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Phase 2a > Haematology 2 > Flashcards

Haematology 2 Flashcards

1
Q

What is lymphoma?

A

Malignancy of lymphatic system

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2
Q

Who does Hodgkin lymphoma commonly affect?

A

Young adults

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3
Q

When does non-Hodgkin lymphoma typically present?

A

> 50 years

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4
Q

What is immune thrombocytopenic purpura?

A

Autoimmune destruction of platelets

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5
Q

What is the epidemiology of ITP?

A

More common than ITP
Acute/primary - children following infection
Chronic/secondary - young women

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6
Q

How does ITP present?

A 
Purpura
Epistaxis
Easy bruising
Menorrhagia
Gum bleeding
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7
Q

What is the first line investigation for ITP?

A

FBC (thrombocytopoenia)

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8
Q

How do you manage ITP?

A

IV corticosteroids
IV immunoglobulin
Splenectomy

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9
Q

What is thrombotic thrombocytopenic purpura (TTP)?

A

Platelet deficiency due to ADAMTS13 deficiency

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10
Q

What causes TTP?

A

Congenital or acquired
Postpartum or during pregnancy 10-25%
70% idiopathic
RF: HIV, autoimmunity, cancer, pregnancy

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11
Q

How does TTP present?

A 
Flu like symptoms
Purpura
Easy bruising and bleeding
Abdo/chest pain
Arrhythmias
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12
Q

How do you investigate TTP?

A

First line - FBC (thrombocytopenia)

Gold standard: low ADAMTS13, high ADAMTS13 antibodies

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13
Q

How do you manage TTP?

A 
Emergency
Plasma exchange to remove antibodies
FFP
IV methylprednisolone
Immunosuppression
Splenectomy
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14
Q

What is disseminated intravascular coagulation (DIC)?

A

Systemic activation of coagulation system

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15
Q

What are the risk factors for DIC?

A 
Sepsis (30-50% of patients)
Malignancy (leukaemia)
Major trauma - crush/burn
Pregnancy complications
Rejection of transplant/transfusion
Liver/pancreatic disease
Post op complications
Recreational drugs
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16
Q

How does DIC present?

A 
Bleeding & thrombosis out of control
ARDS
Bruising
Bleeding from at least 3 unrelated sites
Confusion
Fever
Infarction/necrosis/gangrene
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17
Q

How do you investigate DIC?

A

Repeat platelet count (low and decreasing)
Elevated D dimer
Prolonged PT/aPTT
Low fibrinogen

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18
Q

How do you manage DIC?

A

Transfusion of FFP/platelets
Heparin if thrombosis dominant (if not bleeding)
Tranexamic acid (TXA) if bleeding dominant
Treat underlying condition

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19
Q

What is DVT?

A

Venous thrombus in deep vein (leg/pelvis)

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20
Q

What are the risk factors for DVT?

A 
Hx DVT
60+
Surgery
Obesity
Long haul flights
Cancer
Fracture (immobility)
Pregnancy
HRT/COC
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21
Q

How does DVT present?

A 
Discolouration
Pitting oedema
Tenderness along deep veins
Increased skin temperature
Palpable cord
Pain
(in leg)
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22
Q

How do you investigate DVT?

A

Raised D-dimer

US duplex

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23
Q

How do you manage DVT?

A

Heparin 5 days
DOAC/warfarin 6 months
IVC filter

24
Q

What is DVT prophylaxis?

A

Compression stockings

LMWH

25
Q

How do you treat myeloma in young patients?

A

Chemo and autologous stem cell transplant

26
Q

Why is myeloma monitored after treatment?

A

Monitoring every 3 months for smoldering myeloma

27
Q

What are the risk factors for Hodgkin lymphoma?

A

Previous EBV

28
Q

What cells are affected in Hodgkin lymphoma?

A

T/B cells

29
Q

How does Hodgkin lymphoma present?

A

Painless lymph node enlargement (pain after drinking)
Hepatosplenomegaly
B symptoms

30
Q

What are ‘B symptoms’?

A

Fever
Night sweats
Weight loss

31
Q

How do you investigate Hodgkin lymphoma?

A

Lymph node biopsy

32
Q

What is seen on biopsy for Hodgkin lymphoma?

A

Reed Sternberg cells

33
Q

How is lymphoma staged?

A

Ann Arbour staging

34
Q

What is the Ann Arbour staging system?

A

Stage 1 -> the disease is in one area only
Stage 2 - the disease is in 2 or more areas on the same side of the diaphragm
Stage 3 -> the disease is in 2 or more areas on both sides of the diaphragm
Stage 4 - the disease has spread beyond the lymph nodes

35
Q

How is Hodgkin lymphoma treated?

A 
1A-2A = brief ABVD chemotherapy 
2A-4B = 8 cycles of ABVD and irradiation
36
Q

What is the most common childhood cancer?

A

Acute lymphoid leukaemia

37
Q

How is acute lymphoid leukaemia diagnosed?

A

Blast cells in blood film

38
Q

How is acute lymphoid leukaemia treated?

A

Chemo, stem cell transplant

80-90% cure rate

39
Q

What are the key clinical features of nephrotic syndrome?

A 
Proteinuria ++++++
Hypoalbuminaemia
Oedema +++
GFR ↓/↔
Hyperlipidaemia
40
Q

What does FBC show for sickle cell anaemia?

A

Low Hb, high reticulocytes

41
Q

What does blood film show for sickle cell anaemia?

A

Sickled RBCs

42
Q

What does Hb electrophoresis show for sickle cell anaemia?

A

HbS present, no HbA

43
Q

What are the risk factors for non-Hodgkin lymphoma?

A

EBV, hep C, HIV, H pylori, ionising radiation, genetics, autoimmune disease

44
Q

What cells does non-Hodgkin lymphoma affects?

A

B cells

45
Q

How does indolent non-Hodgkin lymphoma present?

A

Slow, presents advanced, incurable

46
Q

How does aggressive non-Hodgkin lymphoma present?

A

Severe but curable

47
Q

How does non-Hodgkin lymphoma present?

A

Painless lymphadenopathy
Hepatosplenomegaly
B symptoms
Extra nodal involvement

48
Q

How do you investigate non-Hodgkin lymphoma?

A

Lymph node biopsy, BM aspirate

49
Q

How do you treat low grade non-Hodgkin lymphoma?

A

Watch and wait, monoclonal antibodies, chemo

50
Q

How do you treat high grade non-Hodgkin lymphoma?

A

RCHOP chemo

51
Q

How do you slow the progression of CKD?

A

DM treatment
HTN treatment
Glomerulonephritis treatment

52
Q

How do thiazide diuretics prevent urolithiasis?

A

Helps with recurrent stones by reducing calcium levels

53
Q

Describe the course of chronic lymphocytic leukaemia.

A

Indolent/slow course

54
Q

How does chronic lymphocytic leukaemia present?

A

Enlarged lymph nodes & frequent infection

55
Q

How do you investigate chronic lymphocytic leukaemia?

A

Smudge cells on blood film

56
Q

How do you treat chronic lymphocytic leukaemia?

A

Incurable - chemo +/- stem cell transplant if young

57
Q

What are the gold standard investigations for ITP?

A 
Blood smear (thrombocytopoenia)
Platelet autoantibodies
Increased megakaryocytes in BM

Phase 2a (25 decks)

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