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Year 3 Finals > Haematology > Flashcards

Haematology Flashcards

1
Q

Name the complaint:
Rapid uncontrolled growth and accumulation of undifferentiated lymphoid cells

A

Acute lymphoblastic leukaemia

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2
Q

What is the most common cancer of childhood?

A

Acute lymphoblastic leukaemia

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3
Q

For how many months must maintenance therapy for haematological malignancy be carried out for?

A

18 months

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4
Q

Name the complaint:
Bone marrow failure + bone pain + infection + fever

A

Acute lymphoblastic leukaemia

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5
Q

Chronic lymphocytic leukaemia requires a white cell count of what to be diagnosed?

A

Over 5 x 10^9/L

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6
Q

Which Binet stage of chronic lymphocytic leukaemia is described:
5 lymph node areas involved + thrombocytopenia

A

Stage 3

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7
Q

What Binet stage of chronic lymphocytic leukaemia is described:
2 lymph node areas involved

A

Stage 1

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8
Q

Describe the Richter transformation

A

Chronic lymphocytic leukaemia transforming to diffuse large B cell lymphoma a

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9
Q

Thrombocytopenia is most likely to cause which type of bleeding?

A

Mucosal membrane bleeding - petechiae, nose bleeds, gum bleeds

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10
Q

Bone marrow aspirate blast cell percentage of how much is diagnostic of acute myeloid leukaemia?

A

More than 20%

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11
Q

Which haematological malignancy is associate with the Philadelphia 9;22 gene translocation?

A

Chronic myeloid leukaemia

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12
Q

Which gene mutation is associated with polycythaemia vera?

A

JAK2

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13
Q

Name the complaint:
Increased haematocrit + blurred vision + iron deficiency anaemia

A

Polycythaemia vera

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14
Q

Which anaemia is associated with polycythaemia vera?

A

Iron deficiency

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15
Q

EPO levels will be what in polycythaemia vera?

A

Low

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16
Q

What is the mode of action of ruxolitinib?

A

JAK2 inhibitor

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17
Q

When is ruxolitinib therapy indicated?

A

Polycythaemia vera, essential thrombocythaemia

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18
Q

Name the complaint:
Digital ischaemia + gout + headache

A

Essential thrombocythaemia

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19
Q

Anagrelide can be given in what haematological malignancy?

A

Essential thrombocythaemia - directly inhibits platelets

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20
Q

Which medication can be given in essential thrombocythaemia to decrease risk of thrombosis?

A

Aspirin

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21
Q

Name the complaint:
Back pain + hypercalcaemia + anaemia

A

Myeloma

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22
Q

Which immunoglobulin type of myeloma does not exist?

A

IgM

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23
Q

Name the clinical features of myeloma

A

CRAB:
C - hyperCalcaemia
R - Renal failure
A - Anaemia
B - Bone disease

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24
Q

Myeloma is a cancerous disorder of which cells?

A

Plasma cells (type of B cell)

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25
Q

The presence of IgM suggests what?

A

Lymphoma

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26
Q

What percentage of plasma cells must there be in bone marrow aspirate to diagnosis myeloma?

A

10%

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27
Q

A 6% plasma cell concentration on bone marrow aspirate warrants a diagnosis of what?

A

Monoclonal gammopathy of uncertain significant (MGUS)

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28
Q

Which bone cell does myeloma stimulate?

A

Osteoclasts

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29
Q

Zoledronic acid inhibits activity of what cells?

A

Osteoclasts

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30
Q

What is the key difference in presentation between lymphoma and leukaemia?

A

Lymphoma presents with B symptoms (fever, night sweats, weight loss, fatigue)

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31
Q

Hodgkin lymphoma is associated with what virus?

A

Epstein Barr virus

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32
Q

Alcohol induced painful lymphadenopathy indicates presence of what haematological malignancy?

A

Hodgkin lymphoma

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33
Q

Where are red blood cells made?

A

Bone marrow

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34
Q

Where is erythropoietin made, and in response to what?

A

Made in the kidneys in response to hypoxia

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35
Q

What is a red blood cells lifespan?

A

120 days

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36
Q

Haemolytic anaemia leads to what type of jaundice?

A

Pre hepatic unconjugated

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37
Q

Severe anaemia in spherocytosis can be treated by what?

A

Splenectomy
- spleen is main site of destruction of RBC, removal allows them to survive in circulation a bit longer

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38
Q

G6PD deficiency confers resistance against what disease?

A

Malaria

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39
Q

Name the complaint:
Anaemia + jaundice + history of DKA

A

G6PD deficiency

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40
Q

Sickle cell disease has what pattern of inheritance?

A

Autosomal recessive

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41
Q

Under what circumstances do red blood cells polymerise in sickle cell disease?

A

Hypoxia

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42
Q

Name the complaint:
Painful bones via vaso-occlusion + anaemia + PMH UTI

A

Sickle cell crisis

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43
Q

What effect does sickle cell disease have on the spleen?

A

Hyposplenism via splenic infarcts

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44
Q

What type of analgesia should be given in sickle cell crisis?

A

Opiate

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45
Q

Which disease modifying drug can be given sickle cell disease?

A

Hydroxycarbamide

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46
Q

Thalassaemia has what pattern of inheritance?

A

Autosomal recessive

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47
Q

G6PD deficiency has what pattern of inheritance?

A

X linked

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48
Q

At what age does beta thalassaemia major present at?

A

3-6 months
- due to foetal haemoglobin not having beta chains and so beta chain deficiency is unnoticeable until later

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49
Q

Name the complaint:
Anaemia + bony deformities + growth retardation

A

Beta thalassaemia major

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50
Q

How often should we give transfusions in beta thalassaemia major patients?

A

4-6 weekly

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51
Q

How can we treat iron overload in beta thalassaemia major?

A

SC desferrioxamine and/or oral desferasirox

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52
Q

What MCV value must cells have in order to be classed as microcytic?

A

Under 80fl

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53
Q

Iron deficiency anaemia presents with what levels of iron binding capacity and ferritin?

A

High iron binding capacity
Low ferritin

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54
Q

Which molecule produced by the liver is involved in absorption of iron?

A

Hepcidin

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55
Q

In what disease state is Hepcidin produced? What may this lead to?

A

Released in inflammatory state, may lead to anaemia of disease e.g. in rheumatoid arthritis

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56
Q

New iron deficiency in patietns over 60 raises concerns of what?

A

Colorectal cancer

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57
Q

What blood parameter should be measured in a normocytic normochromic anaemia?

A

Reticulocyte count

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58
Q

Normochromic normocytic anaemia with high reticulocyte count can be caused by what?

A

Haemolysis, acute blood loss

59
Q

Name the complaint:
Unconjugated hyperbilirubinaemia + anaemia + increased reticulocytes + high LDH

A

Haemolytic anaemia

60
Q

High LDH indicates what?

A

Increased cell turnover

61
Q

Macrocytic megaloblastic anaemia can be caused by lack of what 2 substances?

A

Vitamin B12 or folate

62
Q

What drugs can cause non-megaloblastic macrocytic anaemia?

A

Methotrexate, hydroxycarbamide

63
Q

Pernicious anaemia is characterised by presence of what?

A

Antibodies against intrinsic factor

64
Q

How can we treat pernicious anaemia?

A

IM B12 injections

65
Q

Hypothyroidism, liver disease and alcoholism can lead to what type of anaemia?

A

Non megaloblastic macrocytic anaemia

66
Q

Arterial thrombosis is made up of what 2 constituents?

A

Platelets + fibrin (white clot)

67
Q

Arterial thrombosis is most commonly secondary to what?

A

Atherosclerosis

68
Q

Thrombolysis can be given within how many hours of arterial thrombosis presentation?

A

4.5 hours

69
Q

Venous thrombosis is made up of what 2 constituents?

A

Red cells + fibrin (red clot)

70
Q

The Wells score is used to assess risk for what?

A

DVT

71
Q

D-dimer negative can be used to rule out what?

A

Venous thrombosis

72
Q

Factor V Leiden increases the risk of what?

A

Venous thrombosis

73
Q

Microvascular thrombosis is most commonly due to what?

A

DIC

74
Q

What is the unifying diagnosis for presentation of arterial and venous thrombosis together?

A

Atrial septal defect

75
Q

Wells score of 2 or more indicates the need for what investigation?

A

USS Doppler within 4 hours

76
Q

Wells score of less than 2 indicates the need for what investigation?

A

D-dimer within 4 hours

77
Q

What is the first line treatment for DVT?

A

Direct oral anticoagulant (apixaban, rivaroxaban) for 3 months in provoked DVT and 6 months in unprovoked DVT

78
Q

What assessment score can be used for bleeding significance?

A

ISTH tool

79
Q

Haemophilia has what pattern of inheritance?

A

X linked

80
Q

Name the complaint:
X linked condition + haemarthrosis

A

Haemophilia

81
Q

Which factors are deficient in haemophilia A and B?

A

A - factor VIII (8)
B - factor IX (9)

82
Q

Haemophilia will present with what blood finding?

A

Isolated prolonged APTT
- PT is normal

83
Q

Desmopressin (DDAVP) helps release of what from the endothelium?

A

Factor VIII and vWF

84
Q

Von Willebrand disease has what pattern of inheritance?

A

Autosomal dominant

85
Q

Von Willebrand disease causes what type of bleeding?

A

Platelet type

86
Q

Clinical presentation with bleeding and microvascular thrombosis indicates what?

A

DIC

87
Q

DIC causes depletion of what?

A

Clotting factors and platelets

88
Q

DIC can have what affect on blood pressure?

A

Hypotension
- due to bleeding

89
Q

ITP is most associated with what infectious agents?

A

EBV, HIV

90
Q

Isolated thrombocytopenia is suggestive of what?

A

ITP

91
Q

Which vitamin cannot be absorbed in cholestasis?

A

Vitamin K

92
Q

Haemorrhagic disease of the newborn can be prevented by administering what at birth?

A

Vitamin K

93
Q

Name the complaint:
Pancytopenia + hypo cellular bone marrow + no abnormal cells

A

Aplastic anaemia

94
Q

Name the complaint:
Bronze skin + liver cirrhosis + T2DM + adrenal insufficiency

A

Haemochromatosis

95
Q

Haemachromatosis results in excessive what?

A

Iron accumulation

96
Q

Which factor does vWF stabilise?

A

Factor 8

97
Q

What should be checked and corrected before starting folate?

A

B12

98
Q

Thalassaemia will present with what type of anaemia?

A

Hypochromic microcytic

99
Q

Patients with SLE and APS should be commenced on what 2 medications for DVT prophylaxis?

A

Low dose aspirin + LMWH

100
Q

Which metabolic disturbance is common with heparin?

A

Hyperkalaemia

101
Q

Lymphadenopathy and splenomegaly together are most associated with which haematological malignancy?

A

CLL

102
Q

Reed-Sternberg cells are indicative of which haematological malignancy?

A

Hodgkin’s lymphoma

103
Q

Imatinib can be used in which haematological malignancy?

A

Chronic myeloid leukaemia

104
Q

Which drug can reduce the amount of sickle cell crises experienced by a patient?

A

Hydroxycarbamide
- increases foetal haemoglobin

105
Q

Presence of schistocytes on blood film indicates what type of haemolysis?

A

Intravascular

106
Q

Peptic ulcer disease most commonly causes which type of anaemia?

A

Iron deficiency
- microcytic hypochromic

107
Q

Presence of the CD20 antigen identifies the presence of what type of cells?

A

Mature B lymphocytes
- consider CLL in presence of CD20

108
Q

Malignancy increases the risk of what haematological complication?

A

Venous thromboembolism

109
Q

Thrombocytopenia and raised fibrin degradation products indicates what?

A

DIC

110
Q

Subacute combined degeneration of the cord is a complication of what?

A

Vitamin B12 deficiency

111
Q

The presence of Bence-Jones proteins is suggestive of what diagnosis?

A

Multiple myeloma

112
Q

EPO use in athletes can lead to what?

A

Polycythaemia

113
Q

Which coagulation factors are affected in liver disease?

A

1, 2, 5, 7, 9, 10, 11

114
Q

Abdominal pain in chronic myeloid leukaemia is most commonly caused by what?

A

Massive splenomegaly

115
Q

Factor V Leiden results in what?

A

Activated protein C resistance

116
Q

Definitive diagnosis of sickle cell disease is by what?

A

Haemoglobin electrophoresis

117
Q

What is the most common adult leukaemia?

A

CLL

118
Q

Where are the majority of red blood cells broken down?

A

Spleen
- splenectomy can be beneficial in medication refractory anaemia or very severe anaemia

119
Q

Hydroxyurea is beneficial in the prophylaxis of what condition?

A

Sickle cell disease

120
Q

Cytokines released by myeloma cells increase activity of what cells?

A

Osteoclasts
- leads to hypercalcaemia

121
Q

How long do body stores of vitamin B12 last?

A

2-4 years

122
Q

Haemolysis results in what levels of haptoglobin?

A

Low levels

123
Q

Methotrexate leads to a megaloblastic anaemia via lack of what?

A

Folate

124
Q

Which haematological malignancy presents with no bone marrow failure?

A

Chronic myeloid leukaemia

125
Q

Joint pain + hyperpigmentation on palmar creases are indicative of what complication of beta thalassaemia?

A

Iron overload

126
Q

What is the first line treatment for von-Willebrand disease?

A

Desmopressin

127
Q

Desmopressin increases circulating levels of what?

A

Factor 8 and von Willebrand factor

128
Q

Deficiency in protein S causes increased risk of what?

A

Blood clotting

129
Q

Protein C inhibits what factors?

A

5 & 8

130
Q

To which patient group must Anti-D prophylaxis be given?

A

Rhesus negative

131
Q

What is the current mainstay for ALL treatment?

A

Chemotherapy

132
Q

Pernicious anaemia occurs due to the autoimmune destruction of what?

A

The stomach lining

133
Q

What is the first line treatment for ITP?

A

Oral prednisolone

134
Q

What is the antigen in blood group A?

A

N-acetyl-galactosamine

135
Q

What is the antigen in blood group B?

A

Galactose

136
Q

Which blood type should be given in an emergency?

A

O negative

137
Q

Which blood group is the universal donor?

A

O negative

138
Q

How long after the start of a transfusion do we check obs?

A

15 minutes

139
Q

Acute transfusion reactions can occur up to how long after transfusion?

A

24 hours

140
Q

DHTR can occur up to how long after transfusion?

A

14 days

141
Q

What is the most common reaction in RBC transfusions?

A

Febrile

142
Q

Which cell is involved in parasitic infection?

A

Eosinophils

143
Q

Which cells are involved in fungal infection?

A

Monocytes

144
Q

What blood finding is common after chemotherapy?Neutropenia

A

Year 3 Finals (7 decks)

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