Haematology Flashcards by Mehnaz Aabideen

incidental finding of thrombocytopenia
normal PT and APTT
petechiae, fatigue

immune thrombocytopenic purpura

How well did you know this?

Not at all

Perfectly

Mx of ITP

self limiting, if severe: prednisolone

How well did you know this?

Not at all

Perfectly

petechiae, neurological symptoms, anaemia

thrombotic thrombocytopenic purpura

How well did you know this?

Not at all

Perfectly

Mx of TTP

plasmapheresis

How well did you know this?

Not at all

Perfectly

polycythaemia rubra vera Px

itching after hot shower, redder skin
low erythropoetin
high MCV high haematocrit

How well did you know this?

Not at all

Perfectly

polycythaemia mutation

JAK2 mutation

How well did you know this?

Not at all

Perfectly

ALL Px

children, bone marrow failure, testicular enlargement, hepatosplenomegaly, increased infections

How well did you know this?

Not at all

Perfectly

ALL Ix

Blast cells

How well did you know this?

Not at all

Perfectly

AML Px

bone marrow failure, hepatosplenomegaly

How well did you know this?

Not at all

Perfectly

AML Ix

Auer rods + blast cells

How well did you know this?

Not at all

Perfectly

CML Px

weight loss, fever, massive splenomegaly, gout

How well did you know this?

Not at all

Perfectly

CML Ix

Philadelphia chromosome, mature myeloid cells

How well did you know this?

Not at all

Perfectly

CLL Px

Asymptomatic, old males

How well did you know this?

Not at all

Perfectly

CLL Ix

smudge cells, increased lymphocytes

How well did you know this?

Not at all

Perfectly

Complication of CLL

can transform into non-hodgkins lymphoma (Richter transformation)

How well did you know this?

Not at all

Perfectly

Symptoms of lymphoma

lympadenopathy (rubbery tender lymph nodes)
fever, weight loss, night sweats

How well did you know this?

Not at all

Perfectly

differentiating Hodgkins vs non-Hodgkins

Hodgkins has Reed-Sternberg cells (owls)

How well did you know this?

Not at all

Perfectly

Burkitt’s lymphoma: associated with, Ix

Epstein Barr virus
Malaria
HIV

Starry sky appearance on lymph node biopsy

How well did you know this?

Not at all

Perfectly

MALT lymphoma Px

affected area: around stomach
associated with H pylori

How well did you know this?

Not at all

Perfectly

paraprotein spike, bence jones protein

multiple myeloma

How well did you know this?

Not at all

Perfectly

dark urine in the morning, fatigue, dyspnea.
Ix:

paroxysmal nocturnal haemogloninuria
flow cytometry for CD55 and CD59

How well did you know this?

Not at all

Perfectly

most common cause of aplastic crisis in pts with sickle cell / hereditary spherocytosis

parvovirus b19 infections

How well did you know this?

Not at all

Perfectly

anaemia, bone pain, hypercalcaemia, renal failure
lytic lesions

multiple myeloma

How well did you know this?

Not at all

Perfectly

positive coombs test?

autoimmune haemolytic anaemia

How well did you know this?

Not at all

Perfectly

iron deficiency anaemia, high ferritin and iron. pappenheimer bodies

sideroblastic anaemia

haemophilia A inheritance

x linked recessive

Dx of haemophilia A

prolonged APTT normal PT

Pathophis of haemophilia A

factor 8 deficiency

Mx fo haemophilia A in mild vs severe bleeds

mild: desmopressin and tranexamic acid severe: recombinant factor 8

post partum haemorrhage, prolonged APTT and PT, low Hb, low fibrinogen

DIC

investigation for multiple myeloma

urine electrophoresis to look for Bence-Jones protein

hereditary haemochromatosis

iron deposition in the tissues Px: diabetes mellitus, hyperpigmentation, testicular enlargement, erectile dysfunction, weakness

hereditary haemochromatosis Ix

low TIBC, high ferritin, high transferrin

rouleaux, when does it occur

stacks of RBC multiple myeloma, waldrens macroglobulinemia

howell jolly bodies

nuclear remnants found in RBC hyposplenism

schistocytes

jagged fragments of RBC haemolysis

tear drop cells

abnormality of bone marrow function (myelofibrosis)

nocturnal haemoglobinuria cause

defect in phosphotidylinitol glycan A

Ix findings in anaemia of chronic disease

increased ferritin decreased TIBC normal transferrin

features of hodgkins lymphoma

Reed sternberg cells (B cells with multi lobed nuclei) B symptoms Cervical/mediastinal lymph nodes Lymph nodes hurt with alcohol SVC obstruction, dysnpnoea

chemo for hodgkins lymphoma

ABVD

Diffuse large b cell lymphoma

high grade NHL layers of Large B cells growing in sheets CLL can turn into this Assoc with Hepatitis C

Burkitt lymphoma associated with

EBV

2 variants of Burkitt lymphoma

endemic/african variant. Risk factor is co infection of EBV and malaria Massive Jaw tumour Sporadic variant: ileocecal tumour

Staging system for lymphoma

Ann Arbor 1: one node 2: spread on same side of diaphragm 3: both sides of diaphragm 4: extra nodal

Symptoms of ALL

bone marrow failure infiltration (lymphadenopathy, splenomegaly, orchidomegaly, CNS involvement)

CNS involvement common in which leukaemia?

ALL lymphocytes cross the blood brain barrier more readily

what is diagnostic of ALL

> 20% blast cells on bone marrow aspirate

3 phases of chemo for ALL and AML

1. remission induction 2. remission consolidation 3. maintenance therapy

what should be added for management for CNS involvement

intrathecal chemotherapy

what is diagnostic of AML

>20% blast cells and Auer rods

what is t(9:22)

Philadelphia chromosome associated with CML indicates poor risk for ALL

what is t(15:17)

Acute Promelanocytic Leukaemia (APML). The PML gene fuses with the RAR alpha gene (retinoic acid receptor alpha) to make a PML-RAR fusion. This causes arrest of promelanocyte differentiation. Retinoic acid ATRAs are effective in targeting this gene fusion, and then restoring differentiation.

important gene in CML + management

Fusion gene encoding the BCR-ABL protein, which enhances Tyrosine kinase activity Imatinib is a tyrosine kinase inhibitor, inhibits phosphorylation

3 Phases of CML development:

1. Chronic 2. Accelerated 3. Blastic (transforms to acute leukaemia)

CLL diagnostic criteria

smear cells

mx of non-diet related B12 deficiency

1mg hydroxycobalamin IM 3x week for 2 weeks 1mg IM every three months

sickle cell disease, anaemia and low reticulocyte count

parvovirus infection

polycythemia or myelodysplasia can lead to what malignancy?

AML

moa of rituximab

monoclonal antibody against CD20

what virus to screen for before starting rituximab

Hep B

causes of drug induced haemolytic anemia

cephalosporins (cefalexin) quinine

transfusion threshold for ACS

Hb < 80

Transferrin, ferritin and TIBC in IDA

Low transferrin Low ferritin High tibc

mnemonic for multiple myeloma

CRABBI hypercalcemia renal impairment anemia bone pain bleeding infections

which thalassemia has high HbA2

beta thalassemia major

interesting thing about CML presentation

no bone marrow failure

what is the philadelphia chromosome

t(9,22)

standard treatment for diffuse large b cell lymphoma

RCHOP

blister cells on blood film

G6PD deficiency

recurrent DVTs, passed down families

factor 5 leiden

anti phospholipid syndrome, primary thromboprophylaxis with no prior thrombotic events:

aspirin daily

anti phospholipid syndrome, secondary thromboprophylaxis after a thrombotic episode :

lifelong warfarin, INR target 2-3

heparin induced thrombocytopenia in DVT, Mx?

stop heparin, start direct thrombin inhibitor

long term anticoagulation method after mechanical mitral valve surgery

lifelong warfarin, 3.5 INR

long term anticoagulation after mechanical aortic valve surgery

lifelong warfarin 2.5 INR

what DOAC is preferred in renal impairment

apixaban

how is PE in pregnancy managed

LMWH

anticoagulation for bio prosthetic aortic valve

lifelong aspirin 75mg