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Finals > Haem > Flashcards

Haem Flashcards

1
Q

Features of Iron deficiency anaemia ?

A

koilonychia
atrophic glossitis
post-cricoid webs
angular stomatitis/cheilitis

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2
Q

Symptoms of Iron Deficiency Anaemia?

A

Fatigue, Dyspnoea, palpitations, headache, angina (IHD already)

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3
Q

Blood film for Iron deficiency anaemia?

A

Microcytic Hypochromic
Target cells
‘pencil’ poikilocytes

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4
Q

Types of Autoimmune haemolytic anaemia ?

A

‘warm’ and ‘cold’ types, according to at what temperature the antibodies best cause haemolysis

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5
Q

Test for Autoimmune haemolytic anaemia?

A

Direct coombs +ve

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6
Q

Warm Haemolytic anaemia features/treatment? Which antibody?

A

Haemolysis tends to occur in extravascular sites, for example the spleen. Management options include steroids, immunosuppression and splenectomy. Usually IgG

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7
Q

Cold Haemolytic anaemia features/treatment? Which antibody?

A

Cold AIHA is usually IgM and causes haemolysis best at 4 deg C. Symptoms of Raynaud’s and acrocynaosis.

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8
Q

Causes of warm Haemolytic anaemia?

A

SLE, Methyldopa, CLL, Lymphoma

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9
Q

Causes of cold haemolytic anaemia?

A

Neoplasia: e.g. lymphoma
infections: e.g. mycoplasma, EBV

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10
Q

Define anaemia?

A

Males <13 Females <12

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11
Q

When to refer iron deficiency for cancer pathway?

A

> 60years or <50 with rectal bleeding or adverse signs

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12
Q

Threshold for anaemia if have ACS vs normally?

A

<8g/dl normally <7g/dl

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13
Q

TIBC in iron deficiency?

A

High

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14
Q

TIBC in normocytic?

A

Normal

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15
Q

TIBC in chronic disease anaemia?

A

Normal or low

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16
Q

Microcytic not responding to iron?

A

Sideroblastic

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17
Q

How long continue iron to replenish stores?

A

3 months

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18
Q

Symptoms of febrile reactions to blood transfusion, what to do?

A

Fever, chills, pruritis, urticaria ~ 1/1.5 hrs from transfusion

Slow transfusion, give Paracetamol

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19
Q

What blood product is most commonly associated with bacterial contamination?

A

Platelets due to higher temp storage

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20
Q

Bacterial contamination transfusion symptoms, treatment?

A

↑Temp, Hypotension, Rigors

Call haematologist, stop transfusion broad abx

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21
Q

Fluid overload with transfusion, symptoms and management?

A

SOB, Hypoxia, TAchy, JVP and creps. o2 and furosemide.

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22
Q

Haemolytic transfusion reactions symptoms?

A

minutes: ↑Temp, Agitation, Hypotension, Flushing, Abdo or Chest Pain, Oozing venepuncture sites
Can progress to DIC

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23
Q

Haemolytic transfusion treatment?

A

Stop transfusion, Check identity/name on unit, Keep IV line open, IV Fluid resus, send blood back to lab, Direct Coombs test

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24
Q

Who should have have irradiated blood? What has happened to it specifically reduced?

A

Immunocompromised usually, depleted t lymphocytes

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25
Q

Macrocytic anaemia two types? Causes?

A

Megaloblastic- deficiency

non-=megaloblastic- Alcohol, liver issues, thyroid, pregnancy, drugs(aza)

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26
Q

Signs of macrocytic anaemia (mostly b12/pernicious)?

A

Stomatitis, glossitis, dizziness and syncope worrying.

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27
Q

Order of replacement of b12/folate and why?

A

B12 first risk of subacute combined degeneration of the cord.

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28
Q

Sub acute degenration cord triad?

A

Classic triad: extensor plantar (babinski) (UMN), absent ankle jerk (LMN) absent knee jerk (LMN)

29
Q

Lemon tinge noted in what disease?

A

Pernicious anaemia/B12 deficiency

30
Q

Miocrocytic anaemia with billirubin and reticulocytes?

A

Thallasaemia

31
Q

Classical x-ray in B thallasaemia?

A

Hair on end skull

32
Q

Haemolytic anaemia bloods?

A

Unconjugated bilirubin increased, MCV increased

33
Q

Causes of iron deficiency anaemia?

A

Loss, low intake, Malabsorption

34
Q

Ethnicity of thalassaemia patients?

A

Mediterranean and far east

35
Q

Beta Thalassaemia trait symptoms?

A

Mild anaemia which is usually harmless

↓ MCV (“too low for the anaemia”): e.g. <75

36
Q

β Thalassaemia Major symptoms and treatment?

A

Severe anaemia
Jaundice
Haemochromatosis >10years of life
Regular transfusions possible Bone marrow transplant

37
Q

B12 deficiency causes?

A

↓ Intake Vegan
↓ intrinsic factor Pernicious anaemia
Post-gastrectomy

Terminal ileum Crohn’s
Ileal resection
Bacterial overgrowth

38
Q

B12 deficiency symptoms?

A

Glossitis, paraesthesia, neuropathy, optic atrophy

39
Q

Recent e-coli, low platelets normal clotting, renal failure? Treatment?

A

Haemolytic uraemic

usually spont resolution

40
Q

Drugs precipitating G6PD haemolysis?

A

Broad (Fava) beans
Mothballs (naphthalene)
Infection

Drugs: antimalarials, henna, dapsone, sulphonamides

41
Q

Diagnosis of sickle cell bloods?

A

Can be genetic but also Hb 6-9, ↑ retics, ↑ bilirubin

Film: sickle cells and target cells

42
Q

Aplastic crisis in sickle cell?

A

Parvovirus, (erythema infectisosum)

43
Q

Sequestration crisis in sickle?

A

Splenomegaly, splenic pooling which leads to shock and severe anaemia

44
Q

DIC blood results?

A

Prolonged bleeding times for all tests low fibrinogen and low platelets.

45
Q

Antiphospholipid symptoms?

A

CLOT

Coag -APTT increased
Livido reticularis
Obstetrics
Thrombocytopaenia

46
Q

Most common thrombophillia?

A

Factor 5 leiden (protein c resistance)

47
Q

Most common clotting disorder?

A

VWD

↑ APTT, ↑ bleeding time, normal plat

48
Q

APTT in haemophillia? Symptoms?

A

Prolonged

Haemarthrosis, muscles bleeding, bruising- male sex

49
Q

Pancytopaenia?

A

Aplastic anaemia, Haematological malignancy, HIV, radiation, Drugs-Thyroid, clozapine, thiazide, sulphonamide, methotrex

50
Q

Acute lymphoblastic leukaemia bloods?

A

↑WCC: lymphoblasts
↓RBC, ↓PMN, ↓plats
BM aspirate
≥20% blasts

51
Q

ALL age of onset?

A

V Young

52
Q

Acute myeloid leukaemia bloods and age?

A

65-70 most common leukaemia adults.

WCC- Blasts anaemia and low platelets

BM asirate-Auer rods >20% blasts

53
Q

Chronic lymphocytic leukaemia age and bloods?

A

↑ WCC, lymphocytosis
Smear cells

Elderly

54
Q

CLL features?

A

Often asymptomatic

Symmetrical painless lymphadenopathy
HepSplenMeg
Anaemia
B symptoms: wt. loss, fever, night sweats

55
Q

CML symptoms and bloods? Assoc with?

A

Philadelphia chromosome

↑↑WBC-PolyMorphNeut (granulocytes)and basophils Myelocytes

56
Q

Features of non-hodgkins?

A

75% lymphadenopathy symmetrical multiple sites, splenomegaly, wt loss night sweats

57
Q

Most common non-hodgkins?

A

B-cell - diffuse large high grade but may be curable

58
Q

Burkit lymphoma assoc with?

A

EBV

59
Q

Treatment of non-hodgkins?

A

High grade R-CHOP

60
Q

Hodgkins lymphoma features?

A

Cervical symmetrical lymphadenopathy

can be alcohol >pain

61
Q

Hodgkins chemo treatment?

A

ABVD

62
Q

Age incidence for hodgkins lymphoma?

A

Bimodal 20-30 and >60

63
Q

Backache, anaemia, neutropenia, vertebral fractures?

A

Multiple myeloma

64
Q

Myeloma mnemonic?

A 
CRAB
Calcium high >2.6
Renal insufficiency 
Anaemia <10g/dl
Bone lesions
65
Q

Blood film in myeloma? Other bloods?

A

Roleaux, plasma cells, ESR,
NORMAL ALP
Hypercalcaemia and normocytic anaemia

66
Q

Anaemia in myeloma type?

A

Normocytic normochromic

67
Q

Investigations in myeloma?

A

Serum/urine electorphoresis (paraprotein spikes) and skeletal survey/whole body low dose ct

68
Q

Rapid gingival hyperplasia associated with?

A

AML

69
Q

How long to eat gluten before TTG?

A

At least 1 meal for six weeks

Finals (16 decks)

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