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Finals > Haematology > Flashcards

Haematology Flashcards

1
Q

How does hereditary spherocytosis present?

A
  • Anaemia
  • Jaundice
  • Splenomegaly
  • Pigment gallstones
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2
Q

Describe the management of hereditary spherocytosis

A
  • Folic acid
  • Transfusion
  • Splenectomy (if very severe anaemia)
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3
Q

How does G6PD present?

A
  • Anaemia
  • Neonatal jaundice
  • Splenomegaly
  • Pigment gallstones
  • Drug, broad bean or infection precipitated jaundice and anaemia
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4
Q

How does sickle cell disease present?

A
  • Bone crisis
  • Chest crisis
  • Stroke
  • Increased infection risk (hyposplenism)
  • Gallstones
  • Aplastic crisis
  • Sequestration crisis: spleen and liver
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5
Q

Describe the management of a sickle cell crisis

A
  • Analgesia (opiates and NSAIDs)
  • Hydration
  • Oxygen
  • Blood transfusion
  • Consider antibiotics
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6
Q

Name some of the treatment options for sickle cell disease

A
  • Vaccinations
  • Penicillin
  • Folic acid
  • Blood transfusion
  • DMARDs: hydroxycarbamide
  • Bone marrow transplantation
  • Gene therapy
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7
Q

What is beta thalassaemia major?

A
  • No beta chains

- Transfusion dependent anaemia

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8
Q

What is thalassaemia minor?

A
  • Carrier state

- Hypochromic microcytic red cell indices

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9
Q

How does beta thalassaemia major present?

A
  • Severe anaemia
  • Ineffective bone marrow
  • Bony deformities
  • Splenomegaly
  • Growth retardation
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10
Q

How is beta thalassaemia major managed?

A
  • Chronic transfusion support
  • Iron chelation therapy (s/c desferrioxamine)
  • MRI scans
  • Bone marrow transplantation
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11
Q

What investigations might be done for the different types of anaemia?

A
  • Microcytic: ferritin
  • Normocytic: reticulocyte count
  • Macrocytic: B12, folate and bone marrow
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12
Q

Name the causes of a microcytic anaemia with a normal ferritin

A
  • Thalassaemia
  • Secondary anaemia
  • Sideroblastic anaemia
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13
Q

Name the causes of a normocytic anaemia with an increased reticulocyte count

A
  • Acute blood loss

- Haemolysis

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14
Q

Name the causes of a normocytic anaemia with a normal or low reticulocyte count

A
  • Secondary anaemia
  • Hypoplasia
  • Marrow infiltration
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15
Q

Name some of the causes of a haemolytic anaemia

A
  • Congenital
  • Autoimmune
  • Mechanical e.g. artificial valve
  • Severe infection/DIC
  • PET/HUS/TTP
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16
Q

Describe the management of haemolytic anaemia

A
  • Folic acid
  • Immunosuppression
  • Splenectomy
  • Treat causes
  • Transfusion
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17
Q

Name the causes of megaloblastic anaemia

A
  • B12 deficiency

- Folate deficiency

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18
Q

Name the causes of non-megaloblastic macrocytic anaemia

A
  • Myelodysplasia
  • Marrow infiltration
  • Drugs
19
Q

Which drugs are given as prophylaxis for neutropenic sepsis in haematological malignancy?

A
  • Ciprofloxacin
  • Fluconazole
  • Aciclovir
  • Co-trimoxazole
20
Q

How does neutropenic sepsis present?

A
  • Fever
  • Rigor
  • Chest infection/pneumonia
  • Cellulitis
  • UTI
  • Septic shock
21
Q

How can neutropenic sepsis be managed?

A
  • Resuscitate
  • Tazocin + Gentamicin +/-vancomycin or tecoplanin
  • Antifungal if no response within 72 hours
  • CT CAP
22
Q

Name the types of transfusion reactions

A
  • Transfusion associated dyspnoea
  • Transfusion related lung injury
  • Transfusion associated circulatory overload
  • Transfusion associated graft vs host
23
Q

What is Factor V Leiden ?

A
  • A autosomal dominant mutation in the gene for Clotting factor V
  • Causes a hypercoagulable state
24
Q

How can Factor V Leiden be managed?

A

Anticoagulation after VTE

25
Q

How can DIC be managed?

A
  • Platelet +/- plasma transfusion +/- cryoprecipitate

- Heparin

26
Q

What type of bleeding is found in platelet disorders?

A
  • Epistaxis
  • Purpura
  • Menorrhagia
  • GI
27
Q

What type of bleeding is found in coagulation factor disorders?

A
  • Articular

- Muscle

28
Q

How do Haemophilia A and B present?

A
  • X linked (majority boys)
  • Haemarthrosis
  • Muscle haematoma
  • CNS bleeding
  • Retroperitoneal bleeding
  • Post surgical bleeding
  • Reduced Factor VIII or FIX
29
Q

How can Von Willebrand disease be managed?

A
  • VWF concentrate

- DDAVP (desmopressin)

30
Q

How can ITP be managed?

A
  • Steroids
  • IV IgG
  • Splenectomy
  • Thrombopoietin analogues (romiplostim)
31
Q

How does AML present?

A
  • Bone marrow failure
  • Hepatomegaly and splenomegaly
  • Petechiae
32
Q

How does ALL present?

A
  • Fatigue
  • Malaise
  • Headache
  • Fever
  • Bone marrow failure
  • Recurrent infections
  • Bone pain
33
Q

How does CLL present?

A
  • Immune deficiency
  • Lymphadenopathy
  • Splenomegaly
  • Petechiae
  • Fatigue
34
Q

How does CML present?

A
  • Fatigue
  • Night sweats
  • Weight loss
  • Early satiety or abdominal distension
  • LUQ pain (splenic infarction)
  • Hepatosplenomegaly
  • Lymphadenopathy
  • Easy bruising
  • Gout
35
Q

Name the B symptoms of Lymphomas

A
  • Night sweats
  • Weight loss
  • Fever
36
Q

How are lymphomas staged?

A
  • Stage 1: lymphoma in one group of nodes
  • Stage 2: 2 or more groups of nodes on the same side of the diaphragm
  • Stage 3: lymph nodes on both sides of the diaphragm
  • Stage 4: lymphomas outside the lymphatic system or in thebone marrow
  • B for any B symptoms
37
Q

What is a myeloma?

A

Neoplastic disorder of plasma cells resulting in excessive production of a single type of immunoglobulin

38
Q

How does myeloma present?

A
  • Bone lesions, pathological fractures and cord compression
  • Hypercalcaemia
  • Bone marrow failure
  • Infections
  • Renal failure
39
Q

How can haemachromatosis be managed?

A
  • Venesection
  • Desferrioxamine mesilate
  • Vitamin C
40
Q

How can hyposplemism/splenectomy be managed?

A
  • Immunisations

- Phenoxymethylpenicillin/ amoxicillin/ erythromycin

41
Q

Name three examples of myeloproliferative disorders

A
  • Chronic idiopathic myelofibrosis (scar tissue in the bone marrow)
  • Polycythaemia Vera (excessive production of RBCs)
  • Essential thrombocythaemia (raised platelets)
42
Q

What is pancytopenia?

A

A reduction in red cells, white cells and platelets

43
Q

What is polycythaemia?

A

A increased concentration of red blood cells

Finals (18 decks)

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