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4 MBCHB > HAEM 3 > Flashcards

HAEM 3 Flashcards

1
Q

what is acute leukaemia

ix

A

abnormal proliferation and lack of maturation
excess of blasts >20% in either peripheral blood or bone marrow
decrease or normal haemopoietic reserve

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2
Q

ALL

cx

A

increased production of lymphocytes
children 2-5yo. boys>girls

haemorrhage, thrombosis, tumour lysis syndrome (hyperuricalmia and renal failure)

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3
Q

AML

A

overproduction of immature myeloid white blood cells. subgroups DIC, gum infiltration
denovo or secondary to myeloproliferative disease
auer rods
blood transfusions, ABs, chemo, stem cell transplant

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4
Q

CLL

A

commonest leukaemia. older patients. clonal expansion of small lymphocytes. 95% b cell origin
asymp. recurrent infection. anaemia. splenomegaly. hepatomegaly. LD. pallor
smudge cells

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5
Q

CML

A

malignancy of granulocytes - increased production of myeloid precursor with their differentiation ability still intact
9 and 22 translocation tyrosine kinase production
Imatinib

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6
Q

myeloproliferative disease BCRABI pos

neg

A

CML

polycythaemia, ET, myelofibrosis

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7
Q

what is polycythaemia
secondary
pseudopolycythemia

A

primary overproduction of RBCs.

chronic hypoxia, smoking, erythro secreting tumour, OSA

dehydration, diuretics, obesity

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8
Q

ix for polycythaemia disease
patients in secondary
treatment
cx

A

HCT >0.5 in m and >0.48 in F or increased RC mass >25%
FBC/BF, ferritin, JAK2 mutation

won’t have splenomegaly

venesect to HCT <0.45
aspirin to reduce thrombosis
hydroxycarbomide

myelofibrosis, AML

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9
Q 
ET is what 
at high levels can lead to 
symptoms 
ix
treatment
A

uncontrolled production of abnormal PLT. VW disease

gout, headache, weight loss, fatigue, sweats, splenomegaly, bleeding, microvascular occlusion

exclude reactive thrombosytosis: blood loss, inflam, malig, iron defic, CML
JAK2 in 50%, CALR in rest, MPL mutation . characteristic marrow appearance

aspirin. hydrocycarbimide, anagrelide, interferon beta last line

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10
Q

myelofibrsosis is what
idiopathic causes
secondary causes

symp

blood film:
other ix

leukoerythroblastic film causes

treatment

A

clonal proliferation of haemopoietic stem cells -> BM fibrosis

marrow failure, marrow fibrosis, extra medullary, haemopoiesis, leurkothrombin

post PR/ET

bleeding, anaemia, infection, splenomegaly

tear drop RBC and leukoerythroblastic
dry aspirate vibrate on trephine biopsy. JAK2 or CARL mutation

reative (sepsis), marrow infiltration (cancer), myelofibrsosis

transfusion, ABs, allogenic transplant, splenectomy, JAK inhibitor

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11
Q

decreased production for pancytopenia

A

inherited Fanconis
acquired
secondary BMF

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12
Q

inherited BM failure

A

Fanconi’s
unable to correct understanding cross links
short, skin abnormalities, radial ray abnormalities, hypogenitilia, endocrine, GI, CVS, haem, renal
84% BM failure by age 20
53% leukaemia by 40yo

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13
Q

acquired primary BF aplastic anaemia
myelodysplastic dysplasia
acute leukaemia

A

AI against haemopoietic stem cells

hyper cellular mass, ineffective homepoiesis, 20-30% -> AML

prevention of normal haemopoiesis

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14
Q

secondary BMF

A

drugs: chemo, chloramphenicol
alcohol, b12/folate defi
infiltrative: malignancy, lymphoma, viral (HIV), storage disease

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15
Q

increased destruction pancytopenia

A

hypersplenism
portan htn, CCF, felty’s, splenic lymphoma
treatment - splenectomy

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16
Q

clinical features of pan

A

anaemia, fatigue, SOB, CDV compromise, neutropenia, infections, bleed, symp depending on cause

17
Q

ix for pan

A

FBC, film, b12/folate, LFTs, AB tests, chromosome fragility test (Fanconi’s), hypo cellular - aplastic, hyper: MDS, b12 folate, hypersplenism

18
Q

treatment for pan

general treatment

A

malig: chemo
congenital: transplant
idiopathic aplastic anaemia: immunosup

supportive, transfusion, ABs

19
Q

hodgkins lymphoma symptoms

ix

A

painless cervical LD, cough, hepatosplenomegaly, pruritus, alcohol related pain, B symptoms

reed sterbnergs cells. blows. imaging. histology

20
Q

hodgkins stages

treatment

A 
I confused to a single lymph node
II 2 or over LN groups and on one side of the diaphragm 
III both sides
IV extra lymphatic e.g. bone marrow 
A absence of B symptoms
B presence of them

local - radio
extensive - chemo

21
Q

burkitts NHL

A

b high grade

8: 14 (cymyc)
african: maxillay/mandibular EBV
sporadic: abdomen, HIV

starry sky on micro

22
Q

mantle cell

A

similar to low grade hidgkins

v aggressive and incurable with chemo

23
Q

other types NHL

A

marginal zone
follicular
diffuse large cell (commonest worldwide)
lymphoplasmocytic

4 MBCHB (80 decks)

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