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Yr1 > Haematology > Flashcards

Haematology Flashcards

1
Q

What is myeloma?

A

A malignant tumour of the bone marrow, characterised by monoclonal proteins

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2
Q

What are the common features of myeloma?

A
  • tiredness and malaise
  • bone/back pain
  • infections
  • non-specific
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3
Q

What investigations would you do for myeloma?

A
  • FBC = generally anaemic
  • ESR = raised
  • high calcium
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4
Q

What is amyloidosis?

A
  • Build-up of an abnormal protein called amyloid in organs and tissues throughout the body.
  • Can lead to organ failure
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5
Q

What is the treatment for myeloma?

A
  • Control symptoms (pain medication) and supportive measures
  • chemotherapy and steroids
  • radiotherapy - ‘spot welding’
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6
Q

What are the 4 things to remember with myeloma?

A
  • CRAB
  • calcium
  • renal
  • anaemia
  • bone disease
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7
Q

Name the types of leukaemia.

A
  • Acute Myeloid leukaemia (AML)
  • Chronic Myeloid leukaemia (CML)
  • Acute lymphoblastic leukaemia (ALL)
  • Chronic lymphocytic leukaemia (CLL)
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8
Q

What is leukaemia?

A
  • malignant proliferation of haemopoietic cells
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9
Q

What are the general symptoms of leukaemia?

A
  • anaemia
  • SOB/fatigue
  • thrombocytopenia - bruising and rash
  • infection - fevers/rigors
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10
Q

What are the basic investigations for leukaemia?

A
  • FBC
  • coagulation screen
  • bone marrow aspirate and trephine biopsy
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11
Q

What is chronic myeloid leukaemia (CML)?

A
  • The proliferation of myeloid cells
  • 15% of leukaemias
  • Mostly 40-60 year olds
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12
Q

What are the symptoms of CML?

A
  • insidious (gradual)
  • weight loss
  • tiredness
  • fever/sweats
  • bleeding
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13
Q

What are the signs of CML?

A
  • Splenomegaly (most common) - enlargement of spleen
  • Hepatmegaly
  • Anaemia and bruising
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14
Q

What investigations would you do for CML?

A
  • FBC - raised WCC (all). Hb = low/normal

- Cytogenetics FISH/PCR - show Philadelphia chromosome

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15
Q

What is the 1st line treatment for CML?

A
  • Imatinib

- 2nd line is dasatinib

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16
Q

What are other treatments for CML?

A
  • chemotherapy - hydroxycarbimide

- stem cell treatment - only cure, used mainly in younger patients

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17
Q

What is chronic lymphocytic leukaemia (CLL)?

A
  • Accumulation of mature B cells that have escaped programmed cell death
  • Commonest leukaemia
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18
Q

What are the symptoms for CLL?

A
  • Often asymptomatic
  • Anaemia/prone to infection
  • weight loss
  • anorexia
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19
Q

What are the signs for CLL?

A
  • Enlarged rubbery non-tender nodes

- Splenomegaly

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20
Q

What are the investigations for CLL?

A

FBC - raised lymphocytes

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21
Q

What are the complications with CLL?

A
  • Autoimmune haemolysis leading to decreased RBCs
  • infection
  • marrow failure
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22
Q

What is the treatment for CLL?

A
  • Often none required in early disease

- More advanced = rituximab

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23
Q

What is acute lymphocytic leukaemia (ALL)?

A
  • Malignancy of B/T lymphocyte cell lines

- Commonest cancer of childhood

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24
Q

What are the symptoms and signs of ALL?

A
  • bone pain
  • marrow failure
  • Enlarged liver and spleen
  • CNS involvement - cranial nerve palsies
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25
Q

What is acute myeloid leukaemia (AML)?

A
  • Malignancy of myeloid cell lines

- Commonest acute leukaemia in adults

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26
Q

What are the symptoms and signs of AML?

A
  • Marrow failure
  • Infiltration
  • gum hypertrophy
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27
Q

What investigations are used in ALL?

A
  • FBC = decreased RBC and platelets
  • Blood film = basts cells unless confined to bone marrow
  • Lumbar puncture - CNS involvement
28
Q

What is the treatment for ALL?

A
  • Supportive e.g. blood/fluids
  • Chemotherapy
  • bone marrow transplantation
29
Q

What investigations are used in AML?

A
  • FBC = decreased RBC and platelets

- Clotting screen = DIC may occur

30
Q

What is the treatment for AML?

A
  • Supportive

- Chemotherapy

31
Q

What is lymphoma?

A
  • A malignant growth of white blood cells, predominantly in the lymph nodes
32
Q

How does lymphoma present?

A
  • Variety of ways
  • Nodal disease
  • Enlarged liver/spleen
  • Systemic symptoms e.g. weight loss, fever etc.
33
Q

How is lymphoma diagnosed?

A
  • Blood film
  • cytogenetics
  • lymph node biopsy = most common
  • diagnosis is COMPLEX
34
Q

How is lymphoma categorized?

A
  • With a WHO performance status

- varies from 0 being asymptomatic to 3 being symptomatic, but not bed-bound and 5 being death

35
Q

How does Hodgkin Lymphoma present?

A
  • painless non-tender, RUBBERY lymph node enlargement

- B symptoms e.g. sweats and weight loss

36
Q

What is the treatment for Hodgkin lymphoma?

A
  • Stages 1-2A = combination chemo then radio

- Stage 2B-4 = combination chemo

37
Q

What is the epidemiology of Hodgkin Lymphoma?

A
  • peak incidence in young adults and elderly

- risk factors include obesity and post-transplantation

38
Q

What is Non-Hodgkin lymphoma?

A
  • All lymphomas without Reed-Sternberg cells
39
Q

What are the symptoms of non-hodgkin lymphoma?

A
  • painless non-tender, RUBBERY lymph node enlargement

- skin involvement

40
Q

What is the treatment for non-hodgkin lymphoma?

A
  • Chemo and radiotherapy
41
Q

What is the prognosis for NHL?

A
  • Variable but generally worse than Hodgkin’s
42
Q

What is anaemia?

A
  • Reduced red cell mass = +/- Hb concentration
43
Q

What are the different types of anaemia?

A
  • Microcytic = MCV <80
  • Normocytic = MCV 80-100
  • Macrocytic = MCV >100
44
Q

How does microcytic anaemia present?

A
  • Iron deficiency

- Thalassaemia - Hb disorder

45
Q

How would you investigate iron deficiency?

A
  • Measure serum ferritin
46
Q

What would a raised reticulocyte count show?

A

Blood loss or haemolytic anaemia

47
Q

What would a decreased reticulocyte count show?

A

Production problem, potentially seen in iron deficiency anaemia

48
Q

What are the symptoms of iron deficiency?

A
  • Koilonychia (spoon nails)
  • Angular stomatitis - affects corners of mouth
  • Atrophic glossitis
  • Brittle hair and nails
49
Q

How do you treat iron deficiency?

A
  • Ferrous sulphate - iron tablets
50
Q

What are the side effects of ferrous sulphate?

A
  • BLACK STOOL
  • Constipation
  • Diarrhoea
  • Epigastric pain
  • GI irritation
  • Nausea
51
Q

How does normocytic anaemia present?

A
  • Acute blood loss

- combined haematinic deficiency

52
Q

How does macrocytic anaemia present?

A
  • B12/folate deficiency
  • Alcohol excess/liver disease
  • Metabolic disease e.g. hypothyroidism
53
Q

What are the symptoms and signs of anaemia?

A
  • Fatigue
  • Faintness
  • Breathlessness
  • Reduced exercise tolerance
  • Pale skin
  • tachycardia
54
Q

What are other causes of B12 deficiency?

A
  • Atrophic gastritis
  • Gastrectomy
  • Crohn’s Disease
  • Coeliac Disease
55
Q

What is sickle cell disease?

A

Group of inherited conditions that affect RBCs, with the most serious being sickle cell anaemia

56
Q

What are symptoms of sickle cell disease?

A
  • Issues in bones
  • Avascular necrosis
  • Osteoarthritis
  • PAH
  • Acute chest syndrome is the worst
57
Q

How would you manage sickle cell disease?

A
  • Transfusion = with non-sickle cell blood
58
Q

What is neutrophilia and why can it occur?

A
  • Too many white blood cells

- Infection, inflammation and malignancy

59
Q

What can cause low iron levels?

A
  • low iron diet
  • blood loss
  • breastfeeding
  • hookworm
  • malabsorption
  • pregnancy
60
Q

What can cause a folate deficiency?

A
  • Poor folate diet
  • malabsorption
  • pregnancy
  • anti-folate drugs (methotrexate)
61
Q

What are the 3 categories for red cell disorders?

A
  • Haemoglobinopathy
  • Membranopathy
  • Enzymopathy
62
Q

What is membranopathy?

A
  • Autosomal dominal condition causing a deficiency in a protein used to make red cell membrane
63
Q

What are the symptoms of membranopathy?

A
  • Neonatal jaundice
  • Enlarged spleen
  • gallstones
64
Q

What is the treatment for membranopathy?

A
  • Folic acid

- Splenectomy

65
Q

Which patients might be over anti-coagulated?

A
  • Vit K antagonists e.g. warfarin

- NOACs e.g. apaxiban

66
Q

What are the symptoms of over prescribing anti-coagulants?

A
  • bruising
  • bleeding
  • epistaxis

Yr1 (13 decks)

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