Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 6 > Haematology > Flashcards

Haematology Flashcards

1
Q

Hodgkin lymphoid lineage

A

Crippled B cell -> Reed Sternberg within inflammatory picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Myeloma cells

A

Malignancy of plasma cells. Natural home is bone marrow not the lymph node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Making and numbers of RBCs

A

In adult made in bone marrow - restricted to pelvis, sternum, vertebrae and ends of long bones
Adults ave approx 4x10^12 red cells/L of blood
Cell lifespan approx 120 days
Control of RBC production controlled by hypoxaemia detection in corticomedullary interstitium (in renal cortex, via HIF pathway), then stimulating Epo synthesis -> incr RBC synthesis in the marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lab clue that anaemia due to haemolysis or haemorrhage

A

Increased reticulocyte count (marrow response), poss consequently causing slight macrocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Iron deficiency anaemia causes

A

Insufficient intake: tea and toast, vegans, pregnancy
Inadequate absorption (in duodenum): coeliac disease, gastrectomy (HCl needed to solubilise iron)
Incr loss: GI bleeding, gynae bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Characteristic haematinics in iron deficiency anaemia

A

Low MCV
Low MCH
Variation in size and shape -> anisocytosis and poikilocytosis
Not v high retic count
low serum iron
incr serum rtansferrin
Low serum ferritin (but is acute phase protein so will rise in infection/inflammation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

B12 deficiency cuases

A

Insufficient diet: tea and toast, vegans, pregnancy
Insufficient absorption: pernicious anaemia (no intrinsic factor), fastrectomy or atrophic gastritis, pancreatic disease, pancreatectomy, Crohn’s, ileal resection
(requirees both intrinsic factor produced in stomach, and absorption of complex in terminal ileum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Findings in B12 deficiency anaemia

A

High MCV anaemia
Neutrophil and platelet count also may be reduced
Not v high retics
Hypersegmented neutrophils
Glossitis
Peripheral neuropathy
Dorsal column degen
Anti-intrinsic factor Ab if pernicious anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

findings in folate deficiency

A

Anaemia
High MCV
White count and platelet may be low
Hypersegmented neutrophils
Confirm w serum folate assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Features of anaemia of chronic disease

A

Often a mild anaemia
typically normal MCV
Often low serum iron, high/normal ferritin and low transferrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical features of haemolysis

A

Pallor, icteric sclerae, jaundiced skin, splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lab results with intravascular haemolysis

A

Red cell fragmentation on film
LDH v high
Free haemoglobin in circulation
Low serum haptoglonin
Haemoglobinuria
Haemosiderinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lab features extravascular haemolysis

A

Spherocytes on film
LDH less high
No haemoglobinuria, no haemosiderinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

S&S of acute transfusion reaction

A

Fever, flushing, chillls
Urticaria
Rigors
Tachycardia
Hypotension
Collapse
Respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is acute haemolytic transufsion reaction

A

life threatening
Acute intravascular haemolysis often with renal failure and DIC
Urgently need help
Due to ABO incompatabiltiy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Transfusion anaphylaxis

A

often rapid onset after starting
rash, swelling of face/lips progressing to airway compromise or hypotension
Need urgent help, ABC
Stop transfusion, resuscitate, IV chlorphenamine and hydrocortisone
May need IM adrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Febrile non-haemolytic transfusion reactions

A

Relatively common and not serious
Due to cytokines in transfused blood
temp rarely rises >2 degrees aboce baseline
continue transfusion but monitor carefully

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TRALI

A

Transfusion related acute lung injury
Usually from plasma products with abx against HLA
looks like ARDS with capillary leak and so pulomnary oedema
Supportve management
Ban the donor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

TACO

A

Transfusion associated circulatory overload
Cardiogenic pulmonary oedema
JVP raised
treat w diuretics
Prevent by cautious transfusion practiceH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Haemolytic disease of the newborn

A

RhD negative mother and RhD+ve fetus in first pregnancy, when red cells enter maternal circ at delivery then mother immunised
In 2nd pregnancy, IgG agains RhD potentially cross placental and haemolyse fetal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
A
22
Q

polycythaemia vera management

A

Aspirin (reduce risk of VTE)
Cenesection
Chemotherapy (2nd line): hydroxyurea, phosphorus 32 therapy
5-15% progress to myelofibrosis. 5-15% progress to acute leukaemia

23
Q

TUmour lysis syndrome biochemistry

A

High potassium, high phosphate, high uric acid, low calcium

24
Q

Prevention of tumour lysis syndrome

A

IV fluids
If at higher risk receive allopurinol or rasburicase (recominant urate oxidase). One of not both

25
Q

Richter transformation

A

CLL transformation into high grade fastr growing non-Hodgkin’s lymphoma. patients often become unwell very suddenly having been absolutely fine for years/
Sympt: lymph node swelling, fever without infection, weight loss, night sweats, nausea, abdo pain

26
Q

Management of sickle cell crises

A

analgesia eg opiates
rehydrate
oxygen
consider abx if evidence infection
blood transfusion if: severe/symptomatic anaemia, pregnancy, pre-op.
Exchange transfusion if: acute vaso-occlusive crisis (stroke, acute chest syndroem, multiorgan failure, splenic sequestration crisis) = actually rapidly reduces % of HbS containing cells

27
Q

VonWillebrand disease Ix results

A

Prolonged bleeding time
APTT may be prolonged
Factor VIII levels may be moderately reduced (Acts as carreir for)
Defective platelet aggregation with ristocetin

28
Q

management of vonwillebrand

A

TXA for milf bleeding
Desmopressin induces release of vWF from cells
Factor VIII concentrate

29
Q

Dabigatran

A

Direct thrombin inhibitor
Excretion majority renal
Reverse: idarucizumab

30
Q

Rivaroxaban

A

Direct factor Xa inhibitor
excretion majority liver
reversal: andexanet alfa

31
Q

Apixaban

A

Direct factor Xa inhibitor
Excreted majority faecal
Reverse w andexanet alfa

32
Q

Edoxaban

A

Mechanism: direct factor Xa inhibitor
Excretion majority faecal
No reversal agent

33
Q

Symptoms of chronic lymphocytic leukaemia

A

Often none, may be picked up from incidetal lymphocytosis
Constitutional: anorexia, weight loss
Bleeding, infections
Lymphadenompathy more marked than CML

34
Q

Causes of massive splenomegaly

A

Myelofibrosis
CML
Visceral leishmaniasis
Malaria
Gaucher’s syndrome

35
Q

Chronic myeloid leukaemia genetics

A

Philadelphia chromosome
translocation between chromosome 9 and 22 generating the BCR-ABL fusion protein with a lot of tyrosine kinase actiity

36
Q

Presentation of CML

A

60-70 year olds
Anaemia: lethargy
weight loss
sweating
marked splenomegaly causing abdo discomfort
increase in granulocytes at different stages of maturation
decr leukocyte alkaline phosphatase
may undergo blast transformation, mostly to AML

37
Q

Management of CML

A

Imatinib= tyrosine kinase inhibitor and is first line

38
Q

Features of G6PD deficiency

A

Neonatal jaundice often
Intravascular haemolysis
Gallstones common
Splenomegaly maybe
Heinz bodies on film, bite and blister cells also possible

39
Q

Drugs causing haemolysis in G6PD

A

Anti malarials eg primaquine
Ciprofloxaacin
Sulph group drugs: sulphonamides, sulphasalazine, sulfonylureas
Infection may precipitate haemolysis
Also broad beans

40
Q

Risk factors for non-Hodgkin’s lymphoma

A

Elderly
Caucasians
History of viral infection, partic EBV
Family history
Cerain chemicals eg pesticides/solvents
history of chemo/radiotherapy
Immunodeficiency (transplant, HIV, DM)
Autoimmune disease (SLE, Sjogren’s. coeliac)

41
Q

Symptoms of non-hodgkins lymphoma

A

Painless lymphadenopathy (non-tender, rubbery, asymnetrical)
Constitutional B symptms (fever, weight loss, night sweats, lethargy)
extra nodal disease (gastric, bone marrow, lungs, skin CNS) (much more common than in Hodgkin’s)

42
Q

Signs of non-hodgkin’s lymphoma

A

Weight loss
lymphadenopathy (typically cervical, axillary or inguinal)
palpable hepatomegaly, splenomegaly or lymph nodes
testicular mass
feverI

43
Q

investigations for non-hodgkins lymphoma

A

Excision biopsy
CT -CAP
HIV test
FBC and film (normocytic anaemia)
ESR (prognostic indicator)
LDH (ditto)

44
Q

Management for non hodgkins lympoma

A

Dependent on subtype and asometimes watchful waiting
Or chemotherapy eg R-CHOP
Radiotherapy
Flu/pneumococcal vaccines

45
Q

Features of lead poisoning

A

ABdominal pain
Peripheral neuropathy
neuropsychiatric features
fatigue
constipation
blue lines on gum margin (fairly rare)

46
Q

Management of lead poisoning

A

Various chelating agents eg dimercaptosuccinic acid
D-penicillamine
EDTA
dimercaprol

47
Q

what roughly is myelofibrosis

A

Myeloproliferative disorder
from hyperplasia of abnormal megakaryovytes
release of platelet derived growth factor thought to stimulate fibroblasts in bone marrow
Haaematopoiesis happens in liver and spleen

48
Q

presentation of myelofibrosis

A

Elderly person presenting with symptoms of anaemia eg fatigue
Massive splenomegaly
Hypermetabolic symptoms: weight loss, night sweats etc

49
Q

Lab findings of myelofibrosis

A

Anaemia
High WBC and platelets early on in disease
Tear drop poikilocytes on blood film
Dry tap bone marrow biopsy
high urate and LDH (incr cell turnover)

50
Q
A

Year 6 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions