Haematology 5: Haematology Of Systemic Disease Flashcards
What is the most common cause of Iron deficiency anaemia ?
Occult blood loss
What do these laboratory findings suggest?
Ferritin: Low
Transferrin saturation: Low
TIBC: High
Iron deficiency anaemia
List 3 features of leucoerythroblastic anaemia of blood film ?
Nucleated red blood cells
Tear drop cells (anisopoikilocytosis)
Immature myelod cells
What is leucoerythroblastic anaemia ?
Anaemia with immature red and white blood cells
Most commonly caused by bone marrow infiltration
List 3 causes of bone marrow infiltration ?
Cancers- Leukaemia/ lymphoma/ myeloma/ solid organ
Myelofibrosis
Severe infection- Miliary TB, Massive fungal infection
List 4 inherited causes of haemolytic anaemia ?
Sickle cell disease
Thalasaemia
G6PD
HS
Which test can be used to diagnose Auto-immune haemolytic anaemia ?
DAT (Coombs’) test
List 2 diseases associated with Auto-immune haemolytic anaemia ?
Lymphoma
SLE
Which cancer type is associated with MAHA ?
Adenocarcinoma
Adenocarcinoma release procoagulant cytokines. This leads to DIC. THis causes a lot of Fibrin strands to form in the micro vasculature. This shears red cells causing them to fragment and undergo haemolysis
Which disease of the returning traveller does not cause neutrophilia ?
Typhoid
What is the difference between reactive neutrophilia and Malignant neutrophilia on blood film ?
Reactive neutrophilia: shows band cells (immature WBC), toxic granulation,
Malignant causes: If Neutrophilia +basophilia + immature myelocytes + Splenomegaly then its likely to be CML
If there is a neutrophilia with Myeloblasts then its likely AML
Which haematological malignancies cause Eosinophilia ?
Hodgkin’s lymphoma
T cell lymphoma
NHL
Which leukaemia has smear cells ?
CLL
features of haemolytic anaemia
anaemia reticulocytosis raised unconjugated bilirubin raised LDH reduced haptoglobins
causes of inherited haemolytic anaemia
membrane defects - HS
cytiplasm/enymes - G6PD deficiency
haemoglobin - scd, thalassaemia
causes of acquired haemolytic anaemia
immune mediated
non-immune mediated
differentiate by DAT/Coombs’ test
list features of AI haemolytic anaemia
reticulocytosis
raised unconjugated bilirubin
raised LDH
positive DAT
two diseases associated with non-immune haemolytic anaemia
malaria
MAHA
lists causes of neutrophilia
corticosteroids underlying neoplasm tissue inflammation myeloproliferative/leukaemic disorders infection
what 3 diseases clasically dont cause neutrophilia
brucella
typhoid
many viral infections
in which conditions in monocytosis often seen
rare
TB, brucella, typhoid
CMV, VZV
sarcoidosis
what causes reactive eosinophilia
parasitic infection
allergic diseases - asthma, rheumatoid arthriyis, pulmonary eosinophilia
underlying neoplasms - Hodgkins, T cell lymphoma, NHL
drug reaction - erythema multiforme
list causes of reactive lymphocytosis
EBV, CMV, toxoplasmosis infectious hepatitis rubella herpes AI disorders sarcoidosis
how can we differentiate between reactive lymphocytosis and lymphoproliferative disorders
FLOW CYTOMETRY
reactive lymphocytosis - even mix of kappa and lambda chains
lymphoproliferative - mainly kappa or lambda
