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Medicine > Haematology > Flashcards

Haematology Flashcards

1
Q

what is the range for anaemia?

A

<130 g/L for men

<120 g/L for women

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2
Q

what is iron deficiency anaemia?

A

when body stores of iron are low leading to reduced production of RBC

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3
Q

what is the most common cause of anaemia?

A

iron deficiency anaemia

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4
Q

what are the 3 causes of iron deficiency aneamia?

A
  1. reduced absorption of iron: diet, malabsorption (gastrectomy, CF, coeliac, IBD), drugs e.g. tetracylcines/quinolones, PPIs
  2. increased utilisation of iron: pregnancy, growth spurts
  3. blood loss: menorrhagia, GORD, ulcers, IBD, malignancy, hookworm, NSAIDs, trauma, haematuria, nose bleeds, blood donation, haemolysis
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5
Q

what are the RF of iron deficiency anaemia?

A

pregnancy, menorrhagia, vegetarian, hookworm, haemodialysis, coeliac, gastrectomy, NSAIDs

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6
Q

what is the presentation of iron deficiency anaemia?

A

history: dyspnoea, fatigue, headache, palpitations, pale skin/conjunctiva, others = hair loss and mouth ulcers
exam: conjunctival pallor, angular chelitis, atrophic glossitis, koilonychia, dry skin and hair
SEVERE: tachycardia, murmurs, HF (oedema), cardiomegaly

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7
Q

what are the symptoms of the underlying disease of iron deficiency anaemia?

A

dysphagia: oesophageal malignancy, stricture
dyspepsia: gastric cancer, peptic ulcer disease
abdo pain: coeliac, malignancy, IBD
change in bowel habit: bowel cancer, coeliac, IBD
rectal bleeding: anal fissures, rectal cancer, haemorrhoids, IBD
weight loss: IBD, bowel cancer

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8
Q

what are the investigations of iron deficiency anaemia?

A

FBC: low Hb, low MCV, reduced MCH, reduced MCHC
ferritin: presence of low ferritin can help confirm BUT ferritin is an acute phase reactant and may appear normal/raised in acute inflammation
transferrin and total iron-binding capacity (TIBC): can be useful in context of inflammation, low transferrin sat and raised TIBC
blood film: hypochromic cells
B12 and folate checked
underlying cause = coeliac serology (tissue transglutaminase antibody), urine dipstick (haematuria), stool exam (parasites), GI endoscopy and colonoscopy (malignancy)

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9
Q

what is the management of iron deficiency anaemia?

A

underlying > referral
oral iron e.g. oral ferrous sulphate x3 months; side effects = nausea and GI
IV iron for IBD or no response to oral; side effects = arthralgia and myalgia

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10
Q

what are the main causes of microcytic anaemia?

A

TAILS:
thalassaemia: microcytic hypochromic
anaemia of chronic disease: normocytic anaemia usually but also normochromic microcytic
iron deficiency anaemia: microcytic hypochromic
lead toxicity and copper def: RARE microcytic
sideroblastic: microcytic hypochromic

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11
Q

what are the 4 features of multiple myeloma?

A

CRAB:

high calcium, renal insufficiency, anaemia and bone lesions

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12
Q

what is the investigation for the diagnosis of multiple myeloma?

A

urinary bence jones proteins

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13
Q

what is the typical presentation of haemochromatosis?

A

abnormal liver function tests, skin discolouration and hyperpigmentation, diabetes, systemic symptoms such as weakness and lethargy, arthropathy and cardiomyopathy
in men: gonadal atrophy and erectile dysfunction

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14
Q

what do blood tests show in haemochromatosis?

A

raised iron, high transferrin sats, decreased total iron-binding capacity and a raised serum ferritin level

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15
Q

which condition is associated with isolated thrombocytopenia and anti-platelet antibodies?

A

idiopathic thrombocytopenia purpura

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16
Q

what is thrombotic thrombocytopenic purpura and what is it a/w?

A

a condition a/w a low platelet count due to clotting, and therefore platelet sequestration inside small vessels of the body
a/w: haemolytic anaemia, thrombocytopenic purpura, fever, and neuro and renal abnormalities

17
Q

what are schistocytes? which condition has them on blood film?

A

fragments of blood cells

TTP

18
Q

what is the investigation of TTP and what is the 1st line treatment?

A

urinary B-hCG to see if pregnant as this affects management

1st line: plasma exchange with fresh frozen plasma

19
Q

what is the difference between ITP and TTP on blood film?

A

ITP presents similar to TTP but with petechiae and bruising

ITP is a/w isolated thrombocytopenia, without anaemia or leukopenia and ITP does not cause renal failure

20
Q

how do you differentiate Conn’s from Cushing’s?

A

Conn’s has excessive mineralcorticoid production alone giving hypertension, hypernatraemia and hypokalaemia
you would NOT expect hyperglycaemia or to have raised cortisol levels

21
Q

how to differentiate between Cushing’s disease and adrenocortical tumour?

A

both cause Cushing’s syndrome

with a tumour, there is a negative feedback and results in a very low/undetectable ACTH

22
Q

what differentiates anaemia of chronic disease from iron deficiency?

A

increased ferritin in anaemia of chronic disease and decreased TIBC

23
Q

is TIBC increased or decreased in iron deficiency anaemia?

A

increased

24
Q

a 23 year old man has been previously admitted for recurrent chest pain and now presents with priapism. what is most likely found upon blood film investigation?

A

sickle cells

25
Q

a 9 year old boy is admitted with lead poisoning. what is most likely found upon blood film investigation?

A

sideroblasts and erythrocytes with basophilic stippling

26
Q

what is the most common cause of iron deficiency anaemia worldwide?

A

hookworm infection - causes chronic GI blood loss

27
Q

what is the triad in Plummer-Vinson syndrome?

A

microcytic anaemia, glossitis and oesophageal webs causing strictures and difficulty swallowing

28
Q

what is useful to give to a patient with Addison’s disease alongside hydrocortisone?

A

fludrocortisone - patient’s with Addison’s should get both glucocorticoid and mineralcorticoid replacement therapy

29
Q

which infection is Burkitt’s lymphoma a/w?

A

a/w EBV and HIV infections

Medicine (15 decks)

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