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Evie Pathology > Haematology > Flashcards

Haematology Flashcards

1
Q

Acanthocytes

A

Spike rbc

Seen in liver disease and hyposplenism

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2
Q

Basophilic RBC stippling

A

Accelerated erythropoiesis or defective Hb synthesis

Due to lead poisoning, liver disease and thalassaemia

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3
Q

Burr cells

A

Irregularly shaped cells

Uraemia, GI bleed or stomach cancer

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4
Q

Heinz bodies

A

Denatured Hb inclusion in RBC

G6PD deficiency or chronic liver disease

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5
Q

Howell Jolly body

A

Basophilic nuclear remenant in RBC

Seen in hyposplenism ie sickle cell or coeliacs

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6
Q

Leucoerythroblastic anaemia

A

Nucleated RBC and primitive WBCs due to marrow infiltration

Seen in myelofibrosis

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7
Q

Pelger Heut cells

A

Hyposegmented neurtrophils

Myelodysplastic syndromes

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8
Q

Reticulocytes

A

Mesh like network of rRNA visible with methylene blue

Increased in haemolytic anaemia

Decreased in aplastic anaemia and chemotherapy

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9
Q

Right shift

A

Hyper mature WBCs with more than five lobes

Seen in megaloblastic anaemia, uraemia and liver disease

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10
Q

Rouleaux formation

A

Stacked RBCs

Seen in myeloma and paraproteinaemia

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11
Q

Schistocytes

A

Fragmented RBCs

Due to microangiopathic anaemia - DIC, haemolytic uraemia syndrome, thrombotic thrombocytopenic purpura

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12
Q

Target cells

A

Bulls eye appearance

Seen in liver disease, hyposplenism, iron deficiency anaemia and thalassaemia.

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13
Q

Blood Hb levels below which one is considered anaemic for:

  • men
  • women
A

Men <13.5g/dl

Women < 11.5g/dl

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14
Q

Causes of a low MCV and anaemia (4)

A

Fe deficiency
Anaemia of chronic disease
Sideroblastic
Thalassaemia

=FAST

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15
Q

Anaemia and high MCV (7)

A 
Foetus 
Antifolates - phenytoin 
Thyroid (low)
Reticulocytosis 
B12/folate deficiency 
Cirrhosis 
Myelodysplastic syndromes

=FAT RBCM

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16
Q

A 45 year old lady with brittle hair and angular cheilosis.

Blood film shows hypochromatic anisocytosis and pencil cells

A

Iron deficiency anaemia

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17
Q

Poikilocytosis and pencil cells are seen in what

A

Iron deficiency anaemia

18
Q

Causes of iron deficiency anaemia (5)

A 
Blood loss 
Increased utilisation - pregnancy or lactation
Decreased intake
Decreased absorption - coeliac
Intravascular haemolysis

NB it is bleeding until proven otherwise in the acute setting

19
Q

Two mechanisms behind anaemia of chronic disease.

A

Cytokines driven RBC production inhibition
1. TNF/IFNs cause a decrease in production of EPO receptors –> decrease in kidney EPO production

  1. IL6/LPS cause an increase in liver hepcidin production –> decreased gut iron absorption and increased macrophage iron levels
20
Q

What is sideroblastic anaemia and what causes it?

A

Ineffective erythropoeisis leading to iron loading in the bone marrow –> endocrine, liver and cardiac damage

Due to myelodysplasia, chemotherapy, excess alcohol or myeloproliferative disease

21
Q

Low iron, high total iron binding capacity and low ferritin

A

Iron deficiency anaemia

22
Q

Low iron, low total iron binding capacity and raised ferritin

A

Anaemia of chronic disease

23
Q

High iron, low total iron binding capacity and high ferritin

A

Chronic haemolysis

24
Q

High iron and high ferritin

A

Haemochromatosis or sideroblastic anaemia

25
Q

What is ferritin?

A

Acute phase protein therefore levels increase with inflammation

NB always check the CRP

26
Q

Three causes of vitamin B12 deficiency

A

Poor diet

Malabsorption due to lack of intrinsic factor from the gastric parietal cells - pernicious anaemia

Loss of the terminal ileum - Crohn’s disease, resection

27
Q

Patient with absent ankle reflexes, anaemia and glossitis

A

Vitamin b12 deficiency

28
Q

Treatment for vitamin b12 deficiency

A

I.m. Hydroxocobalamin

29
Q

Autoantibody in pernicious anaemia

A

90% parietal cell antibodies

30
Q

Five causes of folate deficiency

A

Poor dietary intake

Increased demand - pregnancy

Increased cell turnover - haemolysis/inflammatory disease

Malabsorption - coeliacs

Drugs - phenytoin/methotrexate/alcohol/trimethoprim

31
Q

Normal RBC lifespan

A

120 days

32
Q

Raised unconjugated bilirubin, raised LDH and reticulocytosis

A

Haemolytic anaemia

33
Q

Three inherited causes of haemolytic anaemia

A

Membrane defect - hereditary spherocytosis

Enzyme defect - G6PD, pyruvate kinase deficiency

Haemoglobinopathies - sickle cell

34
Q

Two acquired causes of haemolytic anaemia

A

Immune - cold/warm or transfusion reaction

Non-immune - mechanical/MAHA

35
Q

Inheritance of hereditary spherocytosis

A

Autosomal dominant

36
Q

Deficiency which results in hereditary spherocytosis

A

Ankyrin or spectrin membrane protein deficiency

37
Q

Key investigation to identify hereditary spherocytosis

A

Osmotic fragility

38
Q

Inheritance of G6PD

A

X linked

39
Q

Rapid anaemia, bite cells and Heinz bodies in previously well individual

A

G6PD

40
Q

Triggers for G6PD attacks

A

Oxidants i.e. Sulphonamides, aspirin, primaquine or broad beans

41
Q

Severe neonatal jaundice, splenomegaly and a haemolytic anaemia which is Coombs negative

A

Pyruvate kinase deficiency

Evie Pathology (5 decks)

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