Haematology Flashcards
Key symptom of lymphoma
Drenching night sweats
Fatigue
Weight loss
Main difference between Hodgkin/ Non-Hodgkin lymphoma?
NH - painless lymphadenopathy
H - alcohol induced pain in lymph nodes + MEDIASTINAL MASS (breathless, dyspnoea)
What is follicular lymphoma?
What is it’s key characteristic?
Type of Non-Hodgkin lymphoma
Characterised by slowly growing lymph nodes
What do blood tests show in a lymphoma
Errything raised
• Raised FBC, U+E, LFT, LDH, ACE level
Key characteristic of chronic lymphocytic leukaemia that sets it apart from standard lymphoma?
Drenching night sweats
Fatigue
Weight loss
ABDOMINAL DISTENTION, ANAEMIA, THROMBOCYTOPENIA
How to treat CLL?
Chemo-immunotherapy – Bendamustine + RITUXIMAB (toxic to B cells)
In older people, what are the main 2 causes of iron deficiency?
GI Bleed
Blood loss
What is the relationship between B12 and folate?
B12 needed to make folate
Symptoms of B12/folate deficiency
Macrocytic anaemia
ANGULAR CHELITIS
Mild jaundice
Pancytopenia
Key test results for haemolysis?
HIGH RETICULOCYTES (immature RBC) LOW HAPTOGLOBINS (proteins that bind to free Hb) Anaemia High MCV Raised bilirubin
Key symptoms for PCV?
GOUT TINNITUS headache red face Itching
What gene causes PCV?
JAK2
What is a key cause of thrombocytosis?
IRON DEFICIENCY Hyposplenism Haemolysis Surgery Cancer Drugs (steroids/ TPO mimetic)
What is a key marker of thrombocytosis?
FERRITIN
What genes are involved in causing thrombocytosis?
JAK2
CALR
Like lymphomas, what are the symptoms of myelofibrosis?
DRENCHING NIGHT SWEATS
Weight loss
Fatigue
What does the blood film of myelofibrosis show?
TEAR DROP RBC
How to treat myelofibrosis?
Bone marrow transplant
JAK2 inhibitors
What chromosome causes chronic myeloid leukaemia?
PHILADELPHIA CHROMOSOME
9 & 22 merge together
How to treat chronic myeloid leukaemia?
o low dose oral cytotoxic drugs (busulphan, hydroxycarbamide)
o interferon
o Gleveec/imatinib mesylate: a tyrosine kinase inhibitor (TKI)
Bone marrow transplant
Chemo
What are the differences in chronic myeloid leukaemia and chronic lymphocytic leukaemia?
CML - myeloid cells are cancerous (macrophages/ granuloma cells). Causes ABDO PAIN, splenomegaly, anaemia, venous occlusion
CLL - lymphoid cells are cancerous (B cells). ABDO DISTENTION. Axillary lymphadenopathy, anaemic, decr platelets, splenomegaly, bone marrow failure, systemic symptoms
Patient presents with drenching night sweats, fever and weight loss. What are your differentials?
What separates each one?
Myelofibrosis, Chronic Lymphocytic Leukaemia, lymphoma
Myelofibrosis - tear drop RBC, PANcytopenia
CLL - ABDOMINAL DISTENTION, ANAEMIA, THROMBOCYTOPENIA
Lymphoma - lymphadenopathy (usually painless, but in Hodgkin’s can hurt after drinking alcohol)
