Haematology

Question 1

Histology of post-haemorrhagic anaemia

Answer 1

1) ACUTE Post-Haemorrhagic Anaemia
- RAPID LOSS of Blood, leading to HYPOVOLEMIA + Shock

• Hypoxia STIMULATES Production of Erythropoietin, resulting in INCREASED MARROW Erythropoiesis

2) CHRONIC Post-Haemorrhagic Anaemia
- Loss of Blood is SLOW + INSIDIOUS

• Effects of Anaemia will BECOME APPARENT when Loss Rate is MORE&raquo_space; than Production Rate AND Iron Stores are DEPLETED
• Resulting in Iron Deficiency Anaemia

Question 2

Etiology and classifications of aplastic anemia

Answer 2

APLASTIC ANAEMIA is due:
- APLASIA of the BM

• REDUCTION of Hematopoietic Pluripotent Stem Cells

1) PRIMARY AA
- Fanconi’s Anaemia / Autosomal Recessive

• Immunologically Mediated Acquired Form / Immunosuppressive Therapy

2) SECONDARY AA
- Drugs = Antimetabolites, Mitotic Inhibitors, Alkylating Agents, Anthracycline

• Toxic Chemicals = Industrial, Domestic, Benzene Derivatives, Insecticides
• Infections = Viral Hepatitis, EBV, AIDS
• Miscellaneous = Therapeutic X-Rays

Question 3

What do we call hiatus leukemicus?

Answer 3

• They are MOSTLY FOUND in Acute Myeloid Leukemia, AML
• It’s the ABUNDANCE of MYELOBLASTS + MATURE NEUTROPHILS in a PERIPHERAL Blood Smear
• With NO Intermediate Forms

Question 4

Give a definition for lymphoma. How many main groups of lymphoma do you know?

Answer 4

DEFINITION = Lymphoma is a TYPE of Blood Cancer, that develops when WBC (Lymphocytes) grow OUT OF CONTROL

1) Hodgkin’s
- Characterised by REED-STERBERG Cells
- 4 Types = Nodular Sclerosing / Mixed Cellularity / Lymphocyte RICH / Lymphocyte DEPLETED

2) Non-Hodgkin’s - MOST COMMON

3) B-Cell Lymphoma
- Primary Mediastinal B-Cell Lymphoma
- Intravascular Large B-Cell Lymphoma
- Follicular Lymphoma
- Burkitt’s Lymphoma
- Hairy Cell Lymphoma

4) T-Cell Lymphoma

Question 5

Hodgkin lymphoma how to diagnose and types,

Answer 5

DEFINITION = Malignant Neoplasm of Lymphatic Tissue

• Nodal 2/3
• Extra-Nodal = Tonsils, GI, Spleen
• Contains REED STERNBERG CELLS

ETIOLOGY = EBV Associated

PATHOGENESIS = REED STERNBERG CELLS produce CYTOKINES, leading to CELL PROLIFERATION

SYMPTOMS
- Lymphadenomegaly of Cervical LN
- Lathargic
- Fever,
- Weight Loss
- Night Sweats
- Abdominal Pain = SAGO SPLEEN

Question 6

Hodgkin’s disease - histological variants; description of diagnostic cells

Answer 6

1) Lymphocyte-Predominance = PROLIFERATION of SMALL LYMPHOCYTES, HISTOCYTES, REED-STERBERG Cells

2) Nodular Sclerosis
- FIBROUS TISSUE GROWTH in LN, Reed-Sternberg Cells, Lymphocytes, MFs + FOCI of Necrosis

3) Mixed Cellularity
- Lymphocytes, Eosinophils, Neutrophils, Plasma Cells, Histocytes, Foci of Necrosis, Reed-Sternberg Cells

4) Lymphocyte Depletion
- Lymph Nodes with DEPLETED Lymphocytes, DIFFUSE Fibrosis, Reed-Sternberg Cells + Hodgkin Cells