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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
Alpha Thalassaemia
Less alpha chains
26
Beta Thalassaemia Minor
Carriers only | Small pale RBCs
27
Beta Thalassaemia Intermedia
Varying genetics+ symps No transfusions needed Get pulmonary hypertension, fertility probs and bone changes
28
Beta Thalassaemia Major
``` Severe anaemia Nucleated RBCs Increased marrow activity Short stature, increased iron absorption Splenomegaly Maxillary hypertrophy Treatment= tranfusions ```
29
Pregnancy
Macrocytic anaemia (more iron and folate) Neutrophilia Thrombocytopenia (low folate, pre-eclampsia, DIC, HUS, virus) Procoaguable
30
Myeloma
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
CRAB features
``` Diagnostic of myeloma C= High calcium R= Renal insufficiency A= Anaemia B= Bone abnormalities ```
32
Lymphoma
Neoplastic disease of lymphoid tissue Hodgkin's has Reed-Sternberg cells Often due to t(14,18)
33
Acute Myeloid Leukaemia
``` Granulated nuclei in large cells BM fails FAB staging Monosomy 7 bad Induction therapy for remission, then combo chemos ```
34
Acute Lymphoid Leukaemia
``` 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
Neutropenic Sepsis
Due to intensive chemo Fever and infections Need abx
36
Philadelphia Chromosome
t (9,22) Creates bcr-abl Has tyrosine kinase activity Poor prognosis
37
Chronic Myeloid Leukaemia
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
Polycythaeemia Vera
More RBCs Persistant raised Hb Reduced EPO means JAK2/EXON12 mutations (cytokine signalling) Need venesections and aspirin
39
Essential Thrombocytosis
Increased platelets May be JAK2 or CALR mutations Need antiplatelets and interferon
40
Idiopathic Myelofibrosis
Pancytopenia and splenomegaly JAK2 and CALR mutations Need JAK2 inhibitors or BM transplant
41
Splenomegaly Causes
``` CHICAGO Cancer Haem Infection Congestion Autoimmune Glycogen storage issues Other ```
42
Children
``` Larger and more RBCs Higher WCC Developing Igs at 2 months IgG crosses placenta Platelets larger and hyperresponsive ```
43
Thrombosis
Venous thrombi more fibrin Diagnosed via Well's score and D-Dimer Treatment= LMWH, warfarin, NOACs (dabigatron, rivoraxaban)
44
Factor V Leiden
FV resistant to cleavage so can't be inactivated
45
Prothrombin 20210A
Increases prothrombin levels
46
Antiphospholipid Syndrome
Antiphospholipid Abs | Causes= lupus, anticardiolipin
47
Microcytic Anaemia
Due to iron deficiency, haemoglobinopathies, chronic disease
48
Iron Deficiency
Causes= blood loss, increased demand, decreased intake Tests= FBC, film, ferritin, serum iron, marrow IV iron best
49
Macrocytic Anaemia
Causes= B12 deficiency, folate deficiency, marrow damage, haemolytic
50
B12+Folate Deficiency
Causes= megaloblastic, drugs, alcohol | Can't make DNA bases
51
B12
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
Folate
Absorbed in small intestine Stores well Deficient due to malnutrition, malabsoption, increased need, drugs, alcohol
53
Marrow Damage
Causes=disease, alcohol, drugs
54
Haemolysis
Causes= haemoglobinopathies, G6PD deficiency, sphercytosis, Abs, drugs, heart valves, vasculitis Treatment depends on cause
55
Normocytic Anaemia
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
Thrombocytopenia
Causes= AI, toxins, liver disease, DIC, pregnancy, infections, congenital Get bruising and bleeding Need steroids, IV Igs and immunosuppressants
57
Immune Thrombocytopenic Pupura
Immune disorder
58
Thrombotic Thrombocytopenic Purpura
Get fever, haemolysis and neuro symps | Need urgent plasma and steroids
59
Dendritic Cells
Make interferon Circulate in blood Make cytokines

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