haem Flashcards

1
Q

causes of haemolytic anaemia

A
hereditary: 
spherocytosis 
G6PD deficiency 
haemoglobinopathics: SCD, thalassaemia 
acquired: 
autoimmune (cold/warm) 
microvascular: HUS, TTP, DIC
drugs: penicillin
infection: malaria
blood mismatch
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2
Q

management haemochromatosis

A
cons: MDT, genetic counselling, monitor for complications (cirrhosis, HCC) 
med / surg: 
1. venesection
2. iron chelation: desferrioxamine 
liver transplant
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3
Q

types of polycythaemia

A

primary: polycythaemia rubra vera (JAK2 mutation)
secondary (increased erythropoietin): hypoxia, renal cell carcinoma, erythropoietin abuse in athletes
reactive: due to reduced plasma volume

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4
Q

causes of thrombocytopenia

A

reduced production: infection, drugs (e.g. penicillamine), myelofibrosis, myelodysplasia
increased destruction:
heparin, hypersplenism, HUS, TTP, DIC, ITP

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5
Q

causes of thrombocytosis

A
reactive to infection, surgery, IDA 
malignancy 
hyposplenism 
essential thrombocytosis
polycythaemia ruba vera
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6
Q

causes of neutropenia

A

viral infection
chemo / radiotherapy
drugs: carbimazole, clozapine

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7
Q

causes of lymphocytosis

A

viral infection
lymphoma
CLL

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8
Q

management of warfarin dose w/o bleed

A

< 6: reduce warfarin dose
6-8: omit warfarin dose + start on reduced dose
> 8: oral vit K

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9
Q

management of warfarin w bleed (incl dose)

A

stop warfarin
5-10mg IV vit K
+ prothrombin complex (e.g. beriplex) if major bleed

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10
Q

signs of hyposplenism on blood film

A

howell-jolly bodies
target cells
pappenheimer bodies (post-splenectomy)

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11
Q

complications + management of splenectomy

A

haemorrhage
pancreatic fistula
infection esp encapsulated bacteria: NHS (neisseria, haemophilus, strep)
management:
immunisations: Hib, men A+C, annual influenza, 5yrly pneumococcal
penicillin V

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12
Q

features of HUS

A

triad:
typically following E.coli gastroenteritis
1. renal failure (N&V, fluid retention, oliguria, haematuria, proteinuria)
2. MAHA (anaemia, jaundice, schistocytes)
3. thrombocytopenia (bruising)

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13
Q

rain-drop skull on XR

A

multiple myeloma

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14
Q

investigations for multiple myeloma

A
urine sample → Bence-Jones protein 
bloods: normocytic anaemia, blood profile (normal ALP), raised Ca, deranged U&amp;Es (renal failure), rouleax formation on blood film
skeletal X-ray 
serum electrophoresis → paraprotein 
bone marrow aspirate → plasma cells
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15
Q

disseminated intravascular coagulation

FBC + clotting + blood film findings

A
anaemia (normocytic), thrombocytopenia
prolonged aPTT + PT 
reduced fibrinogen 
increased fibrin degradation products + D-dimer 
schistocytes on blood film
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16
Q

investigations haemochromatosis

A

bloods: FBC, iron studies (↑iron, ↑ferritin, ↑transferrin, ↓TIBC)
genetic testing: HFE
MRI liver + biopsy → Perl’s / prussian blue stain

17
Q

Auer rods

A

AML

18
Q

myeloblast granules +ve for Sudan black staining

A

AML

19
Q

Philadelphia chromosome (t9:22), Abelson-BCR

A

CML

20
Q

smudge / smear cells

A

CLL

21
Q

causes of autoimmune haemolytic anaemia (AIHA)

A

cold (IgM): mycoplasma, mononucleosis, HIV, lymphoma

warm (IgG): CLL, SLE

22
Q

causes of B12 deficiency

A
reduced intake e.g. in vegetarians 
reduced absorption (terminal ileum):
IBD (esp Crohn's) 
pernicious anaemia: Ab against intrinsic factor (Schilling test) 
gastrectomy / ileal resection
23
Q

presentation B12 deficiency

A
signs of anaemia
glossitis
mixed UMN + LMN signs of LL: spastic weakness, areflexia, extensor plantars (Babkinski +ve)
peripheral neuropathy
cerebellar signs: ataxia, +ve Romberg's