Haem Flashcards
Target cells
Hyposplenism, thalassaemia, IDA
Target INR
1st episode DVT/PE
AF
Recurrent DVT/PE
Mechanical valve
1st episode DVT/PE: [2.5]
AF: [2-3]
Recurrent DVT/PE: [3.5]
Mechanical valve: [2.5-3.5]
Types of amyloid and association
AL: associated with multiple myeloma
AA: associated with chronic inflammatory disease e.g. `RA
Rouleux sign
Myeloma
What is TTP? How might it present? What might you see on blood film?
Thrombotic thrombocytopenia purpura
The Terrible Pentad: Fever Neuro signs Renal problems Anaemia Platelets
Blood film: schistocytes
Which type of Hodgkin’s lymphoma carries the best prognosis?
lymphocyte predominant
Hb NR
For men, 13.5 to 17.5 g/dL
For women, 12.0 to 15.5 g/dL
Protein S deficiency results in impaired degradation of what factors?
Factors 5a and 8a
Micromegakaryocytes
Found in myelodysplasia
AIHA after mycoplasma or EBV infection
Cold Agglutinin Disease
Types of paraproteinaemia
Myelomas (MGUS, smouldering myeloma, myeloma) and
Waldenstrom’s Macroglobinaemia
Systemic Amyloidosis
4 infectious causes of NHL?
EBV (Burkitts), H. pylori (MALT), coeliac (EALT), HTLV1 (Adult t cell lymphoma)
donath landsteiner antibodies
paroxysmal cold haemoglobinuria
Intrinsic pathway factors
12, 11, 9, 8, 10
Days after transfusion, jaundice and fever
Delayed haemolytic reaction
Creatinine NR
♂ 59–104 μmol/ L
♀ 45–84 μmol/ L
At what INR would you give Vit K? What would you do with the warfarin?
> 5; stop warfarin, give vit K
physiological changes of pregnancy
platelets fall, plasma increases, MCV increases
Factors 7, vWF and fibrinogen all increase
Protein S falls
Most common type of Hodgkin’s lymphoma
nodular sclerosing
Pancytopenia with skeletal abnormalities, renal malformations, short stature, skin pigmentation
Fanconi’s anaemia
morning haemoglobinuria, thrombosis
paroxysmal nocturnal haemoglobinuria
Thalassaemia intermedia
HbA2
Normal bleeding time, normal or prolonged APTT, low factor 8
Haemophilia
Cabot rings
megaloblastic anaemia
Auer rod + PML RARA fusion gene
Acute promyelocytic leukaemia
Ring sideroblasts
Myelodysplastic syndromes, refractory anaemias
Haemophilia A
Factor 8 deficiency; normal APTT
X linked recessive
Extrinsic pathway factors
7, 5
Skull bossing, maxillary hypertrophy, hairs on end skull x-ray
Beta thalassaemia
Urea NR
2.5 – 7.8 mmol/L
Enzyme controlling urea levels
HGPRT
Pseudo-Pelger Huet anomaly
aka Hyposegmented neutrophils
Found in myelodysplasia
AIHA found in lymphoproliferative disorders, drugs, autoimmune disorders
Warm AIHA
IgM paraprotein plus visual disturbance
Waldenstrom’s
paroxysmal nocturnal haemoglobinuria test?
Ham’s test
Immediately post transfusion: rash, bloody diarrhoea, jaundice
GVHD
HUS? What signs? Cause?
Haemolytic uraemia syndrome
High bleeding time, high creatinine, schistocytes
Toxin mediated (e.g. bloody diarrhoea from E. Coli)
MOA of heparin?
Potentiates antithrombin III, which inactive thrombin and factors 9, 10 and 11
Vitamin K dependent factors
2, 7, 9, 10
prolonged bleeding time, normal or prolonged APTT, low factor 8
vWD
Clover leaf nuclei
Adult T cell lymphoma
Basophilic stippling
Thalassaemia trait, alcoholism
tear drop poikolocytes
myelofibrosis
Antidote to heparin?
Protamine sulphate
Richter’s transformation; what is it and how might it present?
transformation of B cell chronic lymphocytic leukemia (CLL) or hairy cell leukemia into a fast-growing diffuse large B cell lymphoma, a variety of non-Hodgkin lymphoma
Present with endobronchial mass, haemoptysis
Tartrate resistant acid phosphatase
Hairy cell leukaemia
Bleeding from mucous membranes
vWD
massive SM, low plt, low red cells, normal WCC
myelofibrosis
Japanese, caribbean, HTLV-1
Adult T cell leukaemia/lymphoma
17p deletion
bad prognosis in CLL
