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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
Q

who does a burkitt lymphoma typically affect

A

the young and immunocompromised

26
Q

in which lymphoma do “B” symptoms occur earlier

A

occur earlier in Hodgkins lymphoma

27
Q

what can a chronic lymphocytic leukaemia transform into

A

a NHL (richter’s transformation)

28
Q

what is the most common RBC enzyme defect

A

G6PD deficiency

29
Q

describe the pathophysiology of a G6PD deficiency

A

reduced G6PD means reduced glutathione

reduced glutathione means the RBC has an increased susceptibility to oxidative stress

30
Q

in which condition are Heinz bodies, bite cells and blister cells seen on blood film

A

G6PD deficiency

31
Q

can women get a G6PD deficiency

A

no - X linked recessive- its a mans disease 💪🏽

32
Q

which disease causes normocytic anaemia, leukopenia and thrombocytopenia

A

aplastic anaemia

33
Q

how many segments does the nucleus of a neutrophil have

A

up to 5

34
Q

what colour are the granules of eosinophils

A

bright red/orange

35
Q

what is the main role of basophils/mast cells

A

IgE hypersensitivity response

36
Q

what substance is within the granules of basophils

A

histamine

37
Q

what is the function of NADPH

A

reduces glutathione

38
Q

what pathway produces NAHPD

A

pentose phosphate pathway

39
Q

what converts hydrogen peroxide to water

A

reduced glutathione

it combats oxidative stress

40
Q

what is the consequence of G6PD deficiency

A

reduced NAPDH so
lack of
reduced glutathione

increased build up of free radicals, causing oxidative damage and haemolysis

41
Q

is hypoproliferative anaemia microcytic, normocytic or macrocytic?

A

normocytic

42
Q

what are the 2 main causes of microcytic anaemia

A

B12 deficiency

folate deficiency

43
Q

which is absorbed 1st - iron, B12 or folate

A

1st = folate - in the duodenum and ileum

2nd = B12- absorbed in the terminal ileum, 
3rd = iron is absorbed in the proximal small bowel
44
Q

why do B12 and folate deficiencies cause jaundice

A

premature haemolysis of RBC in bone marrow

45
Q

what is the nucleus of neutrophils in patients with a B12/folate deficiency like

A

hypersegmented nucleus (>5segments)

46
Q

what Ig are irregular blood allo-antibodies

A

IgG

47
Q

how do delayed transfusion reactions occur

A

complement is NOT activated (like in an acute reaction) so reaction occurs in the spleen where macrophages attack the cells

48
Q

why is folic acid supplementation needed in HbH disease

A

increased RBC turnover so increased folic acid demand

49
Q

why does splenomegaly occur in HbH disease

A

due to extra medullary haematopoesis

50
Q

what type of anaemia do you get with HbH disase

A

hypo chromic microcytic

with mild to severe anaemia

51
Q

what kind of anaemia do u get with thalassemia trait

A

asymptomatic to mild

52
Q

compare the need for blood transfusions in thalassemia intermedia and major

A

intermedia- they are NOT dependant on transfusions- only when they are ill

major = dependant on transfusions

53
Q

what tests can u do to diagnose thalassemias

A

HPLC (high performance liquid chromatography)

Hb electrophoresis

54
Q

what are the 2 main purposes of blood transuiosn in B thal major

A
  1. suppress ineffective erythropoiesis

2. inhibit over-absorption of iron

55
Q

what is the pathophysiology of sickle cells

A

point mutation in codon 6 of the beta chain
glutamine –> valine

structure of B chain changed

56
Q

do you get hypo or hypersplenism in sickle cell

A

hyposplenism - due to repeated splenic infarcts

57
Q

in which disease can target cells on blood film be seen

A

alpha and beta thalassemias

58
Q

what is seen on blood film when RBCs are damaged

A

spherocytes

59
Q

what is seen on blood film if RBCs have oxidative damage

A

Heinz bodies

60
Q

compare warm and cold

A 
cold = IgM 
warm = IgG

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

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