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HUD > Haematology > Flashcards

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
Q

Name a type of treatment appropriate for an iron-deficient anaemic patient that suffers from fever

A

Parenteral iron therapy

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26
Q

Name an investigation which will allow you to diagnose iron-deficient anaemia.

A

Blood film

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27
Q

What is folate required for in erythropoiesis?

A

DNA synthesis

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28
Q

Where is folate derived from?

A

Green leafy vegetables

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29
Q

Which of these is a cause of folate deficiency?

Methotrexate
Phenytoin
Salbutamol
Acute Blood Loss
TB
A

Methotrexate - causes increased folate removal from the body as side-effect

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30
Q

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
A

Inclusion of vegetables such as Broccoli and asparagus

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31
Q

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

A

Folic acid - 5mg - once daily - 4 months

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32
Q

When testing for folate deficiency what else should you test for?

A

B12 deficiency

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33
Q

When testing for B12 deficiency what else should you test for?

A

Folate deficiency

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34
Q

Name an anti-epileptic drug which could cause of folate deficiency.

A

Phenytoin

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35
Q

What is Vitamin B12’s role in erythropoeisis?

A

Supplying methyl groups required for DNA and protein synthesis

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36
Q

Where is B12 found in the human diet?

A

In foods or animal origin

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37
Q

Why is it important to test for B12 deficiency when testing for folate deficiency?

A

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
Q

Why is it important to test for B12 deficiency when testing for folate deficiency?

A

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
Q

Which of these is a treatment of Vitamin B12 deficiency?

IM Hydroxocobalamin
Blood transfusion
Parenteral Iron infusion
Ramipril

A

Intramuscular Hydroxocobalamin

40
Q

A patient presents with peripheral neuropathy, they state they were treated for stomach cancer 9 months ago, what is the likely cause?

A

Vitamin B12 deficiency

41
Q

Which of the following can cause normoblastic anaemia?

Phenytoin
Methotrexate
Excess Alcohol
Insufficient folate intake

A

Excess alcohol

42
Q

Which one of the following is a cause of haemolytic anaemia?

Type 2 Diabetes
G6PD deficiency
Excess Iron
Folate deficiency

A

G6PD deficiency

43
Q

What does G6PD deficiency result in?

A

Increased cell sensitivity to oxidative stress

44
Q

What is Hereditary Spherocytosis a result of?

A

Congenital Membrane Defect

45
Q

What is an example of an acquired non-immune cause of haemolytic anaemia?

A

Burns

46
Q

What is frontal bossing?

A

Overly pronounced forehead

47
Q

What is frontal bossing a sign of?

A

Anaemia - Erythropoeitic expansion

48
Q

What is a common feature of haemolytic anaemia regarding an organ in the haematopoietic system?

A

Splenomegaly

49
Q

What is the structure of haemoglobin?

A

4 chains - 2 alpha, 2 beta

50
Q

How are thalassemia’s diagnosed?

A

Haemoglobin electrophoresis

51
Q

What is Bart’s Hydrops Fetalis syndrome?

A

A rare type of alpha thalassemia involving the deletion of all 4 globin genes

52
Q

What gene is affected in Beta-thalassemia?

A

HBB

53
Q

What type of beta-thalassemia is the more severe?

Heterozygous Beta-thalassemia
Homozygous Beta-thalassemia
Acquired Beta-thalassemia

A

Homozygous beta-thalassemia

54
Q

What disease can cause acute vaso-occlusion?

A

Sickle Cell Anaemia

55
Q

What mutation causes sickle cell anaemia?

A

A point mutation in the beta globin gene

56
Q

What is a sign found on the legs which is characteristic of sickle cell anaemia?

A

Chronic leg ulcers

57
Q

Name an invasive treatment for sickle cell anaemia.

A

Blood transfusion

58
Q

Which anaesthetic should you avoid in the anaemic patient?

A

Prilocaine

59
Q

Which of these is a radiographic feature of a haematinic deficient patient?

Radiolucent bone
Radiodense bone
Dense Lamina Dura
No PDL
Furcation involvement
A

Dense lamina dura

60
Q

What are the two most important blood group systems?

A

Rh and ABO systems

61
Q

What antigen is related to the ABO group?

A

H

62
Q

What antigen is related to the Rh system?

A

D

63
Q

What is the treatment for haemolytic disease of the newborn?

A

Antenatal Anti-D prophylaxis

64
Q

What does the use of prilocaine in a haematinic deficient patient cause?

A

Methaemoglobinaemia

65
Q

Which phenotype can receive all types of ABO grouped blood?

A

AB+

66
Q

What phenotype can receive only one type of ABO grouped blood?

A

O

67
Q

What ABO blood group can be universally received?

A

O (negative)

68
Q

What is the mechanism of haemolytic disease of the newborn?

A

Placental transfer of IgG from RhD negative mother to RhD positive foetus

69
Q

What is Methaemoglobinaemia and what is its significance in a dental setting?

A

The state of the haemoglobin iron goes to a ferric state, impairing oxygen affinity - prilocaine usage can cause methaemoglobinaemia

70
Q

What is the definition of a leukaemia?

A

Malignant neoplasm of haematopoietic stem cells

71
Q

What are the two cell line differentiated groups of leukaemias?

A

Myeloid and Lymphoid

72
Q

What cells are affected in myeloid leukaemias?

A

Basophils, neutrophils, eosinophils, monocytes and mast cells

73
Q

What cells are affected in lymphoid leukaemias?

A

NK cells, small lymphocytes, T and B lymphocytes

74
Q

What is the diagnostic test for leukaemia?

A

Blood film or bone marrow investigation

75
Q

How are leukaemia’s caused? (4)

A

Ionising radiation
Alkylating agents
Genetic factors
Viruses such as HTLV

76
Q

What are the general symptoms of marrow infiltration in leukaemias?

A

Pallor, malaise, fever, bleeding and bruising

77
Q

What are the general signs of tissue infiltration in leukaemias?

A

Lymphadenopathy and hepatosplenomegaly

78
Q

Which leukaemia is gingival hypertrophy linked to?

A

Acute Myeloid Leukaemia

79
Q

What leukaemia is bone and joint pain linked to?

A

Acute Lymphoblastic Leukaemia

80
Q

What group is predominantly affected by acute lymphoblastic leukaemia?

A

Children - 4-5 years old

81
Q

What is the cure rate of ALL in children?

A

60%

82
Q

What group is predominantly affected by acute myeloid leukaemia?

A

Young adults - 18-24

83
Q

What is the cure rate of AML?

A

> 30%

84
Q

What leukaemia makes up 25% of all leukaemias?

A

Chronic Lymphocytic Leukaemia

85
Q

What leukaemia predominates in people aged 40-50 years of age?

A

Chronic Myeloid Leukaemia

86
Q

What are the features of chronic myeloid leukaemia?

A

Hypermetabolism, splenomegaly, leucostasis, hyperuricaemia

87
Q

What is the most common cause of CML?

A

Philadelphia chromosome

88
Q

What is the Philadelphia chromosome?

A

Balanced translocation between chromosome 9 and 22

89
Q

What is Ann Arbor staging?

A

A system of defining progression of cancer based on level of lymph node implication categorised into stages

90
Q

What are the Ann Arbor stages?

A

1 - Single lymph node
2 - Two lymph nodes
3 - Groups of lymph nodes both sides of diaphragm
4 - Widespread disease outside lymphatic system

91
Q

What is a key oral symptom of NHL?

A

Nodule formation in Waldeyer’s Ring

HUD (4 decks)

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