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SMTS > Haematology > Flashcards

Haematology Flashcards

1
Q

Classic signs of Myeloma

A 
CRAB
C = Calcium (elevated)
R = Renal Failure 
A = Anaemia 
B = Bone lesions
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2
Q

what blood tests would you do if you are thinking hereditary thrombophilia

A
  • Factor V leiden

- prothrombin gene variant

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3
Q

how do you distinguish between haemophilia A and B

A

assays of factor VIII and IX activity

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4
Q

haemophilia A and B inheritance pattern

A

X- linked recessive

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5
Q

what is a tumour marker for myeloma you can test for on serum

A

B2M - beta-2 Microglobulin

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6
Q

what is the use of SPEP (serum protein electrophoresis) or urine electrophoresis in suspected Myeloma

A

95% will have M proteins

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7
Q

when would you do a serum free light chain assay?

A

if suspecting myeloma but no M proteins on SPEP or UPEP.

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8
Q

what radiology tests do you do for multiple myeloma

A

xrays to look for osteopenia “punched out” lesions.

skull, ribs, spine, pelvis, shoulders and long bones

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9
Q

diagnostic criteria for plasma cell myeloma

A

> 10% plasma cells in bone marrow
M protein on SPEP/UPEP
1 or more of CRAB features of organ dysfunction

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10
Q

in staging myeloma, what criteria are used

A

Albumin levels

beta-2 microglobulin levels

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11
Q

tx for myeloma

A

high dose chemo + stem cell transplant

+ bisphosphonates/radiotherapy/analgesics/spinal surgery for lytic bone lesions.

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12
Q

what demographic is at higher risk of AML

A

infants and adults

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13
Q

what demographic is at higher risk of ALL

A

children

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14
Q

what is tumour lysis syndrome

A

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

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15
Q

how do you prevent tumour lysis syndrome

A

hydration and allopurinol 24hrs before starting chemo

allopurinol = uricolytic

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16
Q

what features on coags would suggest DIC

A

prolonged PT (increased INR)
prolonged APTT
markedly decreased D-dimer
decreased fibrinogen

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17
Q

Auer rods = … leukaemia

A

AML

18
Q

signs of AML OE/

A

gum hypertrophy
hepatosplenomegaly
bruising

19
Q

what are myelodysplastic syndromes

A

disorders of bone marrow function/bone marrow failure

20
Q

what features of bone marrow biopsy suggest myelodysplastic syndromes

A

increased marrow cellularity,
abnormal looking cells
ring sideroblasts

21
Q

what is a poor prognostic factor for ALL

A

philadelphia chromosome

t(9;22) - BCR-ABL

22
Q

if someone has philadelphia positive ALL what extra treatment is available to them?

A

tyrosine kinase inhibitors
imatinib
dasatinib

23
Q

myelodysplastic syndrome –> malignancy yes or no

A

yes malignant transformation if additional cytogenetic abnormalities can –> AML

24
Q

tx for myelodysplastic syndrome

A

supportive peripheral transfusions, bone marrow stimulation, cytotoxic chemo.
little role for bone marrow transplant

25
Q

intrinsic pathway factors

A

XII, XI, IX, VIII

26
Q

extrinsic pathway factors

A

VII, III

27
Q

common clotting pathway factors

A

X, V, II, XIII, I

28
Q

what is Burkitt’s lymphoma

A

cancer of the lymphatic system caused by EBV. mostly in central Africa

29
Q

what do you see on microscopy with Burkitt’s lymphoma

A

vacuoles

30
Q

causes of isolated prolonged aPTT

A 
tx with heparin, dabigatran 
SLE 
Haemophilia A, B 
Factor XI deficiency 
VWD
31
Q

how does heparin and dabigatran work?

A

block IIa (thrombin) from converting I –> Ia (fibrinogen –> fibrin)

32
Q

treatment for VWD

A 
desmopressin --> stimulates release of endogenous VWF
plasma derived concentrates --> VWF replacement (recombinant VWF)
other antifibrinolytics (e.g. aminocaproic acid)
33
Q

aPTT long = ….pathway of clotting affected

A

intrinsic and common

34
Q

PT long = …. pathway of clotting affected

A

extrinsic and common

35
Q

causes of long PT normal APTT

A 
warfarin 
vit K deficiency 
liver disease 
rivaroxaban 
factor VII deficiency = v. uncommon
36
Q

how to reverse warfarin fast

A

prothrombinex (FFP if not available)

37
Q

how to reverse warfarin completely

A

vitamin K + FFP

38
Q

what does FFP have that prothrombinex doesn’t

A

factor VII

39
Q

significant bleeding history and family history, but APTT, PT and platelets all normal. Likely cause

A

VWD
Antiplatelet drugs
Platelet dysfunction disorders
factor XI and XIII deficiency (uncommon)

40
Q

what are some inherited qualitative platelet disorders?

A

Disorders of adhesion = Bernard-Soulier syndrome
Disorders of aggregation = Glanzmann thrombasthenia
Platelet granule issues = Storage pool deficiency = αSPD (grey platelet syndrome)

SMTS (16 decks)

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