Haematology Flashcards
Classic signs of Myeloma
CRAB C = Calcium (elevated) R = Renal Failure A = Anaemia B = Bone lesions
what blood tests would you do if you are thinking hereditary thrombophilia
- Factor V leiden
- prothrombin gene variant
how do you distinguish between haemophilia A and B
assays of factor VIII and IX activity
haemophilia A and B inheritance pattern
X- linked recessive
what is a tumour marker for myeloma you can test for on serum
B2M - beta-2 Microglobulin
what is the use of SPEP (serum protein electrophoresis) or urine electrophoresis in suspected Myeloma
95% will have M proteins
when would you do a serum free light chain assay?
if suspecting myeloma but no M proteins on SPEP or UPEP.
what radiology tests do you do for multiple myeloma
xrays to look for osteopenia “punched out” lesions.
skull, ribs, spine, pelvis, shoulders and long bones
diagnostic criteria for plasma cell myeloma
> 10% plasma cells in bone marrow
M protein on SPEP/UPEP
1 or more of CRAB features of organ dysfunction
in staging myeloma, what criteria are used
Albumin levels
beta-2 microglobulin levels
tx for myeloma
high dose chemo + stem cell transplant
+ bisphosphonates/radiotherapy/analgesics/spinal surgery for lytic bone lesions.
what demographic is at higher risk of AML
infants and adults
what demographic is at higher risk of ALL
children
what is tumour lysis syndrome
when start chemo for rapidly proliferating leukaemia –> rapid cell death –> rise in serum urate, K+, and phosphate –> renal failure
get also high LDH, high phosphate, low calcium, and metabolic acidosis
how do you prevent tumour lysis syndrome
hydration and allopurinol 24hrs before starting chemo
allopurinol = uricolytic
what features on coags would suggest DIC
prolonged PT (increased INR)
prolonged APTT
markedly decreased D-dimer
decreased fibrinogen