Haematology Flashcards
difference in hereditary spherocytosis and G6PD deficiency?
G6PD
- African and Mediterranean descent
- Heinz bodies
- Male only
- Measure enzyme activity of G6PD for gold standard diagnosis
Hereditary spherocytosis
- Northern european descent
- Spherocytes
- Male and female
- EMA binding test
What are the causes of macrocytic anaemia?
Megaloblastic
- B12/Folate deficiency
Normoblastic
- alcohol
- liver disease
- hypothyroidism
- pregnancy
- reticulocytosis
- myelodysplasia
- drugs: cytotoxics
What is warm autoimmune haemolytic anaemia associated with?
CLL - complication of
Causes of Microcytic anaemia?
- iron-deficiency anaemia
- thalassaemia*
- congenital sideroblastic anaemia
- anaemia of chronic disease (more commonly a normocytic, normochromic picture)
- lead poisoning
Mechanism of action of TXA?
Antifibrinolytic that reversibly binds to lysine receptor sites on plasminogen or plasmin. This prevents plasmin from binding to and degrading fibrin.
Pappenheimer bodies is/are associated with?
Hyposplenism
What is MGUS? Features?
Monoclonal gammopathy of undetermined significance
Common Paraproteinaemia, sometimes mistaked for myeloma
- Usually asymptomatic
- no bone pain or increased risk of infections
- around 10-30% of patients have a demyelinating neuropathy
Does not have immune dysfunction/lytic lesions like myeloma
Causes of massive splenomegaly?
myelofibrosis chronic myeloid leukaemia visceral leishmaniasis (kala-azar) malaria Gaucher's syndrome
Complications of CLL?
- anaemia
- hypogammaglobulinaemia leading to recurrent infections
- warm autoimmune haemolytic anaemia in 10-15% of patients
- transformation to high-grade lymphoma (Richter’s transformation)
Treatment of CML?
imatinib
Target cells associated with what?
Sickle-cell/thalassaemia
Iron-deficiency anaemia
Hyposplenism
Liver disease
‘Pencil’ poikilocytes associated with?
Iron deficiency anaemia
What blood product is most likely to be contaminated?
Platelets
What symptoms are associated with poor prognosis in hodgkins lymphoma?
weight loss > 10% in last 6 months
fever > 38ºC
night sweats
DIC bloods?
DIC typical blood picture: ↓ platelets ↓ fibrinogen ↑ PT & APTT ↑ fibrinogen degradation products
What is imatinib used for
CML
Most common bleeding disorder?
Von willibrand
Bleeding time bloods in Von willibrand?
Prolonged bleeding time
APTT may be prolonged
Factor VIII levels may be moderately reduced
Treatment for post thrombotic syndrome?
Compression stockings
Most common inherited thrombophilia (clot forming) condition?
Factor V leiden
What are the exceptions for teeatment of VTE with a doac?
Antiphospholipid syndrome (LMWH then VKA)
Renal function <15 GFR (UH, LMWH, or LMWH then VKA)
Paraproteins caused by what things?
MGUS or Multiple Myeloma.
In sickle disease what is a sequestration crisis?
sickling within organs such as the spleen or lungs causes pooling of blood with worsening of the anaemia
associated with an increased reticulocyte count
What are the bleeding times for haemophilia?
prolonged APTT
bleeding time, thrombin time, prothrombin time normal
What is haemophilia, what is the most common type, mode of inheritance?
Clotting disorder.
90% caused by Haemophilia A
X-linked.
What is the cause of haemophilia A and B
Haemophilia A - Factor VIII deficiency
B - IX deficiency
Management for ITP?
First-line treatment for ITP is oral prednisolone
Could also use IVIG.
Features of beta thalassaemia trait?
Mild hypochromic, microcytic anaemia - microcytosis is characteristically disproportionate to the anaemia.
HbA2 raised (> 3.5%)
Lymphocytes in lymphoma high or low?
Low
Viral causes for neutropaenia?
HIV
Epstein-Barr virus
Hepatitis
Iron deficiency anaemia transferrin results?
Transferrin is high (along with TIBC), T sats are low though
Presentation of CML?
anaemia: lethargy
weight loss and sweating are common
splenomegaly may be marked → abdo discomfort
an increase in granulocytes at different stages of maturation +/- thrombocytosis
decreased leukocyte alkaline phosphatase
may undergo blast transformation (AML in 80%, ALL in 20%)
Is alpha thalassaemia associated with hb A2 % rise?
No.
HIT onset time?
5 - 10 days post starting.
Bleeding times in HIT?
Procoagulant so not prolonged
Bleeding times in DIC? Other bloods?
Prolonged. Both PT and APTT.
Others:
- Low plts
- Low fibrin
- Raised fibrin degradation products
Causes of DIC?
sepsis
trauma
obstetric complications e.g. aminiotic fluid embolism or hemolysis, elevated liver function tests, and low platelets (HELLP syndrome)
malignancy
Dabigatran reversal agent?
Idarucizumab
if B12 and folate both low what would you treat first?
B12
