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Core Conditions > Haematology > Flashcards

Haematology Flashcards

1
Q

What is the most common cause of anaemia in the world ?

A

Iron deficiency

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2
Q

Which Histological cells are characteristic of Hodgkin’s lymphoma ?

A

Reed-steinberg cells - mirror-image nuclei

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3
Q

What are the peak incidence of Hodgkin’s lymphoma ?

A
  • 20-34 (young adults)

- >70 (elderly)

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4
Q

What signs may be found in Hodgkin’s lymphoma ?

A
  • lymphadenopathy (usually cervical, axilliary)
  • cachexia
  • anaemia
  • splenomegaly or hepatomegaly
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5
Q

Which virus is known to increase the risk of lymphoma ?

A

EBV

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6
Q

Symptoms of Hodgkin’s lymphoma ?

A
  • enlarged, painless, rubbery superficial lymph nodes
  • fever, night sweats
  • weight loss
  • lethargy
  • pruritis
  • if mediastinum involvement = bronchial, SVC obstruction
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7
Q

Tests for suspected lymphoma ?

A
  • lymph node excision biopsy

- full bloods

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8
Q

What is the link with alcohol and Hodgkin’s lymphoma ?

A

After ingesting causes pain at site of lymph node involvement

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9
Q

What is the difference between Hodgkin’s and non Hodgkin’s lymphoma ?

A

Non Hodgkin’s originates in the WBC , T and B lymphocytes whereas Hodgkin’s originate in the lymph nodes
- non Hodgkin’s more likely to disseminate to extra nodal sites

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10
Q

Which type of lymphoma is H pylori associated with ?

A

Gastric mucosa-associated lymphoid tissue (MALT)

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11
Q

What are the common extra nodal sites of non Hodgkin’s lymphoma ?

A

Bone, gut, CNS or lung

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12
Q

What is burkitts lymphoma ?

A

Childhood disease with characteristic jaw lymphadenopathy

Example of high-grade non Hodgkin’s lymphoma

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13
Q

What are the causes of macrocytic anaemia ? (8)

A
  • B12/folate
  • Alcohol excess/liver disease
  • Reticulocytosis
  • cytotoxics (e.g. Hydroxycarbamide)
  • myelodysplastic syndromes
  • marrow infiltration
  • hypothyroidism
  • anti folate drugs e.g. Phenytoin, trimethoprim
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14
Q

What are the causes of iron deficiency anaemia ? (4)

A
  • blood loss, e.g. Periods, GI bleed
  • poor diet (usually in children)
  • malabsorption e.g.coeliacs
  • parasitic e.g.hookworm in the tropics
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15
Q

What is the treatment for iron deficiency anaemia ?

A
  • treat underlying cause

- oral iron tablets

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16
Q

What else should be considered if microcytic anaemia not responding to iron replacement ?

A

Sideroblastic anaemia

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17
Q

Which vitamin enhances absorption of iron ?

A

Vitamin C

18
Q

Which drugs may impair absorption of iron ?

A

antacids and PPIs - as increase pH

19
Q

Which bacteria can impair uptake of iron ?

A

h pylori - also increases iron loss

20
Q

What is the symptoms of iron Deficiency anaemia ?

A
  • fatigue
  • SOB
  • palpitations
  • pruritis
  • Headache
  • tinnitus
21
Q

What signs may you find in someone with iron deficiency anaemia ?

A
  • koilonychia
  • atrophic Glossitis
  • angular chelitis
  • pallor in conjunctiva, palmar creases etc
22
Q

Define anisocytosis ? When is it seen ?

A

= variation in RBC size

As in megaloblastic anaemia, thalassaemia etc

23
Q

Define poikilocytosis, when does it occur ?

A

= variation in RBC shape

As in IDA, myelofibrosis, thalassaemia

24
Q

What a Reticulocytes?

A

Young, larger RBCs - signify active erythropoiesis

25
Q

What do neutrophils do ? When might they be increased ?

A

Ingest and kill bacteria, fungi and damages cells

Increased in:

  • bacterial infections
  • inflammation e.g. MI
  • myeloproliferative disorders
  • drugs e.g. Steroids
  • stress e.g. Trauma, surgery, burns
26
Q

When might neutrophil count be low ?

A
  • viral infections
  • drugs e.g. Chemo
  • severe sepsis
  • bone marrow failure
27
Q

What do lymphocytes do ?

A

Cell mediated immunity and antibody production

28
Q

When might lymphocyte count be increased ?

A
  • acute viral infections
  • chronic infections e.g. Hepatitis, syphilis
  • leukaemias, lymphomas
29
Q

Which virus typically causes large amounts of atypical lymphocytes ?

A

EBV

30
Q

What may cause lympopenia

A
  • steroid therapy
  • SLE
  • legionnaires
  • HIV
  • chemo
31
Q

What do eosinophils do ?

A

Mediate allergic reactions and defend against parasites

32
Q

What are monocytes ?

A

Precursors of tissue macrophages

33
Q

What is the role of basophils ?

A

On binging IgE, release histamine

34
Q

What drugs would you ask about in a history of suspected IDA ?

A
  • NSAIDS
  • SSRIs
  • clopidogrel
  • corticosteroids
35
Q

What is a megaloblast?

A

A cell in which nuclear maturation is delayed compared to cytoplasm

36
Q

What are the megaloblastic causes if macrocytic anaemia ?

A

B12 and Folate as these are required for DNA synthesis (and so causes maturation to be delayed due to impaired synthesis)

37
Q

What are the non megaloblastic causes of macrocytic anaemia ?

A
  • alcohol
  • reticulocytosis (e.g. Haemolysis)
  • liver disease
  • hypothyroidism
  • pregnancy
38
Q

Why would you not treat folate deficiency alone without B12 treatment as well ?

A

As low B12 states may precipitate or worse subacute combined degeneration of the cord

39
Q

Who is macrocytic anaemia most likely to present in ?

A

Women over 60 years old

40
Q

What is the management of macrocytic anaemias?

A
  • correct the deficiency that caused the macrocytosis

- treat the underlying condition that lead to the deficiency

41
Q

What type of anaemia is iron deficiency ?

A

Macrocyctic, hypochromic

Core Conditions (15 decks)

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