Haem Flashcards

1
Q

What is the best way to measure someones iron store level?

A

Serum ferritin

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2
Q

What type of cell on blood smear indicates myelofibrosis?

A

Tear drop cells (dacrocytes)

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3
Q

What conditions causes a schistocyte on blood smear?

A

Haemolytic anaemia, DIC

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4
Q

What conditions cause a spherocyte?

A

Haemolytic anaemia

Hereditary spherocytosis

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5
Q

What conditions cause a target cell?

A

Obstructive jaundice
Liver disease
Haemaglobinopathies
Hyposplenism

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6
Q

Pt post op who had 3 blood units. PC: fever, low BP, cyanosis, dry cough. Dx?

A

TRALI - tissue related lung injury

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7
Q

What is a TRALI?

A

2-6hrs after transfusion, neutrophils get sequestered in lungs and ABs form against donor WBCs. ABs then attack the pt’s lungs

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8
Q

How do you differentiate between immediate haemolytic transfusion reaction and a delayed haemolytic reaction?

A

IHTR < 24hrs post transfusion

DHR >24hr post transfusion

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9
Q

What are 2 differentials for megaloblastic anaemia?

A

B12 deficiency

Folate deficiency

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10
Q

Limb parasthesia and numbness. Hypersegmented neutrophils. Dx?

A

B12 deficiency

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11
Q

What is pernicious anaemia?

A

AI condition where ABs bind to intrinsic factor thus preventing B12 absorption

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12
Q

What condition is associated w pernicious anaemia?

A

Thyroid disease

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13
Q

What does PT vs PTT measure?

A
PT = extrinsic pathway 
PTT = intrinsic pathway
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14
Q

Normal PT and platelets. Abnormal PTT and bleeding time. Dx?

A

vWF deficiency

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15
Q

Normal bleeding time and platelets. Prolonged PT and PTT. DDx?

A

Factor V deficiency
Vitamin K deficiency
Warfarin therapy

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16
Q

Fever + neutropenia. Dx?

A

Septicaemia

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17
Q

Neutropenia, anaemia, thrombocytopenia. >20% myeloblasts. Dx?

A

AML

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18
Q

Neutropenia, anaemia, thrombocytopenia. >20% lymphoblasts. Dx?

A

ALL

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19
Q

Sx of thrombotic thrombocytopenia purpura?

A
PENTAD 
Fever
Thrombocytopenia 
Microangiopathic haemolytic anaemia 
Renal failure 
Neuro Sx
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20
Q

Headaches, dizziness, severe pruritus after hot baths. Dx?

A

Polycythaemia vera

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21
Q

What is myelofibrosis?

A

Fibrosis of bone marrow due to abnormal megakaryocytes which produce XS fibrosising factors.

22
Q

List 4 causes of massive splenomegaly

A

CML
Thalassaemia
Polycythaemia rubra vera
Kala-azar

23
Q

What cell type on blood film indicates haemolysis?

A

Schistocytes

24
Q

What is the function of G6PD?

A

Maintaining levels of glutathione (protects against oxidative stress)

25
Q

What happens if someone with G6PD deficiency takes anti malarias?

A

Denatures Hb producing HEINZ BODIES

26
Q

What is characteristic of microangiopathic haemolytic anamiea?

A

Anaemia and schistocytes on blood smear

27
Q

Which test is used for investigating potential sickle cell?

A

Sodium metabisulfate

28
Q

What test is used for B12 deficiency?

A

Schilling’s

29
Q

What test can be used to investigate causes of haemolytic AI anaemia?

A

Coomb’s

30
Q

What stain is used to differentiate between AML and ALL?

A

Sudan black

31
Q

What are the erythropoetin and red cell mass levels in polycythaemia rubra vera?

A

HIGH red cell mass

LOW erythropoetin

32
Q

Which iron protein is raised in iron deficiency anaemia?

A

Transferrin - it is the iron carrying protein so increases when reduced iron

33
Q

Malaise, SoB, parasthesia in hands. Schillings positive. Dx?

A

Pernicious anaemia

34
Q

Pancytopenia, macrocytosis with bone marrow hypocellularity. Dx?

A

Aplastic anaemia

35
Q

What type of Hb is raised in aplastic anaemia?

A

Foetal

36
Q

Fatigue. Fevers. Bleeding gums. Blood film shows auer rods, hypogranular neutrophils. Stains with Sudan black B. Dx?

A

AML

37
Q

What cells are seen on blood film in ALL?

A

Lymphoblasts

38
Q

Philadelphia chromosome present. Dx?

A

CML

39
Q

Tx of CML?

A

Imatinib (tyrosine kinase inhibitor)

40
Q

What is the INR?

A

Ratio between pt’s prothrombin time vs normal

41
Q

What is a normal INR?

A

0.9 to 1.3

42
Q

Pt with rheumatic mitral valve + AF. INR?

A

2 - 3

43
Q

Is multiple myeloma hereditary?

A

NO

44
Q

List risk of multiple myeloma

A

Radiation, herbicides/insecticides, herpes HHV-8, HIV

45
Q

What test differentiates between hypersplenism and aplastic anaemia?

A

Reticulocyte test - reduced in AA but raised in hypersplenism

46
Q

What AB is associated with pernicious anaemia?

A

Anti-intrinsic factor AB

47
Q

How do you investigate leukaemia?

A

bone marrow aspirate under microscopy

48
Q

What is the numerical definition of acute leukaemia?

A

> 20% of bone marrow cells being blasts

49
Q

What type/part of AB is Bence Jones protein?

A

Light chain

50
Q

Why do you get bence jones proteins?

A

Myeloma cells produce them