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1
Q

Mnemonic for macrocytosis?

A

FAT RBC

Fetus 
Alcohol
Thyroid (hypo)
Reticulocytosis
B12/Folate 
Cirrhosis
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2
Q

Cells that have granules of iron accumulated in the mitochondria surrounding the nucleus

A

Sideroblasts - they can be called ring sideroblasts if the mitochondria form a ring around the nucleus.

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3
Q

Perls’ Prussian blue stain turns blueish purple. What does it indicate the presence of?

A

Iron

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4
Q

How can the causes of sideroblastic anaemia be categorised?

A

Congenital
Acquired
Acquired reversible

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5
Q

What are causes of acquired reversible sideroblastic anaemia?

A

Excess alcohol
Pyidoxine (B6) deficiency
Lead poisoning
Copper deficiency

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6
Q

How can you treat sideroblastic anaemia?

A 
Remove the cause
Consider Pyridoxine (B6) to promote RBC production
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7
Q

What is the general mechanism in Anaemia of chronic disease?

A

IL-6 production

  • -> promote hepcidin production by liver
  • -> reduces ferroportin activity
  • -> reduces transfer of iron to circulation
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8
Q

What are the Iron, TIBC and Ferritin levels like in Anaemia of Chronic Disease?

A

Iron: Low
TIBC: Low
Ferritin: High

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9
Q

What is the most common antibody involved with warm autoimmune haemolytic anaemia?

A

IgG

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10
Q

What type of antibody is usually involved in cold autoimmune haemolytic anaemia?

A

IgM

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11
Q

Is it the indirect or direct Coombs test that is used when testing for autoimmune haemolytic anaemia?

A

direct

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12
Q

Is it the indirect or direct Coombs test that is used when testing blood for transfusion?

A

indirect

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13
Q

Basic steps in a direct Coombs test?

A
  • patient blood sample
  • wash it
  • add Coombs reagent (antihuman antibodies)
  • agglutination = positive result
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14
Q

Basic steps in an indirect Coombs test?

A
  • recipient serum
  • add donor blood
  • add Coombs reagent (antihuman antibodies)
  • agglutination = positive
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15
Q

What is the inheritance pattern of beta-thalassaemia?

A

autosomal recessive

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16
Q

What impact does beta-thalassaemia have on chain synthesis and haemoglobin types?

A

Reduced beta-chain synthesis, excess alpha-chains.

Under production of haemoglobin A

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17
Q

What is the chain composition of haemoglobin A?

A

two alpha

two beta

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18
Q

What is the chain composition of haemoglobin A2?

A

two alpha

two delta

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19
Q

What is the chain composition of haemoglobin F?

A

two alpha

two gamma

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20
Q 
dysphagia
iron deficiency anaemia 
cheilosis
glossitis
oesophageal webs
A

Plummer-Vinson syndrome

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21
Q

Role of ferritin in the body?

A

store/deposit iron in a safe form (i.e. in cells away from invading pathogens)

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22
Q

Low iron
High TIBC
Low ferritin

A

Iron deficiency

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23
Q

Low iron
Low TIBC
High ferritin

A

Anaemia of chronic disease

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24
Q

High iron
Low TIBC
High ferritin

A

Chronic haemolysis

Haemachromatosis (could also have normal TIBC)

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25
High iron High TIBC Normal ferritin
Pregnancy
26
High iron Normal TIBC High ferritin
Sideroblastic anaemia | Haemachromatosis
27
Causes ofa macrocytic megaloblastic anaemia?
B12 or folate deficiency | cytotoxic drugs
28
A type of anaemia due to an inhibition of DNA synthesis during red blood cell production
Megaloblastic anaemia (the folate/B12 is needed for the nucleic acid recycling)
29
Large immature red blood cells Howell-jolly bodies hypersegmented polymorphs
Megaloblastic anaemia
30
spectrin or ankyrin defects
Hereditary spherocytosis
31
just spectrin defect
Hereditary elliptocytosis
32
Sickle cell patient with parvovirus B19
Aplastic crisis
33
E. Coli impaired renal function diarrhoea thrombocytopenia
Haemolytic uraemic syndrome
34
ADAMTS13
enzyme for cleaving vWF
35
Pathogenesis of TTP?
- enzyme (ADAMTS13) that cleaves vWF is inhibited - more vWF - more platelet clotting - RBCs pass through clots, undergo shear stress --> rupture --> anaemia and schistocyte formation
36
``` Anaemia Jaundice Thrombocytopenia Schistocytes Neurological symptoms Renal impairment Fever ```
Thrombotic Thrombocytopenic Purpura
37
What releases factor VIII from vWF
thrombin
38
gpIb/IX/V
on platelets, vWF binds to these
39
What does vWF bind to on the blood vessel?
exposed collagen in the endothelial cells
40
Condition with defective/low levels of GpIIb/IIIa?
(Glanzmann's) thrombasthenia
41
gpIIb/IIIa
on platelets, form crosslinks between platelets and binds fibrinogen
42
What do platelets secrete once activated?
ADP TXA2 increase gpIIb/IIIa expression on platelets
43
Thrombocytopenia Bruises and petechiae Normal bone marrow No iatrogenic cause
Auto-immune thrombocytopenic purpura
44
``` Long aPTT Long Thrombin time Long bleeding time Low platelets Increased D-dimer ```
DIC
45
Anaemia Pancytopenia t(15;17)
Acute promyelocytic leukaemia
46
Anaemia Pancytopenia Myeloperoxidase and Sudan black stain positive
AML
47
Anaemia Pancytopenia Myeloperoxidase and Sudan black stain negative
ALL
48
t(9;22) less than 5% blasts What's the diagnosis and treatment?
CML - chronic phase | Treatment = Tyrosine Kinase inhibitor, e.g. imatinib
49
t(9;22) greater than 20% blasts What's the diagnosis and treatment?
CML - Blast phase Treatment = - Tyrosine Kinase inhibitor, e.g. imatinib - induction chemo (as for AML like cytarabine plus a 'rubicin') - all-SCT
50
t(9;22) between 10 and 20% blasts What's the diagnosis and treatment?
CML - accelerated phase Treatment= - Tyrosine Kinase inhibitor, e.g. imatinib - consider allo-SCT plus induction chemo like cytarabine with a 'rubicin'
51
Old person Lymphocytosis Smear cells Flow cytometry demonstrating coexpression of CD5 and CD19
CLL
52
Binet staging
CLL
53
CD30 positivity
Anaplastic large-cell lymphoma
54
t(2;5)
Anaplastic large-cell lymphoma
55
HTLV-1 infection
Adult T cell leukaemia
56
Lymphoma associated with mycosis fungoides
Cutaneous T Cell lymphoma
57
Myelodysplastic syndrome: Blood:Anaemia No blasts BM: Erythroid dysplasia with less than 5% blasts
Refractory anaemia
58
Myelodysplastic syndrome: Blood: Anaemia No blasts BM: Erythroid dysplasia with greater than 15% ringed sideroblasts
Refractory anaemia with ringed sideroblasts
59
Myelodysplastic syndrome: Blood: Cytopenia in more than/equal to 2 cell lines BM: Dysplasia in more than 10% cells in/greater than 2 cell lines
Refractory cytopenia with multilineage dysplasia
60
Myelodysplastic syndrome: Blood: Cytopenia in more than/equal to 2 cell lines BM: Dysplasia in more than 10% cells in/greater than 2 cell lines with ringed sideroblasts
Refractory cytopaenia with multilineage dysplasia and ringed sideroblasts
61
Myelodysplastic syndrome: Blood: Cytopenia Less than 5% blasts No Auer rods BM: Dysplasia and 5-9% blasts
Refractory anaemia with excess blasts - 1
62
Myelodysplastic syndrome: Blood: Cytopenia or 5-19% blasts or Auer rods BM: Dysplasias, 10-19% blasts or Auer rods
Refractory anaemia with excess blasts - II
63
Myelodysplastic syndrome: Blood: Anaemia, normal or increased platelets BM: Megakaryocytes with hypolobated nuclei and
MDS with 5q syndrome
64
Myeloproliferative disorder which is Philadelphia chromosome negative
Polycythemia vera Myelofibrosis Essential thrombocytosis
65
``` Blurred vision headaches Plethoric - congested with blood Gout Splenomegaly Raised Hb and HCT Low EPO ```
Polycythaemia rubra vera
66
Treatment of polycythaemia rubra vera?
Venesection Hydroxycarbamide Aspirin
67
JAK2 mutation raised Hb and HCT Low EPO
Polycythaemia rubra vera
68
Megakaryocytes dominate the BM maybe associated with JAK2 Thrombosis
Essential thrombocythaemia
69
Tear drop poikilocytes Leukoerythroblasts Bm fibrosis
Myelofibrosis
70
Transfusion: Urticaria
Mild allergic reaction
71
Transfusion: Mild fever only
Febrile non-haemolytic transfusion reaction
72
Transfusion: Bleeding Dark urine
ABO incompatibility
73
Transfusion: Swelling Wheeze
Severe allergic reaction
74
Transfusion: high fever tachycardia
Bacterial infection
75
Transfusion: Fever Breathless normal CVP
TRALI
76
Transfusion: Fever Breathless Raised CVP
TACO/fluid overload
77
Transfusion | leukocyte antibodies in transfused plasma
TRALI

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