Haem Flashcards

1
Q

Blasts > 20%

A

Acute leukemia

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2
Q

Myeloperoxidase

A

Myleoblasts (AML)

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3
Q

Auer rod

A

AML

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4
Q

C10, C19 and C20

A

Surface markers in B-ALL

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5
Q

C2-C8

A

Surface markers in T-ALL

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6
Q

t(15;17)

A

acute promyelocytic leukemia

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7
Q

Why is acute promyelocytic leukemia a medical emergency?

A

Risk of DIC due to lots of Auer rods

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8
Q

Tx of acute promyelocytic leukemia

A

ATRA

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9
Q

Swollen gums?

A

Acute monocytic leukemia

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10
Q

What kind of cancer do down’s kids get before the age of 5?

A

Acute megakaroblastic leukemia

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11
Q

What kind of cancer do down’s kids get after the age of 5?

A

ALL

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12
Q

Sudan Black B stains

A

AML

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13
Q

BCR-ABL

A

Philidelphia chromosome which activates tyrosine kinases

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14
Q

Richter’s transformation

A

Collection of lymphomas that can damage the body - derived from CLL

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15
Q

Which haematological cancer is associated with AIHA?

A

CLL

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16
Q

Smudge/smear cells?

A

CLL

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17
Q

Tx of CML

A

Imatinib (Tyrosine kinase inhibitor)
Dasatinib (used for resistance)
Oral hydroxyurea

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18
Q

Binet staging?

A

Used in CLL
Stage A - high WBC, less than 3 groups of enlarged lymph nodes
Stage B - more than 3 groups of enlarged lymph nodes
Stage C - anaemia or thrombocytopenia

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19
Q

Tx of CLL

A

Chlorambucil
SCT
Alemtuzumab

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20
Q

Asymmetrical painless lymphadenopathy and EBV associated

A

Hodgkins lymphoma

Seen in teens and old people

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21
Q

Pain in lymph nodes after drinking alcohol

A

Hodgkins lymphoma

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22
Q

Pel-Ebstein fever

A

Hodgkins lymphoma

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23
Q

Mneumonic for HL - GOLDWATER

A

GOLDWATER

Good prognosis (90% survival in 10 year prognosis)
Old (over 55)
Lymphnode
Different types (classic types and nodular lymphocyte predominant)
WBC (lymphocyte)
Ann-Arbor Staging (I-IV)
Teenager & young adults (15-35)
EBV (40% of patients; mononucleosis)
Reed-Sternberg cells
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24
Q

Reed-Sternberg cells

A

Hodgkins lymphoma

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25
Q

Owl -eye

A

Hodgkins lymphoma

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26
Q

LN and BM biopsy - cells stained with CD15 and CD30

A

Hodgkins lymphoma

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27
Q

Chemo used in HDL (ABVD)

A

Adriamycin
Bleomycin
Vinblastine
Dacarbazine

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28
Q

When do we use autologous SCT?

A

More used in lymphoma and multiple myeloma esp with relapses

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29
Q

When do we use allogenic SCT?

A

Used more in leukemia

Risk of GVHD

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30
Q

Starry sky

A

Burkitt’s lymphoma

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31
Q

Types of NHL

A
Burkitt's 
Diffuse large B-cell lymphoma 
Follicular 
Mantle cell 
Marginal zone
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32
Q

Thick and viscous blood associated with lymphoma?

A

Waldenstrom macroglobulinemia

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33
Q

Cerebriform nucleus

A

looks like a brain

Seen in T-cell lymphoma of skin - mycosis fungoides

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34
Q

Sezary syndrome

A

Itchy red rash related to t-cell lymphoma of the skin

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35
Q

Rituximab

A

Anti-CD20, seen in NHL

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36
Q

No pain after drinking alcohol

A

NHL

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37
Q

HTLV-1 infection seen in japanese and carribean peeps

A

Adult T-cell lymphoma

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38
Q

Enteropathy-associated T-cell lymphoma

A

Patients with coeliac disease at risk

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39
Q

t(2;5), kids and teens

A

Anaplastic large cell lymphoma

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40
Q

t(8;14) c-myc

A

Burkitt’s lymphoma

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41
Q

t(11;14)

A

Mantle cell lymphoma

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42
Q

t(14;18)

A

Follicular lymphoma

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43
Q

Malt-B lymphoma associated with…

A

H.pylori

Sjogren’s syndrome

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44
Q

CRAB

A

Multiple myeloma :

Calcium high
Renal failure
Anaemia
Bones : osteoporosis, lytic lesions, fractures, pepper pot skull

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45
Q

Neoplasia of the plasma cells

A

Multiple myeloma

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46
Q

Rouleux formation

A

Multiple myeloma (RBC stacking)

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47
Q

High ESR

A

Multiple myeloma

48
Q

Bence-jones protein in urine

A

Multiple myeloma

49
Q

Paraprotein > 30

A

Multiple myeloma

50
Q

<20%

A

Could be myelodysplastic syndrome

51
Q

Ring sideroblasts

A

Defective RBCs seen in myelodysplastic syndrome

52
Q

Pseudo-pelger-huet

A

Defective WBCs

53
Q

Erythroid dysplasia with <5% blasts

A

Refractory anaemia

54
Q

Erythroid dysplasia with >15% ringed sideroblasts

A

Refractory anaemia with ringed sideroblasts

55
Q

Dysplasia in >10% cells in >2 or 2 cell lines

A

Refractory cytopenia with multilineage dysplasia

56
Q

Dysplasia 5-9% blasts

A

Refractory anaemia with excess blasts (RAEB-1)

57
Q

Dysplasia 10-19% blasts or auer rods

A

Refractory anaemia with excess blasts 2 (RAEB-2)

58
Q

Megakarocytes with hypolobated nuclei and <5% blasts

A

MDS with 5q deletion

59
Q

Absent thumb, radii, short and pigmented skin

A

Fanconi anaemia (AUTOSOMAL RECESSIVE)
Risk of MDS and AML
Pancytopenia

60
Q

pigmented skin, white patches in mouth, BM failure and nail dystrophy

A

Dyskeratosis congenita (telomere shortening) - X-liked

61
Q

Pure red cell aplasia - WCC and plts normal

A

Diamond-Blackfan syndrome

62
Q

Jak2 mutations

A

seen in myeloproliferative disorder but Ph-ve

PRV

63
Q

Low serum EPO but raised Hb and itchy and plethoric

A

PRV

64
Q

Tx of PRV

A

Venesection
Hydroxycarbamide
Aspirin

65
Q

Blood film in myelofibrosis

A

Tear drop poikilocytes

Leukoerythroblasts

66
Q

Platelet count more than 600

A

Think essential thrombocytopenia

67
Q

Tx of essential thrombocytopenia

A

Aspirin
Anagrelide
Hydroxycarbamide

68
Q

Acanthocytes (spike/spur cells)

A

Hyposplenism
Abetalipoproteinemia
Liver disease

69
Q

Basophilic RBC stippling

A
Lead poisoning 
Haemoglobinapathies (thalassemia) 
Liver disease 
Megablastic anaemia 
Myelodysplasia
70
Q

Burr cells

A

GI bleed
Gastric carcinoma
Uremia

71
Q

Heinz bodies

A

G6PD

Chronic liver disease

72
Q

Howell-Jolly bodies

A
Hyposplenism/post-splenectomy 
Sickle cell disease 
Coeliac disease 
UC/IBD 
Myeloproliferative disease 
Hereditary spherocytosis 
Megaloblastic anaemia
73
Q

Pelger huet

A

Hyposegmented neutrophil
Congenital
Myelodysplastic disease

74
Q

Right shift

A

Hypermature white cells
Hypersegmented polymorphs (>5 lobes to nucleus)
Seen in megaloblastic anaemia

75
Q

Rouleux formation

A

Seen in multiple myeloma, paraproteinaemia, chronic inflammation

76
Q

Schistocytes

A

Seen in MAHA, DIC, HUS, TTP and pre-eclampsia

77
Q

Spherocytes

A

Hereditary spherocytosis

AIHA

78
Q

Stomatocytes

A

Excessive alcohol intake
Hereditary stomatocytosis
Liver disease

79
Q

Target cells

A
4Hs: 
Happy meal - IDA 
Hyposplenism 
Hepatic - liver disease 
Haemoglobinaemia - thalassemia
80
Q

Causes of microcytic anaemia (FAST)

A

Fe deficiency
Anaemia of chronic disease
Sideroblastic anaemia
Thalassemia

81
Q

Causes of normocytic anaemia

A
Blood loss 
Haemolysis 
Hypothyroidism 
Bone marrow failure 
Renal failure (EPO deficiency)
ACD
82
Q

Causes of macrocytic anaemia FATRBC

A
Fetus 
Anit-folate (phenytoin) 
Thyroid (hypo) 
Reticulocytosis 
B12 or folate def. 
Cirrhosis 
Myelodysplatic syndrome
83
Q

How does anaemia of chronic disease work?

A

Cytokine driven inhibition of red cell production
Inflammatory markers reduce EPO receptor
IL6 and LPS stimulate liver to make hepcidin which decreases iron absorption from gut by inhibiting transferrin and also causes iron accumulation in macrophages

84
Q

Tx of sideroblastic anaemia

A

Doesnt respond to iron
Give pyridoxine (vit B6 - promotes RBC production)
Treat underlying cause

85
Q

Why does pernicious anaemia cause megaloblastic anaemia

A

lack of instrinic factor so less B12 absorption

86
Q

Tx of megaloblastic anaemia

A

IM hydroxocobalamin (B12)

87
Q

Intravascular haemolysis leads to …

A

Dark urine

88
Q

Beta-thalassemia

A

High HbA2 and HbF

89
Q

Hairs on end skull x-ray

A

Beta-thalassemia

90
Q

Warm, my G for AIHA

A

Warm - IgG

37 degrees

91
Q

Men are cold so AIHA

A

Think IgM

Less than 37 degrees

92
Q

Tx of warm AIHA

A

Steriods
Immunosuppresion
Splenectomy

93
Q

Tx of cold AIHA

A

Tx underlying cause
Avoid cold
Chloramabucil (chemo)

94
Q

Donath Landsteriner antibodies

A

Paroxysmal cold haemoglobinuria

Viral related - syphilis measles and VZV

95
Q

Measures the function of the intrinsic pathway

A

APTT (monitors heparin therapy)

96
Q

Measures the function of the extrinsic pathway

A

PT (monitors warfarin therapy)

97
Q

Haemophilia A factor??

A

VIII

98
Q

Haemophilia B factor?? X-mas disease

A

IX

99
Q

Resistance to protein C

A

Factor V Leiden

100
Q

1st VTE with known cause

A

3 months warfarin

101
Q

Cancer VTE

A

3-6 months warfarin

102
Q

1st VTE unknown cause

A

3-6 months warfarin

103
Q

Recurrent VTE

A

Lifelong warfarin

104
Q

How does heparin work?

A

Potentiates anti-thrombin III

105
Q

What happens if the patient takes too much heparin?

A

Protamine sulphate

106
Q

Target INR

A

1st VTE : 2.5

Recurrent : 3.5

107
Q

Ham’s test

A

PNH

108
Q

Tear drop cells

A

Myelofibrosis

109
Q

Dry bone marrow tap/aspirate

A

Myelofibrosis

110
Q

What does protein C inhibit?

A

Factor 5

111
Q

Corkscrew appearance of arteries

A

Buerger’s disease - associated with smoking - vasculitis

112
Q

What does protein S inhibit?

A

Factor 5a and Factor 8a

113
Q

What does anti-thrombin inhibit?

A

Thrombin

Factor 10

114
Q

BCL-1

A

Mantle-cell lymphoma

115
Q

BCL-2

A

Follicular lymphoma