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CP > Haematology > Flashcards

Haematology Flashcards

1
Q

When does haemopoiesis begin in the embryo?

Where does it start?

A

Day 9

Aorto-gonado mesonephros

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2
Q

What is the most common WBC in adult blood?

A

Neutrophils

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3
Q

What are eosinophils important for?

A

Parasitic infections and allergies

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4
Q

What WBCs are involved in CML?

A

Basophils

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5
Q

Kuppfer cells and Lagerhans cells are examples of

A

APCs (monocytes)

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6
Q

What is the NR for platelets in adult blood?

A

150-400

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7
Q

What is the NR for WBCs in adult blood?

A

4-11

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8
Q

Microcytic hypochromic anaemia can be caused by

A

iron deficiency

thalassemia

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9
Q

Macrocytic anaemia can be caused by

A

Vit B12 deficiency

alcohol

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10
Q

Leucodepletion is

A

where RBCs are removed from whole blood

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11
Q

What does FFP contain?

A

Clotting factors

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12
Q

What does Prothrombin complex concentrate contain?

A

Vit K dependent factors

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13
Q

What does cryoprecipitate contain?

A

fibrinogen, vWF, FVIII and FXIII

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14
Q

What is giving transfusions of platelets contraindicated in?

A

TTP
ITP
Heparin induced thrombocytopenia&thrombosis

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15
Q

What can be used to reverse warfarin?

A

Prothrombin complex concentrate

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16
Q

What is the most common reaction to transfusion?

A

Febrile non-haemolytic transfusion reactions

it is due to cytokines and other active molecules accumulating during storage

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17
Q

What are the pulmonary complications of transfusion?

A

TACO- acute LV failure with pulmonary oedema
TRALI- immune mediated reaction causing leaky pulmonary capillaries
TAD- dyspnoea without signs of LV failure/abnormalities

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18
Q

What is measured in thrombin time?

A

Fibrinogen

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19
Q

What factors are measured in prothrombin time?

A

Fibrinogen

Factor II, V, VII and X

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20
Q

What factors are measure in aPTT?

A

Factors II, V, X, VIII, IX, XI and fibrinogen

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21
Q

What are examples of anticoagulants?

A

Heparin
Warfarin
DOACs
Fondaparinux

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22
Q

when treating someone with unfractioned heparin, what must be checked?

A

The patient hasn’t had a vasectomy or allergy to fish

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23
Q

What would you give to reverse the effect of heparin?

A

Protamine sulphate

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24
Q

What DOACs work to inhibit FXa?

A

Rivaroxaban
Apixaban
Edoxaban

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25
Q

What DOAC inhibits thrombin?

A

Dabigatran

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26
Q

What is virchow’s triad?

A

stasis of blood flow
endothelial injury
hypercoagulability

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27
Q

What type of thrombi are predominantly composed of fibrin?

A

Venous thrombi

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28
Q

What can be used a pharmacological prophylaxis for VTE?

A

LMW heparin (Tinzaparin)
Fondaparinux
Rivaroxaban
Dabigatran

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29
Q

Is the D-dimer test positive or negative in VTE?

A

Positive

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30
Q

Factor V Leiden is

A

where Arg 506 is replaced by Gln and so FV is more resistant to cleavage

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31
Q

Prothrombin 20210A is caused by

A

a point mutation in the 3’ untranslated region of the prothrombin gene

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32
Q

Anti-phospholipid syndrome can cause

A

thrombophilia

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33
Q

What type of inheritance pattern does vWD have?

A

Autosomal dominant

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34
Q

Haemophilia B and Haemophilia A are caused by deficiencies in

A

FIX and FVIII respectively

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35
Q

When does postnatal screening occur?

A

Day 5

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36
Q

When in thrombocytopenia most marked in pregnancy?

A

After 20 weeks

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37
Q

When does someone with the HbA/S trait struggle?

A

In extreme hypoxia and dehydration

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38
Q

What are examples of chronic complications of sickle cell disease?

A

Hyposplenism
Renal disease with tubular damage (bed wetting)
Avascular necrosis @ femoral/humeral heads
Leg ulcers

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39
Q

How is sickle cell disease treated?

A

From 6 months: penicillin

In an acute crisis: analgesia and hydration, hydroxycarbamide (to increase HbF)

40
Q

Hb Barts can cause what

A

hydrops fetalis

41
Q

beta-thalassaemia major can cause

A

anaemia
short stature and distorted limb growth
enlarged and overactive spleen

42
Q

X-rays that show ‘hair on end’ skulls are caused by

A

Beta-thalassaemia major

43
Q

What is a complication of beta-thalassemia major?

A

Severe iron overload and toxicity

It can be treated with iron chelation therapy (desferrioxamine) to prevent death

44
Q

What are examples of chronic myeloproliferative disorders?

A

Polycythaemia vera
Essential thrombocytosis
Idiopathic myelofibrosis

45
Q

What are causes of some secondary polycythaemia?

A

chronic lung diseases
high altitude
CO poisoning
Epo producing tumours

46
Q

JAK2 mutations are common in what

A

various myeloproliferative disorders

47
Q

In the JAK2 V617F mutation, what occurs?

A

Phenylalanine is changed to valine at position 617 in the protein

48
Q

How is polycythaemia vera treated?

A

Aspirin 75mg

49
Q

Reactive thrombocytosis can be caused by

A

surgery
Infection
Inflammation
Hyposplenism

50
Q

In thrombocytosis and myelofibrosis, what mutations can be found?

A

JAK2

CALR (calreticulin mutation on exon 9)

51
Q

Massive splenomegaly and pancytopenia can be found in

A

myelofibrosis

52
Q

What are causes of splenomegaly?

A 
C Cancer
H Haematological (CML,CLL)
I Infection (malaria, EBV)
C Congestion
A Autoimmune
G Glycogen storage disorders
O Other (sarcoidosis)
53
Q

Gout, splenomegaly and fatigue are symptoms of

A

CML

54
Q

Where is iron absorbed?

A

Duodenum

55
Q

What group is at risk of megaloblastic anaemia due to a lack of vit B12?

A

Vegans (it is only found in animal sources)

56
Q

what is also associated with a vit B12 deficiency?

A

subacute degeneration of the cord and pernicious anaemia

57
Q

What can cause haemolysis?

A

Haemoglobinopathies
G6PD deficiency
Hereditary spherocytosis
Drugs

58
Q

In anaemia of chronic disease what will the MCV be like?

A

Normal

59
Q

What should ITP be treated with?

A

Steroids

IV immunoglobulin

60
Q

A deficiency in ADAMTS-13 can lead to

A

TTP

61
Q

TTP should be suspected where there is evidence of thrombocytopenia and

A

fever
neurological symptoms
haemolysis

62
Q

How does AML present?

A

Bone marrow failure:

  • Anaemia
  • Infections
  • Easy bruising and haemorrhage
63
Q

FLT3 ITD mutation points to a

A

‘bad risk’ AML

64
Q

NPM1 mutation points to a

A

‘good risk’ AML

65
Q

What are hypomethylating agents that can be used in AML?

A

Azacytidine

Decitibine

66
Q

Where is FLT3 found?

A

Chromosome 13q12

it is a proto-oncogene

67
Q

How can ALL present?

A

Fatigue
Bruising/bleeding
Night sweats
Lymphadenopathy

68
Q

How does Blinatumomab work?

A

combines the binding site of CD3 and CD19 to engage T cells in the lysis of CD19 B cells

69
Q

CD22 is the most attractive target of

A

Immunotoxins and immunoconjugates

70
Q

Myelodysplasia can be described as

A

clonal bone marrow stem cell disorders that result in ineffective haematopoiesis

71
Q

Where is haemoglobin produced initially?

A

Yolk sac, liver and then bone marrow

72
Q

In the embryonic stage, what type of Hb is present?

A

Hb Gower 1
Hb Gower 2
Hb Portland

73
Q

In the fetal stage, what type of Hb is present?

A

HbF (2 alpha, 2 gamma)

74
Q

In the adult, what type of Hb is present?

A

HbA (2 alpha, 2 beta)

HbA2 (2 alpha, 2 delta)

75
Q

Why does Hb switching occur?

A

to take 02 from the mother

76
Q

What type of Ig can cross the placenta?

A

IgG

77
Q

What type of factors are normal at birth?

A

5, 8, 13 and fibrinogen

78
Q

What factors are Vit K dependent?

A

1972, Protein S and C

79
Q

What is myeloma preceded by?

A

MGUS

monoclonal gammopathy of undetermined significance

80
Q

How can myeloma be diagoned?

A

C hypercalcaemia
R renal insufficiency
A anaemia
B bone lesions (osteolytic)

81
Q

How can myeloma be treated?

A

Dexamethasone

82
Q

Patients with myeloma will often have

A

renal insufficiency

83
Q

AKI with suspected myleoma is

A

a medical emergency that should be treated with steroids

84
Q

What is AL amyloidosis?

A

Where amyloid light chain fragments are aggregated and form deposits in organs

85
Q

Lymphoma with Reed Sternberg cells are known as

A

Hodgkin’s

86
Q

What type of lymphoma has a bimodal age distribution?

A

Hodgkin’s lymphoma

87
Q

Follicular lymphoma can be characterised by

A

slowly enlarging lymph nodes

88
Q

What is used for prognosis of follicular lymphoma?

A

FLIPI

>60 
Ann Arbor stage III or IV
LDH above limit at diagnosis
Hb <120g/L
4 nodal sites of disease
89
Q

Diffuse large B-cell lymphoma and Burkitt’s lymphoma are

A

aggressive non-Hodgkin lymphomas

90
Q

CLL is

A

a malignant disorder of mature B-cells

staged using the Binet system

91
Q

What can be used to treat CLL?

A

Rituximab

Bendamustine

92
Q

17p deletion in CLL is associated with

A

a worse prognosis

93
Q

Neutropenic sepsis can’t be judged by

A

temperature

there is an abnormal neutrophil count

it should be treated with Abx promptly

94
Q

Secondary ITP can be caused by

A

infection
drugs
herbal remedies

95
Q

How should ITP be treated?

A

Glucocorticoids (prednisolone)

IV immunoglobulin

96
Q

Pneumonia in immunocompromised patients is usually caused by

A

normally ‘harmless’ organisms

CMV, RSV, Streptococcus pneumoniae, pneumocystitis

CP (12 decks)

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