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Finals Revision > Haem blood test patterns > Flashcards

Haem blood test patterns Flashcards

1
Q

Iron deficiency anaemia:

  • Iron
  • Ferritin
  • TIBC
  • Transferrin saturation
  • Film
  • Reticulocytes
A 
Iron - low
Ferritin - low
TIBC - high
Trans sat - low
Film - microcytosis, hypochromia
Reticulocytes - low
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2
Q

Anaemia of chronic disease:

  • Iron
  • Ferritin
  • TIBC
  • Film
  • Reticulocytes
A 
Iron - low
Ferritin - high
TIBC - low
Film - normocytic OR microcytic
Reticulocytes - low
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3
Q

Sideroblastic anaemia:

  • Iron
  • Ferritin
  • TIBC
  • Transferrin saturation
  • Film
  • Marrow
A 
Iron - high
Ferritin - high
TIBC - normal
Trans sat - high
Film - hypochromic microcytic
Marrow - ring sideroblasts
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4
Q 
Alpha Thalassaemia:
- Iron
- Ferritin
- TIBC
- Transferrin saturation
- Film
- Reticulocytes
(HPLC if HbH?)
A 
Iron - normal/high
Ferritin - normal/high
TIBC - normal
Transferrin saturation - normal
Film - microcytic hypochromic, Heinz bodies, Target cells
Reticulocytes - High
(HPLC - low HbA, HbA2, HbF, high HbH)
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5
Q

Beta Thalassaemia:

  • Iron
  • Ferritin
  • TIBC
  • Transferrin saturation
  • Film
  • Reticulocytes
  • HPLC
  • Skull XR
A 
Iron - normal
Ferritin - normal
TIBC - normal
Transferrin sat - normal
Film - microcytic hypochromic, target cells, nucleated RBC's
Reticulocytes - high
HPLC - low HbA, high HbA2 and HbF
Skull XR - hair on end sign
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6
Q

B12/Folate Deficiency:

  • Iron
  • Ferritin
  • TIBC
  • Transferrin saturation
  • Film
  • Reticulocytes
  • Potential antibodies
A

Iron - normal
Ferritin - normal
TIBC - normal
Trans sat - normal
Film - macrocytosis, hypersegmented neutrophils, macroovalocytes. Target cells if from liver disease.
Reticulocytes - may/may not be present
Ig - anti-patietal cell, anti-intrinsic factor

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7
Q

Haemochromatosis:

  • Iron
  • Ferritin
  • TIBC
A

Iron - high
Ferritin - high
TIBC - normal/low

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8
Q

ITP:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Additional?
A 
PT - normal
aPTT - normal
TT - normal
PLT - LOW
Bleeding time - HIGH
Add - autoantibodies
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9
Q

TTP:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Additional?
A 
PT - normal
aPTT - normal
TT - normal
PLT - LOW
Bleed time - HIGH
Add - MAHA, low Hb, fever, schistocytes, high LDH
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10
Q

Abnormal PLT:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • When does this happen?
A

all normal but

Bleed time HIGH

due to aspirin/other anti-platelet OR high urea

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11
Q

von Willebrand Disease:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Additional?
A 
PT - normal
aPTT - HIGH
TT - normal
PLT - normal
Bleed time - HIGH
Add - Low factor 8, autoantibodies
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12
Q

Haemophilia:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Additional?
A 
PT - normal
aPTT - HIGH
TT - normal
PLT - normal
Bleed time - normal
Add - Low factor 8/9
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13
Q

Liver Disease:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Additional?
A 
PT - HIGH
aPTT - HIGH
TT - normal or HIGH
PLT - normal or HIGH
Bleed time - normal or HIGH
Add - Abnormal LFTs, may be macrocytosis or target cells
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14
Q

DIC:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Additional?
A 
PT - HIGH
aPTT - HIGH
TT - HIGH
PLT - LOW
Bleed time - HIGH
Add - High D-dimers, low Hb
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15
Q

Warfarin:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Reversal?
A 
PT - HIGH (higher than aptt)
aPTT - HIGH
TT - normal
PLT - normal
Bleed time - normal
Reversal - 4-factor complex concentrate
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16
Q

Heparin:

  • PT
  • aPTT
  • TT
  • PLT
  • Bleed time
  • Reversal?
A 
PT - HIGH
aPTT - HIGH (higher than PT)
TT - HIGH (higher than PT)
PLT - normal
Bleed time - normal
Reversal - Protamine
17
Q

3 causes of warm haemolytic anaemia?

A

Autoimmune e.g. SLE
Neoplasia e.g. CLL, Lymphoma
Drugs e.g methyldopa

18
Q

2 causes of cold haemolytic anaemia?

A

Neoplasia e.g. lymphoma

Infection e.g. EBV, mycoplasma

19
Q

Causes of normocytic anaemia? (7)

A 
Chronic disease
Aplastic anaemia
Haemolysis
Sickle cell
Leukaemia
Mixed Iron and B12 deficiency
Increased plasma volume e.g. pregnancy, fluid resuscitation after haemorrhage
20
Q

Causes of microcytic anaemia? (

A 
Iron deficiency
Thalassaemia
Sideroblastic
Lead poisoning
Chronic disease (but this is normally normocytic)
21
Q

Types of Macrocytosis and causes?

A

Megaloblastic:
- B12/folate deficiency or chemo - also presence of macroovalocytes and hypersegmented neutrophils

Non-Megaloblastic:

  • alcohol
  • hypothyroidism
  • pregnancy
  • liver disease
  • marrow failure
  • reticulocytosis
  • -> these can be assoc with anaemia or just isolated macrocytosis
22
Q

Causes of target cells?

A

Liver disease
Hyposplenism
Thalassaemia (alpha or beta)
Iron deficiency

23
Q

Cause of Howell Jolly bodies?

A

Hyposplenism

24
Q

Causes of Heinz bodies?

A 
G6PD deficiency
Alpha thalassaemia (HbH)
Chronic liver disease
25
Q

Intrinsic causes of haemolytic anaemia? (3)

A
  • Membrane problem - e.g. spherocytosis
  • Haem problem - e.g. thalassaemia, sickle cell
  • Metabolic problem - e.g. G6PD deficiency
26
Q

Extrinsic causes of haemolytic anaemia? (4)

A
  • Autoimmune - e.g. SLE, RA
  • Splenomegaly - any cause e.g. cirrhosis, Felty’s syndrome
  • Vascular damage - burns, vasculitis
  • Infection - malaria
27
Q

Common to both intravascular and extravascular haemolysis?

A

Both - Increased bilirubin and LDH

Extra - increased urinary/faecal urobilinogen (normal product in excess)

Intra - Haemoglobinaemia, haemoglobinuria (turns black), haemosiderinuria, low haptoglobin

28
Q

ALL:

  • who?
  • cells?
  • blood test?
  • marrow?
  • RF?
  • Spread?
  • Rx?
A
  • Kids
  • Lymphocyte progenitor cells
  • low Hb, low PLT, low WCC, >20% blasts
  • > 20% blasts
  • Down syndrome, radiation in pregnancy
  • CNS, testes, liver, spleen, lymph nodes
  • 2-3 years chemo
29
Q

CLL:

  • who?
  • cells?
  • blood test?
  • buzzwords?
  • RF?
  • Prognosis?
  • Rx?
A
  • adults >50
  • clonal B cell population that has undergone cell cycle arrest in G0/G1 - CD20+ (rituximab)
  • low Hb, low platelets, High WCC/lymphocytes, low other white cells
  • hypogammaglobulinaemia, smudge cells
  • autoimmune haemolytic anaemia, ITP
  • 1/3 don’t progress, 1/3 will in future, 1/3 currently doing so. Can become high-grade Non-Hodgkin’s
  • watch and wait OR chemo
30
Q

AML:

  • who?
  • cells?
  • blood test?
  • marrow?
  • buzzwords?
  • spread?
  • Rx?
A
  • adults
  • Myeloid progenitor cells
  • low Hb, low platelets, variable WCC but usually neutropaenia
  • > 20% blasts
  • AUER RODS
  • Gums, liver, spleen, lymph (NEVER TO CNS)
  • 5 cycles of chemo 1 week apart
31
Q

Acute promyelotic leukaemia:

  • translocation?
  • Rx?
A

t(15; 17)

ALTRA - all-trans retinoic acid

32
Q

CML:

  • who?
  • cells?
  • bloods?
  • marrow?
  • buzzwords?
  • progression?
  • treatment?
A
  • adults
  • granulocytes
  • low Hb, low PLT, HIGH URATE, high WCC (granulocytes)
  • Hypercellular marrow
  • Gout, Philadelphia chromosome t(9; 22) BCR-ABL
  • Chronic - 3-5 years of proliferation with maturation
  • Accelerated - maturation starts to fail and symptoms worsen
  • blast crisis - transformation to AML

Rx: Imatanib (tyrosine kinase inhibitor)

33
Q

Hodgkin’s:

  • who?
  • cells?
  • buzzwords?
  • RF?
  • Rx?
A
  • younger (15-30)
  • CD30+ B lymphocytes
  • Reed Steenberg cell, pain on drinking alcohol
  • EBV, FHx
  • Brontuximan Vedotin (anti-CD30+)
34
Q

Non-Hodgkin’s:

  • RF?
  • Cells?
  • Types and chromosomes?
  • spread?
  • Rx?
A
  • EBV, immunosuppression
  • Usually B cell - CD20+
  • Burkitt’s - t(8; 14) c-myc - African kids EBV, facial tumour, starry sky appearance
  • Follicular - t(14; 18) bcl-2 - high grade
  • mantle - t(11; 14) - low grade
  • CNS, Waldeyer’s ring, marrow, spleen, skin
  • Usually R-CHOP (R=Rituximab - CD20+)
35
Q

Leukoarythroblasts and tear-drop poikilocytes?

A

Myelofibrosis

Finals Revision (29 decks)

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