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Phase 2A > Haematology > Flashcards

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
Q

State 5 types of microcytic anaemia.

A
  1. Iron deficiency
  2. Chronic disease
  3. Sickle cell
  4. Thalassemia
  5. Siberoblastic anaemic
26
Q

State 4 causes of normocytic anaemia?

A
  1. Acute blood loss
  2. Bone marrow failure
  3. Pregnancy
  4. Haemolytic anaemia
27
Q

On top of the classic anaemia presentations, how does haemolytic anaemia present?

A

Jaundice

Dark urine

28
Q

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

A

Raised reticulocytes (chronic), raised bilirubin, raised urobilinogen, schistocytes.

29
Q

State 4 causes of haemolytic anaemia.

A
  1. Autoimmune
  2. Sepsis/Disseminated intravascular coagulopathy (DIC)
  3. Sickle cell
  4. Thalassemia
30
Q

How is pernicious anaemia classified?

A

Macrocytic anaemia

31
Q

What causes pernicious anaemia?

A

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
Q

State 4 possible causes of a B12 deficiency.

A
  1. Pernicious anaemia
  2. Malabsorption
  3. Decreased dietary intake
  4. Chronic nitrous oxide use
33
Q

How does B12 deficiency present on a blood test?

A

Raised MCV, low Hb, low B12

34
Q

True or False: B12 deficiency causes a range of neurological symptoms.

A

True

35
Q

What kind of anaemia does B12 deficiency present as?

A

Megaloblastic anaemia

36
Q

State 3 common causes of macrocytic anaemia.

A
  1. Diseases of the liver and spleen
  2. Haematological malignancy
  3. Alcohol (chronic consumption affects bone marrow)
37
Q

Give 3 potential causes of neutrophilia.

A
  1. Infection
  2. Inflammation
  3. Chronic myeloid leukaemia (CML)
38
Q

Give 4 potential reasons for neutropenia

A
  1. Antibiotics
  2. Chemotherapy
  3. Marrow failure
  4. Liver disease
39
Q

Give 5 potential causes of thrombocytosis.

A
  1. Infection
  2. Inflammation
  3. Tissue injury
  4. Splenectomy
  5. Essential thrombocythemia
40
Q

Give 5 potential causes of lymphocytosis.

A
  1. Epstein-Barr virus (EBV)
  2. Cytomegalovirus (CMV)
  3. Hepatitis
  4. Malignancy
  5. Stress
41
Q

Give 5 potential causes of lymphocytopenia.

A
  1. Steroids
  2. HIV
  3. Post-viral
  4. Marrow failure
  5. Chemotherapy
42
Q

Which factors does warfarin affect in the clotting cascade?

A

2, 7, 9, 10a

43
Q

How do you reverse the effects of warfarin?

A

Give the patient enough vitamin K to get clotting factors 2, 7, 9, and 10a working again.

44
Q

What kind of genetic condition is sickle cell?

A

Autosomal recessive

Heterozygous = ‘trait’
Homozygous = disease
45
Q

A gene on which chromosome causes the sickle cell?

A

A gene on Cr11 (codes for Beta-globin)

46
Q

How does a faulty gene cause sickle cell?

A

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
Q

What is the acute presentation of a sickle cell crisis?

A 
MSK: bone and joint pain
Infection
Respiratory: dyspnoea, cough, hypoxia
CNS: stroke
GI: sequestration crisis
48
Q

State 4 triggers for sickle cell.

A
  1. Low oxygen
  2. Cold weather
  3. Parvovirus B19
  4. Exertion
49
Q

State 5 chronic complications of sickle cell.

A
  1. Avascular necrosis of joints
  2. Silent CNS infarcts
  3. Retinopathy
  4. Nephropathy
  5. Erectile dysfunction

Phase 2A (4 decks)

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