Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

yr3 > Haem > Flashcards

Haem Flashcards

1
Q

Erythroderma (chronic inflammatory skin condition with scaling in >50% of total body) is associated with which cutaneous malignancy

A

T-cell lymphoma

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

Treatment of hypercalcaemia (i.e. due to mets/multiple myeloma)

A 
IV saline (first-line for dehydration)
Then afterwards give IV bisphosphonates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

12 year patient - easy bruising, nose bleeds, small ecchymoses on skin. Last week he reported a mild fever and sore throat. Nose bleeds are not prolonged and soon stop after pressure is applied. Blood test = mild thrombocytopenia.

A

Immune thrombocytopenic purpura
Abs from the spleen against Ags e.g. GlpIIb/IIIa. Acutely follows a viral infection in children, and usually self limited.

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

A 78 year old woman with widespread itching O/E: hepatosplenomegaly. The patient appears plethoric with no lymphadenopathy.

A

Polycthaemia rubra vera

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

A 78 year old woman attends complaining of recent onset of tiredness. She is pale, has hepatosplenomegaly and generalised painless lymphadenopathy in the neck, axillae and groin. Coombs’ (DAT) test is positive

A

CLL, generally older adults and asymptomatic. Peripheral blood smear shows smear cells and is associated with warm type AIHA = pallor and fatigue (and positive Coombs DAT test). Lymphocytosis will be seen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 27 year old Afro-Caribbean man presents with fever, weight loss and an intractable itch. His spleen is just palpable and he has two 3cm nodes in his right neck. Hb is low.

A

Hodgkin’s lymphoma

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

Reed-Sternberg cells

A

Hodgkin’s lymphoma

Non-tender firm rubbery lymphadenopathy in cervical, axillary and inguinal regions
More painful on drinking alcohol
Ann-Arbor staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Non-hodgkin’s lymphoma

A 
B cell (85%) - burkitt's caused by EBV
T cell (15%)
NK cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Enlarged rubbery, non-tender lymph nodes, blood film shows smear cells, lymphocytes with no blast cells

A

CLL

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

A 65 year old male undergoing chemotherapy for acute myeloid leukaemia starts to deteriorate on the ward. He complains of a tingling sensation in his fingers and around his lips. He also complains of muscle weakness and appears confused. His biochemistry reveals that he is hyperkalaemic, hyperphosphataemic, hyperuricaemic and hypocalcaemic. His creatinine is elevated to 300umol/L. What is the diagnosis?

A

Tumour lysis syndrome occurs in patients undergoing chemotherapy for lymphoproliferative malignancies. Lysis of tumour cells leads to the release of large amounts of potassium, phosphate and uric acid into the circulation. Excess phosphate binds to calcium, leading to hypocalcaemia and its clinical features. Patients are also at risk of developing AKI due to the deposition of uric acid and calcium phosphate crystals in renal tubules.

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

Philadelphia Chr (Abelson-BCR gene), sweats, massive splenomegaly, increased WCC

A

CML

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

Bruising, pale, usually children btw 2-4 years old, blast cells seen on blood film

A

ALL

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

Auer rods and blast cells seen on blood film, splenomegaly, SOB, bone pain

A

AML

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

Hereditary haemochromatosis (increased iron absorption) liver model and crypt cell model

A

Liver model: decreased expression of hepcidin hormone

Crypt cell model: impaired uptake of transferrin-bound iron into crypt cells

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

Hereditary haemochromatosis (increased iron absorption) signs and symptoms

A

Skin - slate grey pigmentation from increased melanin deposits
Liver - hepatomegaly
Heart - HF, arrhythmias
Hypogonadism
Bloods: high iron, ferritin, low TIBC and transferrin sats

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

Jaundice and increased unconjugated bilirubin suggests

A

Haemolytic anaemia

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

Sideroblastic anaemia blood film

A

Dimorphic blood film

Hypochromic microcytic cells

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

Basophilic stippling on blood film suggests

A

lead poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Megaloblastic macrocytic anaemia causes

A

B12/folate def

Anti-folate drugs e.g. methotrexate, phenytoin, azathioprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Large erythrocytes

Hypersegmented neutrophils nuclei (>5lobes) on blood film suggests

A

Megaloblastic macrocytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pernicious anaemia Rx

A

IM hydroxycoalbumin

22
Q

Folate deficiency Rx

A

Oral folic acid

n.b. treat underlying vit B12 def first because folic acid can worsen vit B12 def neuro complications

23
Q

High MCV
Normal RCDW

cause is likely to be…

A

Alcohol
Liver disease
Marrow problem (chemo or aplastic anaemia)

24
Q

Increased RCDW is due to

A

Mixed anaemias

Microcyte and macrocyte prsence at the same time e.g. iron and folate deficiencies

25
Myelodysplasia (chronic cytopenia) presents with BM failure. What investigations would you do and what would the findings be?
Blood - FBC shows pancytopenia Blood film - low granulocytes Bone marrow trephine biopsy - hypercellular and ringed sideroblasts (haemosiderin deposits) N.b. there is NO splenomegaly
26
Myelofibrosis (progressive marrow fibrosis) = abnormal megakaryocytes secreting platelet growth factor. What investigations would you do and what would be the findings?
Blood - FBC shows pancytopenia Blood films - tear drop pilokilocyte RBCs Bone marrow trephine biopsy - aspiration is unsuccessful = dry tap. Trephine biopsy shows fibrotic hypercellular marrow. O/E - massive splenomegaly
27
von Willebrand's disease definition
Abnormalities in expression or function of vWF Autosomal dominant - type 1 Acquired forms possible F>M
28
vWF signs and symptoms
Easy bruising Bleeding after minor trauma Mucocutanenous bleeding (menorrhagia, epistaxis) Internal bleeding/into joints Anaemia Signs of liver disease Increases APTT and bleeding time. Low factor 8 + vWF
29
vWF functions
1. Brings platelets in contact with exposed subendothelium (acts as adhesive bridge) 2. Makes platelets bind together 3. Binds to factor 8 and prevents it degradation
30
Causes of DIC (widespread activation of coagulation)
Infection: sepsis Malignancy: acute leukaemias, chronically lung breast and GI cancers Obstetric: pre-eclampsia, miscarriages Trauma
31
``` Low platelets High PT and APTT Low fibrinogen High fibrin degradation products Schistocytes ``` What is diagnosis?
DIC Acute: petechiae, purpura, ecchymosis, mucosal bleeds, haemorrhage, end organ damage Chronic: DVT/ thrombi
32
A child is 2 weeks post-viral infection has acute sudden self-limiting purpura with epistaxis. What is the likely diagnosis?
Immune thromobocytopenic purpura - anti-platelet Abs - causes thrombocytopenia - bruising, mucosal bleeds, petechiae, menorrhagia
33
Bone marrow failure symptoms and signs | present in leukaemias
Anaemia - lethargy, dyspnoea, pallor Bleeding - thrombocytopenia Recurrent infections Cardiac flow murmur
34
Organ/tissue infiltration symptoms and signs | present in leukaemias
``` Skin rashes Tender bones Lymphadenopathy CNS - headache, N+V Hepatosplenomegaly Gum hypertrophy + bleeds ```
35
Myelodysplasia definition
Chronic cytopenia (anaemia, neutropenia, thrombocytopenia) and abnormal cellular maturation 30% transform to AML
36
Myelofibrosis definition
Disorder of haematopoietic stem cells (megakaryocyte hyperplasia) leading to progressing bone marrow fibrosis and myeloid metaplasia Associated with extramedullary haematopoiesis and massive hepatosplenomegaly
37
Myelofibrosis risk factors
Polycthaemia rubric vera (30%) | Essential thrombocytopenia
38
Types of polycthaemia (distinguish between relative and absolute)
Relative - low plasma volume, normal RBC mass. Acute causes = dehydration. Chronic = obesity, HTN, alcohol, smoking. Absolute - high RBC mass
39
Absolute polycthaemia (high RBC mass) can be primary or secondary. Define these
Primary - polycthaemia rubric vera. Malignant proliferation. JAK2 tyrosine kinase mutation. Secondary - due to chronic hypoxia (appropriate high erythropoietin) and inappropriate high erythropoietin (e.g. renal/HCC)
40
A man aged 50 presents with headache, dizziness, dyspnoea, itchy after a hot bath and visual disturbance/blurriness. O/E: facial plethora, splenomegaly. What is the likely diagnosis?
Polycthaemia
41
Sickle cell crisis types
Vaso-occlusive crisis - infarction. Severe pain triggered by cold, dehydration, infection, hypoxia. i.e. bone pain, abdo pain, splenic atrophy/infarction, stroke Aplastic - parovirus B19, sudden low BM production, 2 weeks, self-limiting, low reticulocytes Sequestration crisis - RBC pools in organs e.g. spleen (splenomegaly), high reticulocytes, severe anaemia, shock. mainly in children.
42
Sickle solubility test will confirm ...
Sickle cell disease Increases turbidity of solution N.b. does not distinguish between HbSS and HbAS (carrier) - do Hb electrophoresis
43
Sickle cell anaemia | Acute crisis and chronic Rx
Acute - O2, IV fluids, analgesia (IV opiates), Abx ±transfusion Chronic - infection prophylaxis (IV penicillin etc). Folic acid (pregnancy or severe haemolysis). Hydroxyurea to increase HbF and reduce crisis risk. RBC transfusions Surgical: BM transplant Advice: avoid triggers
44
a-thalassaemia Decreased a-globin chain synthesis Chr has 4 a-globin genes. Types of a-thal?
Hb Barts - 4 gene deletion. Intrauterine death 3 gene deletion - microcytic hypochromic anaemia. Splenomegaly. 1-2 gene deletion - microcytic hypochromic RBCs. No anaemia.
45
b-thalassaemia Decreased b-globin genes on Chr11 Types of b-thal?
B-thal major - homozygous. Severe anaemia and failure to thrive at age 1 B-thal intermedia - mild defect in b-chain synthesis. Microcytic anaemia, low a-chain synthesis or increased gamma chains B-thal trait - heterozygous, asymptomatic, mild microcytic anaemia
46
A child (presenting ~3-6months old) has recurrent infections. They are noted to have pallor, malaise, dyspnoea and mild jaundice. Frontal bossing and hepatosplenomegaly are present. What is the likely diagnosis?
B-thalassaemia major Failure to thrive Marrow hyperplasia due to extra-medullary haematopoiesis Hepatosplenomegaly due to RBC pooling and haematopoiesis. n.b. b-thal intermedia may present similarly
47
Howell Jolly bodies are found in a patient with coeliac disease. What do they show
HJBs are found in hyposplenism. Coeliac disease is associated with hyposplenism in 15%. Hyposplenism is also caused by sickle cell disease, radiation of spleen e.g. in Hodgkin's lymphoma and splenectomy.
48
A 45yr old man presents with fever, wt loss, tiredness and gout. O/E: splenomegaly. WCC is raised and Philadelphia Chr is detected. What is the likely diagnosis?
CML - high WCC, Philadelphia Chr, massive splenomegaly. N.b. hyperuricaemia occurs with leukaemias hence gout
49
Myelofibrosis bone marrow aspirate or biopsy results
Aspiration = unsuccessful (‘dry tap’) | Trephine biopsy = fibrotic hypercellular marrow with dense reticulin fibres on silver staining
50
Criteria for severe aplastic anaemia
<25% normal cells or <50% normal cells + <30% haemopoietic cells and two of the following: low neutrophils low platelets low reticulocytes

yr3 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions