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Medicine > Haematology > Flashcards

Haematology Flashcards

1
Q

What cells do myeloblasts form?

A

Basophil
Eosinophil
Neutrophil

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2
Q

What cells do lymphoblasts form?

A

Lymphocytes

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3
Q

What part of the coagulation cascade does APTT measure

A

Intrinsic patheay (factor 12 onwards)

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4
Q

What part of the coagulation cascade does prothrombin time measure

A

Extrinsic (tissue factor)

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5
Q

What factors does wayfaring effect?

A

2,7,9,10

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6
Q

Clotting results for haemophilia

A

APTT - increased
PT - normal
Bleeding time - normal

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7
Q

Clotting results of von willebrands disease

A

APTT increased
PT normal
Bleeding time increased

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8
Q

Iron results in iron deficient anaemia

A 
Transferrin increased 
Saturation decreased 
TiBC - increased 
Serum iron decreased 
Ferritin decreased
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9
Q

Blood film in folate and B12 deficiency

A

Hypersegmented neutrophils

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10
Q

Is B12 ot foliate deficiency more common?

A

B12

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11
Q

Tests for sickle cell anaemia

A 
Newborn screening - heelprick test
Hb low
Increase in reticulocytes
Blood film - sickle cells 
Hb electrophoresis
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12
Q

Complications of sickle cell disease

A

Vaso-occlusive painful crisis

  • microvascular occlusion causing distal ischaemia
  • commonly occurs when cold, infection, dehydration

Aplastic crisis

  • temporary loss of RBC production
  • due to parvovirus B19

Sequestration crisis

  • RBCs block blood flow within spleen
  • pooling of blood in spleen and liver
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13
Q

Management of sickle cell anaemia

A 
Avoid triggers of crisis 
Ensure vaccines up to date 
Abx prophylaxis 
Blood transfusions 
Bone marrow transplant 
Hydroxycaebamide- can be used to stimulate production of fetal haemoglobin 
Hydroxyurea
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14
Q

The myeloproliferative disorders and the cells

A

Myelofibrosis - haematopoietic stem cell
Polycythaemia Vera - erythroid cells
Essential thrombocytothaemia - megakaryocyte

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15
Q

What is myelofibrosis

A

Proliferation of stem cells leads to fibrosis and scarring of the bone marrow
Leads to haematopoeisis occurring in liver and spleen = massive hepatosplenomegaly

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16
Q

Presentation of myelofibrosis

A 
Anaemia
Leuocoytosis of leukaemia 
Massive hepatosplenomegaly 
B SYMPTOMS 
- Fevers
- night sweats 
- weight loss 
- abdominal discomfort 
- bone marrow failure- anaemia, infections, bleeding
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17
Q

What Smisby showed on the film in myelofibrosis

A

Tear drop cells

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18
Q

Presentation of polycythaemia vera

A 
Insidious onset
Over 60 years old 
Tiredness 
Headache 
Visual disturbance 
Erythromelagia - red and hot peripheries, especially when getting in Bath 
Gout
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19
Q

What mutation is associated with polycythaemia vera

A

JAK2 mutation

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20
Q

Management of polycythaemia vera

A

Venesection
Aspirin
Hyrroxycarbamide
Chemotherapy

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21
Q

Ages of leukaemia presentation

A

Under 5 of greater than 45 - ALL
Over 55 - CLL
Over 65 - CML
Over 75 - AML

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22
Q

Which leukaemia is common in children

A

Acute leukoblastic leukaemia

23
Q

Blood film of ALL

A

Blast cells

24
Q

Blood film of CLL

A

Smear or smudge cells

25
Q

What leukaemia is associated with the philedelphia chromosome?

A

CML

26
Q

How is CML treatment?

A

Main treatment is a tyrosine kinase inhibitor

27
Q

Age of presentation of hodgkins lymphoma

A

20 and 75 years

28
Q

What are reed-sternberg cells associated with.

A

Hodgkins lymphoma

29
Q

Clinical features of myeloma

A

CRABI

High calcium 
Renal impairment 
Anaemia 
Bony disease 
Infections - recurrent
30
Q

Investigations for myeloma

A

BLIP

B - BENCE Jones protein (request urine electrophoresis)
L - light chain assay
I - serum immunoglobulin
P - serum protein electrophoresis

Film - rouleaux
Bone marrow biopsy - to confirm diagnosis
X rays- punched out lesions

31
Q

Investigations for DVT

A

Wells score
If <2 - D-dimer within 4 hours
>2 - proximal leg US should be carried out within 4 hours

Therapeutic anticoagulation should be carried out in the meantime

32
Q

Investigations for DVT

A

Wells score
If <2 - D-dimer within 4 hours
>2 - proximal leg US should be carried out within 4 hours

Therapeutic anticoagulation should be carried out in the meantime

33
Q

Length of treatment for DVT

A

Warfarin or DOAC

Provoked - 3 months
Unprovoked- 6 months

34
Q

Autoimmune hemolytic anaemia classification

A

Coombs positive

Warm and cold

35
Q

Warm autoimmune hemolytic anaemia cause and management

A

IgG antibody
Tends to occur in extravascular beds - spleen
Causes - autoimmune- SLE, neoplasia - lymphoma, CLL, drugs- methyldopa

Management - steroids, immunosuppression, splenectomy

36
Q

Cold autoimmune hemolytic anaemia features and causes

A

Usually IgM
Causes haemolysis at 4 degrees
More common intravascular occurs
Featues - Raynauds

Cause- neoplasia - lymphoma
Infection - mycoplasma, EBV

37
Q

Causes of hemolytic anaemia

A

Hereditary

  • membrane - hereditary spherocytosis
  • metabolism - G6PD deficiency
  • haemoglobinopathies - sickle cell, thalassemia

Acquired

  • immune causes - autoimmune (warm/cold(
    • autoimmune- transfusion reaction
  • drugs - methyldopa
  • malaria
38
Q

What is G6DP deficiency?

A

Metabolism deficit
Chief RBC deficit
Makes cells vulnerable to oxidative stress
Cause of hereditory hemolytic anaemia

Inherited in an X-linked recessive fashion

39
Q

Features of G6DP deficiency

A

Most are asymptomatic
Can present as crisis - after infection or certain drugs - rapid anaemia and jaundice

Neonatal jaundice
Gallstones common

40
Q

Diagnosis of G6DP deficiency

A

Blood film - heinz bodies, bite and blister cells

G6DP enzyme assay - checked around 3 months after an acute episode of haemolysis

41
Q

What can prosthetic heart valves cause?

A

Haemolytic anaemia

42
Q

Management of neutropenic sepsis

A

Taz and piperacillin

Assessed by senior

43
Q

Neck lump, severe pain on alcohol drinking, points to a diagnosis of what?

A

Hodgekins lymphoma

44
Q

Tear drop poikilocytes are associated with what

A

Myleofibrosis

45
Q

Smear cells are associated with what

A

CLL

46
Q

Spherocytes are associated with what

A

Hereditary spherocytosis

Autoimmjne hemolytic anaemia

47
Q

What is the most common form of non-hodgkins lymphoma in the UK?

A

Diffuse large B cell lymphoma

48
Q

Type of anaemia in B-thalassaemia

A

Haemolytic

Hypochromic microcytic anaemia

49
Q

What are Howell jolly bodies seen into?

A

Severe hemolytic anaemia
Hereditary spherocutosis
Sickle cell disease

They suggest hyposplenism

50
Q

Differences between G6DP deficiency and hereditary spherocytosis

A

G6 - male (X-linked recessive),
HS - male and female (autosomal dominant)
HS - northern European descent

G6 - neonatal jaundice, infection/drugs precipitate hemolysis.
HS - neonatal jaundice, chronic symptoms although hemolytic crisis may be precipitated by infection. Gallstones and splenomegsly is common

G6 - heinz body
HS - spherocytes

51
Q

Inheritance pattern of hereditary spherocytosis

A

Autosomal dominant

52
Q

Blood film of hereditary spherocytosis

A

Spherocytes

53
Q

Conditions associated with polycythaemia vera

A

DVT
Gout
Gallstones

54
Q

Treatment of hereditary spherocytosis

A

Folate
Splenectomy
Removal of gall bladder if gallstones

Medicine (25 decks)

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