Haem Flashcards
What are Auer rods seen on bone marrow biopsy or blood film pathognomonic of?
AML
What translocation is most likely present in CML?
t(9;22) Bcr-Abl translocation –> forms unregulated tyrosine kinase which causes excessive proliferation and reduction in apoptosis.
What type of leukaemia does high levels of neutroph and platelets indicate?
CML –> as these are mature myeloid derived cells.
What mutation is implicated in the majority of cases of polycythaemia vera>
JAK2 mutation
What is polycythaemia vera?
Malignancy of RBCs
What investigations are indicated in tumour lysis syndrome?
1) ECG
2) U&Es
3) Calcium
4) Uric acid
What investigation will confirm a diagnosis of aplastic anaemia?
Bone marrow biopsy
What is aplastic anaemia?
When the bone marrow fails to produce blood cells of all lineages –> pancytopenia.
What is Richter transformation?
This is when CLL transforms into a rare type of non-Hodgkin lymphoma (usually diffuse large B cell lymphoma).
What type of leukaemia does Richter transformation happen in?
CLL
What key feature indicates Richter transformation?
Rapidly enlarging lymph nodes
Inheritance of G6PD deficiency?
X-linked recessive
What Abx used in UTIs can predispose to haemolysis in G6PD deficiency?
Nitrofurantoin
How can mechanical heart valves lead to haemolytic anaemia?
Valves can cause intravascular haemolysis as the turbulent blood flow around the mechanical valve causes mechanical damage to the erythrocyte.
What is the management of an acute flare of RA?
Analgesia + corticosteroids
Define heparin induced thrombocytopenia
A drop of platelet by >30%.
This tends to be seen after 5-10 days of heparin treatment.
What are smudge cells seen on blood film pathognomonic of?
CLL
What are smudge cells in CLL?
In CLL, lymphocytes are fragile so may be damaged during slide preparation, resulting in smudge/smear cells.
Who does CLL typically present in?
Male patients >60
How is CLL often picked up?
Incidentally as a raised WCC
What is the treatment of choice in acute and severe faciparum malaria?
IV artesunate
What organism typically causes osteomyelitis in sickle cell?
Salmonella species
What is the gold standard investigation in osteomyelitis?
MRI
How does CML typically present?
In middle aged patients with massive splenomegaly