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Medicine Year 5 > Haematology > Flashcards

Haematology Flashcards

1
Q

threshold for blood transfusion in normal population and people with ACS

A

70

ACS 80

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2
Q

timing for non urgent blood transfusions

A

over 90-120 mins

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3
Q

threshold for a platelet transfusion

A

low platelets and bleeding

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4
Q

what bacteria are platelets susceptible to and why

A

gram positive
stored at room temperature

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5
Q

hypotension, pyrexia and normal JVP

A

transfusion related acute lung injury

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6
Q

hypertension, afebrile and increased JVP

A

transfusion associated circulatory overload

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7
Q

management of transfusion associated circulatory overload

A

IV loop diuretic

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8
Q

management of minor allergic reactions during blood transfusion

A

temporarily stop and give an antihistamine

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9
Q

RF for allergic reactions during blood transfusion

A

IgA deficiency

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10
Q

presentation and cause of acute haemolytic reaction

A

fever, abdominal pain and hypotension during a transfusion
RBC destroyed by IgM

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11
Q

management of non-haemolytic transfusion pyrexia

A

paracetamol

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12
Q

what is the universal donor for fresh frozen plasma

A

AB RhD negative

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13
Q

management of DVT/PE if you cannot do a US/d-dimer within 4 hours

A

start a DOAC

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14
Q

scan negative but d-dimer positive

A

stop DOAC and rescan in 1w

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15
Q

slowly progressive symptoms of chronic pain, swelling, hyperpigmentation, venous ulcers and puritis 6m-2y after a DVT

A

post thromotic syndrome

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16
Q

pathophysiology of post thrombotic syndrome

A

chronic venous hypertension

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17
Q

management of post thrombotic syndrome

A

compression stocking

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18
Q

what does olanzapine increase the risk of

A

DVT

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19
Q

management of antiphospholipid syndrome in pregnancy

A

Aspirin and LMWH

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20
Q

which medications are direct factor xa inhibitors

which should be used in renal failure

A

rivaroxaban
apixaban (use in renal failure)

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21
Q

which medication is a direct thrombin inhibitor

A

dabigatran

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22
Q

which medication activates antithrombin III

A

heparin

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23
Q

which medication inhibits factors II VII IX and X

A

warfarin

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24
Q

definite diagnosis of sickle cell anaemia

A

haemoglobin electrophoresis

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25
Q

how often do people with sickle cell need the pneumococcal vaccination

A

5 years

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26
Q

diagnosis of vaso-occlusive crisis

A

clinical

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27
Q

reticulocyte levels in aplastic and sequestration crisis

A

aplastic: reduced reticulocytes
sequestration: increased reticulocytes

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28
Q

which virus predisposes an aplastic crisis

A

parvovirus B19

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29
Q

how do you manage the symptoms of anaemia in sickle cell crisis

A

exchange transfusions to increase the number of normal cells and reduce the number of sickle cells

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30
Q

dyspnoea, chest pain, cough, hypoxia, new pulmonary infiltrates on CXR

A

acute chest syndrome

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31
Q

which medication reduces the number of crisis’ in sickle cell

A

LT hydroxycarbamide

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32
Q

red beefy tongue caused by ileocaecal resection

A

Vitamin B12 deficiency

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33
Q

what must you replace first, B12 or folate

A

correct B12 deficiency before folate

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34
Q

cause of megaloblastic anaemia secondary to folate deficiency

A

methotrexate

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35
Q

cause of an isolated rise in GGT in macrocytic anaemia

A

alcohol

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36
Q

hyper segmented neutrophil polymorphs

A

megaloblastic anaemia

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37
Q

heinz bodies and RBC fragments

A

haemolytic anaemia

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38
Q

positive coombs test and spherocytes on blood film

A

autoimmune haemolytic anaemia
give steroids

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39
Q

intravascular haemolysis and reduced haptoglobin levels

A

idiopathic autoimmune haemolytic anaemia

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40
Q

management of warm autoimmune haemolytic anaemia

A

steroids and rituximab

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41
Q

IgM mediated haemolysis at cold temperatures causing a macrocytic anaemia

A

cold autoimmune haemolytic anaemia
(link with lymphoma)

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42
Q

splenic rupture causing chronic haemolysis and gallstones

A

hereditary spherocytosis

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43
Q

diagnosis of hereditary spherocytosis

A

EMA binding test

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44
Q

jaundice, fatigue, anaemia and red macules on cheeks in hereditary spherocytosis

A

haemolytic crisis

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45
Q

TIBC and transferrin levels in iron deficiency anaemia

A

increased

46
Q

hypochromic microcytic anaemia with increased ferritin and transferrin and basophilic stripping of RBC

A

sideroblastic anaemia

47
Q

high HbA2 and disproportonate microcytic anaemia

A

beta thalassaemia trait

48
Q

management of beta thalassaemia major

A

lifelong blood transfusions and iron chelation therapy with desferroxamine to prevent iron overload

49
Q

what anaemia does phenytoin cause

A

aplastic

50
Q

what condition can precipitate AML

A

polycythaemia rubra vera

51
Q

tear drop polilocytes

A

myelofibrosis

52
Q

what age does polycythaemia rubra vera peak at

A

60

53
Q

management of polycythaemia rubra vera

A

aspirin (high stroke/vte risk)
venesection
chemo

54
Q

name one cause of secondary polycythaemia

A

COPD (reduced plasma to RBC ratio)

55
Q

auer rods

A

acute promyelotic leukaemia

56
Q

3 genetic associated with CML

A

Philadelphia chromosome
9:22 translocation
BCR ABL gene

57
Q

anaemia, splenomegaly, weight loss, sweats in 60-70y

A

CML

58
Q

leucocytosis, high granulocytes, reduced ALP, thrombocytosis

A

CML

59
Q

treatment for CML

A

imatinib
tyrosine kinase inhibitor

60
Q

reduced weight, bleeding, lymphadenopathy and a LARGE NUMBER OF INFECTIONS

A

CLL

61
Q

smear/smudge cells

A

CLL

62
Q

new B sx in CLL

A

richters transformation to non-hodgkins (do a lymph node biopsy)

63
Q

which anaemia is associated with CLL

A

warm haemolytic anaemia

64
Q

what sign does myelofibrosis, CLL, malaria, gauchers syndrome and visceral leishmaniasis cause

A

massive splenomegaly

65
Q

3 features of reed sternberg cells (what cancer?)

A

large multinucleate nucleus
prominent eosinophilic nuclei
mirror image nuclei

HODGKINS

66
Q

staging of Hodgkin’s

A

1: single lymph node
2: 2+ lymph nodes on the same side of the diaphragm
3: lymph nodes on both sides of the diaphragm
4: spread beyond the lymph nodes

67
Q

lymphoma with the best prognosis

A

lymphocyte predominant

68
Q

lymphoma with the worst prognosis

A

lymphocyte depleted

69
Q

most common lymphoma

A

nodular sclerosing

70
Q

signs of a poor prognosis in lymphoma

A

B Sx (night sweats, fever above 38, weight loss 10% in 6m)
age
male
stage 4

71
Q

rapidly proliferating lymphoma associated with ebstein barr virus

A

burkitt lymphoma

72
Q

gene in burkitt lymphoma

A

c-myc

73
Q

biopsy in burkitt lymphoma

A

starry sky

74
Q

what complication can burkitt lymphoma cause

A

tumour lysis syndrome (seizures and arrhythmias)

75
Q

how do you reduce the incidence of tumour lysis syndrome

A

give allopurinol/rasburicase prior to chemo

76
Q

most common non-hodgkins lymphoma

A

diffuse large B cell

77
Q

cause of gastric lymphoma (MALT)

A

h pylori

78
Q

most common cancer in children

A

ALL

79
Q

child with unexplained petechiae or hepatosplenomegaly

A

urgent specialist assessment
FBC

80
Q

CRAB

A

hyperCalcaemia
Renal failure
Anaemia
Bone disease

Multiple Myeloma

81
Q

Roluaux formation

A

multiple myeloma

82
Q

inheritance of G6PD deficiency

A

x linked

83
Q

greek boy with pallor and jaundice after LRTI with a history of neonatal jaundice and heinz bodies on film

A

G6PD deficiency

84
Q

cause of haemolysis in G6PD deficiency

A

drugs: nitrofurantoin, sulph, glipizide
malaria prophylaxis: primaquine
infection
acidosis
beans

85
Q

when would you repeat the G6PD enzyme assay after an acute episode

A

3m

86
Q

bite and blister cells

A

G6PD deficiency

87
Q

what are the following all causes of
factor V leiden
prothrombin gene mutation
antithrombin III deficiency
protein C deficiency
protein S deficiency

A

thrombophilia

88
Q

which is the most common inherited thrombophilia

A

factor V leiden (protein C resistance)

89
Q

deficiency in haemophilia A

A

factor VIII

90
Q

hemarthrosis without trauma

A

haemophilia A or B

91
Q

most common isolated thrombocytopenia

A

ITP

92
Q

management of ITP

A

prednisolone

93
Q

pentad in thrombotic thrombocytopenia purpura

A

fever
neuro signs
thrombocytopenia
haemolytic anaemia
renal failure

94
Q

platelet levels prior to surgery

A

50: most people
50-75: high bleed risk
100: severe bleed risk

95
Q

what contains factor VII, fibrinogen, factor XIII, von willibrand factor and is used if reduced fibrinogen found during active bleeding

A

cryoprecipirate

96
Q

normal paltelet levels, increased bleeding time and increased APTT

A

vwd

97
Q

treatment of vwd

A

desmopressin

98
Q

what can alcoholic liver disease cause

A

thrombocytopenia

99
Q

treatment of neutropenia

A

filgrastim

100
Q

which groups are affected by benign ethnic neutropenia

A

black african and Afro-Caribbean

101
Q

treatment of neutropenic sepsis

A

tazocin
piperacillin and tazobactam

102
Q

abdo pain, constipation, neuropsych and basophilic stippling

A

lead poisoning

103
Q

2 cells found in hyposplenism (coeliac) on blood film

A

target cells
howell jolly bodies

104
Q

where do the lymphatics from the ovaries drain to

A

para aortic lymph nodes

105
Q

which medication for major haemorrhage given as an IV bolus then infusion

A

tranexamic acid

106
Q

painful maculopapular rash after recent allogenic bone marrow transplant

A

graft vs host

107
Q

how do you reduce the risk of graft vs host disease

A

give irradiated blood products

108
Q

blood profile in DIC

A

reduced platelets and fibrinogen
increased PT, APTT and fibrinogen degradation products
deranged coagulation
schistocytes

109
Q

urine turns deep red on standing with abdo, neuro and pysch sx
often precipitated by nitrofurantoin

A

acute intermittent porphyria

110
Q

management of acute intermittene porphyria

A

haem arginate

111
Q

secretion of monoclonal IgM paraprotein causing raynauds, hepatosplenomegaly and stroke from increased viscosity

A

waldenstrom’s mactoglobulinaemia

Medicine Year 5 (27 decks)

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