Haematology Flashcards
Hodgkins lymphoma features
most dangerous type ?
Most common ?
Reed Sternberg cells
Painful after drinking alcohol
younger adults
Most dangerous is lymphocyte depleted
Most common is nodular sclerosisng ( think of roses )
Non Hodgkins lymphoma
More common than Hodgkins lymphoma
B cells is more common
- Diffuse large B cell lymphoma
- Burkitt lymphoma associated with EBV, starry sky appearance , causes tumor lysis syndrome
Polycythemia rubra vera definition
features and treatment
JAK2 mutation , increase in red cell volume and overproduction of neutrophils and platelets
Itchy after a hot bath
hyperviscousity
hypertension
high haematocrit
treatment :
- aspirin to prevent clots
- regular venesection
neutropenic sepsis
A complication of cancer therapy because of low neutrophils
- PIP + TAZ
CML features
- Marked splenomegaly - abdominal discomfort
- Philadelphia chromosome
- may undergo transformation to ALL
Treatment is Imatinib
pathophysiology of beta thalassemia minor
Beta thalassemia = microcytic anemia
chromosome 11
Defect in the Beta global chain
1) hemotetromas form and are insoluble so they ppt in RBCs , haemolysis occurs in spleen = ineffective erythropeosis
2) Decreased globin , decreased Hb, decreased RBC ‘s but HbF increased and HBA2 is increased too
Minor :
- Heterogenous
- microcytic RBCs , increased HBA2 and HbF
-Autosomal recessive
pathophysiology of beta thalassemia major
Major :
-Homogenous where there are no B global chains so the alpa globin ppts and RBC dies
- haemolytic anemia from spleen
- so kidney increases EPO to increase RBC numbers , causing erythroid hyperplasia meaning more immature RBC
- but we still need more mature RBC –> Bones and liver increase production = Hepatosplenomegaly and enlarged skull
Alpha thalassemia features
defect in chromosome 8
microcytic anaemia from defective alpha chain production
very severe mutation x4 = hydrops fatales
sickle cell anemia features
anemia and high reticulocyte count
treatment of thalassemia
life long blood transfusion and desferroxamine to stop iron overload
Myelofibrosis
bone marrow is replaced by connective tissue
+Pancytopenia
+tear drop cells
+massive splenomegaly
treatment
1) EPO for anaemia
2) blood transfusion for pancytopenia
G6pd disease features
think of Heinz sauce on a burger you want to Bite into
+ Heinze bodies
+ Bite and blister cells
+ neonatal jaundice
+ meditteran and African descent
+X linked recessive
drugs that can ppt this :
- ciprofloxacin
- sulfa drugs
- anti-malarials
CLL features
Most common leukaemia in adults
smear/smudge cells
increased WBC, decreased Platelets, RBCs
+ AIHA
+ increased risk of infections
+ increased lymphocytes with sparse cytoplasm
Sudden change in CLL = Richters transformation
Coeliacs disease haematological cells
Howell jolly bodies
Target cells
Seen due to hyposplenism
Acute haemolytic reaction to transfusion features
Fever, abdominal pain, hypotension during a blood transfusion
TRALI
TRALOWWW = low bp
TACO
TACOVER ! hypertension
Sickle cell disease complications
1) vaso occlusive crisis ( iv opiates and fluids ), acute onset with no significant drop in Hb
2) Acute chest syndrome
3) sequestration crisis , where blood pools in spleen => worsening anaemia, abdominal pain , palpable mass in LUQ, pallor, high reticulocytes ( because you have to get up on a horse)
4) Aplastic crisis - reticulocytes less than 1% , tachypnoea , tachycardia , no splenomegaly
due to : parvovirus B19
Myeodysplastic syndromes
group of clonal hematopoietic stem cell disorders characterized by ineffective hematopoiesis, peripheral blood cytopenias, and a risk of progression to acute myeloid leukaemia (AML).
Multiple Myeloma features
CRAB
Ca2+ raised
Renal failure
Anaemia
Bone pain and back pain
+ rouleaux formation
+paraprotein spike of IgG
DVT investigations
- If wells score is less is 1 or less
- If wells score is more than 1
- if less than one and you want to rule out DVT then D DIMER
- If more than one and you want to find DVT - proximal vein USS within 4 hrs
Signs of haemolytic Anemia
-Jaundice
-Pallor
-Reticulocytosis = increased reticulocytes
- Raised LDH
- Spherocytes and reticulocytes on blood film ( AIHA)
- Low haptoglobin ( attaches to free Hb)
Macrocytic anaemia causes
B12 deficiency
- Administer Hydroxocobalamin
-Folate deficiency
- chronic alcohol use
- Hypothyroidism - dysregulation of EPO
Treatment for a mild bleed in patient with VWD
desmopressin
