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Haematology Flashcards

1
Q

What makes up the Haematopoietic System?

A

Bone marrow, spleen, liver, lymph nodes and thymus

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2
Q

What is Haematopoiesis?

A

Process by which all blood cells are derived from

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3
Q

Name the process of Haematopoeisis (Lymphoid Pathway)

A

Multipotent Haematopoietic Stem Cell - Common Lymphoid Progenitor - Small lymphocyte - T and B cells

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4
Q

Name the process of Haematopoiesis (Myeloid Pathway)

A

Multipotent Haematopoietic Stem Cell - Common Myeloid Progenitor - Myeloblast - Basophil, Eosinophil, Neutrophil and Monocytes

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5
Q

3 functions of neutrophils

A

Chemotaxis, phagocytosis, killing of phagocytosed cells

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6
Q

What is the primary function of Eosinophils

A

Neutrophil function, as well as antibody dependent damage to parasites

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7
Q

2 main functions of Basophils

A

React in immediate hypersensitivity, modulate inflammatory response via protease, histamine and heparin - increase in heparin inhibits blood clotting cascade, and histamine inducing inflammation and increasing vessel permeability.

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8
Q

Where does haematopoiesis occur in children?

A

Bone marrow of all bones

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9
Q

Where does haematopoeisis occur in adults?

A

Axial skeleton and proximal areas of long bones

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10
Q

3 functions of monocytes and macrophages

A

Phagocytosis, killing of micro-organisms and APC’s, release of IL-1 and TNF

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11
Q

Primary function of platelets and mechanism

A

Primary haemostasis via sub-endothelial tissue adherence

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12
Q

Average Hb level in Adult Males

A

130-170 g/L

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13
Q

Average Hb level in Adult Females

A

120-155 g/L

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14
Q

Average Hb level in children from 6m-6Yrs

A

110-145 g/L

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15
Q

Average Hb level in children from 6yrs-14yrs

A

120-155 g/L

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16
Q

What is the definition of Anaemia?

A

Reduction in Haemoglobin level BELOW the reference range for the age and sex of the individual

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17
Q

5 Key Symptoms of Anaemia

A 
Lassitude
Fatigue
Dyspnoea on exertion
Palpitation
Headaches
Chest pain
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18
Q

5 Signs of Anaemia

A 
Pallor
Tachycardia
Wide Pulse Pressures
Flow Murmurs
Congestive Cardiac Failure
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19
Q

5 Mechanisms of Anaemic Development

A 
Blood Loss
Haemolysis/Decreased RBC lifespan e.g. Malaria, SSA
Impairment of RBC formation
Pooling and destruction in Spleen
Increased plasma volume during pregnancy
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20
Q

3 main morphological classifications of Anaemia

A

Normocytic
Microcytic
Macrocytic

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21
Q

What is microcytic anaemia attributed to? (2 points)

A

Iron deficiency

Thalassaemias

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22
Q

What is normocytic anaemia attributed to? (3 points)

A

Acute blood loss, anaemia of chronic disease e.g. TB , chronic renal failure

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23
Q

What is the most common type of anaemia?

A

Iron deficiency Anaemia

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24
Q

Which of these are examples of classic presentation of iron-deficient anaemia?

Bulging eyes
Stress-induced incontinence
Enlarged parotid glands
Koilonychia

A

Koilonychia

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25
Name a type of treatment appropriate for an iron-deficient anaemic patient that suffers from fever
Parenteral iron therapy
26
Name an investigation which will allow you to diagnose iron-deficient anaemia.
Blood film
27
What is folate required for in erythropoiesis?
DNA synthesis
28
Where is folate derived from?
Green leafy vegetables
29
Which of these is a cause of folate deficiency? ``` Methotrexate Phenytoin Salbutamol Acute Blood Loss TB ```
Methotrexate - causes increased folate removal from the body as side-effect
30
Which one of the following is a treatment for folate deficiency? ``` Inclusion of vegetables such as Broccoli and asparagus Inclusion of more red meat into the diet Iron supplements Candesartan Blood transfusion ```
Inclusion of vegetables such as Broccoli and asparagus
31
Which one of the following is a treatment for folate deficiency? Folic Acid - 20 mg - twice daily - 6 months Folic Acid - 5mg - once daily - 4 months Folic Acid 2mg - four times daily - 9 months
Folic acid - 5mg - once daily - 4 months
32
When testing for folate deficiency what else should you test for?
B12 deficiency
33
When testing for B12 deficiency what else should you test for?
Folate deficiency
34
Name an anti-epileptic drug which could cause of folate deficiency.
Phenytoin
35
What is Vitamin B12's role in erythropoeisis?
Supplying methyl groups required for DNA and protein synthesis
36
Where is B12 found in the human diet?
In foods or animal origin
37
Why is it important to test for B12 deficiency when testing for folate deficiency?
They have similar presentations and if the B12 deficiency diagnosis is missed over a long period of time can result in peripheral neuropathy and demyelination of subacute combined degeneration of the spinal cord
38
Why is it important to test for B12 deficiency when testing for folate deficiency?
They have similar presentations and if the B12 deficiency diagnosis is missed over a long period of time can result in peripheral neuropathy and demyelination of subacute combined degeneration of the spinal cord
39
Which of these is a treatment of Vitamin B12 deficiency? IM Hydroxocobalamin Blood transfusion Parenteral Iron infusion Ramipril
Intramuscular Hydroxocobalamin
40
A patient presents with peripheral neuropathy, they state they were treated for stomach cancer 9 months ago, what is the likely cause?
Vitamin B12 deficiency
41
Which of the following can cause normoblastic anaemia? Phenytoin Methotrexate Excess Alcohol Insufficient folate intake
Excess alcohol
42
Which one of the following is a cause of haemolytic anaemia? Type 2 Diabetes G6PD deficiency Excess Iron Folate deficiency
G6PD deficiency
43
What does G6PD deficiency result in?
Increased cell sensitivity to oxidative stress
44
What is Hereditary Spherocytosis a result of?
Congenital Membrane Defect
45
What is an example of an acquired non-immune cause of haemolytic anaemia?
Burns
46
What is frontal bossing?
Overly pronounced forehead
47
What is frontal bossing a sign of?
Anaemia - Erythropoeitic expansion
48
What is a common feature of haemolytic anaemia regarding an organ in the haematopoietic system?
Splenomegaly
49
What is the structure of haemoglobin?
4 chains - 2 alpha, 2 beta
50
How are thalassemia's diagnosed?
Haemoglobin electrophoresis
51
What is Bart's Hydrops Fetalis syndrome?
A rare type of alpha thalassemia involving the deletion of all 4 globin genes
52
What gene is affected in Beta-thalassemia?
HBB
53
What type of beta-thalassemia is the more severe? Heterozygous Beta-thalassemia Homozygous Beta-thalassemia Acquired Beta-thalassemia
Homozygous beta-thalassemia
54
What disease can cause acute vaso-occlusion?
Sickle Cell Anaemia
55
What mutation causes sickle cell anaemia?
A point mutation in the beta globin gene
56
What is a sign found on the legs which is characteristic of sickle cell anaemia?
Chronic leg ulcers
57
Name an invasive treatment for sickle cell anaemia.
Blood transfusion
58
Which anaesthetic should you avoid in the anaemic patient?
Prilocaine
59
Which of these is a radiographic feature of a haematinic deficient patient? ``` Radiolucent bone Radiodense bone Dense Lamina Dura No PDL Furcation involvement ```
Dense lamina dura
60
What are the two most important blood group systems?
Rh and ABO systems
61
What antigen is related to the ABO group?
H
62
What antigen is related to the Rh system?
D
63
What is the treatment for haemolytic disease of the newborn?
Antenatal Anti-D prophylaxis
64
What does the use of prilocaine in a haematinic deficient patient cause?
Methaemoglobinaemia
65
Which phenotype can receive all types of ABO grouped blood?
AB+
66
What phenotype can receive only one type of ABO grouped blood?
O
67
What ABO blood group can be universally received?
O (negative)
68
What is the mechanism of haemolytic disease of the newborn?
Placental transfer of IgG from RhD negative mother to RhD positive foetus
69
What is Methaemoglobinaemia and what is its significance in a dental setting?
The state of the haemoglobin iron goes to a ferric state, impairing oxygen affinity - prilocaine usage can cause methaemoglobinaemia
70
What is the definition of a leukaemia?
Malignant neoplasm of haematopoietic stem cells
71
What are the two cell line differentiated groups of leukaemias?
Myeloid and Lymphoid
72
What cells are affected in myeloid leukaemias?
Basophils, neutrophils, eosinophils, monocytes and mast cells
73
What cells are affected in lymphoid leukaemias?
NK cells, small lymphocytes, T and B lymphocytes
74
What is the diagnostic test for leukaemia?
Blood film or bone marrow investigation
75
How are leukaemia's caused? (4)
Ionising radiation Alkylating agents Genetic factors Viruses such as HTLV
76
What are the general symptoms of marrow infiltration in leukaemias?
Pallor, malaise, fever, bleeding and bruising
77
What are the general signs of tissue infiltration in leukaemias?
Lymphadenopathy and hepatosplenomegaly
78
Which leukaemia is gingival hypertrophy linked to?
Acute Myeloid Leukaemia
79
What leukaemia is bone and joint pain linked to?
Acute Lymphoblastic Leukaemia
80
What group is predominantly affected by acute lymphoblastic leukaemia?
Children - 4-5 years old
81
What is the cure rate of ALL in children?
60%
82
What group is predominantly affected by acute myeloid leukaemia?
Young adults - 18-24
83
What is the cure rate of AML?
>30%
84
What leukaemia makes up 25% of all leukaemias?
Chronic Lymphocytic Leukaemia
85
What leukaemia predominates in people aged 40-50 years of age?
Chronic Myeloid Leukaemia
86
What are the features of chronic myeloid leukaemia?
Hypermetabolism, splenomegaly, leucostasis, hyperuricaemia
87
What is the most common cause of CML?
Philadelphia chromosome
88
What is the Philadelphia chromosome?
Balanced translocation between chromosome 9 and 22
89
What is Ann Arbor staging?
A system of defining progression of cancer based on level of lymph node implication categorised into stages
90
What are the Ann Arbor stages?
1 - Single lymph node 2 - Two lymph nodes 3 - Groups of lymph nodes both sides of diaphragm 4 - Widespread disease outside lymphatic system
91
What is a key oral symptom of NHL?
Nodule formation in Waldeyer's Ring

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