Haematology

Question 1

Thrombocytopaenia signs and symptoms

Answer 1

Low platelet count 
Bruising 
Bleeding gums
Epistaxis 
GI bleeding

Question 2

Thrombocytopaenia causes

Answer 2

Decreased platelet production - malignancy, viral infection, alcohol, chemo, pernicious anaemia, aplastic anaemia

Increased platelet destruction - autoimmune, sepsis, disseminated intravascular coagulation, drugs, HELLP syndrome, trauma

Sequestering due to splenomegaly - Lysosomal storage disease, liver disease, malignancy, malaria

Question 3

Crossmatching

Answer 3

Adding recipients plasma to donors RBCs to check if there is an antibody-antigen reaction

Question 4

Disseminated intravascular coagulation lab findings

Answer 4

Low platelets 
High PT
Low fibrinogen 
Elevated DD 
Depleted clotting factors V, VIII, X and XIII

Question 5

Aplastic anaemia lab findings

Answer 5

Pancytopaenia (reduced RBC, WBC and platelets)

Hypocellular bone marrow with no abnormal cells

Question 6

Causes of iron deficient anaemia

Answer 6

Impaired absorption (e.g. coeliac, GI surgery)

Malnutrition

Iron loss through bleeding (e.g. GI bleed, menorrhagia)

Increased iron demand due to pregnancy or lactation

Question 7

Lab findings in iron deficient anaemia

Answer 7

Hb low 
Platelets normal or elevated 
MCH, MCV and MCHC low 
Reticulocytes low
RDW elevated 
Iron, ferritin and trans-ferritin low

Test for coeliacs
Test for H.pylori
Urinalysis for blood

Question 8

Type of anaemia caused by iron deficiency

Answer 8

Microcytic, hypochromic

Question 9

Type of anaemia causes by folate deficiency

Answer 9

Megablastic macrocytic anaemia

Question 10

Lab findings in folate deficient anaemia

Answer 10

Hb low
MCV and MCH high
Folate low
Hypersegmented neutrophils

Make sure to test B12 before commencing folate treatment as it can mask it!

Question 11

Type of anaemia causes by B12 deficiency

Answer 11

Megablastic macrocytic anaemia

Question 12

Causes of B12 deficiency

Answer 12

Poor dietary intake
Malabsorption - CD, short gut, SIBO, surgery
Pernicious anaemia - autoimmune destruction of parietal cells leading to low intrinsic factor

Question 13

Lab tests in B12 deficiency

Answer 13

FBC may show elevated MCV and low haematocrit but can also be normal

Blood smear shows hypersegmented polymorphonucleated cells and magalocytes

Intrinsic factor and/or anti-parietal cell antibody may be positive

Question 14

Neutrophilia

Answer 14

Raised neutrophils

Question 15

Causes of neutrophilia

Answer 15

Increased production (primary) - CML, AML, myelodysplastic neoplasm, hereditary etc.

Increased production (secondary) - Infection, inflammation, anaemia, solid tumour malignancy

Demargination - stress, drugs

Question 16

Causes of neutropenia

Answer 16

Congenital
Acute lymphocytic leukaemia
Lymphoma  
Immunodeficiency 
Infection 
Radiation 
Drugs

Question 17

Causes of lymphocytopaenia

Answer 17

AIDS/HIV
Malnutrition 
Iatrogenic from chemo or radio
SCID
Lymphoma
AI diseases such as SLE