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MSRA > Haem > Flashcards

Haem Flashcards

1
Q

Failure to thrive, jaundice, gallstones, splenomegaly, Anaemia, MCHC inc

A

Heriditary spherocytosis
ADom
Dx via EMA binding test, inc reticulocytes, inc LDH, inc bili
Tx - folate rep, splenectomy

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2
Q

Heriditary spherocytosis - aplastic crisis

A

Caused by parvovirus inf

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3
Q

CKD anaemia - cause + Tx

A

= normocytic normochromic (AoCD)
Causes; dec EPO levels, dec iron abs, reduced red cell survival (esp if haemodialysis)

Tx - iron replacement + ESAA (erytho-stim agents)

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4
Q

Causes of B12 anaemia

A

Pernicious anaemia (most common)
Atrophic gastritis (secondary to H Pylori inf)
Malnutrition (eg alcohol)

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5
Q

Pernicious anaemia

A

Tiredness + B12 def (periph neuropathy)
Mild jaundice
Atrophic gastritis (sore tongue)

Ix - Macrocytic anaemia, Dec B12, +ve anti-IF-antibodies

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6
Q

Macrocytic anaemia causes

A

Megaloblastic; B12/folate def (eg secondary to methotrex)

Normoblastic; Alcohol, liver dis, hypothy, pregnancy, reticulocytosis, myelodysplasia

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7
Q

RFs for VTE

A

Surgery/Trauma
Inc age, preg, immobility, COCP, HRT
Malig, IBD, nephrotic syndro
Obesity
APC res, FV leiden, prothrombin gene mut, prot c/s def, antithrombin def

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8
Q

Microcytic anemia, high Iron/ferritin, low TIBC

A

Thalassaemia
Pc <12mo, failure to thrive, hepatosplenomeg
Tx = repeated transfusion
+ desferrioxamine (vs iron overload)

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9
Q

Valves affected in infective endocarditis

A

If prev normal valves - commonly Mitral
If IVDU - tricuspid

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10
Q

Bacterial causes of inf endocarditis

A

Staph a - esp if acute presentation/IVDA
Strep viridans - poor dental hygeine
Staph epidermidis - following prosthetic valvue surgery

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11
Q

Pc - fever, systolic heart murmur

A

Inf endocarditis

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12
Q

Young adult. Sore throat, anterior lymphadenopathy, pyrexia, palatal petechia, splenomegaly

A

Infectious mononucleosis - due to EBV (HHV4))

haemolytic anaemia secondary to cold agglutine IgM, transient rise in ALT

Dx = +_ve heteropohile antibody test (monospot)

Tx = supportive + avoid contact sports

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13
Q

Sore throat, given amox - develops maculopapular rash

A

inf mononucleosis

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14
Q

Adult, anaemia / weight loss, massive splenomegaly

A

CML
WCC massively raised

Philidelphia Chr +ve (tanslocation between Chr 9 and 22)

Tx - imatinib (tyrosine kinase inhib), hydroxyurea

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15
Q

Kid present with haemarthrosis, haematoma and prolonged bleeding
+ve FHx

A

Haemophilia

Bloods - prolonged APTT, BT/PT normal
A = def in F8, B = def in F9
X-linked rec
Avoid NSAIDs/IM injections
Desmopressin raises F8 levels

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16
Q

Warfarin and INR - summarise

A

Major bleed - stop warfarin, IV Vit K 5mg, PCC (FFP if not available)
INR >8 + minor bleed - stop W, IV vit K 1-3mg, repeat after 24 if needed, restart when INR <5
INR >8 no bleed - Stop W, PO Vit K 1-5mg, repeat after 24 hrs in needed, restart when INR <5
INR 5-8 - Minor bleed - Stop W, IV Vit K 1-3mg, restart when INR <5
INR 5-8 , no bleed - withhold 1-2 doses, reduce dose

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17
Q

Blood film - target cells

A

Sickle cell/thalassaemia
IDA
Hyposplenmnism
Liver D

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18
Q

Blood film - basophillic stripping

A

Lead poisoning, Thalassaemia, siberoblastic anaemia, Myelodysplasia

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19
Q

Blood film - howell-Jolly bodies

A

Hyposplenism

20
Q

Blood film - heinz bodies

21
Q

Blood film - pencil poikilocytes

22
Q

Blood film - burr cells (echinocytes)

A

Uraemia, PK def

23
Q

Hyposplenism - blood film findings

A

Eg post splenectomy, coeliac dis
Blood film: Target cels, howell-joly bodies

24
Q

IDA blood film findings

A

Target cells, pencil cells

25
Blood film - schistocytes
Intravasc haemolysis
26
Anaemia, lethargy, neutropenia, thrombocytopenia, splenomeg, bone pain Blod film - Auer rods
AML Auer rods = APML
27
Features of myeloma
CRABBI Ca (hypercalcaemia), Renal impairement, Anaemia, Bleeding, Bone pain (esp back pain), Inc Infection Periph bloods - rouleaux Urine = bence jones prot
28
Hodgkins lymphoma staging
Ann Arbor I - single LN II - 2 or more LN on same side of diaphragm III - LNs on both side of diaphragm IV - diffuse and involvement of organs
29
Complications in CLL
CLL - slowly progressive lymphanedopathym, hepatosplenomeg Often incidental findings on FBC (lymphocytosis) Comp: Anaemia (often shows smear cells) Hypogammaglobinaemia -> recurrent inf WAHA Richter transformation - transform to high grade lymphoma
30
Elderly, anaemia, massive splenomeg, weight loss, tear drop cells
Myelofibrosis 10% risk of transformation to AML
31
Mediteranean, neonatal jaundice, intravasc haemolysis, gallstones, splenomeg
G6PD Def More common in mediteranean/african, X-linked Rec Blood film - heinz bodies Things that precipitate crisis - infection, fava beans Drugs: anti-malarials, cipro, sulph- drugs
32
Anaemia, reticulocytosis, raised LDH. Film - spherocytes & reticulocytes, +ve DAT
AIHA Warm = IgG Cold = IgM
33
Who needs CMV neg blood
Granulocyte transfusions Intra-uterine transfusion Neonates (<28d) Transfusions during preg
34
Contents of Cryoprecipitate
concentrated Factor VIII, von Willebrand factor, fibrinogen, Factor XIII and fibronectin Use in significant haemorrhage with low fibrinogen
35
Signs of tumour lysis syndrome
Hyperkal, hyperphos, hyperuric hypocal acute renal failure
36
Reversal of DOACs
Dabigatran (direct thrombin i) - rev = Idarucizumab Rivaroxaban/Apixaban (Direct F Xa i) = Andaxanet alpha Edoxaban (Direct F Xa i)
37
Episodes of painless swelling of subcut tissues, non-pruritic, proceeded by painful macular rash
Heriditary angioedema (low levels plasma C1 inhibitor) Tx - IV C1-Inhibitor or FFP
38
Tx for ITP in adults
Oral pred IVIG if plt needed to be raised rapidly
39
Pc - abdominal pain, peripheral neuropathy, neuropsych features, fatigue, constipation, blue lines on gum margin Microcytic anaemia + basophilic stippling
Lead poisoning Tx - chelations; DMSA, D-penicillamine, EDTA
40
Causes of microcytic anaemia (5)
IDA Thalassaemia Congenitalk sideroblast ic anaemia AoCD (more commonly normocytic) Lead poisoning
41
Causes of plycythaemia
Primary - PRV Secondary - COPD, altitude, OSA
42
Long term management of sickle cell
Hydroxyurea - inc HbF levels - prophylaxis vs painful episodes Pneumococcal polysaccharide vaccine every 5 years
43
Cases of splenomegaly 3x massive
Massive - Myelofibrosis, CML, Malaria Normal - Portal HTN (cirrhosis), lymphoproliferative disorders (CLL, Hodgekins), hemolytic anaemia, inf (hep/glandular), inf endocarditis, sickle cell
44
Essential thrombocytosis ft, mut, Tx
Ft - characteristic burning of hands JAK 2 - mutation Tx - Hydroxyurea (dec plt count)
45
Most common cause of thombrophilia
FV leiden - (activated protein C resistance) 2nd most common = prothrombin gene mut
46
AKI while on tx for lymphoma Bloods - raised K & phos, low Ca, raised uric acid
Tumour lysis syndro Prevention - IVF, high risk pt - allopurinol OR rasburicase

MSRA (21 decks)

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