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Haematology Flashcards

1
Q

types of microcytic anaemia

A

iron deficiency, chronic disease, sideroblastic

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2
Q

most common haem cancer in children

A

acute lymphoblastic leukaemia

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3
Q

what cells are affected in ALL

A

lymphoid cells

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4
Q

what do you see on the blood film in ALL

A

blast cells, more white cells than normal

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5
Q

How do you manage ALL

A

fluid, blood products and chemotherapy

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6
Q

what age group are affected most by myeloma

A

older patients

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7
Q

what cells are affected in myeloma

A

malignant B cell proliferation

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8
Q

what might you see on X-ray in a patient with myeloma

A

osteolytic bone lesions

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9
Q

name protein abnormalities seen in myeloma

A

IgA, IgG abnormalities

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10
Q

What protein can be found in the urine of myeloma patients

A

Bence Jones protein

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11
Q

what are risk factors for Hodgkins

A

EBV, SLE, post-transplant and obesity

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12
Q

what age group get hodgkins

A

young adults or the elderly

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13
Q

what happens in hodgkins

A

malignant proliferation of lymphocytes which get stuck in the nodes

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14
Q

describe the lymphadenopathy seen in hodgkins

A

enlarged, non tender

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15
Q

describe the blood film in hodgkins

A

cells with mirror image nuclei, Reed-Sternberg cells

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16
Q

treatment of hodgkins

A

chemotherapy and radiotherapy

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17
Q

most common acute leukaemia in adults?

A

acute myeloid leukaemia

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18
Q

what is the physiology behind AML

A

neoplastic proliferation of blast cells

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19
Q

what is seen on the blood film in AML

A

Auer rods

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20
Q

treatment of AML

A

allogenic BM transplant

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21
Q

what is the difference between Hodgkins and non-hodgkin

A

Reed-sternberg cells

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22
Q

management of low grade non-hodgkins

A

usually incurable, treat symptoms

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23
Q

management of high grade non-hodgkins

A 
RCHOP 
rituximab 
cyclophosphamide 
h-doxorubicin 
o- vincristine 
prednisolone
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24
Q

what disease is the philadephia chromosome found in

A

chronic myeloid leukaemia

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25
what age range does CML affect
40-60
26
CML may predispose to what conditions
AML, ALL
27
bone marrow appearance in CML
hypercellular
28
management of CML
tyrosine kinase inhibitors - Imatinib
29
what is the science behind CML
proliferation of myeloid cells
30
what is the most common leukaemia worldwide
CLL
31
what is the science behind CLL
accumulation of mature B cells that escape apoptosis
32
describe lymphadenopathy in CLL
enlarged rubbery nodes
33
management for CLL
fludarabine and cyclophosphamide | radiotherapy for the nodes
34
what is the definitive diagnostic test for ALL and AML
immunophenotyping
35
what do you see on blood film in myeloma
rouleaux
36
what does congo red stain show
amyloid deposition in myeloma
37
stage 1 in Hodgkins is
single region of nodes affected
38
stage 2 in Hodgkins is
2 sites affected on the same side of the diaphragm
39
stage 3 in Hodgkins is
several sites affected on both sides of the diaphragm
40
stage 4 in Hodgkins is
non-lymphatic spread
41
does alcohol make Hodgkins worse
yes
42
what cell is the target of Rituximab
CD20
43
what is polycythaemia
over production of red cells
44
describe apparent polycythaemia
not overly increased. caused by diuretics, obesity and HTN
45
describe primary polycythaemia
caused by polycythaemia ruba vera. increased red blood cells, increased wcc, and increased platelets
46
what are the causative factors of secondary polycythaemia
hypoxaemia, renal issues and other miscellaneous
47
management of polycythaemia
venesection, aspirin and cytotoxic therapy
48
what is essential thrombocytopenia
uncontrolled platelet production
49
what do patients with essential thrombocytopenia present with
usually a thrombotic event
50
blood film appearance of essential thrombocytopenia
increased platelets
51
bone marrow appearance of essential thrombocytopenia
increased megakaryocytic
52
management of essential thrombocytopenia
aspirin and hydroxyurea
53
wha tis myelofibrosis
when the bone marrow is replaced by fibrous tissue, therefore lowered red and white cell production
54
blood film appearance in myelofibrosis
leukoerythroblastic, tear drop RBCs
55
bone marrow appearance in myelofibrosis
usually a dry aspirate
56
management of myelofibrosis
give blood products, Abx, stem cell transplant, JAK2 inhibitors e.g. Ruxolitinib
57
target cells
sickle cell, iron, hyposplenism, liver disease
58
tear drop poikilocytes
myelofibrosis
59
spherocytes
hereditary spherocytosis, haemolytic anaemia
60
basophilic stippling
lead, thalassaemia, sideroblastic, myelodysplastic
61
howell-jolly bodies
hyposplenism
62
heinz bodies
g6PD, alpha-thal
63
schistocytes
intravascular haemolysis, DIC
64
pencils
iron
65
burr cells
uraemia, pyruvate kinase
66
hypersegmented neutrophils
megaloblastic anaemia
67
translocation seen in CML
t(9:22)
68
translocation seen in Burkitts
t(8:14)
69
cells of lymphoid progeny
t, NK, B (plasma cells), dendritic
70
bacterial infection results in spike in what type of cell
neutrophils
71
action of heparin
prevents 2 9 10 11 activation
72
action of warfarin
prevents 2 7 9 10 synthesis
73
bleeding results in haemophilia
APTT - up PT - normal bleeding time - normal
74
bleeding results in vWF
APTT - up PT - normal bleeding time - up
75
bleeding results vitamin K deficient
APTT - up PT - up bleeding time - normal
76
what kind of anaemia do people on epileptic drugs get
macrocytic, they are on anti-folate drugs
77
name the components of tumour lysis syndrome
hyperkalaemia hyperphosphataemia hyperuricaemia hypocalcaemia
78
most common hereditary thrombocytopenia
factor V Leiden
79
monitoring unfractionated heparin
APTT
80
monitoring LMWH
anti-Xa
81
heparin reversal
protamine sulphate
82
how long to vitb12 stores last
3 years
83
treatment of vitb12 deficiency
IM hydrooxycobalamin 3x for 2 weeks then once every 3 months
84
what regulates the process of stem cell development to common progeny cells
activation of transcription factors
85
what regulates the process of common progeny cells to precursor cells
increased expression of colony stimulating factors (CSF)
86
what regulates process of precursors to end cells
transcription and CSF induced maturation
87
what is neutrophil maturation regulated by
G-CSF
88
what are megakaryocytic regulated by
thrombopoietin
89
name the cell stages of eyrthropoeisis
pro --> baso/early norm --> poly/inter norm --> ortho/late normo --> reticulocyte
90
``` ferritin is (soluble or insoluble) haemsiderin is (soluble or insoluble) ```
ferritin is soluble haemsosiderin is insoluble
91
what is produced when haemoglobin is degraded
LDH, amino acids, iron, unconjugated bilirubin
92
causes of iron deficiency anaemia
``` blood loss (GI, menstrual, malignancy) malabsorption (coeliac), high demand ```
93
investigate iron deficiency anaemia
FBC - microcytic hypochromic ferritin - low transferrin/TIBC high
94
manage iron deficiency anaemia
ferrous sulphate 200mg BD/TDS
95
counsel a patient about ferrous sulphate
causes black stools, reflux, nausea
96
describe sideroblastic anaemia
reduced haemoglobin synthesis leading to iron accumulation
97
congenital causes of sideroblastic anaemia
x-linked, wolframs syndrome
98
acquired causes of sideroblastic anaemia
myelodysplasia, myeloma, polycythaemia, leukaemia, RA, alcohol, preganncy
99
investigate sideroblastic anaemia
bone marrow - sideroblastic rings seen | MCV
100
manage sideroblastic anaemia
desferrioxamine chelation congenital = pyridoxine
101
high MCV without anaemia may indicate
myeloma, hyperglycaemia
102
what would cause megaloblastic macrocytic anaemia
impaired DNA synthesis due to B12 or folate deficiency
103
what does vitamin b12 combine with? | where is this product absorbed
gastric intrinsic factor absorbed in the terminal ileum
104
what is pernicious anaemia?
rare, autoimmune chronic tropic gastritis
105
investigate pernicious anaemia
anti-IF, FBC, Schilling test

Finals (11 decks)

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