Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Finals - Medicine > Haematology > Flashcards

Haematology Flashcards

1
Q

Define anaemia

A

A low level of haemoglobin in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Examples of microcytic anaemia

A

TAILS
Thalassaemia
Anaemia of chronic disease
Iron deficiency anaemia
Lead poisoning
Sideroblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Examples of normocytic anaemia

A

3 As and 2 Hs
Acute blood loss
Anaemia of chronic disease
Aplastic anaemia
Haemolytic anaemia
Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Examples of macrocytic anaemia

A

Megaloblastic - B12, folate deficiency
Normoblastic - alcohol, reticulocytosis, hypothyroidism, liver disease, azathioprine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

History of anaemia

A

Tiredness
Shortness of breath
Headaches
Dizziness
Palpitations
Worsening of other conditions

Iron deficient
Pica - crave abnormal things like dirt
Hair loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical signs of anaemia

A

Pallor
Tachycardia
Raised respiratory rate
Koilonychia - iron
Angular cheilitis - iron
Atrophic glossitis - iron
Brittle hair - iron
Jaundice - haemolytic
Bone deformities - thalassaemia
Oedema HTN and excoriations - CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations in anaemai

A

Bloods - MCV, B12, folate, ferritin, film
OGD + colonoscopy - cancer?
Bone marrow biopsy if cause unclear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of iron deficiency anaemia

A

Insufficient dietary iron
Increased requirements - pregnancy
Iron being lost - slow bleed, colon cancer
Inadequate iron absorption
Most common cause - menorrhagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of iron deficiency anaemia

A

Investigate cause - ?cancer
Blood transfusion
Iron infusion
Oral iron supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define pernicious anaemia

A

An autoimmune condition attacking the parietal cells or intrinsic factor. This prevents the absorption of vitamin B12 and they become deficient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

History of B12 deficiency

A

Peripheral neuropathy
Loss of vibration sense or proprioception
Visual changes
Mood or cognitive change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of pernicious anaemia

A

If dietary deficient - cyanocobalamin
IM hydroxocobalamin - B12 replacement
Treat B12 before folate -spinal cord degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define haemolytic anaemia

A

Anaemia caused by the destruction of red blood cells. Caused often by inherited condition .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Inherited haemolytic anaemias

A

Hereditary spherocytosis
Hereditary elliptocytosis
Thalassaemia
Sickle cell anaemia
G6PD dificiencty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acquired haemolytic anaemia

A

Auto immune
Alloimmune - transfusion reactions, haemolytic disease of newborn
Paroxysmal nocturnal haemoglobinuria
Microangiopathic haemolytic anaemia
Prosthetic valve related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinical signs of haemolytic anaemia

A

Splenomegaly
Jaundice
Normocytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Investigations in haemolytic anaemia

A

FBC - normocytic anaemia
Film - schistocytes
Direct coombs test - positive in autoimmune haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define hereditary spherocytosis

A

Most common inherited haemolytic anaemia - causing sphere shaped red blood cells that are fragile and easily broken down when passing through the spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

History of hereditary spherocytosis

A

Jaundice
Gall stones
Splenomegaly
Aplastic crisis - parvovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of hereditary spherocytosis

A

Folate supplementation
Splenectomy
Cholecystectomy - stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define G6PD deficiency

A

Defect in the red blood cell enzyme G6PD
X linked recessive condition causing crises that are triggered by infection medications or fava beans.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Classic presentation of G6PD deficieny

A

Mediterranean or African patient turns jaundiced and anaemic after eating broad beans, an infection or treatment with antimalarials.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is seen on blood fil in G6PD deficiency

A

Heinz bodies - individual blobs seen inside rbcs - denatured globin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define target cells

A

Central pigmented area surrounded by a pale arrea, surrounded by a ring of thicker cytoplasm on the outside - bull’ eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What conditions would you see target cells in

A

Iron deficiency anaemia
Post splenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Define Howell-Jolly bodies

A

Individual blobs of DNA material seen inside RBCs,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What conditions would you see Howell-Jolly bodies in

A

Post splenectomy
Severe anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Define reticulocytes

A

Immature RBCs - still have RNA in, appears in a mesh like (reticular) pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What conditions would you see reticulocytes in

A

Normal to have 1% or RBCs as reticulocytes
Goes up if increased turnover
Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Define schistocytes

A

Fragments of red blood cells - indicate physical damage by trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What conditions would you see schistocytes in

A

Networks of small clots
Haemolytic uremic syndromes
DIC
TTP
Metallic heart valves
Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Define sideroblasts

A

Immature RBCs that contain blobs of iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What conditions would you see sideroblasts in

A

Myelodysplasic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define smudge cells

A

Ruptured white blood cells occur during the process of preparing the blood film due to aged or fragile cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What conditions would you see smudge cells in

A

Chronic lymphotic leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Define spherocytes

A

Spherical red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What conditions would you see spherocytes in

A

Autoimmune haemolytic anaemia
Hereditary spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Define thalassaemia

A

A autosomal recessive genetic defect that changes the protein chains that make up haemoglobin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Define thalassaemia

A

A autosomal recessive genetic defect that changes the protein chains that make up haemoglobin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Define thalassaemia

A

A autosomal recessive genetic defect that changes the protein chains that make up haemoglobin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Clinical signs of thalasaemia

A

Microcytic anaemia
Fatigue
Pallor
Jaundice
Gallstones
Splenomegaly
Poor growth and development
Pronounced forehead and malar eminences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Investigations in thalassaemia

A

FBC
Haemoglobin electrophoresis
DNA testing
Screening in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Features of iron overload

A

Fatigue
Liver cirrhosis
Infertility
Heart failure
Arthritis
Diabetes
Osteoporosis and joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Define alpha-thalassaemia

A

Thalassaemia caused by defects in the alpha globin chain - issues with chromosome 16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Management of alpha thalassaemia

A

Monitoring FBC
Monitoring complication
Blood transfusions
Splenectomy
Bone marrow transplant - can be currative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Define beta thalassaemia

A

Defects in the beta globin chains - defect on chromosome 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Define beta thalassaemia minor

A

Carriers of abnormal gene - one abnormal and one normal.
Causes mild microcytic anaemia - often no active treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Define beta thalassaemia intermedia

A

Two abnormal copies of the beta globin gene - either two defective or one defective and one deletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Define beta thalassaemia major

A

Patients who are homozygous for the deletion genes - no functioning beta-globin gene
Severe microcytic anaemia, splenomegaly, bone deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Define sickle Cell anaemia

A

A autosomal recessive condition causing production of sickle shaped RBCs. Defect on chromosome 11 on the beta globin gene. Makes RBCs more fragile leading to haemolytic anaemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What affect does sickle cell disease have on malaria

A

Having one copy of the sickle-cell trait reduces the severity of malaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Investigations in sickle cell anaemia

A

Newborn screening heel prick
Film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Complications of sickle cell anaemia

A

Anaemia
Increased risk of infection
Stroke
Avascular necrosis
Pulmonary hypertension
Priapism
CKD
Sickle cell crises
Acute chest syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Management of sickle cell anaemia

A

Avoid dehydration
Ensure vaccines up to date
Antibiotic prophylaxis
Hydroxycarbamide - stimulate HbF production
Blood transfusion - in severe anaemia
Bone marrow transplant - can be curative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Define sickle cell crises

A

Ubrella term for a spectrum of acute crises related to the condition
Range from mild to life threatening, can be spontaneous or triggered by infection, dehydration, cold or significant events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Examples of sickle cell cises

A

Vaso-occlusive crisis - painful crisis
Splenic sequestration crisis
Aplastic crisis
Acute chest syndrome

55
Q

Define vaso-occlusive crisis

A

Caused by sickle shaped blood cells clogging capillaries causing distal ischaemia - associated with dehydration and raised haemocrit.

56
Q

Presentation of vaso-occlusive crisis

A

Pain
Fever
Triggering infection
Priapism - urological emergency

57
Q

Define splenic sequestration crisis

A

Caused by red blood cells blocking blood flow within the spleen - acutely enlarged and painful spleen
Leads to pooling of blood in the spleen, severe anaemia and circulatory collapse

58
Q

Management of splenic sequestration

A

Supportive
Blood transfusion
Fluid resuscitation
Splenectomy

59
Q

Define aplastic crisis

A

Describes a situation where there is temporary loss of the creation of new blood cells
Causes significant anaemia requiring blood transfusion - is often transient

60
Q

Cause of aplastic crisis

A

Parvovirus B19

61
Q

Define acute chest syndrome

A

Fever or respiratory symptoms with new infiltrates seen on CXR

62
Q

Management of acute chest syndrome

A

Abx or antivirals
Blood transfusion
Incentive spirometry - encourages deep breathing
Artificial ventilation - NIV

63
Q

Define leukaemia

A

Cancer of a particular line of the stem cells in bone marrow causing unregulated production of certain blood cells.

64
Q

Main types of leukaemia

A

Acute myeloid leukaemia
Acute lymphoblastic leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

65
Q

What ages do the leukaemia occur

A

ALL CeLLmates have CoMmon AMbition
Under 5 and >45 - ALL
>55 - CLL
>65 - CML
>75 - AML

66
Q

History of leukaemia

A

Fatigue
Fever
Failure to thrive
Pallor
Petechiae and abdominal bruising due to thrombocytopaenia
Abnormal bleeding
Lymphadenopathy
Hepatosplenomegaly

67
Q

Differentials for petechiae

A

Leukaemia
Meningococcal septicaemia
Vasculitis
Henoch-Schonlein purpura
Idiopathic thrombocytopenia purpura
NAI

68
Q

Investigations in leukaemia

A

FBC!!
Blood film
Lactate dehydrogenase - raised but not specific
Bone marrow biopsy
CXR
Lymph node biopsy
Lumbar puncture - CNS involvement
CT, MRI, PET

69
Q

Define acute lymphoblastic leukaemia

A

Malignant change to one of the lymphocyte precursor cells - causes acute prolifferation of a single type of lymphocyte (usually B-lymphocytes)

70
Q

What is seen on blood film in ALL

A

Blast cells

71
Q

What genetics are associated with ALL

A

Philadelphia chromosome

72
Q

Define Chronic lymphocytic leukaemia

A

Chronic proliferation of a single type of well differentiated lymphocyte (usually B). Occurs in older ages. Easily transforms into high grade lymphoma - Richter’s transformation

73
Q

What is seen on blood film in CLL

A

Smear or smudge cells

74
Q

Define chronic myeloid leukaemia

A

Malignant production of myoblasts

75
Q

What are the phases of CML

A

Chronic
Accelerated
Blast

76
Q

What is the chronic phase of CML

A

Lasts around 5 years and is often asymptomatic and is diagnosed incidentally

77
Q

What is the accelerated phase of CML

A

Occurs where the abnormal blast cells take up high proportion of cells in the bone marrow and blood - patients become more symptomatic, anaemia and thrombocytopaenia and immunocompromised

78
Q

What is the blast phase of CML

A

Follow acceleratsed phase and involves even high proportions of blast cells - severe symptoms and is often fatal

79
Q

What genetics are associated with CML

A

Philadelphia chromosome

80
Q

Define AML

A

Most common type of leukaemia with a few differnt types.

81
Q

What is seen on AML blood film

A

High proportion of blast cells
These blasts have rods in the Auer rods

82
Q

Management of leukaemia

A

Chemo
Steroids
Radio
Bone marrow transplant
Surgery

83
Q

Complications of leukaemia

A

Failure
Stunted growth
Infections
Neurotoxicity
Infertility
Secondary malignancy
Cardiotoxicity
Tumour lysis syndrome

84
Q

Define tumour lysis syndrome

A

Caused by the release of uric acid from cells that are being destroyed by chemotherapy

85
Q

Management of tumour lysis syndrome

A

Allopurinol
Rasburicase
Reduce uric acid levels
Monitor potassium and phosphate

86
Q

Define lymphoma

A

A group of cancers that affect the lymphocytes inside the lymphatic system. These cancerous cells proliferate within the lymph nodes and cause them to become abnormally large

87
Q

Main types of lymphoma

A

Hodgkin’s
Non-Hodgkin’s

88
Q

Define Hodgkin’s lymphoma

A

Lymphoma with the presence of Reed-Sternberg cells on biopsy, 1 in 5 are Hodgkin’s.
Peak ages are 20 and 75

89
Q

Risk factors for Hodgkin’s lymphoma

A

HIV
Epstein-Barr virus
Autoimmune conditions - rheumatoid, sarcoid
FH

90
Q

History of Hdogkin’s lymphoma

A

Enlarged non tender rubbery lymph node - often neck, axilla or inguinal.
Fever
Weight loss
Night sweats
Fatigue
Itching
Cough
Shortness of breath
Abdo pain
Recurrent infections

91
Q

Investigations in Hodgkin’s lymphoma

A

Lactate dehydrogenase - not specific
Lymph biopsy - reed sternberg
CT, MRI, PET

92
Q

What is seen on biopsy of Hodgkin’s lymphoma

A

Reed-Sternberg cell

93
Q

What staging system is used for lymphoma

A

Ann Arbor staging -
Stage 1 - confined to one region of lymph nodes
Stage 2 - mor than one region but same side of diaphragm
Stage 3 - lymph nodes above and below diaphragm
Stage 4 - widespread involvement including non-lymphatic organs

94
Q

Management of Hodgkin’s lymphoma

A

Chemo - risk of leukaemia and infertility
Radio - risk of other cancers, damage to tissue, hypothyroidism

95
Q

Define non-hodgkin’s lymphoma

A

Any lymphoma with out the presence of Reed-Sternberg cells

96
Q

Examples of non-hodgkin’s lymphoma

A

Burkitt lymphoma
MALT lymphoma
Diffuce large B cell lymphoma

97
Q

Risk factors for non-hodgkin’s lymphoma

A

HIV
EBV
H. pylori - MALT
Hep B or C
Pesticides - trichloroethylene
FH

98
Q

Management of non-hodgkin’s lymphoma

A

Watchful waiting
Chemo
Monoclonal antibodies
Radiotherapy
Stem cell transplant

99
Q

Define myeloma

A

Cancer of the plasma cells - b lymphocytes that produce antibodies

100
Q

Define multiple myeloma

A

Where myelomas affect multiple areas of the body.

101
Q

Define myeloma bone disease

A

Results from increased osteoclast activity and suppressed osteoblast resulting in more bone being reabsorbed

102
Q

Complications of myeloma

A

Pathological fractures
Hypercalcaemia
Myeloma renal disease
Infection
Pain
Renal failure
Anaemia
Hypercalcaemia
Peripheral neuropathy
Spinal cord compression
Hyperviscocity

103
Q

Define myeloma renal disease

A

Development of renal impairment as a result of myeloma by causing -
High levels of Ig block the tubules
Hypercalcaemia
Dehydration
Medication

104
Q

Features of myeloma

A

CRAB
Calcium - elevated
Renal failure
Anamia - normocytic, replacement of bone marrow
Bone lesions/pain

105
Q

Risk factors for myeloma

A

Age
Male
Black african
FH
Obesity

106
Q

Investigations in myeloma

A

FBC, Calcium, ESR, plasma viscosity, serum protein electrophoresis

BLIP
Bence-Jones protein - urine electrophoresis
Light chain assay
Immunoglobulins
Protein electrophoresis

Bone marrow biopsy
XR, MRI, CT

107
Q

Signs of myeloma on xray

A

Punched out lesions
Lytic lesions
Raindrop skull

108
Q

Management of myeloma

A

Chemo
Stem cell transplant
VTE prophylaxis

Bisphosphonates
Radio - bones
Orthopaedic surgery
Cement augmentation
Manage complications of myeloma

109
Q

What genetics are myeloproliferative disorders associated with

A

JAK2
MPL
CALR

110
Q

Define meyloproliferative disorders

A

Uncontrolled proliferation of a single type of stem cell - have potential to progress to AML

111
Q

Examples of myeloproliferative disorders

A

Primary myelofibrosis - haemoatopoietic stam cells
Polycythaemia Vera - reythroid cells
Essential thrombocythaemia - megakaryocytes

112
Q

Define myelodysplastic syndrome

A

Caused by bone marrow cells not maturing properly and not producing healthy blood cells/

113
Q

Define thrombocytopenia

A

Low platelet count

114
Q

Causes of poor platelet production

A

Sepsis
B12 or folate deficiency
Liver failure
Leukaemia
Myelodysplastic syndrome

115
Q

Causes of platelet destruction

A

Medication - sodium valproate, methotrexate, isotretinoin, antihistamines, PPIs,
Alcohol
Immune thrombocytopenic purpura
TTP
Heparin induced thrombocytopenia
Haemolytic-uraemic syndrome

116
Q

History of thrombocytopenia

A

Incidental
Spontaneous bruising
Prolonged bleeding - nosebleeds, gums, heavy periods, blood in urine/stool

117
Q

Define immune thrombocytopenic purpura

A

Also called autoimmune, idiopathic and primary
Condition where antibodies are created against platelets

118
Q

Management of immune thrombocytopenic purpura

A

Prednisolone
IV Ig
Rituximab
Splenectomy

119
Q

Define thrombotic thrombocytopenic purpura

A

Conition where tiny blood clots develop throughout small vessels using up platelets causing thrombocytopenia, bleeding under the skin and other systemic issues. affectrs small vessesl so is a microangiopathy.

120
Q

Management of TTP

A

Plasma exchange
Steroids
Rituximab

121
Q

Define von Willebrand disease

A

Deficiency, absence or malfunctioning of von Willebrand factor often caused by an autosomal dominant gene

122
Q

History of von Willebrand disease

A

Bleeding!
Bleeding gums
Nose bleeds
Heavy menstrual
During surgery or trauma
FH!

123
Q

Management of von Willebrand disease

A

Managed only in response to major bleeding or trauma, or in preperation for surgery
Desmopressin - stimulates release of VWF
VWF infusion
Factor VII

Heavy periods
Tranexamic acid
Mefanamic acid
Norethisterone
COCP
Mirena
Hysterectomy

124
Q

Define haemophillia

A

X linke recessive severe bleeding disorders.

125
Q

Which factor is affected in each haemophilia A and B

A

A - Factor VIII
B - Factor IX

126
Q

History of haemophilia

A

Bleeding!
Intracranial, haematoma, cord - neonates
Joints and muscles

127
Q

Management of haemophilia

A

Replace specific clotting factor

Acute
Infusion
Desmopressin
Antifibrinolytics - tranexamic acid

128
Q

Define venous thromboembolism

A

Common condition where clots develop in the circulation and become dislodged and occlude small blood vessels

129
Q

Risk factors for DVT or embolism

A

Immobility
Recent surgery
Long haul travel
Pregnancy
Oestrogen! - HRT, contraceptive
Malignancy
Polycythaemia
Systemic lupus erythematosus
Thrombophilia

130
Q

Examples of thrombophilias

A

Antiphospholipid syndrome
Factor V Leiden
Antithrombin deficiency
Hyperhomocysteineaemia
Prothrombin gene variant
Activated protein C resistance

131
Q

DVT presentation

A

Unilateral painful swollen leg
Calf swelling - >3cm
Dilated superficial veins
Tenderness
Oedema
Redness

132
Q

What score is used to assess risk of DVT or PE

A

Wells score

133
Q

Investigations in PE

A

CTPA

134
Q

Management of DVT

A

Anticoagulation

135
Q

Define Budd-Chiari syndrome

A

Blood clot developlable statess in the hepatic vein blocking outflow of blood. Associated with hyper-coagu

136
Q

Triad in Budd-Chiari syndrome

A

Abdo pain
Hepatomegaly
Ascites

Med Finals - Medicine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions