raised haemoglobin after shower (aquagenic pruritis)

A

Polycythaemia (Rubra) Vera

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6
Q

Acute promyelocytic leukemia (APML)

  • translocation and its name
  • common presentation
A

t(15:17)
PML-RARA translocation
Still has Auer rods like AML

Presents with bleeds (DIC common)

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7
Q

61yo with CLL

Presents with pneumonia, haemoptysis, endobronchial mass, anaplastic large cell lymphoma

A

Richter’s transformation
Diffuce B cell Lymphoma (DBCL)

Sheets of large lymphoid cells

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8
Q

Clumsiness, progressive weakness, personality change after chemo

A

Progressive multifocal leukencephalopathy (JC virus)

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9
Q

Massive splenomegaly (classically which leukemia? which other haem condition?)

A

CML, Myelofibrosis

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10
Q

High calcium, CLOVER LEAF nuclei, LNs

A

Adult T cell Lymphoma

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11
Q

HTLV-1

A

Adult T cell Lymphoma

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12
Q

Paraprotein IgM

A

Waldenstroms macroglobulinaemia

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13
Q

Paraprotein IgG

A

Multiple Myeloma (or MGUS or Smouldering depending on blasts and symptoms)

<30g/dl IgG and <10% blasts for MGUS
>30g/dl IgG and >10% blasts for SM or MM

Only MM is CRAB Sxs

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14
Q

AA vs AL amyloidosis

A

AA = Chronic illness e.g. RA, IBD

AL = Multiple Myeloma

Amyloidosis is a paraproteinaemia!! Can see raised paraproteins (often less than 30)

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15
Q

Post transplant EBV

A

PTLD (Post transplant lymphoproliferative disease)

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16
Q

Anaplastic lymphom

A

Alk 1

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17
Q

Past histort of DVT, easy bruising, LOADS of platelets

A

ET (essential thrombocythaemia)

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18
Q

Pregnant woman with low platelets, schistocytes, neuro sxs (headache and seizures), but LOW BP

A

TTP

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19
Q

Pregnant patient with slightly low platelets in 3rd trimester (asymptomatic)

A

Gestational thrombocytopenia (not same as physiological but it is benign and no tx is needed. It is the most common cause of low platelets in pregnancy. If platelets <70 think HELLP or ITP)

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20
Q

Can’t breathe and DIC

A

Amniotic fluid embolism

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21
Q

Normal heam values in preg for

  • Hb
  • MCV
  • WCC
  • Platelets
  • Plasma volume
A

Normal heam values in preg for

  • Hb low
  • MCV normal or high (macrocytosis)
  • WCC high
  • Platelets low
  • Plasma volume high
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22
Q

Prolonged APTT, normal PT, prolonged bleeding time

A

vWD

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23
Q

Prolonged APTT, normal PT, normal bleeding time

A

Haemophilia

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24
Q

INR Targets

  • AF/cardioversion
  • MI!!
  • Single DVT
  • Recurrent DVTs
  • Prosthetic valve
A

INR Targets

  • AF/cardiov 2.5
  • MI 2.5
  • Single DVT 2.5
  • Recurrent DVTs 3.5
  • Prosthetic valve 3.5

Lower = more clots
INR within 0.5 of target is satisfactory

Rule of thumb - everything except recurrent DVTs/PEs and some prosthetic valves is 2.5 target!

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25
Q

Is heparin intrinsic/extrinsic pathway and APTT or PT

A

intrinsic pathway and APTT

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26
Q

Is warfarin intrinsic/extrinsic pathway and APTT or PT

A

Extrinsic and PT

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27
Q

Anaemic with frontal bossing and XR: hairs on end

A

Thalassaemia

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28
Q

osmotic fragility

A

hereditary spherocytosis

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29
Q

Membrane defect RBCs

A

Spectrin deficiency –> hereditary sphero/elliptocytosis

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30
Q

Heinz bodies

A

G6PD

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31
Q

Warm haemolytic anaemias

  1. antibody type
  2. blood film
  3. causes
A
  1. IgG
  2. Spherocytes
  3. CLL, SLE, methyldopa
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32
Q

Cold Agglutinin disease (Cold HA)

  1. antibody type
  2. Associated with
  3. causes
A
  1. IgM
  2. Raynaud’s
  3. Mycoplasma, EBV
33
Q

Donath-Landsteiner antibodies

A

Paroxysmal cold haemoglobinuria (PCH)

34
Q

Ham’s test or immunophenotype

A

Paroxysmal nocturnal haematuria

complement mediated, morning haematuria

35
Q

Hypercellular BM

A

CML (but maybe other leukemias too)

36
Q

Prognostic factors in CLL

A

Good: hypermutated Ig gene, 13q14 deletion
Bad: CD38+ve, 11q23, 17p, LDH raised

37
Q

Owl eyed cells

A

Reed Sternberg

HL

38
Q

What would you give these patients (transfusion)?

  1. triple AAA surgery
  2. C/S
  3. Past transfusion, allergy to plasma proteins
A
  1. X-match
  2. G&S
  3. Washed red cells
39
Q

Transfusion

Acute SOB, dry cough, hypoxia

A

TRALI

40
Q

Transfusion

Febrile with collapse

A

Bacterial infection

41
Q

Transfusion

RTA, jaundice and anaemia a few days later

A

Delayed haemolytic reaction

42
Q

Thalaessaemia pt with tan and diabetes

A

Haemosiderosis (focal iron overload)

43
Q

SCC pt with short stature and poor cardiac function

A

Iron overload

44
Q

Old lady gets 4 units of blood and feels unwell + basal creps+ankle oedema

A

Fluid overload

45
Q

Seizures and schistocytes

A

TTP

46
Q

Pelger Huet cells, hyposegmented neutrophils

A

MDS

47
Q

> 20% blasts

A

leukemia

48
Q

haemolysis after antimalarials

A

G6PD

49
Q

6 features of myelofibrosis

A
  1. pancytopenia
  2. leucoerythroblastic picture
  3. Massive splenomegaly
  4. dry tap
  5. tear drop (poikilocytes/dacrocytes)
  6. Some are JAK2+
50
Q

Cabot rings

A

Megaloblastic anaemia

51
Q

Factor V Leiden pathogenesis

A

Impaired degradation of factor V by protein C

52
Q

Buerger disease

A

Vasculitis in smokers (corkscrew arteries)

53
Q

Dry cough, dyspnoea and fever post transfusion

A

TRALI

54
Q

Tartrate resistance acid phosphatase (TRAP) ass with which condition?

A

Hairy cell leukemia

55
Q

Clover leaf appearance and high calcium

A

Adult T cell lymphoma

56
Q

Smudge/smear cells

A

CLL

57
Q

Bleeding and thrombosis with high platelets

A

Essential

Thrombocythaemia

58
Q

ET treatment

A

Hydroxyurea + anagrelide

59
Q

Macrocytic anaemia and stomatitis

A

B12 deficiency

60
Q

Pregnant greek patient with father who is on warfarin and sister had a DVT

A

Antithrombin III deficiency

61
Q

Transfusion in past with allergy plasma proteins

A

Washed red cells

62
Q

Sickle cell transfusion

A

?Group in C,E,K crossmatch/anti-CcRR Abs

63
Q

Splenectomy is useful in

The PIIES - what does the acronym stand for?

A

Thalessaemia

Pyruvate kinase deficiency
ITP
Immune HA
Elliptocytosis
Spherocutosis
64
Q

Cold AI HA causes

A

Cold LID

Lymphoproliferative disease (lymphomas and leukaemias)

Infections (mycoplasma/EBV)

Don’t know (idiopathic)

65
Q

PNH Signs

A

PNH is also the acronym

Pancytopenia
New thrombus
Haemolytic anaemia

66
Q

Basophilic stripping

A

ß-thal and lead poisoning

67
Q

Acanthocytes

  1. another name
  2. when do you see?
A
  1. Spur cells

2. Hyposplenism

68
Q

Anisopoikilocytosis

  1. meaning
  2. conditions associated
A
  1. different size and shapes (respectively)
  2. anaemias e.g. IDA
    ßthal
    hereditary spherocytosis
    B12 deficiency
69
Q

Target cells seen in which 3 conditions?

A

3 Hs

Hepatic pathology
Hyposplenism
Haemoglobinopathies

70
Q

Paroxysmal cold haemoglobinuria

A

Children, acute onset haemolysis in cold temperatures

71
Q

Aplastic anaemia causing drugs (4)

A

4 C’s

Carbamazepine
Chloramphenicol
Cytotoxics
anti-Convulsants (e.g. phenytoin)

72
Q

ALP in MM

A

NORMAL despite bone lesions (but raised calcium)

MM activates osteoclasts but shuts off ALP producing osteoblasts hence just destruction and no rebuilding which would cause the raised ALP

73
Q

TTP signs and symptoms

A

MARCH Low platelets

MAHA
A fever
Renal failure
CNS signs --> seizures etc.
Haematuria/proteinuria
74
Q

Massive transfusion with low platelets after

A

Happens if you don’T replace platelets too

75
Q

Smoker with COPD, high Hb and Hct (low plasma volume)

A

Combined polycythaemia

high plasma volume AND high Hb

76
Q

Polycythaemia and not dehydrated, what happens to RBC mass?

A

Increases

77
Q

ßthal minor presentation

A

35 year old with tiredness

78
Q

Mild vWD - which drug can they take before seeing the dentist?

A

Desmopressing (releases intracellular store of vWF)

!!Path Past Papers (COPY) (6 decks)

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