Haematological Histories Flashcards
What are the sx of anaemia?
Fatigue
SOB
Reduced exercise tolerance
Light headedness
Worsening angina
Ankle swelling
What are constitutional sx?
Fatigue
Lethargy
Malaise
Wt loss
Night sweats
What are the sx of neutropenia?
Mouth ulcers
Skin infections
Other recurrent infections
What are sx of bleeding diathesis?
Easy bruising
Epistaxis
Gum bleeding
Joint pain / swelling
What are the sx of lymphoma?
Enlarged / painful lymph nodes
Painful splenomegaly
B symptoms
What are the sx of hyperviscosity
Neuropathy
Epistaxis
Blurred vision
Headache
What are the sx of thromboembolism
Limb pain / swelling
Chest pain
SOB
Palpitations
What do you want to ask in the HPC in a haem hx?
SOCRATES
TIMELINE
ASSO SX
What do you want to ask in the PMH in a haem hx?
Any medical cond?
management of them?
Haematologic malignancy - AML, ALL, CML, CLL, myeloma, lymphoma
Myeloproliferative neoplasms - polycythaemia vera, essential thrombocytosis, myelofibrosis
Myelodysplastic syndrome
Anaemias - aplastic anaemia, iron deficiency Anaemia, anaemia of chronic disease, haemolytic anaemia, thalassaemias, sickle cell anaemia
Bleeding disorders - haemophilias, Von Willebrand disease
Thrombotic disorders - DVT / PE, antiphospholipid syndrome
Platelet disorders - ITP, DIC, TTP, HUS, HELLP, HITS
Haemochromatosis
Amyloidosis
Ask about a history of recurrent infections, which suggests immunosuppression and may occur in patients with neutropaenia.
Also ask about excessive bleeding or bruising in the past, which may be a symptom of platelet disorders or coagulopathy.
Transfusion History - blood comp or all comp?
Transplant History ?autologous or allogeneic stem cell transplant in the past.
What do you want to ask in the DHx in a haem hx?
Regular meds?
Why?
SE?
Common haem SE
- Bleeding - NSAIDs, antiplatelets, SSRIs
- Thrombosis - oral contraceptives, hormone replacement,
- COX-2 inhibitors, erythropoietin, warfarin (initially)
- Neutropaenia - NSAIDs, antipsychotics, anticonvulsants,
antithyroid drugs, antibiotics, chemotherapy
- Neutrophilia - corticosteroids, adrenaline, lithium, G-CSF
What do you want to ask in the FHx in a haem hx?
Haematological malignancy
AML / ALL / CML / CLL / Myeloma / Lymphoma
Inherited haematologic disorders
Haemochromatosis / Haemophilia, Von Willebrand’s disease
/ thalassaemia
What do you want to ask in the SHx in a haem hx?
Occupation
Living situation
Mobility
ADLs
Diet and exercise
?VTE -> recent long-haul travel -> particularly long flights.
Alcohol intake -> bone marrow suppression / myelodysplasia.
Smoking
Recreational drug use
