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Integrated > Haematology > Flashcards

Haematology Flashcards

1
Q

Erythrocytes

A

120 day lifespan

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2
Q

Granulocytes

A

Neutrophils, Eosinophils, Basophils

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3
Q

Neutrophils

A

Lobed nucleus
Lifespan= few hours
Decreased due to drugs, AI, chemo

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4
Q

Eosinophils

A

Increased due to parasites, allergies and aspirin

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5
Q

Basophils

A

Rare

Increased in CML

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6
Q

Monocytes

A

Macrophages in tissue

Increased in TB

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7
Q

Lymphocytes

A

Increased in CLL+ EBV

Decreased after BM transplant

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8
Q

NK Cells

A

Recognise non-self

Large and granuler

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9
Q

Plasma Cells

A

Mature B cells
Make IgG
Increased in infection and myeloma

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10
Q

RBC Transplant

A

=RBCs, electrolytes, glycose, adenine
Takes 1.5-3 hours
Need if over 30% blood loss

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11
Q

Platelet Transplant

A

Stored at room temp

30mins/unit

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12
Q

Fresh Frozen Plasma

A

Needs defrosting
30mins/unit
Used in bleeding
Not warfarin reversal

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13
Q

Platelet Defects

A

Mucosal and skin bleeding

Less platelets/not working platelets/abnormal interaction

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14
Q

Von Willebrand Disease

A

vWF can’t make platelets release granules or carry FVIII
AD
Treatment= antifibrinolytics, DDAVP, vWF, COCP

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15
Q

Coag Factor Defects

A

Prolonged bleeding

Muscle and joint bleeds

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16
Q

Haemophilia

A 
A= FVIII
B= FIX
Treatment= replacement, DDAVP, factor conc, antifibrinolytic agents
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17
Q

Vit K deficiency

A

Cofactor of II, VII, IX, X

Causes= obstructive jaundice, nutritional deficiency, broad spectrum abx, neonates, warfarin

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18
Q

Liver Disease

A

Causes thrombocytopenia, less factors and excessive plasmin

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19
Q

Massive Transfusion

A

Dilutes platelets and factors

Get DIC, citrate toxicity and hypocalcaemia

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20
Q

DIC

A

Clot until factors and platelets used up then bleed
Fibrinolysis products inhibit fibrinolysis
Thrombosis in small vessels= tissue ischaemia
Causes= sepsis, obstetrics, trauma, transfusions, cancer, liver disease

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21
Q

Warfarin

A

INR controls doses
Effect increased by erythromycin, cephalosporins, NSAIDs, steroids and ampicillin
Effect decreased by spiranolactone, vit K, rifampicin, carbamazepine, cholestyramine

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22
Q

Heparin

A 
UF= APTT, bleeding stopped by protamine
LMWH= more anti-Xa, once a day, anti-Xa assays
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23
Q

Haem

A 
2 alpha (chr 16)
2 beta/delta (chr 11)
Marrow makes beta/delta
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24
Q

Sickle Cell Disease

A

Polymerises in low O2 making fibrils
Short lifespan as destroyed
Trait= heterozygous (only problem if hypoxic or dehydrated)
Disease= homozygous
Crises cause septicaemia, priaprism and organomegaly
Hydroxycarbamide increases Hb-F

25
Q

Alpha Thalassaemia

A

Less alpha chains

26
Q

Beta Thalassaemia Minor

A

Carriers only

Small pale RBCs

27
Q

Beta Thalassaemia Intermedia

A

Varying genetics+ symps
No transfusions needed
Get pulmonary hypertension, fertility probs and bone changes

28
Q

Beta Thalassaemia Major

A 
Severe anaemia
Nucleated RBCs
Increased marrow activity
Short stature, increased iron absorption
Splenomegaly
Maxillary hypertrophy
Treatment= tranfusions
29
Q

Pregnancy

A

Macrocytic anaemia (more iron and folate)
Neutrophilia
Thrombocytopenia (low folate, pre-eclampsia, DIC, HUS, virus)
Procoaguable

30
Q

Myeloma

A

Incurable malignant disease of plasma cells
Preceded by MGUS
Get CRAB features, focal lesions and BM plasma cells
High IgG so renal insufficiency
Therapies of cyclopriming and melphalan

31
Q

CRAB features

A 
Diagnostic of myeloma
C= High calcium
R= Renal insufficiency
A= Anaemia
B= Bone abnormalities
32
Q

Lymphoma

A

Neoplastic disease of lymphoid tissue
Hodgkin’s has Reed-Sternberg cells
Often due to t(14,18)

33
Q

Acute Myeloid Leukaemia

A 
Granulated nuclei in large cells
BM fails
FAB staging
Monosomy 7 bad
Induction therapy for remission, then combo chemos
34
Q

Acute Lymphoid Leukaemia

A 
Small round cells
Organ infiltration
Peroneal infections
Candida
Need induction chemo, intensive chemo and meningeal prophylaxis (methotrexate and irradiation)
Often due to philadelphia chromosome
35
Q

Neutropenic Sepsis

A

Due to intensive chemo
Fever and infections
Need abx

36
Q

Philadelphia Chromosome

A

t (9,22)
Creates bcr-abl
Has tyrosine kinase activity
Poor prognosis

37
Q

Chronic Myeloid Leukaemia

A

Get leukocytosis, anaemia, gout and splenomegaly
Chronic phase treated with cytotoxins and interferon
Acute transformation needs intensive chemo
Phil chr treated with gleevec/imalinib

38
Q

Polycythaeemia Vera

A

More RBCs
Persistant raised Hb
Reduced EPO means JAK2/EXON12 mutations (cytokine signalling)
Need venesections and aspirin

39
Q

Essential Thrombocytosis

A

Increased platelets
May be JAK2 or CALR mutations
Need antiplatelets and interferon

40
Q

Idiopathic Myelofibrosis

A

Pancytopenia and splenomegaly
JAK2 and CALR mutations
Need JAK2 inhibitors or BM transplant

41
Q

Splenomegaly Causes

A 
CHICAGO
Cancer
Haem
Infection
Congestion
Autoimmune
Glycogen storage issues
Other
42
Q

Children

A 
Larger and more RBCs
Higher WCC
Developing Igs at 2 months
IgG crosses placenta
Platelets larger and hyperresponsive
43
Q

Thrombosis

A

Venous thrombi more fibrin
Diagnosed via Well’s score and D-Dimer
Treatment= LMWH, warfarin, NOACs (dabigatron, rivoraxaban)

44
Q

Factor V Leiden

A

FV resistant to cleavage so can’t be inactivated

45
Q

Prothrombin 20210A

A

Increases prothrombin levels

46
Q

Antiphospholipid Syndrome

A

Antiphospholipid Abs

Causes= lupus, anticardiolipin

47
Q

Microcytic Anaemia

A

Due to iron deficiency, haemoglobinopathies, chronic disease

48
Q

Iron Deficiency

A

Causes= blood loss, increased demand, decreased intake
Tests= FBC, film, ferritin, serum iron, marrow
IV iron best

49
Q

Macrocytic Anaemia

A

Causes= B12 deficiency, folate deficiency, marrow damage, haemolytic

50
Q

B12+Folate Deficiency

A

Causes= megaloblastic, drugs, alcohol

Can’t make DNA bases

51
Q

B12

A

From animal sources
Absorbed by gastric cells, IF and terminal ileum
Deficient due to veganism, gastric or small bowel probs
Pernicious if Abs to IF or gastric cells
Get subacute combined degeneration of the cord

52
Q

Folate

A

Absorbed in small intestine
Stores well
Deficient due to malnutrition, malabsoption, increased need, drugs, alcohol

53
Q

Marrow Damage

A

Causes=disease, alcohol, drugs

54
Q

Haemolysis

A

Causes= haemoglobinopathies, G6PD deficiency, sphercytosis, Abs, drugs, heart valves, vasculitis
Treatment depends on cause

55
Q

Normocytic Anaemia

A

Caused by chronic disease
Less RBCs due to abnormal iron metabolism, poor EPO response or poor marrow response
Cytokines released
Normal ferritin but low iron

56
Q

Thrombocytopenia

A

Causes= AI, toxins, liver disease, DIC, pregnancy, infections, congenital
Get bruising and bleeding
Need steroids, IV Igs and immunosuppressants

57
Q

Immune Thrombocytopenic Pupura

A

Immune disorder

58
Q

Thrombotic Thrombocytopenic Purpura

A

Get fever, haemolysis and neuro symps

Need urgent plasma and steroids

59
Q

Dendritic Cells

A

Make interferon
Circulate in blood
Make cytokines

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