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AKT > Haematology > Flashcards

Haematology Flashcards

1
Q

AML poor prognostic factors (2)

A

> 60yo
20% blasts after first chemo

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2
Q

Translocation 15;17
Average age 25yo
Auer rods
Presents with thrombocytopenia/ DIC
=

A

Acute promyelocytic leukaemia

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3
Q

Antiphospholipid syndrome
Features (3)

Could be secondary to which condition?

A

Predisposition to:
1. Venous and arterial thrombus
2. Recurrent fetal aloss
3. Thrombocytopenia

SLE

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4
Q

Antiphospholipid syndrome
In pregnancy which complications may occur? (6)

A

Recurrent miscarriage
IUGR
PET
Abruption
Pre-term labour
VTE

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5
Q

Mx antiphospholipid syndrome in pregnancy (3)

A

Low dose aspirin once pregnancy confirmed
LMWH once FHR on US
Discontinue at K34

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6
Q
  1. Pancytopenia
  2. Hypoplastic bone marrow
  3. Could be the presenting feature of AML/ALL
  4. Normochromic, normocytic anaemia
  5. Lekopenia with lymphocytes spared

30yo

A

aplastic anaemia

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7
Q

Auto immune haemolytic anaemia classification
Which is more common?
Which antibody?
Extra/intravascular?

A

Warm - most common, IgG, extravascular e.g spleen

Cold - less common, IgM, intravascular
Features Raynaud’s, acrocyanosis

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8
Q

Causes of warm (3) and cold autoimmune haemolytic anaemia (2)

Which one response well to steroids?

A

Warm - underlying autoimmune condition e.g SLE, lymphoma, CLL
Steroids

Cold - lymphoma, EBV

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9
Q

Beta thalassemia trait
What type of anaemia?
What may be raised?

A

Hypochromic, microcytic anaemia
HbA2 raised

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10
Q

‘starry sky’ appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

Classification (2)

A

Burkitt’s lymphoma
1. Endemic (African) form - involves maxilla or mandible
2. Sporadic (most common) - common in pts with HIV

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11
Q

What is strongly implicated in the development of the endemic Burkitt’s lymphoma?

A

EBV

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12
Q

Tumour lysis syndrome signs (5)

A

AKI
Low calcium
High potassium, phosphate, uric acid

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13
Q

CLL complications (3)

A

Hypogammaglobulinaemia leading to recurrent infections
Warm autoimmune haemolytic anaemia
High grade lymphoma

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14
Q

What is Richter’s transformation?

Features (5)

A

Leukaemia turning into high grade Hodgkin’s lymphoma

  1. Lymph node swelling
  2. Fever without infection
  3. Weight loss
  4. Night sweats
  5. AP
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15
Q

CLL
Blood film
What will you seen on FBC?

A

Smudge cells
Anaemia
Lymphocytosis

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16
Q

Raynaud’s
Ulceration
Arthralgia
Glomerulonephritis
=
Can be caused by? (3)

C4 high or low
ESR high or low

A

Cryoglobulinaemia
HIV/ hep C/ lymphoma

C4 low
High ESR

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17
Q

Where would you see Howell Jolly bodies?

A

Asplenia

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18
Q

How to diagnose DVT

A

Wells score
If =>2 US within 4 hours

If +ve - DOAC
If -ve do a d-dimer

If scan -ve but d-dimer +ve stop DOAC and repeat scan in 1 week

If <2
D-dimer within 4 hours
If negative then likely alternative diagnosis
If positive then US within 4 hours

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19
Q

DVT length of anticoag

A

Provoked 3 months
Unprovoked 6 months total

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20
Q

Three DOACs direct factor Xa inhibitor
x1 direct thrombin inhibitor
Reversal drugs

A

Rivarox
Apix
Edox
Reversal: Andexanet

Dabigatran
Reversal: Idarucizumab

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21
Q

What is Fanconi anaemia? (5)

A

Aplastic anaemia
Increased risk of AML
Pancytopenia
Short stature
Cafe au lai spots

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22
Q

G6PD deficiency is most common in which patient group?
Inheritance?

A

X linked recessive
Mediterranean & AFrica

23
Q

Features G6PD deficiency (4)
Blood film (2)

A

Neonatal jaundice
Intravascular haemolysis
Gall stones
Splenomegaly

Heinz bodies
Bite and blister cells

24
Q

G6PD deficiency
Diagnosis

A

G6PD enzyme assay three months after an acute episode of haemolysis

25
Q

Which drugs can precipitate haemolysis in G6PD defiency?

A

Primarquine
Cipro
Sulphonamides

26
Q

Hereditary spherocytosis
Inheritance
Patient group

Features that make it different from G6PD deficiency(1)

A

AD
Northern European
Extravascular haemolysis

27
Q

Primary immunodeficiency

Recurrent bacterial infections
Eczema
Thrombocytopenia
Low IgM levels

X linked recessive

A

Wiskott-Aldrich syndrome

28
Q

Weight loss
Visual disturbance
Hepatosplenomegaly
Lymphadenopathy
Cryoglobulinameia e.g Raynaud’s

A

Waldenstrom’s macroglobulinaemia

29
Q

Most common inherited bleeding disorder
Inheritance

Features (2)

A

Von Willebrand’s disease
AD

Epistaxis
Menorrhagia

30
Q

Von Willebrand’s Ix (2)
Mx (3)

A

APTT prolonged
Factor VIII reduced

TXA
Desmopressin
Factor VIII concentrate

31
Q

Rx essential thrombocytopenia (3)

A

Hydroxyurea
Interferon a
Low dose aspirin

32
Q

Essential thrombocytosis features (3)

A

Burning sensation in the hands
Thrombosis and haemorrhage
Platelet count >600

33
Q

Causes of splenomegaly (4)

A

Myelofibrosis
CML
Malaria
Visceral leishmaniasis

34
Q

How often should sickle cell patients receive the pneumococcal vaccine?

A

Every 5 years

34
Q

Secondary causes of polycythaemia (4)

A

COPD
Altitude
Obstructive sleep anoea
Excessive EPO

34
Q

Secondary causes of polycythaemia (4)

A

COPD
Altitude
Obstructive sleep anoea
Excessive EPO

35
Q

What is polycythaemia?
Mutation of what gene?

A

Overproduction of red blood cells
JAK2

36
Q

Fatigue
Dizziness
Increased sweating
Redness in the face
Blurred vision
Itchiness after a hot shower
=

A

Polycythaemia rubra vera

36
Q

Polycythaemia features (7)

A

Hyperviscosity
Pruritus
Splenomegaly
Haemorrhage
Plethoric appearance
HTN
Low ESR

37
Q

Polycythaemia
Age
Mx (3)

A

60yo
Aspirin, venesection, chemo (hydroxyurea)

38
Q

Polycythaemia can go on to develop which two diseases?

A

Myleofibrosis
Acute leukaemia

39
Q

Haemophillia
Inheritance
A deficiency in factor?
B deficiency in factor?
Ix

A

X linked recessive
A - factor 8
B factor 9 deficiency
Prolonged APTT, all the rest normal

40
Q

Reed-Steenberg cell

Age?

A

Hodgkin’s lymphoma
30yo and 70yo

41
Q

Hodgkin’s lymphoma features (5)

A

Lymphadenopathy
Weight loss
Alcohol pain
Eosinophilia
LDH raised

42
Q

Mx immune thrombocytopenia

A

PO prednisolone
IVIG

43
Q

What is Evan’s syndrome?

A

ITP in association with autoimmune haemolytic anaemia

44
Q

In IDA a
High TIBC/ transferrin =

A

Low iron stores

45
Q

abdominal pain
peripheral neuropathy (mainly motor)
neuropsychiatric features
fatigue
constipation
blue lines on gum margin (only 20% of adult patients, very rare in children)
=

A

Lead poisoning

46
Q

Lead poisoning investigations (3)
Blood film (2)

A

Lead levels >10
Microcytic anaemia
Raised serum and urine levels of aminolaevulinic acid

Blood film: basophillic stippling, clover leaf morphology

47
Q

Mx lead poisoning (2)

A

Dimercaptosuccinic acid (DMSA)
D penicillamine

47
Q

Causes of megaloblastic macrocytic anaemia (2)

A

B12 and folate

48
Q

usually asymptomatic
no bone pain or increased risk of infections
around 10-30% of patients have a demyelinating neuropathy
paraprotinaemia
normal immune function
=

A

Monoclonal gammopathy of undetermined significance

49
Q

Myeloma features (5)

Ix (3)

A

Bone pain
Hypercalcaemia
Renal failure
Lethargy
Infection

Monoclonal antibodies (bence jones proteins)
Whole body MR
XR rain drop skull

50
Q

What is paroxysmal nocturnal haemoglobinuria?
Features (4)

A

Acquired disorder leading to haemolysis
More prone to venous thrombosis

Haemolytic anaemia
Pancytopenia
Haemoglobinuria (dark coloured urine in the morning)
Thrombosis (Budd Chiari syndrome)

AKT (52 decks)

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