Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CP3 Medicine > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the general S+S of anaemia (7 +4)

A

Asymp
Non specific: fatigue / headache / weakness

CV: angina / SOB on exertion / palpitations / IC

Pallor
Cardiac failure
Tachycardia
Systolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List some specific signs of certain types of anaemia (4)

A

Koilonychia - Fe defc
Jaundice - haemolytic
Leg ulcers - sickle
Bone marrow expansion (abnormal facies + fractures) - thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is transfusion indicated in anaemia + how should it be given?

A

If anaemia is severe

Caution of heart failure: transfuse slowly + w. furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the causes of microcytic anaemia (4)

A

Fe defc (blood loss unless proven otherwise)
Thalassaemia
Lead poisoning
Sideroblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the causes of normocytic anaemia (8)

A 
Acute blood loss
Anaemia of chronic disease
Pregnancy
Dimorphic blood film (micro+macro)
Renal anaemia
Haemolytic anaemia
Marrow failure
Connective tissue disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the causes of macrocytic anaemia (6)

A 
Alcohol excess (or severe liver disease)
B12 defc (Pernicious / Crohn's)
Folate defc (coeliac)
Myelodysplastic syndromes
Severe hypothyroidism
Reticulocytosis haemolytic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the normal Hb levels in men + women

What is the normal range for MCV

A

Men: Hb >13.5
Women: Hb >11.5

MCV Normal range: 80–96fL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List some specific peripheral stigmata of microcytic anaemia (3)

A

Koilonychia
Angular stomatitis
Brittle hair/nails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What would Iron studies show in Fe defc anaemia

A

Reduced Fe
Reduced Ferritin
Raised TIBC
Raised transferrin receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List some causes for Fe defc anaemia (8)

A 
Hookworm (worldwide)
Menorrhagia
GI bleed
Coeliac (reduced absorption)
Post-gastrectomy
Growth / Pregnancy
Premature infants
Prolonged breast fed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What further Ix should be done in microcytic anaemia (2)

A

Blood film

Iron studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the features of Paterson-Brown-Kelley (Plummer-Vinson) syndrome (5)
How is it treated

A 
Dysphagia
Odynophagia
Oesophageal webs
Fe defc anaemia
Glossitis / Chelitis

Fe supplementation + Oesophageal widening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the features of:
B minor (trait) thalassmia
B major (Cooley’s) thalassaemia
Alpha thalassaemia

A

Trait: Asymp/Worsens in preg, mild microcytic (confused w. Fe defc)

Major, presents in 1st yr:
Severe anaemia / FTT
Hepatosplenomegaly / Abnorm facies

Alpha: Barts hydrops (4) / haemolytic sx / asymp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What Ix can be done into thalassaemia?

A

Blood film:

Targets cells + Nucleated RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What diseases are usually responsible for anaemia of chronic disease (ACD)

A

Due to predominate WBC prodn:

Chronic infection
Rheumatoid disorders
Malignancy
CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What further Ix should be done in normocytic anaemia

A

NB if clear h/o menorrhagia – NONE

Iron studies
Coeliac screen
Recent travel – stool microscopy
No obvious source – OGD/Colonoscopy
Bone marrow biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List the causes for bone marrow failure (6)

A 
Aplastic anaemia
Haematological malignancies
Metastasis
Myelofibrosis
Myelodysplasia
Parvovirus (stops marrow erythropoiesis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What further Ix should be done in macrocytic anaemia + why (5)

What further Ix should be done if B12 is shown to be low (2)

A 
Blood film: 
Hypersegmented neutrophils = B12/Fol defc
Target cells (liver disease)

LFTs:
Liver cause
Raised bili B12/Fol

TFTs: severe hypothyroid

Bone marrow biopsy:
Megaloblasts = B12-Fol // Myelodysplasia

Serum B12-Fol

If B12 low:
Anti-parietal Ab / anti-IF Ab
Schilling (gold standard) (pernicious vs small bowel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List some causes for B12 defc (10)

A

VEGANS

Impaired stomach binding:
Pernicious anaemia
Gastrectomy
Congenital IF absence

Small bowel:
Crohn’s
UC backwash ileitis
Bacterial overgrowth

On mild defc:
Pancreatitis
Coeliac
Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List some causes for Folate defc (9)

A

Dietary: defc/anorexia
Alcohol excess
Malabs: Coeliac

Anti-folates (trimethoprim, MTX)

Pregnancy
Premature

Malignancy
Inflamm conditions
XS RBC prodn e.g. haemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List the differentials for haemolytic anaemia (2: 3+5)

A

Intrinsic (hereditary):
Haemoglobinopathies – sickle / thalassaemia
Membranopathies – spherocytosis / eliptocytosis
Enzymopathies – G6PD / PK defc

Extrinsic (acquired):
Autoimmune – lymphproliferatives // others e.g. SLE
Alloimmune – Rh / transfusion / transplant
Drugs – e.g. penicillins
Parasites – plasmodium
Microangiopathic – DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What Ix results (FBC+LFTs) would suggest a haemolytic picture? (4)

A

Increased breakdown:
Macrocytic
Raised bilirubin
Raised LDH

Increased prodn:
Raised reticulocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What further Ix should be done if suspect haemolytic anaemia? (6)

A

Blood film
Coombs’

Hb electrophoresis
Plasma haptoglobin
Urinary haemosiderin
Enzyme assays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What occurs in a sequestration crisis?

A

Organomegaly
Severe anaemia
Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is seen on blood film of: Thalassaemia G6PD Microangiopathic
Thalassaemia: hypochromic / microcytic G6PD: Heinz bodies / 'bite/blister' cells DIC: schistocytes
26
List some complications of sickle cell anaemia (8)
``` Bone infarction (necrosis) Renal infarction (CKD) Splenic infarction (hyposplenism) Painful dactylitis Chronic leg ulcers Chronic lung damage Fe overload (transfusions) CVA ```
27
How does a sickle cell crisis present? (Sickle Cell Acute Presentation) (4) List some precipitating factors (4)
Severe bone pain** CVA (Cerebral infarct) Acute abdo (acute mesenteric ischaemia) Priapism Dehydration Hypoxia Cold Infection
28
What is an aplastic crisis? What is it due to? How is it managed?
Sudden reduced bone marrow prodn Due to parvovirus Self-resolves 2wks but may need transfusion
29
Outline the acute management of sickle cell crises
``` A–E (inc. high flow O2 / fluids) Strong analgesia FBC / X-match / Reticulocytes Infection screen (culture/MSU/CXR) LMWH (prophylaxis) Transfusion ```
30
Outline the long-term management of sickle cell anaemia
``` Lifelong transfusions Lifelong folate supplements Pneumococcal vx / Pen V (hyposplenism) Hydroxycarbamide/hydroxyurea if freq crises (HbF prodn) Bone marrow transplant (curative) ```
31
What are the possible features of G6PD
African / Mediterranean males Asymp Oxidative crises: Rapid anaemia / jaundice
32
What may trigger a crisis in G6PD (3)
Drugs: aspirin / sulphonamides / primaquine Broad beans Illness
33
How does PK defc present? (3)
Neonatal jaundice Chronic jaundice (later) Hepatosplenomegaly
34
What types of acquired haemolytic anaemia are | Coombs' +ve / –ve
Coombs' +ve: Drug-induced Autoimmune Alloimmune Coombs' –ve: Infection Microangiopathic
35
List some causative drugs of drug-induced haemolytic anaemia (3) List some causes of autoimmune haemolytic anaemia
Methyldopa Quinidine Penicillin Idiopathic** 2º to lymphoproliferatives
36
List some causes of microangiopathic haemolysis (6)
``` Malignant HTN / Pre-Eclampsia DIC Thrombotic thrombocytopenic purpura HUS Vasculitis (SLE) Mechanical heart valves ```
37
List the DDx for neutrophilia (6)
``` Bacterial infection Inflammatory Stress e.g. surgery/burns Corticosteroids Disseminated malig Myeloproliferative conditions ```
38
List the DDx for neutropenia (6)
``` Cytotoxics Marrow failure Severe sepsis Viral infection Hypersplenism e.g. Felty's Neutrophil Abs e.g. SLE ```
39
List the DDx for lymphocytosis (3)
Chronic infection (e.g. TB, hepatitis) Viral infection Myeloproliferatives
40
List the DDx for lymphopenia (6)
``` SLE HIV Cytotoxics Marrow failure Corticosteroids Uraemia ```
41
List some RFs for Hodgkin's lymphoma (4)
Obese FH SLE EBV
42
What are the features of Hodgkin's lymphoma (7)
``` Painless 'rubbery' LNs Alcohol –> painful LNs B symptoms (profuse night sweats) SVC/Bronchial Obstrn Pleural effusion Hepatosplenomegaly (50%) S/o cachexia S/o anaemia ```
43
How may non-Hodgkin's present ? (4)
Nodal (75%): superficial LNs Extra-nodal (20%): gut / skin / lungs / CNS / testes B Sx (NB wt loss = dissem) Bone marrow failure
44
What Ix done if suspecting lymphoma?
``` Bloods: FBC Blood film / ESR U+Es / Ca LDH ``` CT - staging LN excisional biopsy (± image guided / laparotomy)
45
What are some poor prognostic factors for lymphoma (3)
Raised LDH Age >60 Disseminated
46
List any RFs for multiple myeloma (2)
Age >70 | Afro-Caribbean
47
What are the features of multiple myeloma (CRAB)
Ca: hypercal Renal impairment Anaemia: bone marrow failure Bone: osteolytics (backache / patho #s)
48
What Ix are done if suspecting multiple myeloma?
Urine: Serum/urine electrophoresis (monoclonal paraprot band) Urine Bence-Jones protein ``` FBC (normochromic normocytic) Blood film (rouleaux formn) ESR (raised) UEs (deranged) Ca (raised) ALP (normal) ``` Skeletal XR Bone marrow biopsy (clonal plasma bands)
49
What are the features of acute leukaemia?
B Sx Bone pain Bone marrow failure Hepato/splenomegaly
50
What Ix are done into acute leukaemia?
``` FBC Blood film (blasts) CXR (T-ALL mediastinal widening) Bone marrow aspiration (confirm Dx) PET scan (check for mets) UEs/LFTs/ECG/ECHO - therapy planning ```
51
What are the features of CLL? (6)
``` Asymp** (incidental FBC) Anaemic Infection prone B Sx (severe) Enlarged painless LNs Hepatosplenomegaly ```
52
When is Tx indicated in CLL?
``` Symptomatic Cytogenetic markers (of poor prig) ```
53
What is Richter's syndrome?
Transformation of CLL into diffuse large B-cell lymphoma (type of NHL) Refractory to Tx / poor prog
54
List the Rai Prognosis Classifications of CLL (4)
Stage 0: lymphocytosis only; 13yrs Stage 1: lymphocytosis + enlarged LNs; 8yrs Stage 2: lymphocytosis + hepatosplenomeg; 5yrs Stage 3: lymphocytosis + anaemia; 2yrs Stage 4: lymphocytosis + thrombocytopenia; 1yr
55
List some features of hyperviscosity that may be seen PCV (polycyth rubra) (7)
``` Thrombotic complications Headache Dizziness / vertigo Facial plethora Burning in fingers/toes (erythromelalgia) Splenomegaly Gout (turnover) ```
56
List some causes of aplastic anaemia
Autoimm: Drugs / viruses / irradiation Inherited: Fanconi anaemia
57
List the DDx causes of thrombocytopenia (3+5 THISA)
Reduced Prodn: Marrow failure Marrow infiltration Aplastic anaemia ``` Excess destrn: TTP HUS ITP Sequestration (hypersplenism) Autoimm (SLE/Viruses) ```
58
What is the management of ITP in adults?
1st: Corticosteroids ± IVIG (if req rapid rise platelets) ± Platelet transfusions (massive h'age) 2nd: Splenectomy
59
Which part of coag pathway is the Prothrombin Time (PT) measuring? What can prolonged PT be indicative of? (2)
Tests EXTRINSIC Prolonged in: Liver disease Warfarin
60
Which part of coag pathway is the APTT testing? | What can cause APTT to be prolonged? (3)
Intrinsic Factors 8/9/11/12 defc APL Heparin usage
61
Which part of coag pathway is the Thrombin Time testing? | What may cause TT to be prolonged?
Thrombin Time - testing common pathway | Prolonged in fibrinogen defc
62
List some non-Warfarin causes of Vit K defc (3)
Malabsorption Cholestatic jaundice Abx (gut flora disturbances)
63
Differentiate Haemophilia A and B
A: Factor 8 defc (lots spent muts) B: Factor 9 defc (aka Christmas disease) Both X-linked recessive
64
Outline the management of haemophilia
Avoid NSAIDs / IMs Minor bleed: compression / elevation / desmopressin Major (e.g. haemarthrosis): recombinant factor 8/9
65
What will be see on coag studies in VWd?
Raised APTT | Platelets / INR normal
66
How is VWd treated in mild/severe?
Mild: tranexamic acid Severe: desmopressin/recomb VIII
67
What is a possible 'antidote' for NOACs, used in a major bleed
Prothrombin complex concentrate (Octaplex)
68
What pts must dose alteration of NOACs be considered?
CKD (NOACs renally excreted) NB surgical pts NO BRIDGING ANTICOAG REQ
69
List some causes for thrombophilia (3+1)
Inherited: APC resistance (Factor V Leiden mutation) Antithrombin III defc Prothrombin gene mutation Acquired: APL syndrome
70
List indications for screening for a thrombophilia (6)
``` Arterial thrombosis <50 Venous thrombosis <40 Unusual thrombosis site (mesenteric, portal) Familial VTE Recurrent unexplained VTE Recurrent miscarriages ```
71
List some conditions that cause target cells seen on a blood film (5)
``` Obstructive liver disease Thalassaemia Fe defc anaemia Sickle Post-splenectomy ```
72
What are the features of an acute haemolytic transfusion reaction (5) How is it managed?
``` Agitation Abdo/chest pain BP low DIC Sx Pyrexia ``` STOP transfusion A–E 0.9% saline
73
List the possible complications of blood transfusion (7)
``` Haemolytic (immed/delayed) Febrile reaction Infection transmission Hyperkalaemia Fe overload ARDS Coagulopathy ```

CP3 Medicine (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions