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Haematology > Haem from questions > Flashcards

Haem from questions Flashcards

1
Q

Target cells, howell-joly bodies, Pappenheimer bodies

siderotic granules, acanthocytes

A

Hyposplenism - post-splenectomy

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2
Q

target cells and ‘pencil’ poikilocytes

A

Iron deficiency anaemia

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3
Q

‘tear-drop’ poikilocytes

A

Myelofibrosis

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4
Q

schistocytes

A

Intravascular haemolysis

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5
Q

hypersegmented neutrophils

A

megaloblastic anaemia

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6
Q

What is Feltys syndrome

A

Splenomegaly and neutropenia in RA patient

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7
Q

4 types of hodgkins lymphoma and prognosis

A

nodular fibrosing - good prognosis (70% are this)
mixed cellularity - good prognosis (20%)
lymphocyte deplete - worst prognosis - rare
lymphocyte predominant - best prognosis (5%)

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8
Q

What is rouleaux formation on blood film

A

In multiple myeloma

red cells aligned and resemble stacks of coins

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9
Q

Differences between ALL and AML

A

ALL - organ infiltration eg. hepatosplenomegaly, testicular, eye problems, CN problems
AML - tissue infiltration eg. skin rashes, gum hypertrophy, CNS involvement

ALL - young, AML - adult

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10
Q

FBC in ALL and AML

A

normochromic normocytic anaemia
low platelets
WCC variable
Uric acid and LDH raised

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11
Q

Features of CLL

A

Benign nature in many - 80% picked up on routine blood tests

Otherwise widespread painless lymphadenopathy over months/years - splenohepatomegaly

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12
Q

Blood tests and blood film in CLL

A

lymphocytosis in blood count

Blood film - small lymphocytes - many which disrupted to form smear/smudge cells

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13
Q

Presentation of CML

A

Chance finding in 20%

Otherwise weight loss, gout, anaemia, splenomegaly (common)

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14
Q

Tests in CML

A

White cell count raised plus raised basophils and eosinophils

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15
Q

Treatment of CLL and CML

A

CLL can watch and wait depending on blood count
CML urgent referral to haematology for treatment with chemo or tyrosine kinase inhibitors (if less than 10% of cells in bone marrow are blasts - occurs 90% of time)

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16
Q

Features of Burkitts lymphoma

A

Common in childhood
Related to EBV in Africa
Peak age 5-10y
Presents with bulky central node disease with or without extra nodal disease (usually abdomen), bone marrow and CNS involvement

17
Q

Features of mantle lymphoma

A

Although low-grade, behaves as high grade
Affects adults with widespread disease
Poor prognosis

18
Q

Lymphoplasmacytic lymphoma features

A

Also called Waldenstrom’s macroglobulinaemia. B-cell lymphoma. Average age at presentation is 63y
Often presents late with lymphadenopathy, splenomegaly, and bone marrow involvement. May spread to the lung or GI tract.
Usually associated with paraproteinaemia (IgM)

19
Q

Features of hodgkins lymphoma

A

Typical presentation of night sweats, fever and weight loss, pruritis
splenomegaly in 30%

20
Q

What increases Prothrombin time (PT)

A

Coumarins (e.g. warfarin); vitamin K deficiency; liver disease

21
Q

What increases activated partial thromboplastin time (APTT)

A

↑ in heparin treatment, haemophilia, anti-phospholipid syndrome, or DIC

22
Q

Post-DVT management

A

3 months anti-coagulant if provoked

6months if not provoked

23
Q

Do platelets, packed red cells, fresh frozen plasma and cryoprecipitate need to be crossmatched

A

Platelets - no

packed red cells, FFP, cryoprecipitate - need to be crossmatched

24
Q

Management if active bleeding and on warfarin

A

Stop warfarin
Vit K
Prothrombin complex concentrate (FFP if not available)

25
Q

Management if INR over 8 and minor bleeding on warfarin

A

Stop warfarin
give IV Vit K - repeat vit k after 24h if INR not better
restart warfarin when INR below 5

26
Q

Management if INR over 8 and no bleeding on warfarin

A

Stop warfarin
give ORAL Vit K - repeat vit k after 24h if INR not better
restart warfarin when INR below 5
(oral only change from minor bleed)

27
Q

INR 5-8 on warfarin - minor bleed

A

Stop warfarin
IV vit k
Restart when below 5

28
Q

INR 5-8 on warfarin - no bleed

A

withhold 1-2 doses of warfarin and reduce subsequent continuance dose

29
Q

Clotting studies in haemophilia

A

bleeding time, PT normal

APTT prolonged

30
Q

First-line investigation for Polycythaemia rubra vera

A

JAK2

then red cell mass if JAK2 negative

31
Q

Hypercoagulability, hyperviscosity, IgM, hepatosplenomegaly, weight loss, lethargy, lymphadenopathy
In an older man
Without bone lesions or hypercalcaeia

A

WALDENSTROM MACROGLOBULINEMIA

32
Q

Difference between painless and painful glossitis

A

Painful - megaloblastic anaemia ie. b12 and folate

Painless - iron deficiency

Haematology (6 decks)

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