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UK MLA AKT quesmed youtube videos - notes > Haematology > Flashcards

Haematology Flashcards

1
Q

how does growth hormone deficiency lead to obesity

A

The reduction in GH secretion may further increase fat accumulation by reducing lipolysis, and therefore exacerbate obesit

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2
Q

32yr old man - TB therapy - microcytic anaemia with low HB , raised ferritin transferrin sat and serum iron - basophilic granules seen on film what dx

A

sideroblastic anaemia

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3
Q

when in anaemia do you get signs of hyper dynamic circulation such as raised HR , flow murmurs and HF

A

when HB unver 8

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3
Q

well known drug cause of sideroblastic anaemia

A

isoniazid

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4
Q

causes of iron defiency anaemia

A

malabsoprtion - eg coeliac
BLood loss - menorrhagia , GI
hookworm

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5
Q

malabsorption bloods what is shown - electrolytes

A
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6
Q

ix and Mx for iron def an.

A

Ix
FBC, blood film, iron studies, Gi ix, menorrhagia

treat cause and replace iron stores for 3 months with PO fe - aware of se such as gi disturbance and black stools

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7
Q

27yr old vegan woman - weakness of legs and numbness and paraesthesia. reflexes present and plantars upgoing . romberg positive - dx?

A

subacute degeneration of the cord

ALS - no sensory
MS - not gradual - flares and remissions
vit E - not as common

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8
Q

what are megaloblasts

A

large immature RBCs and also hypersegemented neutrophils over 5 on blood film

caused by inhibtion of DNA synthesisi - folate and B12 needed for this

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9
Q

4 meagloblastic an cuases

A

B12 , folate, methotrexate and hydroxyurea

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10
Q

no megaloblasti cmacrocytsis cx

A

alcohol
hypothyrodisim
myelodysplastic syndromes
reticulocytosis

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11
Q

60 man - hernia repars, HB 19.2, platlet 490, mild splenomegalym and red complexion - raised cell mass and EPO level normla. what dx

A

VTE

this is polycythaemia rubera vera

not high Ca - associated with myeloma not PCV

hypouricaemia - tumour lysis syndrome
cor pulmonale

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12
Q

mutuation with polycthaemia

A

jak2

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13
Q

difference between primary and secondary polycythaemia

A

primary - normal or low EPO
secondary - high EPO

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14
Q

primary polycthaemia what cause

A

neoplastic - polcythaemia vera

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15
Q

secondary polycthaemia could be what

A

repsonse to hypoxia, neoplasma or cysts
chronic cause

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16
Q

ix for polycythameia

A

hb and plasma cell vol - both up

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17
Q

mx of PCV

A

venesection
hydroxyurea - suppress production
aspirin - reduce platelet aggregation and occlusion.

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18
Q

36 F, SOB and pleuritic CP, PE dx, PMH of antiphospholipid syndrome adn DVT 10m ago - on warfarin. What is appropriate long term mx plan

A

warfarin for life, target INR of 3-4 ( normal VTE target 2-3- so in this case tx failure)

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19
Q

provoked PE

A

3m tx

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20
Q

unprovoked pe

A

6mon

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21
Q

recurrence target INR

A

3-4

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22
Q

28
fatigue and SOB
recent penumonia - mycoplasma
red-brown urine
icteric - jaundiced
Hb 98
normal WCC and platelete
pre-hepatic hyperbilirubinaemia and raised LDH
what is this?

A

autoimmune intravascualr haemolysis

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23
Q

raised LDH

A

haemolytic anaemia - rbc contain LDH

24
Q

mycoplasma is a common cuase of what

A

cold autoimmune haemolysis

25
Q

different types of haemolytic anaemia

A

hereditary and acquired

H - h. spherocytosis
metabolism - G^PD and pyruvate def
Hb - sickle cell, thalsassaemic, HBc

acquired
immune - autoimmune - warm/cold
alloimmune

red cell frag
infections such as malaria and clostridia
secondary to renal or liver disease
nocturnal

26
Q

autoimmune causes differnces between warm and cold

A

warm - antibodies bind at body temp - centrally haemolytic - iGg - lymphoma, drugs and SLE

cold- normal in peripherals and binding occurs here under 4 degrees - Igm - infections usch as mycoplasma and EBV

steriods treat

27
Q

75m
asx but mildly anemic
PMH - HTN, AF, metallic arotic valve
Hb 106 normocystic , uncoguated hyperbilirubinaemia
high LDH
reitucloytes on film
most likely cause?

A

haemolytic anaemia

28
Q

how do you distinguish between an immune and non immune haemolytic anemia

A

coombes test
positive in immune

29
Q

30F , fatigue, WL and menorrhagia. Easy bruising, HB 8 WCC of 30 and platelets of 40. Prolonged PT and APTT and low fibrinogen, raised d-dimer - which blood film consistent with most likely dx

A

auer rods - APL
clotting disorder looks like DIC

AML with DIC is APL - get auer rods on film

30
Q

smudge cell

31
Q

mx of AML

anaemia
thrombocytopenia
DIC
infection
TLS - cell breakdoen
CNS prophylaxis

A

packed RBC
platelts if udner 10
FFP cryo
ABx and reverse barriernurising
allopurinol
intrachecal chemo such as methotrexaae

34
Q

vWD what pattern on clotting tests

A

normal platelets and normal PT and TT
prolonged bleeding and prolonged APTT

35
Q

vWF factor nromally linkes platelets to exposed endothelium and stabalises clotting factor

A

8 - which is why APTT prologned in due to decreased factor 8 activity

in contrast to haemophilia, bleeding into joints or muscles is uncommon

36
Q

64yr old man - high ant resection for ca - post op hb of 68. SON - tranfuse - 2 units - develops fever at 37.7 - obvs normall what do you do

A

slow down transfusion and consider paracetamol - as for febrile non-h transfusion reaction

37
Q

TACO presents with fluid overloads hwo to manage

A

slow transfusion and give furosemide

38
Q

acute haemolytic transfusion reaction caused by giving incompatible blood how to manange

A

can develop to dic
stop transfusion and give saline and manage DIC

39
Q

5yr old male - fever headache and skin rash. ,ICU - blood oozin from cannula sites, gingival bleeding and low bP - what coag profile most liekly seen

A

decreased fibrinogen, decreased platelets, elevated d-dimer

sounds like DIC secondary to meningitis
- DIC lots of clotting happenin and using up all platelts and fibrinogen and because clotting d-dimer will rise as breaking it all down, Therefore normal function does not occur so bleed

40
Q

how does DIC present

A

inappropriate activation of clotting cascade resulting in thrombus formation and depletion of clotting factors and platelets. Pt presents with excess bleeding

petechiae, bruising and confusion and low BP
RF - major trauma, burns, sepsis, obstetric complications, solid tumour or haematological malignancies

40
Q

1m hx back pain and fatigue in 75M. IgG paraprotein spike and urinary bene jones protein spike what complication of dx

A

hypercalcaemia

41
Q

myeloma features

A

evidecne of organ damage– CRAB HAI - hyperCa, renal impair, anaemia, bone disease, hyperviscoity, amylodiosis, infection(recurrent)

42
Q

ix for myeloma

A

FBC, film, ESR, urine dip, 24hr urine collection, UandEs , urate, albumin, calcium, phosphate, ALP, serum and urinary electrophoresis. serum ig , X-ray and bone marrow biopsy

43
Q

amyloidosis what is it - can get in myeloma too

where do you take biopsy from

A

deposition of extraceullar insoluble fibrins in organ and BV

macroglossia( large toungue), hepatosplenomegay, neuropathuoes

take biopsy from the rectum( chritz jeuger - tonsils)

44
Q

80M , 3rd admission in 6m with LRTI requiring IV. course exp creps at base with consolidation on CXR - WCC 47 - dx?

A

CLL - can watch and wait, severe can chemo

45
Q

what is richters syndrome

A

CLL turn into high grade lymphoma

usually asx in CLL

46
Q

causes of massive splenomegaly - MS

A

CML
myelofibrosis
malaria
visceralleishManiasis

47
Q

what drug causes low magnesium and low calcium and sodium

A

omeprazole

48
Q

malnutrition causes what electrolytes to be low

A

Phosphate and magnesium

49
Q

what flow murmur

A

Blood flowing faster than normal through the heart valves
When it occurs
During exercise, pregnancy, rapid growth, or other times when blood flow increases
Who it affects
Common in children and teens, but some people experience them into adulthood

50
Q

what are the two types of lymphoma

A

Lymphoma is the malignant proliferation of lymphocytes which accumulate in lymph nodes or other organs. Lymphoma may be classified as either Hodgkin’s lymphoma (a specific type of lymphoma characterized by the presence of Reed-Sternberg cells) or non-Hodgkin’s lymphoma (every other type of lymphoma that is not Hodgkin’s lymphoma).

51
Q

what is more common hodgkins or non hodgkins

A

Non-Hodgkin’s lymphoma is much more common than Hodgkin’s lymphoma

52
Q

NonH sx

A

Painless lymphadenopathy (non-tender, rubbery, asymmetrical)
Constitutional/B symptoms (fever, weight loss, night sweats, lethargy)
Extranodal Disease - gastric (dyspepsia, dysphagia, weight loss, abdominal pain), bone marrow (pancytopenia, bone pain), lungs, skin, central nervous system (nerve palsies)

53
Q

Lymphadenopathy in Hodgkin’s lymphoma can experience alcohol-induced pain in the node

54
Q

B’ symptoms typically occur earlier in Hodgkin’s lymphoma and later in non-Hodgkin’s lymphoma

55
Q

Extra-nodal disease is much more common in non-Hodgkin’s lymphoma than in Hodgkin’s lymphoma

56
Q

non h tx

A

Rituximab is used in combination with conventional chemotherapy regime

screened for hep B as rituximab can cause reactivation

57
Q

hodgkins features and signs

A

lymphadenopathy - alcohol
systemic b sx
mediastinal mass

nromocytic anaemia
esoinophilia
LDH raised
lymph node biopsy showing multinucleated or bilobed nucelus with eosoinophlic inclusion

UK MLA AKT quesmed youtube videos - notes (1 decks)

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