Haematology Flashcards

1
Q

What are the features of TTP

A

Features (ask the FAT RN): Fever, anaemia, thrombocytopaenia, renal impairment, neurological involvement [e.g. confusion])

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2
Q

What is the treatment of TTP?

A

Plasma exchange

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3
Q

What are thymomas associated with?

A

myasthenia gravis (30-40% of patients with thymoma)
red cell aplasia
dermatomyositis
also : SLE, SIADH

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4
Q

First line treatment CML?

A

Imatinib

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5
Q

Commonest type of hodgkin’s lymphoma

A

Nodular sclerosing

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6
Q

What’s seen on blood film in hyposplenism?

A

Howell-Jolly bodies

siderocytes

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7
Q

follicular lymphoma translocation

A

t(14;18)

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8
Q

What is the gold standard test for paroxysmal nocturnal haemaglobinuria? (COMMON Q)

A

flow cytometry of blood to detect low levels of CD59 and CD55

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9
Q

Treatment of VTE if patient has cancer?

A

6 months DOAC

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10
Q

VTE treatment length if provoked VTE?

A

DOAC Stop after 3 months (6 months if active cancer)

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11
Q

VTE treatment length in unprovoked VTE?

A

DOAC 6 months total

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12
Q

What drug is first line in VTE?

A

DOAC

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13
Q

When should you use LMWH in VTE? (i.e. when is DOAC contraindicated)

A

Severe renal impairment

Antiphospholipid syndrome

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14
Q

in haemolytic disease/anaemia, what blood level is low and why?

A

Haptoglobin (as it binds to free haemoglobin)

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15
Q

Key investigation/gold for CLL?

A

Flow cytometry (immunophenotyping)

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16
Q

What is a leukamoid reaction? how can you distinguish it from leukaemia?

A

reactive leucocytosis, often secondary to infection or inflammation

High leucocyte alkaline phosphatase (LAP)

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17
Q

what cytotoxic agent is associated with peripheral neuropathy?

A

Vincristine

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18
Q

Treatment for aplastic anaemia?

A

Supportive: blood + products
Anti-thymocyte globulin (ATG) and anti-lymphocyte globulin (ALG)
Stem cell Tx

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19
Q

In addition to vit K, what blood product should be given in emergency reversal of anticoagulation in patients with severe bleeding or a head injury?

A

Prothrombin complex concentrate

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20
Q

In major haemorrhage what blood product should be given if fibrinogen level is low <1.5?

A

Cryoprecipitate

21
Q

When should FFP be used in haemorrhage?

A

prothrombin time (PT) ratio or activated partial thromboplastin time (APTT) ratio > 1.5

22
Q

3 types of paraprotinaemias

A

myeloma
Waldenstorm’s macroglobinaemia
monoclonal gamopathy of unknown significance

23
Q

How to differentiate myeloma from Waldenstorm’s?

A

Myeloma –> hypercalcaemia, lytic bone lesions, no organomegaly, usually not IgM

Waldenstorms –> organomegaly, no lytic bone lesiosn, normal calcium, hyperviscocity (DVT)

24
Q

What is seen on blood film in myelofibrosis?

A

Tear drop poikilocytes

25
Similarities between Hereditary spherocytosis + G6PD Deficiency?
Both haemolytic anaemia may have gallstones + neonatal jaundice HS: Splenomegaly present; northern european descent G6PD: No splenomegaly + precipitant leading to haemolysis (e.g. quinolones e.g. ciprofloxacin) + middle eastern / African descent
26
Diagnostic tests for Hereditary spherocytosis?
EMA binding
27
Diagnostic tests for G6PD deficiency
Measure G6PD activity
28
When to discharge someone after anaphylaxis?
2 hours min after symptom resolution if good response to 1 dose IM adrenaline 6 hours minimum if 2 doses needed or previous biphasic reaction 12 hours minimum if >2 doses, presents at night, asthma,
29
What is the treatment for CLL? What are the indications for treatment?
FCR: fludarabine, cyclophosphamide and rituximab Indications: progressive marrow failure: the development or worsening of anaemia and/or thrombocytopenia massive (>10 cm) or progressive lymphadenopathy massive (>6 cm) or progressive splenomegaly progressive lymphocytosis: > 50% increase over 2 months or lymphocyte doubling time < 6 months systemic symptoms: weight loss > 10% in previous 6 months, fever >38ºC for > 2 weeks, extreme fatigue, night sweats autoimmune cytopaenias e.g. ITP Therefore if asymptomatic + incidental - don't treat
30
First line treatment CML?
Imatinib (tyrosine kinase inhibitor)
31
What is the best screening marker for hereditary angioedema between attacks? What about during an attack?
between: C4 (low) during attack: C1-INH level (low)
32
MoA of texanes (E.g. docetaxel)?
prevents microtubule depolymerisation & disassembly To remember: microtubules are responsible for transport in the cell, just like a TAXI ( TAXEL)
33
What is seen on blood film in DIC?
Schistocytes
34
Diagnosis of CLL
Immunophenotyping
35
what causes CLL?
monoclonal proliferation of B-cell lymphocytes
36
Hodgkin's lymphoma staging
Ann arbor I: single lymph node II: 2 or more lymph nodes/regions on same side of diaphragm III: nodes on both sides of diaphragm IV: spread beyond lymph nodes A: if no symptoms B: if symptoms
37
How to prevent tumour lysis syndrome acutely?
Rasburicase
38
Microscopy of burkitt's lymphoma
'starry sky' appearance
39
What causes burkitt's lymphoma + what translocation
EBV T(8;14)
40
What translocation in AML suggests a good prognosis?
15;17
41
In unprovoked DVT what investigation must you do?
Clotting screen
42
In haemolytic anaemias, what happens to haptoglobin?
Low (as binds to free Hb [more of this in haemolytic anaemia])
43
If very high wcc but raised leucocyte alkaline phsophatase what is the diagnosis?
Leukamoid reaction
44
How can you differentiate CML from leukamoid reaction?
Leukamoid reaction - raised leukocyte alkaline phosphatase
45
Why is factor VIII decreased in vWd?
Because vW factor carries factor VIII
46
What factor is reduced in vom willebrand disease and why?
Factor 8 as vw factor carries it
47
What is the clotting results in vWd?
APTT increased as drop in factor 8 PT normal Bleeding time increased as platelets can’t aggregate to endothelium
48
What are the clotting results in haemophilias?
Bleeding time normal (as platelets unaffected) PT normal APTT increased