Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MedEd + PathSoc + Laz's Qs + Romesh Path > Haem 5: Haem of systemic disease > Flashcards

Haem 5: Haem of systemic disease Flashcards

1
Q

Which types of anaemia can be caused by cancer?

A

Iron deficiency

Anaemia of chronic disease

Haemolytic anaemia

Leucoerythroblastic anaemia

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

Which types of cancer are associated with causing secondary polycythaemia? Why?

A

Renal cell carcinoma
Liver cancer

Due to the production of EPO

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

What do these laboratory findings suggest?

Ferritin: Low
Transferrin saturation: Low
TIBC: High

What is the most common cause of this condition?

A

Iron deficiency anaemia

Occult blood loss (e.g. GI cancers, urinary tract cancers)

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

What is leucoerythroblastic anaemia? Cause?

A

Anaemia characterised by the presence of red and white cell precursors

Infection: miliary TB/severe fungal infection

Malignancy: myelofibrosis/ leukaemia/lymphoma/myeloma/ metastatic Ca

USUALLY A MALIGNANCY INVOLVING BM

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

Morphological features on blood film of leucoerythroblastic anaemia?

A
  • Tear drop red blood cells (aniso- and poikilocytosis)
  • Nucleated RBCs
  • Immature myeloid cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define haemolytic anaemia?

A

Anaemia caused by reduced red blood cell survival

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

List some key laboratory findings in haemolytic anaemia.

A 
Anaemia
Raised LDH 
Raised reticulocytes 
Raised unconjugated bilirubin
Low haptoglobins
NOTE: LDH is an intracellular enzyme that is released when RBCs are destroyed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two main groups of haemolytic anaemia? List some examples.

A

Inherited (defects with the cell)

  • Hereditary spherocytosis (membrane problem)
  • G6PD deficiency (enzyme problem)
  • Sickle cell disease, thalassemia (haemoglobin problem)

Acquired (defects with the environment)

  • Immune-mediated
  • Non-immune mediated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which test distinguishes immune-mediated and non-immune mediated haemolytic anaemia?

A

DAT or Coombs’ test

DAT +ve means that the haemolytic anaemia is mediated through immune destruction of red cells

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

What morphological change is seen on the blood film of patients with autoimmune haemolytic anaemia?

What are some systemic diseases that can cause this?

A

Cancer involving the immune system (e.g. lymphoma)

Disease of the immune system (e.g. SLE)

Infections (disturbs the immune system)

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

List some causes of non-immune haemolytic anaemia.

A

Infection (e.g. malaria)

Microangiopathic haemolytic anaemia (MAHA)

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

List some key features of MAHA. What is it usually caused by?

A

Usually caused by underlying adenocarcinoma

DIC/bleeding
Red cell fragments
Low platelets

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

MoA of MAHA?

Another cause?

A

An underlying adenocarcinoma produces procoagulant cytokines that activate the coagulation cascade

This leads to DIC and the formation of fibrin strands in various parts of the microvasculature

Red cells will be pushed through these fibrin strands and fragment

Another cause is HUS (instead of adenocarcinoma driven)

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

What should always be considered in any patient presenting with MAHA

A

underlying adenocarcinoma

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

List some causes of secondary polycythaemia.

A

Cancer (renal, hepatocellular, bronchial)

High altitude

Hypoxic lung disease

Congenital cyanotic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What disease is characterised by primary raised erythrocytes?

A

Polycythaemia vera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the main difference seen in the blood film of patients with acute and chronic leukaemia?

A

Acute – immature blast cells are raised

Chronic – mature white cells are raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List some causes of neutrophilia.

med?

A

Corticosteroids (due to demargination)

Underlying neoplasia

Myeloproliferative/leukaemia disorder

Tissue inflammation (e.g. colitis, pancreatitis)

Infection

19
Q

List some infections that characteristically do not cause neutrophilia.

A

Brucella

Typhoid

Many viral diseases

20
Q

List some key features of a reactive neutrophilia on a blood film.

A

Band cells (presence of immature neutrophils (band cells) show that the bone marrow has been signalled to release more WBCs)

Toxic granulation

Clinical signs of infection/inflammation

21
Q

What are some key blood film and clinical features suggestive of a myeloproliferative disorder?

A

Neutrophilia

Basophilia

Immature myelocytes

Splenomegaly

NOTE: you may see raised Hb and raised platelets in CML if it affects those lineages

22
Q

Key blood film features suggestive of AML?

A

Neutrophilia

Myeloblasts

23
Q

Causes of monocytosis?

A

Bacteria - TB, Brucella, Typhoid

Viral - CMV, VZV

Sarcoidosis

Chronic myelomonocytic leukaemia

24
Q

List some causes of reactive eosinophilia.

A

Parasitic infection

Allergy (e.g. asthma, rheumatoid arthritis)

Underlying neoplasms (e.g. Hodgkin’s lymphoma, T cell lymphoma, NHL)

Drug reaction (e.g. erythema multiforme)

25
Q

What does FIP1L1-PDGFRa fusion gene normally cause?

A

chronic eosinophilic leukaemia

26
Q

Which type of virus typically causes basophilia?

A

Pox viruses

27
Q

Which disease is caused by a genetic deficiency of factor IX?

A

Haemophilia B

28
Q

Which disease is caused by a genetic excess of factor IX?

A

Factor IX Padua

29
Q

How can haemophilia B be treated using gene therapy?

A

Factor IX Padua gene can be put into adenoviruses as a vector, to cause factor IX production

30
Q

Which disease is caused by an acquired mutation in JAK2?

A

Polycythaemia vera

31
Q

Which disease is caused by an acquired mutation in PIG A?

A

PNH paroxysmal nocturnal haemoglobinuria

32
Q

What is a raised factor VIII likely to be secondary to?

A

Inflammatory process

33
Q

What type of anaemia is caused by mycoplasma infection?

A

Immune haemolytic anaemia

34
Q

How do you distinguish a reactive neutrophilia vs a malignant one?

A

Reactive neutrophilia has a limit (they won’t be sky high)

No immature cells in reactive neutrophilia

Malignant has immature cells + either basophils (indicative of CML) or myeloblasts (indicative of AML)

35
Q

What is the most common cause of a reactive lymphopaenia?

A

HIV

36
Q

In which 2 conditions might smear cells appear on the blood film?

A

CLL

Non-hodgkins lymphoma

37
Q

What investigations are typically used when investigating lymphocytosis?

A

Clinical examination
FBC

Light microscopy

Flow cytometry (identify lineage and stage of differentiation)

Molecular genetics (TCR or Ig gene)

38
Q

List some causes of reactive lymphocytosis.

A

Infection (EBV, CMV, toxoplasmosis, rubella, HSV)

Autoimmune diseases
(NOTE: these are more likely to cause lymphopaenia)

Sarcoidosis

39
Q

How would the lymphocytes seen on a blood film due to a viral infection be different from leukaemia/lymphoma?

A

Viral infection: reactive or atypical lymphocytes (EBV)

CLL or NHL: small lymphocytes and smear cells

40
Q

What is light chain restriction?

A

An individual B cell will either express kappa or lambda light chains (not both)

In response to an infection, you will get a polyclonal B cell response so there will be a roughly even mixture of kappa and lambda light chains

In lymphoproliferative disorders, monoclonal proliferation of a B cell expressing only one type of light chain (e.g. kappa) will mean that the proportion of kappa relative to lambda will increase (e.g. showing an overwhelming majority of kappa)

41
Q

How is B cell clonality determined?

A

Look for light chain restriction - the ratio of kappa and lambda

(60:40 would be reactive, 99:1 would be malignant)

42
Q

Recall 2 tests that can determine immunophenotype in blood malignancies, and one use of knowing this info?

A

Flow cytometry
Immunohistology

Use: working out if T or B lineage, working out if myeloid or lymphoid

43
Q

Recall 2 tests that can determine cytogenetics in blood malignancies and one use of knowing this info?

A

Translocations
FISH studies

Use: Philadelphia chromosome identification

44
Q

Recall 2 tests that can determine molecular genetics in blood malignancies and one use of knowing this info?

A

PCR
Pyro sequencing

Use: Detect JAK2 mutation, or BCR ABL cDNA

MedEd + PathSoc + Laz's Qs + Romesh Path (99 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions