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Conditions > Haematology > Flashcards

Haematology Flashcards

1
Q

What is tumour lysis syndrome?

A

The breakdown of malignant cells resulting in their contents being released and metabolic disturbances

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2
Q

Describe 4 disturbances that occur during tumour lysis syndrome.

A
  • Hyperuricaemia
  • Hyperphosphataemia
  • Hyperkalaemia
  • Hypocalcaemia
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3
Q

Give 3 ways tumour lysis syndrome is treated.

A
  • Aggressive hydration
  • Monitor electrolytes
  • Give allopurinol
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4
Q

How does allopurinol work?

A

Xanthine oxidase inhibitor - inhibits the conversion of xanthine to uric acid

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5
Q

Which clotting factors are vitamin K dependent?

A

2, 7, 9 and 10

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6
Q

What is haemophilia A?

A

Clotting factor 8 deficiency

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7
Q

What is haemophilia B (Christmas disease)?

A

Clotting factor 9 deficiency

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8
Q

Who is more likely to be affected by haemophilia? Why?

A

Males - it is X-linked recessive

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9
Q

What is disseminated intravascular coagulation (DIC?)

A

Out of control haemostasis that is caused by another disease or condition e.g sepsis, malignancy or crush injury

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10
Q

What happens during DIC?

A
  • Excessive abnormal clotting occurs in blood vessels
  • All this clotting uses us platelets and clotting factors
  • No longer enough circulating platelets and clotting factors
  • Other parts of the body bleed with the slightest of damage
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11
Q

Give 3 key findings in DIC.

A
  • Low platelets
  • Low clotting factors
  • Blood film shows schistocytes
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12
Q

How should DIC be treated?

A

Treat the underlying cause e.g sepsis

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13
Q

How should DIC be treated if there is low fibrinogen?

A

Give cryopercipitate

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14
Q

How should DIC be treated if there is low platelets?

A

Give platelet transfusion

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15
Q

Describe the process of normal fibrinolysis.

A
  • tPA converts plasminogen to plasmin

- Plasmin converts fibrin to fibrin degradation products

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16
Q

What is Von Willebrand’s disease?

A

A defect in the quality and quantity of VWF

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17
Q

What is the most common type of Von Willebrand’s disease? How is it inherited?

A

Type 1 - autosomal dominant

18
Q

How is type 1 Von Willebrand’s disease treated?

A

Desmopressin

19
Q

Give 4 signs or symptoms of Von Willebrand’s disease.

A
  • Epitaxis
  • Easy bruising
  • Gum bleeding
  • Menorrhagia
20
Q

What could be used to reverse the impact of warfarin?

A

Vitamin K or Berliplex

21
Q

What is thrombocytopenia?

A

Deficiency of platelets in the blood

22
Q

What is immune thrombocytopenia purpura (ITP)?

A

Immune destruction of platelets - antibody-covered platelets are removed by macrophages

23
Q

Which antibodies are involved in ITP?

A

IgG

24
Q

When does ITP usually occur?

A

Following a viral infection

25
Q

Describe the presentation of ITP (5).

A
  • Epitaxis
  • Easy bruising
  • Gum bleeding
  • Menorrhagia
  • Purpura
26
Q

How is ITP diagnosed?

A

Diagnosed by exclusion - rule out other conditions first

27
Q

What is key finding of ITP on blood film?

A

Normal RBCs

28
Q

What is the 1st and 2nd line treatment for ITP?

A
  • 1st line - corticosteroids e.g prednisolone (cheaper and easier to administer)
  • 2nd line - IV IgG (can improve platelet count more rapidly in an active bleed)
29
Q

What happens during thrombotic thrombocytopenia pupura (TTP)?

A
  • A reduction of ADAMTS-13 - a protease responsible for the degradation of VWF
  • Decreased degradation of VWF
  • Widespread platelet aggregation causing thrombocytopenia
30
Q

Describe the presentation of TTP (3).

A
  • Fever
  • Fluctuating cerebral function
  • Florid purpura
31
Q

What is the gold standard investigation to diagnose TTP?

A

ADAMTS-13 low

32
Q

What will be found on FBC and blood film for TTP?

A

FBC - low platelets

Blood film - schistocytes

33
Q

How can TTP be treated?

A
  • Plasma exchange - remove antibody to ADAMTS-13 and provide a source of ADAMTS-13
  • Corticosteroids e.g prednisolone
34
Q

What is contraindicated in TTP?

A

Platelet transfusion

35
Q

What is leukaemia?

A

Cancer of the WBCs

36
Q

What are the 4 main types of leukaemia?

A
  • Acute lymphoblastic leukaemia (ALL)
  • Acute myeloid leukaemia (AML)
  • Chronic myeloid leukaemia (CML)
  • Chronic lymphocytic leukaemia (CLL)
37
Q

Who does ALL usually affect?

A

Children aged 0 - 4 - commonest childhood cancer

38
Q

What happens during ALL?

A

Proliferation of immature lymphoblasts

39
Q

Describe the presentation of ALL (7).

A
  • Anaemia
  • Infection
  • Bleeding
  • Bone pain
  • Hepatosplenomegaly
  • Headache
  • Cranial nerve palsies
40
Q

What is the gold standard investigation for ALL?

A

Bone marrow biopsy - at least 20% of cells in the bone marrow are lymphoblasts

41
Q

What indicates a poor prognosis of ALL?

A

Very high WBC count

Conditions (10 decks)

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