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Ned's PassMed notes 2019/20 > Haem > Flashcards

Haem Flashcards

1
Q

is vit K fat or water soluble

A

fat soluble

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2
Q

what does vit K do to preformed clotting factors to activate them

A

carboxylates them

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3
Q

what is the difference in terms of blood cells produced in AML and CML

A

AML- an excess of primitive cells - due to the block in differentiation

CML - an excess of immature blood cells (differentiation is not blocked)

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4
Q

what does a pancytopenia with a macrocytic red cell development suggest?

A

pernicious anaemia- lack of vit B12 absorption impairs nuclear maturation, affecting all 3 haemopoetic lineages

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5
Q

first line treatment for AI haemolytic anaemia

A

1mg/kg prednisolone per day and folic acid

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6
Q

what does a low Hb with normal serum ferritin suggest in a pregnant women?

A

anaemia of pregnancy (physiological)

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7
Q

what is the best test to investigate a haemoglobinopathy

A

haemoglobin analysis

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8
Q

what is the protein target in NHL treatment

A

CD20+

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9
Q

what causes the HbS in sickle cell anaemia

A

the point mutation causing glutamic acid to valine substitution in the beta chain

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10
Q

what is the key characteristic to help you remember a neutrophil on histology

A

it has a multisegmented nucleus (polymorphonuclear leucocyte)

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11
Q

which blood cell has a characteristic BiLobed nucleus (spectacle shaped nuclei)

A

eosinophil

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12
Q

which blood cell has a horse shoe-shaped nucleus and a steel grey coloured nucleus

A

monocyte

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13
Q

is antiphospholipid syndrome an inherited or acquired thrombophillia

A

acquired

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14
Q

name the 4 causes of inherited thrombophillia

A

factor V leiden, antithrombin deficiency, protein c and protein s deficiency

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15
Q

which anticoagulant is a direct inhibitor of factor Xa

A

rivaroxiban

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16
Q

what is the pathology behind sickle cell disease

A

point mutation in globin gene

predisposes the Hb to polymerisation, resulting in sickled cells

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17
Q

the presence of which cell characterises a Hodgkin’s lymphoma

A

reed Sternberg cell

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18
Q

name the 3 ‘B’ symptoms in lymphoma that suggest a poor prognosis

A

weight loss
fever
night sweats

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19
Q

which lymphoma causes severe pain on alcohol consumption

A

Hodgkin’s lymphoma

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20
Q

what is the NOAC dabigitrans mechanism of action

A

direct thrombin inhibitor

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21
Q

what is the mechanism of action of rivaroxaban and apixaban

A

direct factor Xa inhibitors

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22
Q

which drugs are indicated for the treatment of PE/DVT

A

NOACS

dabigitran, rivaroxaban and apixaban

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23
Q

which lymphoma is ‘itchy skin without a rash’ characteristic of

A

non Hodgkins lymphoma

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24
Q

which lymphoma is the most common form in the UK

A

diffuse large B cell lymphoma

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25
who does a burkitt lymphoma typically affect
the young and immunocompromised
26
in which lymphoma do "B" symptoms occur earlier
occur earlier in Hodgkins lymphoma
27
what can a chronic lymphocytic leukaemia transform into
a NHL (richter's transformation)
28
what is the most common RBC enzyme defect
G6PD deficiency
29
describe the pathophysiology of a G6PD deficiency
reduced G6PD means reduced glutathione reduced glutathione means the RBC has an increased susceptibility to oxidative stress
30
in which condition are Heinz bodies, bite cells and blister cells seen on blood film
G6PD deficiency
31
can women get a G6PD deficiency
no - X linked recessive- its a mans disease 💪🏽
32
which disease causes normocytic anaemia, leukopenia and thrombocytopenia
aplastic anaemia
33
how many segments does the nucleus of a neutrophil have
up to 5
34
what colour are the granules of eosinophils
bright red/orange
35
what is the main role of basophils/mast cells
IgE hypersensitivity response
36
what substance is within the granules of basophils
histamine
37
what is the function of NADPH
reduces glutathione
38
what pathway produces NAHPD
pentose phosphate pathway
39
what converts hydrogen peroxide to water
reduced glutathione it combats oxidative stress
40
what is the consequence of G6PD deficiency
reduced NAPDH so lack of reduced glutathione increased build up of free radicals, causing oxidative damage and haemolysis
41
is hypoproliferative anaemia microcytic, normocytic or macrocytic?
normocytic
42
what are the 2 main causes of microcytic anaemia
B12 deficiency | folate deficiency
43
which is absorbed 1st - iron, B12 or folate
1st = folate - in the duodenum and ileum ``` 2nd = B12- absorbed in the terminal ileum, 3rd = iron is absorbed in the proximal small bowel ```
44
why do B12 and folate deficiencies cause jaundice
premature haemolysis of RBC in bone marrow
45
what is the nucleus of neutrophils in patients with a B12/folate deficiency like
hypersegmented nucleus (>5segments)
46
what Ig are irregular blood allo-antibodies
IgG
47
how do delayed transfusion reactions occur
complement is NOT activated (like in an acute reaction) so reaction occurs in the spleen where macrophages attack the cells
48
why is folic acid supplementation needed in HbH disease
increased RBC turnover so increased folic acid demand
49
why does splenomegaly occur in HbH disease
due to extra medullary haematopoesis
50
what type of anaemia do you get with HbH disase
hypo chromic microcytic | with mild to severe anaemia
51
what kind of anaemia do u get with thalassemia trait
asymptomatic to mild
52
compare the need for blood transfusions in thalassemia intermedia and major
intermedia- they are NOT dependant on transfusions- only when they are ill major = dependant on transfusions
53
what tests can u do to diagnose thalassemias
HPLC (high performance liquid chromatography) | Hb electrophoresis
54
what are the 2 main purposes of blood transuiosn in B thal major
1. suppress ineffective erythropoiesis | 2. inhibit over-absorption of iron
55
what is the pathophysiology of sickle cells
point mutation in codon 6 of the beta chain glutamine --> valine structure of B chain changed
56
do you get hypo or hypersplenism in sickle cell
hyposplenism - due to repeated splenic infarcts
57
in which disease can target cells on blood film be seen
alpha and beta thalassemias
58
what is seen on blood film when RBCs are damaged
spherocytes
59
what is seen on blood film if RBCs have oxidative damage
Heinz bodies
60
compare warm and cold
``` cold = IgM warm = IgG ```

Ned's PassMed notes 2019/20 (17 decks)

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