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7. Haematology > Haematology > Flashcards

Haematology Flashcards

1
Q

What is normal adult haemoglobin made of?

A

2 alpha and 2 beta chains.

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2
Q

What is foetal haemoglobin made of?

A

2 alpha and 2 gamma chains.

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3
Q

What is haemoglobin S?

A

Haemoglobin S is a variant of Hb arising from a point mutation in the beta globin gene. The mutation leads to a single amino acid change, valine -> glutamine.

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4
Q

What organs are responsible for removal of RBC’s?

A
  1. Spleen.
  2. Liver.
  3. Bone marrow.
  4. Blood loss.
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5
Q

Give 5 causes of iron deficiency.

A
  1. Blood loss.
  2. Poor absorption.
  3. Decreased intake in diet.
  4. Hook worm!
  5. Breastfeeding, low iron in breast milk.
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6
Q

Give 3 symptoms of anaemia.

A
  1. Fatigue.
  2. Faintness.
  3. Breathlessness.
  4. Reduced exercise tolerance.
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7
Q

What hormone is responsible for regulating RBC production?

A

Erythropoietin.

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8
Q

What stimulates EPO?

A

Tissue hypoxia.

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9
Q

What is neutrophilia?

A

Too many neutrophils.

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10
Q

Where are platelets produced?

A

In the bone marrow. They are fragments of megakaryocytes.

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11
Q

What hormone regulates platelet production?

A

Thrombopoietin - produced mainly in the liver.

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12
Q

What is the lifespan of a a platelet?

A

7 - 10 days.

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13
Q

What organ is responsible for platelet removal?

A

The spleen.

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14
Q

What can cause platelet dysfunction.

A
  1. Reduced platelet number (thrombocyotpenia).
  2. Reduced platelet function.
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15
Q

Give 4 causes of bleeding.

A
  1. Trauma.
  2. Platelet deficiency e.g. thrombocytopenia.
  3. Platelet dysfunction e.g. aspirin induced.
  4. Vascular disorders.
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16
Q

Give 5 signs/symptoms of hypercalcaemia.

A
  1. Confusion.
  2. Bone pain.
  3. Constipation.
  4. Nausea.
  5. Abdominal pain.
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17
Q

What might you see in the ECG taken from someone with hypercalcaemia.

A

Shortened QT interval.

Hypercalcaemia = risk of MI.

18
Q

What is the treatment for hypercalcaemia?

A

IV hydration and bisphosphonates.

19
Q

What does rituximab target?

A

Targets CD20 on the surface of B.

20
Q

What is the commonest cause of microcytic anaemia?

A

Iron deficiency.

21
Q

What is the affect of sickle cell anaemia on reticulocyte count?

A

Reticulocyte count is raised.

22
Q

Why is reticulocyte count raised in sickle cell anaemia?

A

Sickle cell disease is haemolytic, there is increased degradation of RBC’s. Production therefore increases in order to keep up with degradation and so reticulocyte count is raised.

23
Q

What clotting factors depend on vitamin K?

A

2, 7, 9 and 10.

24
Q

What kind of anaemia could methotrexate cause?

A

Macrocytic due to folate deficiency.

25
Q

Give 4 causes of folate deficiency.

A
  1. Dietary.
  2. Malabsorption.
  3. Increased requirement e.g. in pregnancy.
  4. Folate antagonists e.g. methotrexate.
26
Q

Give 3 things that can cause coagulation disorders.

A
  1. Vitamin K deficiency.
  2. Liver disease.
  3. Congenital e.g. haemophilia.
27
Q

How does warfarin work?

A

It antagonises vitamin K and so you get a reduction in clotting factors 2, 7, 9 and 10.

28
Q

How does heparin work?

A

It activates antithrombin which then inhibits thrombin and factor Xa.

29
Q

Give 5 risk factors for DVT.

A
  1. Increasing age.
  2. Obesity.
  3. Pregnancy.
  4. OCP (hyper-coagulability).
  5. Major surgery.
  6. Immobility.
  7. Past DVT.
30
Q

Give 3 symptoms of DVT.

A

Unilateral warm, tender, painful, swollen leg.

31
Q

What forms the differential diagnosis for a DVT?

A

Cellulitis.

32
Q

What investigations might you do in someone to see if they have a DVT?

A
  1. D-dimer in those patients with a low clinical probability.
  2. US compression.
33
Q

What is the name of the score used to determine someones probability of having a DVT?

A

The Wells score.

34
Q

The Wells score determines someones clinical probability of having a DVT. Give 3 factors the score takes into account.

A
  1. Active cancer.
  2. Recently bedridden or major surgery.
  3. Tenderness along deep venous system.
  4. Swollen leg/calf.
  5. Unilateral pitting oedema.
35
Q

Describe the management for a DVT.

A

Aim of management is to prevent a PE!
- Anticoagulants e.g. warfarin/heparin.

36
Q

Where would you normally take a bone marrow biopsy from?

A

Posterior iliac crest.

37
Q

What is the most important medical treatment for DVT prophylaxis?

A

LMWH.

38
Q

What is the difference between Raynaud’s disease and Raynaud’s phenomenon?

A

Raynaud’s disease is idiopathic.
Raynaud’s phenomenon can be due to SLE, scleroderma, RA, drugs e.g. beta blockers.

39
Q

Describe the pathophysiological mechanism behind Raynaud’s disease.

A

Peripheral digital ischaemia due to intermittent spasm in arteries that supply the fingers/toes. Precipitated by cold/stress.

40
Q

Describe the colour changes that are seen in Raynaud’s.

A
  • Pale - due to vasoconstriction.
  • Cyanotic - due to deoxygenation.
  • Red - due to hyperaemia.
41
Q

Describe the treatment for Raynaud’s disease.

A
  1. Physical protection.
  2. Vasodilators.
  3. Nifedipine (CCB).
  4. Stop smoking.

7. Haematology (15 decks)

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