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FRACP Clinical > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the late complications of BMT?

A
  • treatment related: gonadal toxicity, neuropathy
  • chronic GVHD
  • infection
  • relapse
  • secondary malignancy
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2
Q

What are signs of acute GVHD?

A

Skin: maculopapular rash
GI: diarrhea, N/V
Liver: deranged LFT/bili, hepatomegaly

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3
Q

What is the treatment of acute GVHD?

A
  • topical steroid
  • systemic steroids: methylpred
  • octreotide for diarrhea

Second line agents: MMF, etanercept

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4
Q

What are the features of chronic GVHD?

A 
> 100 days
Skin: scleroderma-like
GI: dry oral mucosa with ulceration a, dysphagia, chronic diarrhea, malabsorption
Lung: bronchiolitis obliterans
Blood: thrombocytopenia
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5
Q

What is the treatment of chronic GVHD?

A
  • enrol in clinical trial
    Otherwise:
  • prednisone
  • add CNI if no improvement after 4-6/52 of pred
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6
Q

What is the genetic abnormality in CML?

A

Bcr-ABL - always on tyrosine kinase

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7
Q

What is the treatment of CML?

A

Stem cell tx (may be curative)
TKI: imatinib
Chemotherapy for palliation

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8
Q

What are the B symptoms?

A

Fever
Wt loss
Night sweats

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9
Q

What are reed sternberg cells associated with?

A

Hodgkin lymphoma

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10
Q

What is the management of Hodgkin Lymphoma?

A
  1. RTx

2. Chemo: ABVD, BEACOPP

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11
Q

What is the management of NHL?

A

High grade: Rituximab-CHOP

BMTx

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12
Q

What are the complications of lymphoma treatment?

A
  • effects of radiation: fibrosis, pericarditis
  • secondary malignancies: leukaemia, breast, skin
  • fertility: reduced, teratogenic effects of chemo
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13
Q

What causes microcytic anemia?

A
  • iron deficiency
  • thalassemia
  • anemia of chronic disease
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14
Q

What causes normocytic anemia?

A
  • acute bleeding
  • bone marrow failure: aplastic, mds, infiltrative disease
  • CKD
  • hemolysis
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15
Q

What are the causes of macrocytic anemia?

A
  • B12 or folate deficiency
  • alcohol
  • liver cirrhosis
  • mds
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16
Q

What investigations for anemia?

A
  • FBC, Blood film
  • reticulocytes: low if BM issue, high if loss/destruction of RBC
  • iron studies
  • b12/folate
  • intrinsic factor ab
  • hemolysis: low haptoglobin, raised bili, DAT
  • BM biopsy
  • TFT
  • electrophoresis for hemoglobinopathies
17
Q

What are the clinical features of MM?

A

CRAB:

  • hypercalcemia
  • renal failure
  • anemia
  • bone pain

Also, fractures, amyloidosis, cord compression

18
Q

What investigations for MM?

A
  • FBC, ESR, CMP, EUC
  • serum and urine EPG/IEPG: monoclonal protein
  • serum free light chains
  • B2 microglobulin for prognostication
  • urine bence Jones
  • bone marrow biopsy
  • XR skeletal survey
  • MRI if concern for spinal cord compression
  • urate
19
Q

What is the treatment for MM?

A 
Chemotherapy
- high dose steroid plus thalidomide/lenalidomide
- bortezomib
- cyclophosphamide
ATSCTx
Symptom control:
- RTx to bony lesions, bisphosphonates
- allopurinol for raised urate from treatment
20
Q

What are the prognostic factors in MM?

A
  • 13q deletion
  • high b2 microglobulin
  • poor ECOG
  • anemia
  • hypercalcemia
  • renal failure
21
Q

What are the early complications of BMTx?

A
  • Infection
  • Graft Failure
  • acute GVHD (

FRACP Clinical (11 decks)

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