Haematology Flashcards

1
Q

What is the definition of anaemia?

A

Low haemoglobin (Hb) concentration due to low red cell mass or increased plasma volume

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2
Q

Which symptoms can commonly present in all caused of anaemia

A

Fatigue, faintness, dyspnoea, headache, tinnitus, anorexia

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3
Q

What are the signs of severe anaemia

A

Tachycardia, flow murmurs, cardiac enlargement

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4
Q

List the causes of microcytic anaemia (3)

A

Iron-deficiency anaemia
Thalassaemia
Sideroblastic anaemia

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5
Q

List the causes of normocytic anaemia (5)

A
Acute blood loss
Anaemia of chronic disease
Bone marrow failure
Renal failure
Pregnancy
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6
Q

List the causes of macrocytic anaemia (7)

A
B12/Folate deficiency
Alcohol excess / liver disease
Reticulocytosis
Cytotoxics
Myelodysplastic syndromes
Marrow infiltration
Antifolate drugs
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7
Q

What are the signs of iron deficiency?

A

Microcytic anaemia
Brittle hair and nails
Atrophic glossitis
Angular stomatitis

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8
Q

A patient is diagnosed with iron deficiency anaemia. What would you expect their serum ferritin to be?

A

Low

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9
Q

What are the signs of B12 deficiency?

A

Macrocytic anaemia

Neurological problems

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10
Q

What are the signs of haemolysis?

A

Normo or Macrocytic anaemia
Jaundice
Gall stones
Leg ulcers

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11
Q

What are the signs/symptoms of aplastic anaemia?

A

Pancytopenia
Increased susceptibility to infection
Increased susceptibility to bleeding/bruising
Fatigue, faintness, palpitations, headache

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12
Q

How is aplastic anaemia treated?

A

Remove causative agent
Platelet and blood transfusions
Unresponsive: immunosuppression +/- bone marrow transplant

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13
Q

What is the mechanism of sickle cell anaemia?

A

Changes in structure of alpha-haemoglobin. Faulty Hb complex. Distorted shape of RBCs when deoxygenated. Sickle RBCs are easily destroyed and occlude vessels.

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14
Q

How does sickle cell anaemia present?

A

Childhood: pain in hands and feet due to vessel occlusion.
Can lead to avascular necrosis
Anaemia: fatigue, faintness, palpitations, headache

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15
Q

How is sickle cell anaemia managed?

A

Folic acid supplementation
Pain relief
Bone marrow transplant (severe)

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16
Q

What causes thalassaemia?

A

Defective alpha or beta haemoglobin subunit.

17
Q

How and when does each type of thalassaemia present?

A

Alpha - Neonatal
Beta - Infancy
Heterozygote can be asymptomatic
Homozygote - severe anaemia, failure to thrive, bone deformities

18
Q

What is the mechanism of glucose-6-phosphate dehydrogenase deficiency?

A

Lack of enzyme that maintains glutathione, which protects against oxidant injury in the RBCs.
G6PD deficiency therefore = increased haemolysis

19
Q

How does glucose-6-phosphate dehydrogenase deficiency present?

A

Neonatal jaundice
Haemolytic anaemia
Acute haemolysis

20
Q

What is polycythaemia vera (pathophysiology)?

A

Malignant proliferation of a clone derived from one pluripotent stem cell. Excess proliferation of RBCs, WBCs and Platelets.

21
Q

How is polycythaemia vera investigated

A

JAK2 gene mutation in 95%

High haematocrit

22
Q

How does polycythaemia vera present?

A

Incidental finding on FBC
Hyperviscocity - headaches, dizziness, tinnitus, visual disturbance
Facial plethora
Splenomegaly

23
Q

How is polycythaemia vera managed?

A

Low risk - Venesection

Older/high risk - hydroxycarbamide

24
Q

What is the mechanism of hydroxycarbamide?

A

Decreases the production of DNA.

25
Q

How does deep vein thrombosis present?

A
Can progress to PE as presentation
Limb pain
Tenderness
Calf swelling
Increase in limb temperature
Pitting oedema
26
Q

What are the risk factors for DVT?

A
Obesity
Family history
Male
Smoking
Increased age
Cancer
27
Q

Which score and test can be used to rule out DVT?

A

Well’s score

D-dimer

28
Q

How is DVT managed?

A

Low molecular weight heparin or other anticoagulant medication

29
Q

Describe immune thrombocytopenia (ITP)

A

Caused by antiplatelet antibodies.

May be acute or chronic

30
Q

What is the course of chronic immune thrombocytopenia?

A

Fluctuating course of bleeding, purport, epistaxis and menorrhagia

31
Q

How can immune thrombocytopenia be investigated?

A

Bone marrow biopsy shows increased megakaryocytes