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Pathology Buzzwords - Pastpapers > Haem > Flashcards

Haem Flashcards

1
Q

Smear cells

A

CLL

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2
Q

Philadelphia chromosome

A

9:22
BCR-ABL
CML (but can be associated with AML/ALL)
Imatinib (TK inhibitor)

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3
Q

Auer rods

A

AML

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4
Q

Tear drop poikilocytes and JAK2

A

Myelofibrosis

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5
Q

pruritis and raised haemoglobin after shower (aquagenic pruritis)

A

Polycythaemia (Rubra) Vera

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6
Q

Acute promyelocytic leukemia (APML)

  • translocation and its name
  • common presentation
A

t(15:17)
PML-RARA translocation
Still has Auer rods like AML

Presents with bleeds (DIC common)

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7
Q

61yo with CLL

Presents with pneumonia, haemoptysis, endobronchial mass, anaplastic large cell lymphoma

A

Richter’s transformation
Diffuce B cell Lymphoma (DBCL)

Sheets of large lymphoid cells

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8
Q

Clumsiness, progressive weakness, personality change after chemo

A

Progressive multifocal leukencephalopathy (JC virus)

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9
Q

Massive splenomegaly (classically which leukemia? which other haem condition?)

A

CML, Myelofibrosis

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10
Q

High calcium, CLOVER LEAF nuclei, LNs

A

Adult T cell Lymphoma

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11
Q

HTLV-1

A

Adult T cell Lymphoma

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12
Q

Paraprotein IgM

A 
Waldenstroms macroglobulinaemia (Lymphoplasmacytic lymphoma)
Treated with plasmapheresis
Also causes visual impairment
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13
Q

Paraprotein IgG

A

Multiple Myeloma (or MGUS or Smouldering depending on blasts and symptoms)

<30g/L IgG and <10% blasts for MGUS
>30g/L IgG and >10% blasts for SM or MM

Only MM is CRAB Sxs. (important to note that if CRAB symptoms could be confounded by other illness, e.g. renal failure in diabetes, then don’t count as CRAB)

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14
Q

AA vs AL amyloidosis

A

AA = Chronic illness e.g. RA, IBD, familial Mediterranean fever

AL = Multiple Myeloma

Amyloidosis is a paraproteinaemia!! Can see raised paraproteins (often less than 30)

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15
Q

Post transplant EBV

A

PTLD (Post transplant lymphoproliferative disease)

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16
Q

Anaplastic lymphom

A

Alk 1

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17
Q

Past histort of DVT, easy bruising, LOADS of platelets

A

ET (essential thrombocythaemia)

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18
Q

Pregnant woman with low platelets, schistocytes, neuro sxs (headache and seizures), but LOW BP

A

TTP

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19
Q

Pregnant patient with slightly low platelets in 3rd trimester (asymptomatic)

A

Gestational thrombocytopenia (not same as physiological but it is benign and no tx is needed. It is the most common cause of low platelets in pregnancy. If platelets <70 think HELLP or ITP)

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20
Q

Pregnant, can’t breathe and DIC

A

Amniotic fluid embolism

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21
Q

Normal heam values in preg for

  • Hb
  • MCV
  • WCC
  • Platelets
  • Plasma volume
A

Normal heam values in preg for

  • Hb low
  • MCV normal or high (macrocytosis)
  • WCC high
  • Platelets low
  • Plasma volume high
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22
Q

Prolonged APTT, normal PT, prolonged bleeding time

A

vWD

not Haemophilia because does not cause a defect in the primary platelet plug formation.

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23
Q

Prolonged APTT, normal PT, normal bleeding time

A

Haemophilia

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24
Q

INR Targets

  • AF/cardioversion
  • MI!!
  • Single DVT
  • Recurrent DVTs
  • Prosthetic valve
A

INR Targets

  • AF/cardiov 2.5
  • MI 2.5
  • Single DVT 2.5
  • Recurrent DVTs 3.5
  • Prosthetic valve 3.5

Lower = more clots
INR within 0.5 of target is satisfactory

Rule of thumb - everything except recurrent DVTs/PEs and some prosthetic valves is 2.5 target!

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25
Q

Is heparin intrinsic/extrinsic pathway and APTT or PT

A

intrinsic pathway and APTT

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26
Q

Is warfarin intrinsic/extrinsic pathway and APTT or PT

A

Extrinsic and PT

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27
Q

Anaemic with frontal bossing and XR: hairs on end

A

Thalassaemia

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28
Q

osmotic fragility

A

hereditary spherocytosis

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29
Q

Membrane defect RBCs

A

Spectrin deficiency –> hereditary sphero/elliptocytosis

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30
Q

Heinz bodies

A

G6PD

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31
Q

Warm haemolytic anaemias

  1. antibody type
  2. blood film
  3. causes
A
  1. IgG
  2. Spherocytes
  3. CLL, SLE, methyldopa
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32
Q

Cold Agglutinin disease (Cold HA)

  1. antibody type
  2. Associated with
  3. causes
A
  1. IgM
  2. Raynaud’s
  3. Mycoplasma, EBV
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33
Q

Donath-Landsteiner antibodies

A

Paroxysmal cold haemoglobinuria (PCH)

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34
Q

Ham’s test or immunophenotype

A

Paroxysmal nocturnal haematuria

complement mediated, morning haematuria

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35
Q

Hypercellular BM

A

CML (but maybe other leukemias too)

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36
Q

Prognostic factors in CLL

A

Good: hypermutated Ig gene, 13q14 deletion
Bad: CD38+ve, 11q23, 17p, LDH raised

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37
Q

Owl eyed cells

A

Reed Sternberg

HL

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38
Q

What would you give these patients (transfusion)?

  1. triple AAA surgery
  2. C/S
  3. Past transfusion, allergy to plasma proteins
A
  1. X-match
  2. G&S
  3. Washed red cells
39
Q

Transfusion

Acute SOB, dry cough, hypoxia

A

TRALI

40
Q

Transfusion

Febrile with collapse

A

Bacterial infection

41
Q

Transfusion

RTA, jaundice and anaemia a few days later

A

Delayed haemolytic reaction

42
Q

Thalaessaemia pt with tan and diabetes

A

Haemosiderosis (focal iron overload)

43
Q

Sickle-cell-amaenia pt with short stature and poor cardiac function

A

Iron overload

44
Q

Old lady gets 4 units of blood and feels unwell + basal creps+ankle oedema

A

Fluid overload

45
Q

Seizures and schistocytes

A

TTP

46
Q

Pelger Huet cells, hyposegmented neutrophils

A

MDS

47
Q

> 20% blasts

A

leukemia

48
Q

haemolysis after antimalarials

A

G6PD

49
Q

6 features of myelofibrosis

A
  1. pancytopenia
  2. leucoerythroblastic picture
  3. Massive splenomegaly
  4. dry tap
  5. tear drop (poikilocytes/dacrocytes)
  6. Some are JAK2+
50
Q

Cabot rings

A

Megaloblastic anaemia

51
Q

Factor V Leiden pathogenesis

A

Impaired degradation of factor V by protein C

52
Q

Buerger disease

A

Vasculitis in smokers (corkscrew arteries)

53
Q

Dry cough, dyspnoea and fever post transfusion

A

TRALI

54
Q

Tartrate resistance acid phosphatase (TRAP) ass with which condition?

A

Hairy cell leukemia

55
Q

Clover leaf appearance and high calcium

A

Adult T cell lymphoma

56
Q

Smudge/smear cells

A

CLL

57
Q

Bleeding and thrombosis with high platelets

A

Essential

Thrombocythaemia

58
Q

ET treatment

A

ASPIRIN + (Hydroxyurea + anagrelide)

59
Q

Macrocytic anaemia and stomatitis

A

B12 deficiency

60
Q

Pregnant greek patient with father who is on warfarin and sister had a DVT

A

Antithrombin III deficiency

61
Q

Transfusion in past with allergy plasma proteins

A

Washed red cells

62
Q

Sickle cell transfusion

A

?Group in C,E,K crossmatch/anti-CcRR Abs

63
Q

Splenectomy is useful in

The PIIES - what does the acronym stand for?

A

Thalessaemia

Pyruvate kinase deficiency
ITP
Immune HA
Elliptocytosis
Spherocytosis
64
Q

Cold AI HA causes

A

Cold LID

Lymphoproliferative disease (lymphomas and leukaemias)

Infections (mycoplasma/EBV)

Don’t know (idiopathic)

65
Q

PNH Signs

A

PNH is also the acronym

Pancytopenia
New thrombus
Haemolytic anaemia

66
Q

Basophilic stripping

A

ß-thal and lead poisoning

67
Q

Acanthocytes

  1. another name
  2. when do you see?
A
  1. Spur cells

2. Hyposplenism

68
Q

Anisopoikilocytosis

  1. meaning
  2. conditions associated
A
  1. different size and shapes (respectively)
  2. anaemias e.g. IDA
    ßthal
    hereditary spherocytosis
    B12 deficiency
69
Q

Target cells seen in which 3 conditions?

A

3 Hs

Hepatic pathology
Hyposplenism
Haemoglobinopathies

70
Q

Paroxysmal cold haemoglobinuria

A

Children, acute onset haemolysis in cold temperatures

71
Q

Aplastic anaemia causing drugs (4)

A

4 C’s

Carbimazole (anti-thyroid)
Chloramphenicol
Cytotoxics
anti-Convulsants (e.g. carbamezapine, phenytoin)

72
Q

ALP in MM

A

NORMAL despite bone lesions (but raised calcium)

MM activates osteoclasts but shuts off ALP producing osteoblasts hence just destruction and no rebuilding which would cause the raised ALP

73
Q

TTP signs and symptoms

A

MARCH Low platelets

MAHA
A fever
Renal failure
CNS signs --> seizures etc.
Haematuria/proteinuria
74
Q

Massive transfusion with low platelets after

A

Happens if you don’T replace platelets too

75
Q

Smoker with COPD, high Hb and Hct (low plasma volume)

A

Combined polycythaemia
Raised EPO due to CO from cigarettes and low O2 from COPD;
And low plasma volume due to smoking

76
Q

Polycythaemia and not dehydrated, what happens to RBC mass?

A

Increases

77
Q

ßthal minor presentation

A

35 year old with tiredness

78
Q

Mild vWD - which drug can they take before seeing the dentist?

A

Desmopressing (releases intracellular store of vWF)

79
Q

Hereditary spherocytosis Mode of inheritance

A

Autosomal dominant

80
Q

Staging system for MM

A

Durie-Salmon

81
Q

Produced by liver in response to chronic illness

A

Hepcidin.

Leads to reduced iron absorption by the gut.

82
Q

What coagulation factor decreases first with warfarin?

A

VII

83
Q

Treatment of CLL with p53 mutation/17p deleted

A

Ibrutinib

84
Q

develops haematuria with irregularly contracted cells after Rasburicase (for Burkitt’s lymphoma)

A

g6pd

85
Q

How to monitor unfractionated heparin?

A

APTT

86
Q

How to treat MM (multiple myeloma) chord compression?

A

radiotherapy

87
Q

How to treat MM (multiple myeloma) hypercalciaemia?

A

bisphosphonates

88
Q

How to treat MM (multiple myeloma) pathological fractures?

A

bisphosphonates

89
Q

How to treat MM (multiple myeloma) renal problems?

A

Haemodialysis

90
Q

How to treat MM (multiple myeloma) hyperviscosity?

A

Plasmapheresis

91
Q

Effects of haemochromatosis

A 
Joints: chondrocalcinosis
Pancreas: diabetes
Liver: hepatomegaly, deranged LFTs
Heart: dilated cardiomyopathy
Pituitary: hypogonadism, impotence
Adrenals: adrenal insufficiency
Skin: Slate-grey or bronzed
92
Q

Different name for Waldenström’s

A

Lymphoplasmacytic lymphoma

93
Q

Lady (from Germany) with low neutrophils but no abnormal cells on blood film

A

Chronic idiopathic neutropenia

Pathology Buzzwords - Pastpapers (7 decks)

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