Haematology Flashcards
4 symptoms of lymphoma
rubbery lump in neck
fever
night sweats
weight loss
painful nodes when drinking alcohol
pruritis
Name 2 signs you will look for on examination in lymphoma
Enlarged lymph nodes
Splenomegaly
Hepatomegaly
Classical cell name that suggests Hodgkin’s lymphoma
Reed-sternberg cell
State 2 staging investigations for Hodgkins
What staging system is used for Hodgkins?
Lugano classification
Hodgkins pt with dyspnoea, swelling of face and congested veins in neck and chest - what has happened
SVCO
Name 3 signs of anaemia
Tachypnoea
Pale conjunctiva
Tachycardia
Ejection systolic murmur
Other than menorrhagia, name one other cause of iron-deficiency anaemia
Inadequate dietary intake
Internal bleeding e.g. malignancy
Name 2 specific signs of chronic iron-deficiency anaemia
Angular cheilosis
Koilionychia
Atrophic glossitis
Name 2 common side effects of ferrous sulphate
Dark sticky stools
Nausea
Constipation
Diarrhoea
Name 2 drugs used in the long term treatment of sickle cell anaemia
Hydroxycarbomide
Penicillin V
Other than infection, name 2 factors that can bring on a sickle-cell crisis
Dehydration
Exposure to cold
Hypoxia
Acidosis
State 3 general points in managing a vaso-occlusive sickle cell crisis
Oxygen
Analgesia
IV fluids
Empirical abx
Pattern of inheritence of sickle-cell disease?
Likelihood of children carrying sickle cell if partner has normal chromosomes?
Autosomal recessive
100%
Why does sickle cell not clinically manifest until roughly 6 months of age
Fetal Hb mask the effect of the disease
What is multiple myeloma
Malignant clonal proliferation of B-lymphoacytic plasma cell
What is the commonest immunoglobulin expressed as part of multiple myeloma
IgG
Other than bone pain, name 2 other symptoms of multiple myeloma
Recurrent infections
Bruise easily
Tiredness
Polydipsia
Abdominal pain
Confusion
Except an X-ray, name 3 investigations you would perform for multiple myeloma
FBC
Blood film
U&E
Serum electrophoresis
Urine electrophoresis
Serum calcium
Serum immunoglobulins
Bone marrow sampling
Why are multiple myeloma patients prone to infections
Bone marrow infiltration (low WCC)
Immunoparesis secondary to overexpression of one immunoglobulin
State 4 complications of myeloma
Hypercalcaemia
Spinal cord compression
Hyperviscosity
Acute renal failure
Name 2 causes for splenomegaly other than leukaemia
Haemolytic anaemia
Malaria
Lymphoma
Liver cirrhosis w/ portal hypertension
Chronic leukaemia WCC?
High
How could you differentiate on a blood film between acute leukaemia and chronic leukaemia?
AL: immature WBC
CL: mature WBC
What leukaemia has the characteristic philadelphia chromosome?
CML
Bone marrow aspirate with 95% cancer cells after medical treatment - management?
Bone marrow transplant
3 FBC findings in bone marrow failure
Thrombocytopenia
Anaemia
Leucopenia/neutropenia
Why do you get bone pain in bone marrow failure
Marrow infiltration
Immediate investigation in possible haematological malignancy
Blood film
Bone marrow biopsy shows dominant presence of blast cells of myeloid lineage - diagnosis
AML
Supportive treatment during stem cell transplantation
Blood transfusions (anaemia)
Platelet transfusions (thrombocytopenia)
Prophylactic abx
Below what value of Hb should a blood transfusion take place, regardless of symptoms
70
Name 2 signs of severe anaemia
Tachycardia
Tachypnoea
Flow murmur
Pallor
Fever and hypotension after blood transfusion - differential diagnoses of type of transfusion reaction
Acute haemolytic
Bacterial contamination
First management step in adverse transfusion reaction
stop the transfusion
Oozing from cannula site after transfusion reaction - what haematological state has occurred?
DIC
Other than acute haemolytic, name 1 type of early (24h) transfusion complication and 1 late (after 24h)
Allergic
TRALI
TACO
Iron overload
Graft v host
Infection
What is the definition of a massive blood transfusion
Entire pts blood volume / 10 units within 24h
Name 2 causes of each category of macrocytic anaemia
Megaloblastic - folate and B12
Normoblastic - thyroid, liver, alcohol
What test distinguishes between the 2 categories of macrocytic anaemia
blood film
Pt w/ addisons disease and vitiligo has macrocytic anaemia - likely cause?
Name a test that could help confirm your diagnosis
Pernicious anaemia
Intrinsic factor antibody serology
How will you treat the macrocytic anaemia
IM hydroxycobalamin
Signs of thalassaemia major on examination (2)
Hepatosplenomegaly
Frontal bossing
Jaw enlargement
Dental malocclusion
Flow murmur
Generalised pallor
Common name given to beta-thalassaemia major
Cooley’s anaemia
2 main treatments for beta-thalassaemia major
Blood transfusion
Iron chelation therapy
Why does thalassaemia major never usually present in the first 6 months of life
fetal Hb
How can haemophilia lead to compartment syndrome and joint deformities
Bleeding into joints
How is haemophilia A inherited
X-linked recessive
Which clotting factor is deficient in haemophilia A
8
INR and APTT in haemophilia A
normal INR, prolonged APTT
Name a treatment for haemophilia A to improve clotting factor deficiency
Purified factor 8
FFP containing factor 8
Desmopressin
How would you account for a lady being diagnosed with haemophilia A at the age of 70
acquired haemophilia A
