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YEAR 4 CANCER CARE > Haematology > Flashcards

Haematology Flashcards

1
Q

What is purpura?

A

Purpura is the name given to the discolouration of the skin or mucous membranes due to haemorrhage from small blood vessels.

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2
Q

Describe petechiae?

A

plural of petechia; pinpoint form of purpura presenting as red, purple or brown non-blanchable spots
i.e. small, purpuric lesions up to 2mm across

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3
Q

What are ecchymoses?

A

medical term for bruising

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4
Q

Describe the different types of purpura

A
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5
Q

What is this?

A

Steroid purpura

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6
Q

What is this?

A

Disseminated intravascular coagulation

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7
Q

What is this?

A

Vasculitis purpura

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8
Q

What is this?

A

Venous stasis purpura

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9
Q

What is this?

A

Purpura due to injury

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10
Q

What is this?

A

Leukaemia cutis
- get this when leukaemia cells infiltrate the skin
- rare
- usually asymptomatic

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11
Q

What is this?

A

Traumatic bruise / ecchymosis

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12
Q

What is this?

A

Bruising/echymosis from heparin injection sites

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13
Q

What is this?

A

Bruising/echymosis associated with skin atrophy

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14
Q

How can lymphadenopathy be characterised?

A
  • Infective vs non-infective
    Infective = bacterial (beta haemolytic streptococci, staph aureus), viral (adenovirus, rhinovirus, parainfluenza), parasitic (lyme disease)
    Non-infective = amyloidosis, sarcoidosis, or connective tissue disease may cause painless generalized lymphadenopathy, and malignancies.
  • Inflammatory vs malignant
    Inflammatory = benign reactive lymph nodes in children. Would also include bacterial, viral, parasitic infections
    Malignant = leukaemia, lymphoma - Hodgkins and non-hodgkins, metastasis of other cancers.
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15
Q

How can splenomegaly be characterised?

A

First way:
* Haematological - haemolytic anaemias, leukaemias etc
* Infectious - malaria, schistosomiasis etc
* Malignant/ Tumours and cysts - heamangioma, splenic abscesses etc
* Congestive splenomegaly - liver cirrhosis
* Connective tissue disorder - SLE

Second way:
* mild
* moderate
* massive

i have put a few examples for each one. More causes will be in other BS

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16
Q

What are common causes of lymphadenopathy?

A

Inflammatory lymphadenopathy:
* infection - if recent Hx of URTI, dental problem, travel, trauma. *Viral *causes = measles, mumps, adenovirus, HPV, EBV, HIV, CMV, roseola infantum. Bacterial causes = beta-haemolytic streptococci, staphylococcus aureus - cellulitis, periodonitis, otitis externa, otitis media, sinusitis, extra-pulmonary TB. Skin infections - eczema, cradle cap.
* Autoimmune - amyloidosis, sarcoidosis, SLE, RA
* Malignancy - leukaemia, lymphoma, LN metastasis, H+N cancer, oesophageal, breast etc
* Drugs - phenytoin, allopurinol, isoniazid

nice cks

17
Q

What are the functions of the spleen?

A
  • Sequestration and phagocytosis - old/abnormal RBC are removed by macrophages
  • Blood pooling platelets and red cells can be rapidly mobilised during bleeding
  • Extramedullary haemopoiesis - pluripotent stem cells proliferate during haemotological stress or if the bone marrow fails
  • Immunological function - some B cells and T cells are present in the spleen
18
Q

What are causes of splenomegaly?
Group into mild, moderate, massive

A

Mild:
* Infectious hepatitis
* Endocarditis
* Infiltrative disorders - sarcoidosis
* Autoimmune diseases - autoimmune haemolytic anaemia, idiopathic thrombocytopenic purpura, SLE

Moderate
* Lymphoma
* Leukaemias
* Myeloproliferative disorders
* Liver cirrhosis with portal hypertension
* Glandular fever

Massive
* Chronic Myeloid leukaemia
* Myelofibrosis
* Malaria
* LeishManiasis

Pic added from QM and PM

19
Q

What are possible mechanisms for splenomegaly (i.e. why does the spleen grow)?

A
  1. Back pressure = portal hypertension in liver disease
  2. Over work = making more red cells or white blood cells (because of disorder of RBC or immune condition)
  3. Bone marrow failure = so spleen reverts to old job of extramedullary haemopoiesis
  4. Infiltration by cells = cancer cells of blood origin / cancer metastasis into spleen –> cause splenomegaly
  5. Infiltration by other materials (granulomas) = sarcoidosis
20
Q

What are causes of hyposplenism?

A
  • splenectomy
  • sickle-cell
  • coeliac disease, dermatitis herpetiformis
  • Graves’ disease
  • systemic lupus erythematosus
  • amyloid
Pic from MEH
21
Q
  1. What are patients with hyposplenism at risk of?
  2. What can be done to prevent this?
A
  1. At risk of sepsis by encapsulated bacteria
  2. need to be immunised (vaccinated) and given life long antibiotic prophylaxis - usually oral penicillins or macrolides

Vaccines:
* pneumococcal vaccine
* annual flu vaccine

prophylactic prescribing regimes
22
Q

What is the mechanism of hyposplenism in sickle cell?

from QM

A
  • sickle cells commonly sequester in the spleen and undergo phagocytosis by the reticular endothelial system leading to extravascular haemolysis.
  • Commonly this leads to splenic congestion and splenomegaly.
  • The spleen is necessary for phagocytosis of encapsulated bacteria.
  • Consequently, due to a compromised spleen, there is reduced immune function and individuals with sickle cell disease are prone to bacteraemia.
23
Q

What may be seen on blood film of patient with hyposplenism?

A
  • Howell-Jolly bodies
  • Pappenheimer bodies
  • Target cells
  • Siderocytes

YEAR 4 CANCER CARE (22 decks)

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