Haematology Flashcards
Sickle cell tests
- HB ELECTROPHORESIS GOLD STANDARD
- Blood smear- sickled erythrocytes
- FBC - low MCV, low Hb
Sickle cell management
Acute - Morphine, oxygen, IV fluids, transfusion exchange
Chronic - HYDROXYCARBAMIDE
TTP
Thrombotic thrombocytopenic purpura - causes blood clots to form in small blood vessels around body
- ADAMTS-13 DEFICIENCY
- Cant break clumps of vWF into useful monomers so causes microvascular clots
- Primary haemostasis problem (platelet plug)
- Schistocytes on blood smear
TTP investigations
FBC - raised WCC, Low Hb, low platelets
Blood smear - schistocytes
Clotting - normal PT and APTT
TTP treatment
- PLASMA EXCHANGE
- IV METHYLPREDNISOLONE
- MONOCLONAL ANTIBODIES
ITP
Immune thrombocytopenic purpura - autoimmune, characterised by decrease in platelets
- Primary haemostasis problem (platelet plug)
- No schistocytes
DIC investigations
FBC - LOW FIBRINOGEN, HIGH D-DIMER, LONG PT AND APTT, low platelets
Blood smear - schistocytes
ITP treatment
Treat underlying
- Low fibrinogen - cryoprecipitate
- Low platelets - platelet transfusion
Haemophilia A and B deficiency in
A - factor VIII
B - Factor IX (rare)
Haemophilia presentation/treatment
SOFT TISSUE BLEEDING PATTERN into joints, muscles, haematoma formation
Recombinant factor VIII or IX
Von Willebrand’s disease investigation/treatment
- Plasma vWF measurement
- APTT can be prolonged if factor VIII low
- DESMOPRESSIN
ALL management
- METHOTREXATE (CHEMO)
- BLOOD AND PLATELET TRANSFUSION
- Steroids
- Stem cell/bone marrow transplant
- Antibiotics
AML presentation/investigation
- GUM HYPERTROPHY
- Anaemia symptoms
- Bleeding/bruising
- Infections
- Hepatosplenomegaly
- AUER RODS on bone marrow biopsy
CLL management
- Watch and wait early years
- RITUXIMAB (chemo)
- Stem cell/marrow transplant
CML presentation/investigation
- GOUT
- Anaemia symptoms
- Bleeding/bruising
- Infections
- Hepatosplenomegaly
- Weight loss and night sweats
- PHILADELPHIA CHROMOSOME - translocation of 9 and 22
CML management
- IMATINIB - tyrosine kinase inhibitor
- Chemo
- Stem cell/marrow transplant
Hodgkin’s lymphoma def
- Cancer - proliferation of lymphocytes in lymph nodes
- Associated with EBV
- Peaks in early 20s and 70s
Hodgkin’s lymphoma pres/diagnosis/management
- Lymphadenopathy - PAINFUL UPON DRINKING
- B-symptoms - fever, night sweats, weight loss
- REED STERNBERG CELLS on lymph node biopsy
- Imaging CXR/CT for staging
- ABVD CHEMO
Non-Hodgkin’s lymphoma pres/diagnosis/management
- PAINLESS lymphadenopathy
- B-symptoms - fever, night sweats, weight loss
- NO REED STERNBERG CELLS
- RCHOP CHEMO
Multiple myeloma def
Cancer in plasma cells which accumulate in bone marrow crowding out healthy blood cells
BONE MARROW CANCER
Multiple myeloma presentation
CRAB
- HyperCalcaemia - polydipsia, polyuria, abdo pain
- Renal impairment
- Anaemia
- Bone lesions - bone pain
Multiple myeloma diagnosis
- BENCE JONES PROTEIN IN URINE of serum and urine electrophoresis
- ROULEAUX FORMATION on blood film
- Bone marrow biopsy
- Imaging (x-ray/CT) - bone lesions
Multiple myeloma management
- CHEMO COMBINATIONS
- VCD, VTD, MTP
- Bisphosphonates (zoledronic acid)
- Stem cell transplant
- Blood transfusion
Polycythaemia def
- High conc of erythrocytes in blood
- 2 types absolute and relative
