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MSRA- my cards > Haematology > Flashcards

Haematology Flashcards

1
Q

How does polycythaemia vera present?

A

Itchyness, increased HB, and platelets, splenomegaly and HTN

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2
Q

What does liver failure show in terms of coagulation study bloods?

A

Prolonged PT/APTT. All the clotting factors are low apart from Factor 8 which will be super high!

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3
Q

Rouleaux formation is seen in which condition?

A

Myeloma

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4
Q

What is the classical presentation for hereditary spherocytosis?

A

Neonatal jaundice, splenomegaly, failure to thrive

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5
Q

Hereditary spherocytosis - what are the biochemical findings?

A

Haemolytic anaemia, increase unconjugated bilirubin, increased LDH, increased reticulocytes. raised mean haemoglobin concentration MCHC.

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6
Q

What is the reference range for MCV ?

A

82-100

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7
Q

Thalaessmia presents in childhood how? What are the biochemical findings?

A

Beta thalaessmia MAJOR- Anaemia, failure to thrive, frontal bossing of head
Microcytic anaemia with good iron stores.

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8
Q

How does haemophilia present?

A

Bleeding
Early in life
Haemarthorses - bleeding into joints !

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9
Q

What are the bloods for haemophilia?

A

Raised APTT (isolated)
Low factor 8/9 assay

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10
Q

What are the INR ranges for stopping/ continuing warfarin in the context of no bleeding?

A

If over 8 and no bleeding- stop and give vit k
If 5-8 and no bleeding- withhold a couple of doses.

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11
Q

Auer rods indicate?

A

Acute myeloid leukaemia

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12
Q

How does acute lymphoblastic leukaemia present (biochemically)

A

Anaemia, Thromboyctopaenia, neutropenia. PANCYTOPAENIA

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13
Q

Features of ALL

A

Most common malignancy in children
Hepatosplenomegaly
Fever
Recurrent infections

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14
Q

Antiphospholid syndrome- what is seen on bloods and what is the biochemical picture?

A

Recurrent miscarriage
Anticardiolipin
Levido reticularis

On bloods
Thrombocytopenia
Prolonged APTT

First line management is Aspirin

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15
Q

Smear cells are seen in?

A

CLL

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16
Q

Myelofibrosis has which characteristic cell?

A

Tear drop cell

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17
Q

Philadelphia chromosome is associated with which condition?

A

CML

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18
Q

Reed stenberg cells are a/w which condition?

A

Hodgkins lymphoma

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19
Q

What are the features of G6PD deficiency?

A

Precipitated by drugs/ fava beans
Intravascular haemolysis
Males
Mediterranean descent

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20
Q

What is seen on a blood film for G6PD deficiency?

A

Heinz bodies

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21
Q

Howell Jolley bodies are seen in?

A

Post splenectomy
Coeliac disease.

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22
Q

Causes of a microcytic anaemia?

A

Iron deficiency
Thalasseamia

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23
Q

B12 deficiency present with ?

A

Macrocytic (megaloblastic) anaemia and peripheral neuropathy

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24
Q

How does Idiopathic Thomboyctopenia purpura commonly present?

A

Children
Purpuric/ petechial rash following a viral illness
Epistaxis!
Low platelets is the only blood abnormality

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25
Q

Is Haemophilia more common in males or females?

A

Males because X linked recessive

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26
Q

Haemophilia A is reduction in which clotting factor?

A

Factor 8

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27
Q

What are the features of aplastic anaemia?

A

Normocytic anaemia
Pancytopenia (leukopenia and thrombocytopenia)
Hypoplastic bone marrow.

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28
Q

What is found during biopsy when diagnosing amyloidosis?

A

apple green birefringence when using the Congo red stain.

29
Q

DVT management- what are the provoking factors?

A

Surgery, trauma, pregnancy. HRT AND COCP are considered provoking factors!

30
Q

Management of confirmed DVT in a patient with antiphopholipid syndrome?

A

LMWH and WARFARIN for 5 days then just warfarin

31
Q

Ann Arbour staging used for?

A

Hodgkins and Non- Hodgkins lymphoma

32
Q

What is the management of Hodgkins lymphoma?

A

Chemotherapy (ABVD) and Radiotherapy in combination

33
Q

What does PT (prothrombin time) look at?

A

As you Play Tennis outside
Extrinsic
Overall clotting factor synthesis and consumption

34
Q

What does APTT look at?

A

As you Play Table Tennis inside
Intrinsic pathway

35
Q

When switching from warfarin to DOAC what INR can you start the DOAC?

A

Start the DOAC when the INR is less 2.5.
Apixiban start when the INR is less than 2.

36
Q

What factors potentiate Warfarin?

A

Orlistat
NSAIDS
Inhbitors of the PY40 enzyme system (Ciprofloxacin)
Cranberry Juice
Liver disease

37
Q

Management of sickle cell crisis (principles) ?

A

Analgesia
Strong opioid if moderate or severe pain
(Also add in NSAIDS/ paracetamol)

38
Q

Non Hodgkins lymphoma is treated with?

A

RCHOP regime of chemotherapy for AGGRESSIVE disease
R-CHOP = Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone

39
Q

What sort of anaemia do you get with Beta Thalessemia?

A

Microcytic anaemia

40
Q

How would beta thalassemia major present?

A

Microcytic anaemia
Heptasplenomegaly
Recurrent infections

41
Q

CML
- Which age group?
- Which chromosome
- First line treatment?

A

Age group: 60s
Philadelphia chromosome
First Line: Imatinib

42
Q

CLL management?

A

Chemotherapy with FCR Fludarabine, cyclophosphamide and rituximab (FCR)

Curative: allogenic stem cell transplant

43
Q

What type of anaemia does sickle cell give you?

A

Normocytic anaemia

44
Q

Infection with a parasite increases which white blood cell?

A

Eosionphils

45
Q

How does thrombotic thromboyctopenia purpura present?

A

haemolytic anaemia, thrombocytopenia and neurological symptoms.

Non blanching petechial rash
Fever
Renal failure

46
Q

How does acute haemolytic reaction present (following blood transfusion)?

A

Fever, abdominal pain, hypotension

Anaphyaxis is a differential but would have wheeze/angiooedema

47
Q

What are some examples of myeloproliferative disorders?

A

Primary myelofibrosis
PCV (Polycythaemia Rubera)
Essential thrombocytopenia

48
Q

How does essential thrombocytopenia present?

A

High platelets
JAK 2
Burning in hands

49
Q

Inheritance of sickle cell?

A

Autosomal recessive

50
Q

Most common crisis in sickle cell?

A

Vasocculsive- presents with pain and ischaemia.
eg strokes, acute limb ischaemia.

51
Q

Reed Sternberg Cells indicate…

A

HODGKINS lymphoma

52
Q

Von willebrand- what do the clotting studies show?

A

Prolonged APTT
PT Normal

*Most common inherited bleeding disorder**

53
Q

Hodgkins lymphoma- management?

A

Chemo + Radiotherapy!

54
Q

Non Hodgkins lymphoma- management

A

Wide spectrum of disease

Follicular (mild form)- local radiotherapy
Aggressive disease= RCHOP or Bone marrow transplant

55
Q

What is the triad for paroxysmal nocturnal haemoglobinuria? And classic presentation?

A

Aplastic anaemia
Haemolytic anaemia (Raised LDH and Reduced Hb)
Thrombosis

Man presents with dark urine in the morning that clears by afternoon

56
Q

Sickle cell presents how? and what is seen on bloods?

A

Normocytic anaemia
Jaundice
Low ESR
Might present with their first crises eg pain

57
Q

Congenital spherocytosis presents how?

A

Anaemia, failure to thrive
Autosomal dominant
Splenomegaly

58
Q

What are some of the causes of a unprovoked DVT/PE

A

Active ca.
Thrombophillia
EG: Risk factors that are not easily modifiable!
6 months anticoagulation

59
Q

What disorders increase your risk of thrombosis?

A

Factor V leiden
Antiphospholipid

60
Q

Haemochromotosis - what are the features and which are reversible?

A

Problem with Iron
Features: Bronze diabetes
Skin pigmentation (reversible)
Cardiomyopathy (reversible)
Cirrhosis
DM
Erectile dysfunction
Treatment is venesection

61
Q

What is a complication of CML?

A

Blast crisis! Acute illness- ++progenitor cells/ blast cells. Present with fever/ splenomegaly

62
Q

Target cells are seen in which pathological conditions?

A

B Thalasemia
IDA
Hyposplenism
Liver disease

63
Q

Heinz bodies are seen in?

A

G6DPH defiency

64
Q

Features of ALL

A

Children
A/W Downs syndrome
Neutropenia
Thrombocytopenia
Anaemia, bleeding and infections

65
Q

Major bleeding in the context of warfarin?

A

Stop warfarin/ Vit K and OCTAPLEX if
INR >8 and bleeding!

66
Q

Characteristic features of PCV (Polycythaemia vera )

A

Tingling
INCREASED HB!
Itching after a hot bath
JAK 2

67
Q

What is seen on clotting studies of haemophilia?

A

PROLONGED APTT

68
Q
A

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