Haematology Flashcards by Roma Bannon

What are the causes of Microcytic anaemia

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

How well did you know this?

Not at all

Perfectly

What are the causes of normocytic anaemia

3 A’S 3H’s
Acute blood loss
Anaemia of chronic disease
Aplastic anaemia
Haemolytic anaemia
Hypothyroidism

How well did you know this?

Not at all

Perfectly

What are the causes of macrocytic anaemia

Megaloblastic
-B12 def -Folate def

Normoblastic
Alcohol Reticulocytosis (haemolytic anaemia/ blood loss)
Hypothyroid
Liver diseaase
Drugs (azathioprine)

How well did you know this?

Not at all

Perfectly

What blood findings would be present for haemochromatosis (Iron Overload)

High ferritin and Transferrin levels with love TIBC

How well did you know this?

Not at all

Perfectly

What is the management of iron deficiency anaemia

New iron def in adult- colonoscopy and OGD for malignancy

Oral iron- ferrous fumarate/sulphate

Iron infusion

Blood transfusion

How well did you know this?

Not at all

Perfectly

What are the features of pernicious anaemia

Vit b12 def - macrocytic anaemia
-Antibodies produced against intrinsic factor/partieal cells
-Neuro symptoms

-Diagnosed using intrinsic factor antibodies

How well did you know this?

Not at all

Perfectly

What is the management of pernicious anaemia

IM hydroxycobalamin initially
Oral cyancobalamin/ twice orly injections

Treat B12 deficiency THEN treat folate deficiency - if you don’t in this order will cause combined degeneration of the cord

How well did you know this?

Not at all

Perfectly

What is the test for autoimmune haemolytic anaemia

Positive direct Coomb’s test

How well did you know this?

Not at all

Perfectly

What are the features of hereditary spherocytosis

Most common inherited haemolytic anaemia

Fragile, sphere RBCs, autosomal dominant

Anaemia, jaundice, gallstones, splenomegaly

Parovirus B19- aplastic crisis
High MCHC and raised reticulocyte count

Treatment: Folate supplementation, blood transfusions and splenectomy

How well did you know this?

Not at all

Perfectly

What are the features of hereditary ellipocytosis

Ellipse shaped RBCs, autosomal dominant
Same management and presentation as spherocytosis

How well did you know this?

Not at all

Perfectly

What are the features of G6PD deficiency

x linked recessive
Acute episodes of haemolytic anaemia triggered by infection, drugs or broad beans
Triggered by ciprofloxacin, gliclazide, sulfasalazine

Neonatal jaundice, Heinz bodies on film

Diagnose with G6PD assay

How well did you know this?

Not at all

Perfectly

What are the features of autoimmune haemolytic anaemia

Warm - more common - usually idiopathic

Cold- secondary to lymphoma, lupus, leukaemia, infections (EBV,CMV, HIV, mycoplasma)

Management
Blood transfusions
Pred
Rituximab
Splenectomy

How well did you know this?

Not at all

Perfectly

What are the features of micoangipathic haemolytic anaemia

-RBC destroying as they go through small vessels
Secondary to underlying condition
-Haemolytic uraemia syndrome
-DIC
-Cancer
-Thrombotic thromboctopenic purpura
-SLE

Schistocytes on film

How well did you know this?

Not at all

Perfectly

What are the features of thalassaemia

Autosomal recessive
Causes haemolytic anaemia

-Microcytic anaemia
-Can have iron overload

Alpha thalassamia - not as bad

Beta thalassaemia- defects on Chr 11
Minor- just trait
Intermedia- microcytic anaemia, monitoring and transfusions

Major- severe- failure to thrive in childhood, increased fracture risk
-Regular transfusions, iron chelation, splenectomy, bone marrow transplant

How well did you know this?

Not at all

Perfectly

What are the features of sickle cell anaemia

-HbS variant
-Tested for at 5 days old

Autosomal recessive affects beta globin on chromosome 11

How well did you know this?

Not at all

Perfectly

What is vaso-occulsive crisis

Painful crisis- most common sickle cell crisis
Sickle shaped cells block capillaries
Pain and swelling hands and feet
Fever and pripism (constant erection)

What is splenic sequestration crisis

Painful and enlarged spleen as RBC block the flow though
Emergency- can cause hypovolaemic shock
Management supportive- blood transfusions, fluid rhesus

What is aplastic crisis

Temporary absence of new RBCs
Parovirus B19
Supportive management- transfusions etc

What investigations are needed for suspected leukaemia

FBC within 48 hrs
Bone marrow biopsy- gold standard
Lymph node biopsy

What are the features of acute lymphoblastic leukaemia

children and young
Associated with downs syndrome
B lymphocytes

What are the features of chronic lymphocytic leukaemia

B-lymphocytes
Over 60s
Associated with warm haemolytic anaemia
Richters transformation to lymphoma
Smear/smudge cells

What are the features of chronic myeloid leukaemia

3 phases
Chronic, blast and accelerated
Associated with philadelphia chromosome

My long trip to philadelphia

What are the features of acute myeloid leukaemia

Blast cell overgrowth - neutrophils, eosinophils, basophils
Can be from polycythaemia ruby vera/ myelofibrosis
Auer rods and blast cells

my air

What is Tumour lysis syndrome

Chemicals released when cells are destroyed during chemo
-High uric acid (AKI)
-High potassium (Arrthymias)
-High phosphate
-Low calcium

What are the features of lymphoma

Hodgkin's - one disease 20-25 or 80 -Associated with HIV,EBV, RA/Sarcoid, FH -Pain when drinking alcohol -Reed sternberg cells Non-Hodgkin's- many diseases Burkitt lymphoma- associated with EBV and HIV MALT- lymphoma - H.pylori Diffuse Cell lymphoma - rapid growing mass in older people Chemo and radio usually successful

What are the features of myeloma

Cancer affecting production of antibodies- paraproteins Bence jones proteins- free light chains in urine CRAB Calcium elevated - affects kidneys Renal Failure Anaemia Bone lesions/pain - increased osteoclast activity Pathological fractures Bone marrow biopsy to confirm X-ray changes- Pepper pot skull, abnormal fractures Chemo Bortzomib, thalidomide, dexamethasone

What is hyperviscocity syndrome

Plasma viscosity increases when more protein in blood (thicker) Emergency Bleeding Visual symptoms/ eye changes Neuro complications Heart Failure

What is myelofibrosis

-Proliferation of a single cell causes fibrosis of bone marrow (scar tissue) Anaemia, leukopenia and thrombocytopenia Bone marrow makes less RBCs so RBCs produced in other places- liver and spleen- hepatomegaly and splenomegaly Tear dropped RBCs Anisocytosis (varied RBC size) Blasts (immature WBC/RBC)

What is the treatment for myleoproliferative disorders - polycythaemia vera, myleofibrosis etc

Chemo- hydroxycarbamide JAK2 inhibitors- ruxotinib Aspirin in PV and thrombocythaemia

What are the causes of thrombocytopenia (low plts)

Production problems Viral infections- EBV, CMV, HIV B12 def/ folic acid def Liver failure Leukaemia Myleodysplastic syndrome Chemo Destruction problems Alcohol Immune thrombocytopenia purpura Heparin induced thrombocytopenia Haemolytic uraemia syndrome

What is immune thrombocytopenia purpura

antibodies created against plts and are destroyed purpura Non blanching rash Care- monitor Plt counts and BP Management Prednisolone IV immunoglobulins Thrombopoietin receptor agonists Rituximab Splenectomy

What is thrombotic thrombocytopenia purpua

Thombi develop in small vessels Tissue ischaemia and end organ damage AADAMTS13 Inherited or autoimmune condition

What is heparin induced thrombocytopenia

PF4 antibodies against Plts 5-10 days after starting heparin

What are the features of VWD

Most common inherited bleeding disorder Autosomal dominant Management Desmopressin Tranexamic acid VWF infusion

What are the features of haemophilia

A- actor VIII def B- factor XI def X-linked recessive Management Clotting factors infusion

What is antiphospholipid syndrome

Associated with factor V leiden Recurrent VTW Blood test for antiphospholipi antibodies Give warfarin if they have a VTE not a DOAC- Inr BETWEEN 2-3

What is Budd-Chiara syndrome

Obstruction to outflow of blood from liver due to thrombosis in hepatic veins in liver Happens in hypercioagulabe states (myeloproliferative disorders)