Haematology Flashcards
Which are the ACUTE leukaemia types / classifications?
- Acute lymphoblastic leukaemia (ALL)
- Acute myeloid leukaemia (AML)
What is the epidemiology of ALL
?
Children.
What are the symptoms of ALL
?
- Fatigue (anaemia)
- Bleeding, petechia, purpura, ecchymoses (trombocytopenia)
- Recurrent infections (low or abnormal WBC’s)
- LUQ tenderness & early satiety (splenomegaly).
Diagnosis of ALL (acute lymphoblastic leukaemia)
► Most initial
⟶ FBC depression of all 3 cell lines:
* Anaemia (normochromic normocytic)
* WBC (low, normal or elevated)
* Thrombocytopenia
► Most appropriate
⟶ Peripheral blood test: Leukaemic blasts/lymphoblasts on peripheral blood
► Most definitive test
⟶ Bone marrow biopsy:
* Blasts cells.
What is the epidemiology of AML
?
Mostly elderly.
What are the symptoms of AML
?
Acute myeloid leukaemia
⬇︎ RBC
- Anaemia
- Fatigue
⬆︎ WBC
- Fever
- Leukocytosis / leukopenia
- Gingivitis
⬇︎ PLT
- Bleeding
- Hepatosplenomegaly
Diagnosis of AML
?
► Most initial
⟶ FBC (abnormal)
► Most appropriate
⟶Peripheral smear:
Auer rods
► Most definitive test
⟶Bone marrow biopsy:
Myeloblasts
Where are the following absorbed in the body?
- B12
- Folate
B12
-Terminal ileum
Folate
- Jejunum / duodenum
What are the causes of Vitamin B12 defficiency
?
- Vegan diet
- Gastrectomy
- Pernicious anaemia
- Ileal disease
- Chrohn’s disease
- Malabsorption diseases
What are the symptoms of Vitamin B12 defficiency
?
- Macrocytic anaemia
- Pins and needles on the limbs
- Cognitive changes
What is the Rx of Vitamin B12 defficiency
?
Hidroxycobalamin IM.
DDx of peripheral smear
in leukaemias.
ALL
- Lymphoblasts
AML
- Myeloblast
- Auer rods
CLL
- Small mature lymphocytes
- Smudge cells
CML
- Mature myeloblasts
- ⬆︎ Basophils
What are the symptoms of CLL
?
Chronic lymphocytic leukaemia
- Leukocytosis
- Enlarged lymph nodes
Diagnosis of CLL
Peripheral blood smear
-Smudge cells
What is the epidemiology of CML
?
Chronic myelocytic leukaemia
Elderly.
What are the symptoms of CML
?
- Leukocytosis
- Massive splenomegaly
Diagnosis of CML
Peripheral blood smear
- All stages of maturation seen
- Basophils increased
Genetics
- Philadelphia chromossome
DDx between:
- Von Willebrand
- Haemophilia
- Disseminated intravascular coagulation
Von willebrand
- Platelet type bleeding
- Mucosal bleeding
- aPTT prolonged
- Bleeding time prolongued
Haemophlia
- Factor type bleeding
- Bleeding into joints and muscles
- aPTT prolonged
DIC
- Bleeding everywhere
- aPTT prolonged
- PT prolonged
- Bleeding time prolonged
- ↑ D-dimers
-
aPTT (activated partial thromboplastin time): measures the amount of time it takes for a blood clot to form.
Normal:
21 - 35 sec. -
PT (prothrombin time): measures how many seconds it takes for a clot to form in a blood sample
Normal:
11 - 13 sec.
DDx between:
- Vit B12 deficiency
- Folate deficiency
Vit B12 deficiency
- Vegans
- Found in meats
Folate deficiency
- Meat eaters
- Found in vegetables
DDx between:
- Direct coombs test
- Indirect coombs test
Direct coombs test
- Diagnosis of autoimmune haemolytic anaemia
- Detects antibodies on RBC surface
Indirect coombs test
- Detects antibodies in the serum
- Cross-matching of blood
- Antenatal antibody screen
Describe Disseminated intravascular coagulation.
- Widespread activation of the coagulation cascade;
- Results in ⬇︎ clotting factors;
- Blood clots in different organs;
- Bleeding.
What are the causes of DIC
?
- Sepsis
- Major trauma
- Complications of pregnancy
- Cancer
What are the symptoms of DIC
?
- Bleeding
- Purpura
- Petechiae
What are the investigations / LABS of DIC
?
Increased:
- PT
- aPTT
- INR
- D-Dimer
Decreased:
- PLT
- Fibrinogen