Haematology Flashcards
t(9;22) translocation
- Name of resultant chromosome
- Associated Disease
- Resultant Protein
t(9;22) - Philadelphia chromosome
present in > 95% of patients with CML
BCR-ABL gene
Treat with tyrosine kinase inhibitors such as Imatinib!
t(15;17) translocation
Seen in APML (Acute ProMyelocitic Leukaemia)
t(8;14) translocation
Burkitt’s Lymphoma
t(11;14) translocation
Mantle Cell Lymphoma
Massive Splenomegaly = ? (Haem answer)
CML or Myelofibrosis
Non Haem:
Visceral Leishmaniasis (Kala-azar)
Malaria
Post Splenectomy pathogens = ?
Encapsulated bacteria:
Haemophilus Influenzae
Streptococcus pneumoniae
Meningococcus
DVT scoring system = ?
Wells score
Polycythaemia Rubra Vera mutation = ?
JAK2 - also first line test
Bence Jones Protein (BJP) in the urine = ?
Multiple Myeloma - symptoms = CRAB
(Can be Waldenström’s macroglobulinemia - Signs and symptoms of WM include LYMPHADENOPATHY + SPLENOMEGALY, weakness, fatigue, weight loss and chronic oozing of blood from the nose and gums.)
Heinz bodies on blood film (inclusions within RBCs) = ?
G6PD
Howell - Jolly bodies (purple spot of nuclear remnants in RBC)
Post-splenectomy or severe hyposplenism (e.g. sickle cell)
Also megaloblastic anaemia
Donath-Landsteiner antibodies
Paroxysmal cold haemoglobinuria
APTT monitors heparin or warfarin?
Heparin - Intrinsic Pathway
PT monitors heparin or warfarin?
Warfarin - Extrinsic Pathway
Heparin antidote?
Protamine Sulphate
Auer Rods = ?
AML
“Starry Sky” appearance - histology = ?
Burkitt’s Lymphoma
JAK2 mutation = ?
Polycythaemia rubra vera
Aquagenic pruritus
Polycythaemia rubra vera
Smear cell
CLL
Teardrop dacrocyte
Myelofibrosis
Osmotic fragility
Hereditary spherocytosis
Ham’s test
Paroxysmal nocturnal haemoglobinuria
Hypersegmented neutrophils
Megaloblastic Anaemia
Cabot rings
Megaloblastic Anaemia
Schistocytes
Microangiopathic haemolytic anaemia (MAHA)
‘Dry’ / ‘Bloody tap’ on BM aspirate
Myelofibrosis
Low FVIII with nosebleeds / gum bleeding
VwD
Maculopapular rash after transfusion
GVHD
Tartrate-resistant acid phosphatase (TRAP)
Hairy cell leukaemia
Reed-Sternberg cells
Hodgkin’s lymphoma
Centrocytes + Centroblasts on blood film
Follicular lymphoma (14;18)
Monocytosis of >1000/mm3
Chronic myelo-monocytic leukaemia
Severe headache + ESR >60
Temporal arteritis
Test for Hereditary Spherocytosis
Osmotic fragility test
MAHA
Fever
Renal Failure
CNS Signs (hallucinations / headaches etc)
Haematuria
Low platelets
TTP (MARCH with low platelets)
Non classical hodgkins lymphoma
Nodular lymphocytic leukaemia
Drug to treat CML
Imatinib
Mech of action of imatinib
Tyrosine Kinase inhibitor
Prolonged bleeding post dental surgery
VwD
Most common type of Hodgkin’s lymphoma
Nodular Sclerosing (70%)
Good prognosis
Felty’s syndrome =
Neutropenia + splenomegaly with underlying long-standing rhuematoid arthritis
How long should warfarin therapy be continued?
- Provoked (e.g. recent surgery)
- Unprovoked
- 3 months
2. 6 months
Management of DVT
- Low molecular weight heparin (LMWH) or fondaparinux should be given ASAP after a DVT is diagnosed
- a vitamin K antagonist (i.e. warfarin) should be given within 24 hours of the diagnosis
- Continue LMWH for 5 days
- Continue warfarin for 3 - 6 months
Investigation of DVT
If a DVT is ‘likely’ (2 points or more)
a proximal leg vein ultrasound scan should be carried out within 4 hours and, if the result is negative, a D-dimer test
if a proximal leg vein ultrasound scan cannot be carried out within 4 hours a D-dimer test should be performed and low-molecular weight heparin administered whilst waiting for the proximal leg vein ultrasound scan (which should be performed within 24 hours)
If a DVT is ‘unlikely’ (1 point or less)
perform a D-dimer test and if it is positive arrange:
a proximal leg vein ultrasound scan within 4 hours
if a proximal leg vein ultrasound scan cannot be carried out within 4 hours low-molecular weight heparin should be administered whilst waiting for the proximal leg vein ultrasound scan (which should be performed within 24 hours)
anti-Cardiolipin antibody
antiphospholipid syndrome
Warfarin target INR
VTE = 2.5, if recurrent 3.5
Atrial fib = 2.5
Genetic translation associated with Burkitt’s lymphoma
C-myc gene
Most common inherited thrombophilia
FV Leiden
Most common inherited bleeding disorder
VwD
Rate limiting enzyme in haem synthesis
ALA synthase
