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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
mycoplasma is a common cuase of what
cold autoimmune haemolysis
25
different types of haemolytic anaemia
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
autoimmune causes differnces between warm and cold
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
75m asx but mildly anemic PMH - HTN, AF, metallic arotic valve Hb 106 normocystic , uncoguated hyperbilirubinaemia high LDH reitucloytes on film most likely cause?
haemolytic anaemia
28
how do you distinguish between an immune and non immune haemolytic anemia
coombes test positive in immune
29
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
auer rods - APL clotting disorder looks like DIC AML with DIC is APL - get auer rods on film
30
smudge cell
CLL
31
mx of AML anaemia thrombocytopenia DIC infection TLS - cell breakdoen CNS prophylaxis
packed RBC platelts if udner 10 FFP cryo ABx and reverse barriernurising allopurinol intrachecal chemo such as methotrexaae
32
33
34
vWD what pattern on clotting tests
normal platelets and normal PT and TT prolonged bleeding and prolonged APTT
35
vWF factor nromally linkes platelets to exposed endothelium and stabalises clotting factor
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
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
slow down transfusion and consider paracetamol - as for febrile non-h transfusion reaction
37
TACO presents with fluid overloads hwo to manage
slow transfusion and give furosemide
38
acute haemolytic transfusion reaction caused by giving incompatible blood how to manange
can develop to dic stop transfusion and give saline and manage DIC
39
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
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
how does DIC present
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
1m hx back pain and fatigue in 75M. IgG paraprotein spike and urinary bene jones protein spike what complication of dx
hypercalcaemia
41
myeloma features
evidecne of organ damage-- CRAB HAI - hyperCa, renal impair, anaemia, bone disease, hyperviscoity, amylodiosis, infection(recurrent)
42
ix for myeloma
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
amyloidosis what is it - can get in myeloma too where do you take biopsy from
deposition of extraceullar insoluble fibrins in organ and BV macroglossia( large toungue), hepatosplenomegay, neuropathuoes take biopsy from the rectum( chritz jeuger - tonsils)
44
80M , 3rd admission in 6m with LRTI requiring IV. course exp creps at base with consolidation on CXR - WCC 47 - dx?
CLL - can watch and wait, severe can chemo
45
what is richters syndrome
CLL turn into high grade lymphoma usually asx in CLL
46
causes of massive splenomegaly - MS
CML myelofibrosis malaria visceralleishManiasis
47
what drug causes low magnesium and low calcium and sodium
omeprazole
48
malnutrition causes what electrolytes to be low
Phosphate and magnesium
49
what flow murmur
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
what are the two types of lymphoma
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
what is more common hodgkins or non hodgkins
Non-Hodgkin's lymphoma is much more common than Hodgkin's lymphoma
52
NonH sx
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
Lymphadenopathy in Hodgkin's lymphoma can experience alcohol-induced pain in the node
True
54
B' symptoms typically occur earlier in Hodgkin's lymphoma and later in non-Hodgkin's lymphoma
True
55
Extra-nodal disease is much more common in non-Hodgkin's lymphoma than in Hodgkin's lymphoma
true
56
non h tx
Rituximab is used in combination with conventional chemotherapy regime screened for hep B as rituximab can cause reactivation
57
hodgkins features and signs
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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