Haematology Flashcards
non-Hodgkins lymphoma risk factors
elderly, caucasian, FHx
viral infection -EBV
history of chemo/radiotherapy
immunodeficiency- HIV, DM, transplant
AI- SLE, shortens, coeliac
most common lymphoma in UK
diffuse large B cell
sickle cell anaemia blood count
normocytic anaemia with raised reticulocyte count
Thrombotic thrombocytopenia purpura
fever
altered mental state
thrombocytopenia
haemolytic anaemia- schistocytes
reduced renal function
non-hodgkin lymphoma diagnostic investigation of choice
excisional node biopsy
VWD blood tests
bleeding time increase, APTT prolonged, platelets normal
haemolytic anaemia blood tests
low Hb, high reticulocytes
low haptoglobin
high LDH
high indirect bilirubin
blood film –> spherocytes and reticulocytes
drugs associated with increased risk of VTE
COCP
HRT
raloxifene and tamoxifen
antipsychotics- olanzapine
Hodgkins lymphoma poor prognosis
B-symptoms,
increasing age,
male sex,
stage IV disease
lymphocyte depleted subtype
Children and young people (0-24yrs) with unexplained petechiae or hepatosplenomegaly
Refer for immediate specialist assessment for leukaemia
warm AIHA
IgG , extravascular
causes:
AI e.g. SLE
neoplasia e.g. lymphoma CLL
drugs e.g. methyldopa
warm AIHA treatment
treat underlying disorder
steroids +/- rituximab
cold AIHA
IgM, intravascular
causes:
neoplasia - lymphoma
infections- mycoplasma, EBV
lead poisoning
Abdominal pain,
constipation,
neuropsychiatric features,
basophilic stippling
Burton’s lines (blue lines on gum margin)
Platelet transfusion indication
platelet count < 30 x 109 and clinically significant bleeding
ITP treatment
plt count>30 –> observation
plt count<30 –> oral prednisolone
emergency treatment life threatening/organ threatening bleeding –> plt transfusion, IV methylprednisolone and IVIG
Factor V Leiden mutation results in
activated protein C resistance
CLL transformation
high-grade lymphoma (Richter’s transformation) making patients suddenly unwell
polycythaemia vera management
aspirin
venesection
chemotherapy- hydroxyurea
SCA acute sequestration vs aplastic crisis (parvovirus) infection
acute sequestration- high reticulocyte count
aplastic crisis (parvovirus) low reticulocyte count
Sideroblastic anaemia:
hypochromic microcytic anaemia
high ferritin iron & transferrin saturation
- basophilic stippling of red blood cells
Sideroblastic anaemia: causes
congenital
acquired:
- myelodysplasia
-alcohol
-lead
-anti-TB medications
DIC typical blood picture
↓ platelets
↓ fibrinogen
↑ PT & APTT
↑ fibrinogen degradation products
causes of massive splenomegaly
myelofibrosis
chronic myeloid leukaemia
visceral leishmaniasis (kala-azar)
malaria
Gaucher’s syndrome
