Haematology Flashcards
Thrombotic thombocytopaenic purpura
?signs
Fever, neuro signs, thrombocytopaenia, haemolytic anaemia, renal failure
Factor V Leiden
Most common inherited Thrombophilia
Activated protein C resistance
Anti-phospholipid syndrome
Arterial and venous thrombosis
Foetal loss
Thrombocytopaenia
Basophilic stippling (conditions)
Heavy metal poisoning e.g. lead
Myelodysplastic syndrome
Heinz bodies
G6PD deficiency
Removed by spleen resulting in bite cells
Howell-Jolly bodies
Hyposplenism e.g coeliac disease
Target cells
Hyposplenism e.g coeliac disease
Acanthocytes
Hyposplenism e.g coeliac disease
Immune thrombocytopenia (ITP)
Antibodies against…
Signs/symptoms
Treatment
Antibodies against glycoprotein IIa/IIIb or Ib-V-IX complex
Purpura, petechiea, bleeding (eg epistaxis)
Oral prednisolone
Low haemoglobin 2/52 post-transfusion
Positive direct antiglobulin test
Raised unconjugated bilirubin
Reticulocytosis
High LDH
Delayed transfusion reaction
Factor V Leiden prevalence
5%
TTP - cells seen on film
Fragmented cells
central cyanosis (blue lips, nails, body)
Steel-grey complexion
Elevated/normal pO2 but low saturations
Methaemoglobinaemia
Left shift of oxygen dissociation curve
Increased binding affinity with decreased release into the tissues
Hypersegmented neutrophils
Vitamin B12 deficiency
Microangiopathic haemolytic anaemia = non-immune haemolytic anaemia (Coombs negative)
Causes
DIC
TTP
HUS
Atypical HUS
Haemolytic uraemic syndrome
Features
Abdominal pain, bloody diarrhoea -> Shiga toxin
AKI
Haemolytic anaemia
Coombs test negative
Atypical uraemic syndrome
Features
Diarrhoea/abdo symptoms not present
AKI
Haemolytic anaemia
Coombs test negative
TTP
Haemolytic anaemia
Coombs test negative
Neurological symptoms
GI symptoms
AKI can occur but is rare
Paroxysmal nocturnal haemoglobinuria
diagnostic test
flow cytometry of blood to detect low levels of CD59 and CD55
TTP treatment
Plasma exchange
Medication used in prevention of sickle cells crises
Hydroxycarbamide
Immune thrombocytopaenia (ITP)
Features
Treatment
Thrombocytopaenia
Platelet >30, nil effects - observation
Platelet <30 or effects on daily life - Oral prednisolone
Life threatening/organ threatening bleeding - platelet transfusion, IV methylpred, IV Immunoglobulin
Most common haemophilia
Haemophilia A
Haemophilia A
Affects what test and clotting factor?
APTT - intrinsic
Factor VIII
smudge cells
CLL
Basophilic stippling
Lead poisoning
Beta-thalassaemia
Leukemoid reaction vs CML
Leukemoid reaction
- high leucocyte alkaline phosphatase
- toxic granulation (dohle bodies) in WC
- ‘left shift’ of neutrophils
CML
- cytogenics = presence of Philadelphia chromosome
Hereditary spherocytosis
Investigation of choice
EMA binding test
G6PD deficiency haemolysis
Investigation of choice
Beutler fluorescent spot test
low ADAMTS13
diagnosis
TTP
