Haematology Flashcards
What are the common causes of iron deficiency anemia?
Blood loss (menorrhagia, GI bleeding), poor diet, malabsorption, hookworm
What are the two types of thalassemia, and which globin chains are affected in each?
α-thalassemia (ɑ-globin chains), β-thalassemia (β-globin chains)
What is a common symptom seen in both α-thalassemia and β-thalassemia?
Splenomegaly
What characteristic feature is seen in the bone marrow of sideroblastic anemia?
Ringed sideroblasts
What is the primary treatment for iron deficiency anemia?
Ferrous sulfate 200mg/8h continued for >3mo after Hb normalizes
What is a hallmark symptom of sickle cell disease?
Vaso-occlusive “painful” crisis
What is the recommended treatment for acute chest syndrome in sickle cell disease?
O2, fluids, PCA, antibiotics ± blood transfusion
What distinguishes chronic lymphocytic leukemia (CLL) in blood tests?
High lymphocytes
What mutation is commonly associated with chronic myeloid leukemia (CML)?
Philadelphia chromosome, t(9;22)
What coagulation disorder is associated with the presence of Livedo reticularis?
Antiphospholipid syndrome
When is testing for thrombophilia recommended?
Criteria include a history of thrombosis, unexplained thrombosis at a young age, recurrent pregnancy loss, or a family history of thrombosis.
What are the diagnostic criteria for myeloma?
Monoclonal band in serum or urine, increased plasma cells on bone marrow biopsy, evidence of end-organ damage
What symptom is often seen in myelofibrosis?
Pruritis after a hot bath
What are the common symptoms of iron deficiency anemia?
Fatigue, koilonychia, atrophic glossitis, angular cheilosis
What characteristic finding is observed in the blood film of sickle cell disease?
Sickle cells and target cells
What is the primary treatment for thrombocytosis in essential thrombocythemia?
Aspirin, hydroxyurea/hydroxycarbamide
What is the common diagnostic test for inherited thrombophilia? (antiphospholipid syndrome)
Anti-cardiolipin, high aPTT, low platelet count
What are the characteristic symptoms of Hodgkin lymphoma?
Lymphadenopathy (usually regional, alcohol-induced pain), hepatosplenomegaly, B symptoms
What is the primary symptom in thrombotic thrombocytopenic purpura (TTP)?
Pentad of fever, renal failure, hemolytic anemia, thrombocytopenia, neurological changes
What is the primary cause of vitamin B12 deficiency?
Malabsorption (pernicious anemia, post-gastrectomy, bowel resection, Crohn’s disease)
What complications are commonly associated with thalassemia?
Failure to thrive, splenomegaly, bone hypertrophy
What symptoms are commonly observed in acute lymphoblastic leukemia (ALL)?
Bone marrow failure (anaemia, infection, bleeding), lymphadenopathy
What is a primary symptom observed in acute myeloblastic leukemia (AML)?
Gum hypertrophy, hepatosplenomegaly
What is the diagnostic test for von Willebrand’s disease?
Factor VIII and vWF assay
What complications are associated with myelofibrosis?
Tear-drop poikilocytes
What symptoms are commonly observed in immune thrombocytopenic purpura?
Bleeding - petechiae, bruising, B-symptoms, hepatosplenomegaly
What characteristic finding is observed in the blood film of chronic lymphocytic leukemia (CLL)?
Lymphocytes, smear/smudge cells
What is a key feature observed in the blood film of chronic myeloid leukemia (CML)?
Granulocytic cells at different stages of differentiation
What are the common causes of microcytic hypochromic anemia?
Iron deficiency, thalassemia, sideroblastic anemia
What diagnostic test confirms the presence of thalassemia?
Hemoglobin electrophoresis, DNA testing
What diagnostic feature is seen in the blood test of essential thrombocythemia?
Isolated high platelets
What characteristic finding is observed in the biopsy of Hodgkin lymphoma?
Reed Sternburg cells
Antibodies seen in pernicious anaemia
Intrinsic factor and anti-parietal cell antibodies
Which clotting factors are deficient in Haemophilia A and B
8 and 9 respectively
1st and 2nd line treatments of haemophilia A
Desmopressin»_space; Factor VIII + tranexamic acid
What is prolonged in VwF?
Prolonged bleeding time and APTT
Rona’s tapped mnemonic for vitamin absorption sites
Dude Is Just Feeling Ill Bro
Duodenum for iron; jejunum for folate; ileum for B12
Where is iron absorbed?
Duodenum
Where is folate absorbed?
Jejunum
Where is B12 absorbed?
Ileum
How do we differentiate between essential and immune thrombocytopaenia
Essential thrombocytopaenia in older patients. ITP is preceded by URTI or illness
Most common leukaemia in adults in the Western world
B cell chronic lymphocytic leukaemia
How does B cell CLL present in most patients
Generalised lymphadenopathy, and hepatosplenomegaly
‘CRAB’ features of multiple myeloma
hyperCalcaemia, Renal failure, Anaemia (and thrombocytopenia) and Bone fractures/lytic lesions
Investigation of choice in suspected multiple myeloma and result
Monoclonal band on serum electrophoresis.
What is seen on blood film in myelofibrosis?
‘tear-drop’ poikilocytes
Bloods that are raised in myelofibrosis + mutations
Raised LDH and uric acid + JAK2 V617F mutation
Causes of DIC
Sepsis, trauma, infection
What is seen on bloods in DIC?
Low fibrinogen
What type of anaemia is B12 deficiency?
Megaloblastic, macrocytic anaemia
Differentials for macrocytic anaemia
- Folate deficiency
- Hypothyroidism
- Reticulocytosis
- Liver disease
- Myeloproliferative/ myelodysplastic disease
- Chronic alcohol excess
Where exactly is intrinsic factor secreted?
Parietal cells of stomach
If a patient was found to be deficient in both B12 and folate, how should this be managed, and why?
B12 replacement before folate replacement, due to risk of precipitating subacute degeneration of the spinal cord
Blood marker used to identify Granulomatosis with polyangiitis
cANCA positive
Symptoms of Granulomatosis with polyangiitis
- upper respiratory tract: epistaxis, sinusitis, nasal crusting
- lower respiratory tract: dyspnoea, haemoptysis
- rapidly progressive glomerulonephritis (‘pauci-immune’, 80% of patients)
saddle-shape nose deformity
Which type of cancer is associated with pernicious anaemia?
Gastric cancer
Which cancer does Polycythemia rubra Vera typically progress to?
AML
What test is used to confirm autoimmune haemolytic anaemia
Direct Coomb’s test
Which type of pneumonia is associated with autoimmune haemolytic anaemia?
Mycoplasma pneumonia