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Haematology Flashcards

1
Q

Define Anaemia.

A

Anaemia is a lower then normal concentration of haemoglobin or red blood cells.

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2
Q

State the anaemic haemoglobin levels in men and in women.

A

Hb < 130 in men

Hb < 120 in women

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3
Q

State the 3 classifictions of anaemia.

A
  1. Microcytic
  2. Macrocytic
  3. Normacytic
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4
Q

What causes haemolytic anaemia?

A

Increased breakdown of RBCs

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5
Q

What causes aplastic anaemia?

A

Decreased RBC, WC and platelets (often caused by malignancy in bone marrow).

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6
Q

What causes microcytic anaemia?

A

Low Hb and reduced MCV

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7
Q

What causes macrocytic anaemia?

A

Raised MCV.

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8
Q

What causes normocytic anaemia?

A

Normal MCV (often from blood loss).

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9
Q

What symptoms do all types of anaemia have in common?

A

Fatigue
Headache
Dizziness
Dyspnoea (shortness of breath)

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10
Q

What signs do all types of anaemia have in common?

A

Tachycardia
Skin pallor
Conjunctiva pallor
Intermittent claudication

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11
Q

State 4 clinical signs that may present with anaemia.

A
  1. Koilonychia (spoon shaped nails)
  2. Angular stomatitis
  3. Lemon-yellow skin
  4. Jaundice / Dark
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12
Q

What causes koilonychia?

A

Iron deficiency.

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13
Q

What causes angular stomatitis?

A

Iron deficiency and B12 deficiency

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14
Q

What causes lemon-yellow skin?

A

B12 deficiency.

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15
Q

Which type of anaemia causes jaundice and dark urine?

A

Haemolytic anaemia.

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16
Q

What is angular stomatitis?

A

Cracked, red, sores in the corners of the lips.

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17
Q

What would the results of an iron study be in iron deficiency anaemia?

A

Low ferratin (unless active inflammation)
Low serum iron
Low transferrin saturation
Raised transferrin

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18
Q

What would you see on a blood film of a patient with iron deficiency anaemia?

A

Small, hypochromic cells.

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19
Q

State 3 causes of iron deficiency anaemia.

A
  1. Reduced iron absorption (low intake/malabsorption at small intestine/drugs like PPIs and tatracyclines)
  2. Increased utilization (pregnancy)
  3. Blood loss (stools/urine/trauma/surgery/menorrhagia)
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20
Q

What classification of anaemia does iron deficiecy anaemia fall under?

A

Microcytic anaemia.

21
Q

What is the most common cause of iron deficiency anaemia?

A

Menorrhagia (particularly in young women).

22
Q

What would the results of a FBC show in a patient with anaemia caused by chronic disease?

A

Low Hb, low or normal MCV, high ESR.

23
Q

What would an iron study show in chonic disease?

A

Normal/Raised ferratin
Low serum iron
Low transferrin saturation

24
Q

State 3 causes of anaemia caused by chronic disease.

A
  1. Chronic infection
  2. Chronic inflammation (connective tissues diseases)
  3. Neoplasia
25
State 5 types of microcytic anaemia.
1. Iron deficiency 2. Chronic disease 3. Sickle cell 4. Thalassemia 5. Siberoblastic anaemic
26
State 4 causes of normocytic anaemia?
1. Acute blood loss 2. Bone marrow failure 3. Pregnancy 4. Haemolytic anaemia
27
On top of the classic anaemia presentations, how does haemolytic anaemia present?
Jaundice | Dark urine
28
What would you see on a blood film of a patient with haemolytic anaemia?
Raised reticulocytes (chronic), raised bilirubin, raised urobilinogen, schistocytes.
29
State 4 causes of haemolytic anaemia.
1. Autoimmune 2. Sepsis/Disseminated intravascular coagulopathy (DIC) 3. Sickle cell 4. Thalassemia
30
How is pernicious anaemia classified?
Macrocytic anaemia
31
What causes pernicious anaemia?
B12 deficiency. Parietal cells in the stomach do not produce enough intrinsic factor, therefore B12 cannot be absorbed as normal in the terminal ileum.
32
State 4 possible causes of a B12 deficiency.
1. Pernicious anaemia 2. Malabsorption 3. Decreased dietary intake 4. Chronic nitrous oxide use
33
How does B12 deficiency present on a blood test?
Raised MCV, low Hb, low B12
34
True or False: B12 deficiency causes a range of neurological symptoms.
True
35
What kind of anaemia does B12 deficiency present as?
Megaloblastic anaemia
36
State 3 common causes of macrocytic anaemia.
1. Diseases of the liver and spleen 2. Haematological malignancy 3. Alcohol (chronic consumption affects bone marrow)
37
Give 3 potential causes of neutrophilia.
1. Infection 2. Inflammation 3. Chronic myeloid leukaemia (CML)
38
Give 4 potential reasons for neutropenia
1. Antibiotics 2. Chemotherapy 3. Marrow failure 4. Liver disease
39
Give 5 potential causes of thrombocytosis.
1. Infection 2. Inflammation 3. Tissue injury 4. Splenectomy 5. Essential thrombocythemia
40
Give 5 potential causes of lymphocytosis.
1. Epstein-Barr virus (EBV) 2. Cytomegalovirus (CMV) 3. Hepatitis 4. Malignancy 5. Stress
41
Give 5 potential causes of lymphocytopenia.
1. Steroids 2. HIV 3. Post-viral 4. Marrow failure 5. Chemotherapy
42
Which factors does warfarin affect in the clotting cascade?
2, 7, 9, 10a
43
How do you reverse the effects of warfarin?
Give the patient enough vitamin K to get clotting factors 2, 7, 9, and 10a working again.
44
What kind of genetic condition is sickle cell?
Autosomal recessive ``` Heterozygous = ‘trait’ Homozygous = disease ```
45
A gene on which chromosome causes the sickle cell?
A gene on Cr11 (codes for Beta-globin)
46
How does a faulty gene cause sickle cell?
A faulty gene on Cr11 causes a glutamic acid substitution with valine leading to Beta-globin polymerisation at low oxygen tensions. Beta-globin polymerisation causes sickled cells. Sickled cells cause endothelial damage and plug small capillaries, and reduce the oxygen carrying capacity.
47
What is the acute presentation of a sickle cell crisis?
``` MSK: bone and joint pain Infection Respiratory: dyspnoea, cough, hypoxia CNS: stroke GI: sequestration crisis ```
48
State 4 triggers for sickle cell.
1. Low oxygen 2. Cold weather 3. Parvovirus B19 4. Exertion
49
State 5 chronic complications of sickle cell.
1. Avascular necrosis of joints 2. Silent CNS infarcts 3. Retinopathy 4. Nephropathy 5. Erectile dysfunction

Phase 2A (4 decks)

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