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Haem COPY Flashcards

1
Q

Smear cells

A

CLL

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2
Q

Philadelphia chromosome

A

9:22
BCR-ABL
CML (but can be associated with AML/ALL)
Imatinib (TK inhibitor)

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3
Q

Auer rods

A

AML

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4
Q

Tear drop poikilocytes and JAK2

A

Myelofibrosis

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5
Q

pruritis and raised haemoglobin after shower (aquagenic pruritis)

A

Polycythaemia (Rubra) Vera

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6
Q

Acute promyelocytic leukemia (APML)

  • translocation and its name
  • common presentation
A

t(15:17)
PML-RARA translocation
Still has Auer rods like AML

Presents with bleeds (DIC common)

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7
Q

61yo with CLL

Presents with pneumonia, haemoptysis, endobronchial mass, anaplastic large cell lymphoma

A

Richter’s transformation
Diffuce B cell Lymphoma (DBCL)

Sheets of large lymphoid cells

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8
Q

Clumsiness, progressive weakness, personality change after chemo

A

Progressive multifocal leukencephalopathy (JC virus)

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9
Q

Massive splenomegaly (classically which leukemia? which other haem condition?)

A

CML, Myelofibrosis

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10
Q

High calcium, CLOVER LEAF nuclei, LNs

A

Adult T cell Lymphoma

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11
Q

HTLV-1

A

Adult T cell Lymphoma

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12
Q

Paraprotein IgM

A

Waldenstroms macroglobulinaemia

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13
Q

Paraprotein IgG

A

Multiple Myeloma (or MGUS or Smouldering depending on blasts and symptoms)

<30g/dl IgG and <10% blasts for MGUS
>30g/dl IgG and >10% blasts for SM or MM

Only MM is CRAB Sxs

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14
Q

AA vs AL amyloidosis

A

AA = Chronic illness e.g. RA, IBD

AL = Multiple Myeloma

Amyloidosis is a paraproteinaemia!! Can see raised paraproteins (often less than 30)

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15
Q

Post transplant EBV

A

PTLD (Post transplant lymphoproliferative disease)

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16
Q

Anaplastic lymphom

A

Alk 1

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17
Q

Past histort of DVT, easy bruising, LOADS of platelets

A

ET (essential thrombocythaemia)

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18
Q

Pregnant woman with low platelets, schistocytes, neuro sxs (headache and seizures), but LOW BP

A

TTP

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19
Q

Pregnant patient with slightly low platelets in 3rd trimester (asymptomatic)

A

Gestational thrombocytopenia (not same as physiological but it is benign and no tx is needed. It is the most common cause of low platelets in pregnancy. If platelets <70 think HELLP or ITP)

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20
Q

Can’t breathe and DIC

A

Amniotic fluid embolism

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21
Q

Normal heam values in preg for

  • Hb
  • MCV
  • WCC
  • Platelets
  • Plasma volume
A

Normal heam values in preg for

  • Hb low
  • MCV normal or high (macrocytosis)
  • WCC high
  • Platelets low
  • Plasma volume high
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22
Q

Prolonged APTT, normal PT, prolonged bleeding time

A

vWD

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23
Q

Prolonged APTT, normal PT, normal bleeding time

A

Haemophilia

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24
Q

INR Targets

  • AF/cardioversion
  • MI!!
  • Single DVT
  • Recurrent DVTs
  • Prosthetic valve
A

INR Targets

  • AF/cardiov 2.5
  • MI 2.5
  • Single DVT 2.5
  • Recurrent DVTs 3.5
  • Prosthetic valve 3.5

Lower = more clots
INR within 0.5 of target is satisfactory

Rule of thumb - everything except recurrent DVTs/PEs and some prosthetic valves is 2.5 target!

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25
Is heparin intrinsic/extrinsic pathway and APTT or PT
intrinsic pathway and APTT
26
Is warfarin intrinsic/extrinsic pathway and APTT or PT
Extrinsic and PT
27
Anaemic with frontal bossing and XR: hairs on end
Thalassaemia
28
osmotic fragility
hereditary spherocytosis
29
Membrane defect RBCs
Spectrin deficiency --> hereditary sphero/elliptocytosis
30
Heinz bodies
G6PD
31
Warm haemolytic anaemias 1. antibody type 2. blood film 3. causes
1. IgG 2. Spherocytes 3. CLL, SLE, methyldopa
32
Cold Agglutinin disease (Cold HA) 1. antibody type 2. Associated with 3. causes
1. IgM 2. Raynaud's 3. Mycoplasma, EBV
33
Donath-Landsteiner antibodies
Paroxysmal cold haemoglobinuria (PCH)
34
Ham's test or immunophenotype
Paroxysmal nocturnal haematuria | complement mediated, morning haematuria
35
Hypercellular BM
CML (but maybe other leukemias too)
36
Prognostic factors in CLL
Good: hypermutated Ig gene, 13q14 deletion Bad: CD38+ve, 11q23, 17p, LDH raised
37
Owl eyed cells
Reed Sternberg | HL
38
What would you give these patients (transfusion)? 1. triple AAA surgery 2. C/S 3. Past transfusion, allergy to plasma proteins
1. X-match 2. G&S 3. Washed red cells
39
Transfusion | Acute SOB, dry cough, hypoxia
TRALI
40
Transfusion | Febrile with collapse
Bacterial infection
41
Transfusion | RTA, jaundice and anaemia a few days later
Delayed haemolytic reaction
42
Thalaessaemia pt with tan and diabetes
Haemosiderosis (focal iron overload)
43
SCC pt with short stature and poor cardiac function
Iron overload
44
Old lady gets 4 units of blood and feels unwell + basal creps+ankle oedema
Fluid overload
45
Seizures and schistocytes
TTP
46
Pelger Huet cells, hyposegmented neutrophils
MDS
47
>20% blasts
leukemia
48
haemolysis after antimalarials
G6PD
49
6 features of myelofibrosis
1. pancytopenia 2. leucoerythroblastic picture 3. Massive splenomegaly 4. dry tap 5. tear drop (poikilocytes/dacrocytes) 6. Some are JAK2+
50
Cabot rings
Megaloblastic anaemia
51
Factor V Leiden pathogenesis
Impaired degradation of factor V by protein C
52
Buerger disease
Vasculitis in smokers (corkscrew arteries)
53
Dry cough, dyspnoea and fever post transfusion
TRALI
54
Tartrate resistance acid phosphatase (TRAP) ass with which condition?
Hairy cell leukemia
55
Clover leaf appearance and high calcium
Adult T cell lymphoma
56
Smudge/smear cells
CLL
57
Bleeding and thrombosis with high platelets
Essential | Thrombocythaemia
58
ET treatment
Hydroxyurea + anagrelide
59
Macrocytic anaemia and stomatitis
B12 deficiency
60
Pregnant greek patient with father who is on warfarin and sister had a DVT
Antithrombin III deficiency
61
Transfusion in past with allergy plasma proteins
Washed red cells
62
Sickle cell transfusion
?Group in C,E,K crossmatch/anti-CcRR Abs
63
Splenectomy is useful in | The PIIES - what does the acronym stand for?
Thalessaemia ``` Pyruvate kinase deficiency ITP Immune HA Elliptocytosis Spherocutosis ```
64
Cold AI HA causes
Cold LID Lymphoproliferative disease (lymphomas and leukaemias) Infections (mycoplasma/EBV) Don’t know (idiopathic)
65
PNH Signs
PNH is also the acronym Pancytopenia New thrombus Haemolytic anaemia
66
Basophilic stripping
ß-thal and lead poisoning
67
Acanthocytes 1. another name 2. when do you see?
1. Spur cells | 2. Hyposplenism
68
Anisopoikilocytosis 1. meaning 2. conditions associated
1. different size and shapes (respectively) 2. anaemias e.g. IDA ßthal hereditary spherocytosis B12 deficiency
69
Target cells seen in which 3 conditions?
3 Hs Hepatic pathology Hyposplenism Haemoglobinopathies
70
Paroxysmal cold haemoglobinuria
Children, acute onset haemolysis in cold temperatures
71
Aplastic anaemia causing drugs (4)
4 C's Carbamazepine Chloramphenicol Cytotoxics anti-Convulsants (e.g. phenytoin)
72
ALP in MM
NORMAL despite bone lesions (but raised calcium) MM activates osteoclasts but shuts off ALP producing osteoblasts hence just destruction and no rebuilding which would cause the raised ALP
73
TTP signs and symptoms
MARCH Low platelets ``` MAHA A fever Renal failure CNS signs --> seizures etc. Haematuria/proteinuria ```
74
Massive transfusion with low platelets after
Happens if you don'T replace platelets too
75
Smoker with COPD, high Hb and Hct (low plasma volume)
Combined polycythaemia | high plasma volume AND high Hb
76
Polycythaemia and not dehydrated, what happens to RBC mass?
Increases
77
ßthal minor presentation
35 year old with tiredness
78
Mild vWD - which drug can they take before seeing the dentist?
Desmopressing (releases intracellular store of vWF)

Path Past Papers (38 decks)

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