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PT6 > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the hallmark signs and symptoms of megaloblastic anaemia?

A
  • Fatigue
  • Dizziness
  • SOB
  • Loss of appetite
  • Weight loss
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2
Q

What are the signs and symptoms of pancytopaenia?

A
  • Painful swallowing
  • Glossitis
  • Petechiae
  • Angular stomatitis
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3
Q

What is pancytopaenia?

A

Reduction in red and white blood cells as well as platelets

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4
Q

What are the signs and symptoms of haemolytic anaemia?

A
  • Pallor
  • Jaundice
  • Systolic murmur
  • Hepatospenomegaly
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5
Q

What is the normal Hb level for women?

A

115-165 g/L

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6
Q

What is the normal Hb level for men?

A

130-180 g/L

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7
Q

What is the MCV in micro-, normo- and macrocytic anaemia?

A
  • Micro = <80
  • Normo = 80-100
  • Macro = >100
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8
Q

Brief pathophysiology behind microcytic anaemia:

A

As there is a lack of Hb, an extra division of RBCs occurs to maintain adequate Hb concentration. This results in smaller and paler RBCs.

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9
Q

Types of microcytic anaemia:

A
  • Iron deficiency anaemia
  • Sideroblastic anaemia
  • Thalassaemia
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10
Q

What anaemia causes pica (strange cravings for non-food substances e.g. ice, soil or clay)?

A

Iron deficiency anaemia

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11
Q

What anaemia shows the following on investigation?

MCV = <80
MCH = low
MCHC = low
Serum iron = low
Ferritin = low
Total iron-binding capacity = high

A

Iron deficiency anaemia

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12
Q

Red flag signs and symptoms of iron deficiency anaemia:

A
  • Pica
  • Nail changes (e.g. koilonychia)
  • Atrophic glossitis
  • Angular stomatitis/cheilosis
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13
Q

What type of anaemia shows small (microcytic), pale (hypochromic) red cells with variation in shape and size and pencil cells on peripheral blood smear?

A

Iron deficiency anaemia

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14
Q

Treatment for iron deficiency anaemia:

A
  1. Oral iron replacement
  2. IV iron replacement
  3. Red cell transfusion
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15
Q

General symptoms of anaemia:

A
  • Fatigue
  • Dyspnoea
  • Faint/dizziness
  • Palpitations
  • Headache
  • Tinnitus
  • Anorexia
  • Angina (if pre-existing coronary artery disease)
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16
Q

General signs of anaemia:

A
  • Pallor
17
Q

Signs of severe anaemia (<80g/L Hb)?

A
  • Tachycardia
  • Heart murmurs
  • Cardiac enlargement
  • Retinal haemorrhages
  • Heart failure
18
Q

Red flag for thalassaemia:

A
  • From Middle/Far East/South Asia or Africa
  • Abdominal distension
  • Spinal changes
  • Low height and weight
  • Large head
  • Hepatosplenomegaly
  • Jaundice
  • Chipmunk faces
  • Misaligned teeth
19
Q

What anaemia shows the following on investigation?

MCV = <80
MCH = low
MCHC = normal
Serum iron = normal
Ferritin = normal

A

Thalassaemia

20
Q

What type of anaemia shows microcytic red cells, tear drop cells, target cells (Mexican hat cells), some fragments and large number of nucleated red cells on a peripheral blood smear?

A

Thalassaemia

21
Q

Management of Thalassaemia:

A

Depending on severity of disease, blood transfusions +/- chelation to prevent iron overload

22
Q

What is the only cure for thalassaemia?

A

Allogenic haematopoietic stem cell transplant

23
Q

Brief pathophysiology of sideroblastic anaemia:

A

Iron is stuck waiting in the body because the lack of protoporphyrin prevents the formation of haem. This results in iron building up in mitochondria, creating the pathognomonic ringed sideroblasts and anaemia

24
Q

What anaemia shows the following on investigation?

MCV = <80
MCH = low
MCHC = low
Serum iron = high
Ferritin = high
Transferrin saturation = high
Total iron-binding capacity = normal to low

A

Sideroblastic anaemia

25
Q

Causes of normocytic anaemia:

A
  • Acute blood loss
  • Anaemia of chronic disease
  • Bone marrow failure (with low WCC +/- platelets)
  • Renal failure
  • Hypothyroidism
  • Haemolysis
  • Pregnancy
26
Q

Types of megaloblastic anaemia:

A
  • B12 deficiency
  • Folate deficiency
  • Non-megaloblastic macrocytic anaemia
27
Q

What anaemia shows the following on investigation?

MCV = >100
MCH = high
Reticulocyte count = low

A

Folate deficiency or B12 deficiency

28
Q

When is folinic acid used?

A

When patients are taking medications that inhibit dihydrofolate reductase (e.g. methotrexate) to prevent folate deficiency anaemia

29
Q

What type of anaemia shows macrocytosis, hypersegmented neutrophils and anisocytosis (RBCs uneven in size) on a peripheral blood smear?

A

Folate deficiency anaemia

30
Q

What type of anaemia commonly presents with neurological symptoms?

A

B12 deficiency

31
Q

What neurological problems are commonly seen in B12 deficiency?

A

Symmetric paraesthesia or numbness and gait problems

32
Q

What type of anaemia shows megalocytes and hypersegmented polymorphonucleated cells on peripheral blood smear?

A

B12 deficiency

33
Q

Treatment for B12 deficiency:

A

Cyanocobalamin or hydroxocobalamin

34
Q

What is pernicious anaemia?

A

An autoimmune disorder affecting the gastric mucosa that results in vitamin B12 deficiency

35
Q

Brief pathophysiology of disseminated intravascular coagulation (DIC):

A

Activation of coagulation pathways results in formation of intravascular thrombi and depletion of platelets and coagulation factors.

36
Q

What is required in order for disseminated intravascular coagulation (DIC) to be considered?

A

A severe underlying disorder (can be anything)

37
Q

Signs and symptoms of disseminated intravascular coagulation (DIC):

A
  • Oliguria
  • Hypotension
  • Tachycardia
  • Gangrene
  • Purpura fulminans (rash)
  • Acrocyanosis (blue extremities)
  • Delirium/coma
  • Bleeding at at least 3 unrelated sites
38
Q

What condition do the following investigations strongly indicate?

Platelet count = low
Prothrombin time (PT) = prolonged
Fibrinogen = decreased
D-dimer = elevated
aPTT = prolonged

A

Disseminated intravascular coagulation (DIC)

39
Q

Treatment for acute disseminated intravascular coagulation (DIC):

A

1st = treat underlying cause
2nd = platelet transfusion (if <20 x 10⁹/L) or <50 x 10⁹/L with active bleeding)
3rd = fresh frozen plasma to replace coagulation factors and inhibitors

PT6 (16 decks)

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