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Data Interpretation > Haematology > Flashcards

Haematology Flashcards

1
Q

E.g. microcytic anemia

A

Iron deficiency
Sideroblastic
Thalassaemia
Chronic disease

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2
Q

E.g. macrocytic anaemia

A 
B12 / Folate deficiency
Excessive alcohol
Reticulocytosis
Hypothyroid
Multiple Myeloma & Myeloproliferative disease & Myelodysplasia
Aplastic anaemia
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3
Q

E.g. Normocytic anaemia

A

Chronic disease
Acute blood loss
Haemolytic anemia
Marrow infiltration

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4
Q

Absorption points of:
Iron
B12
Folate

A

Iron - Duodenum & Jejunum
B12 - Terminal Ileum
Folate - Small bowel

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5
Q

Iron storage molecules

A

Ferritin anf haemosiderin (ferritin is also acute phase protein so can be elevated in infection / inflammation)

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6
Q

Iron profile in deficiency state

Serum iron
TIBC
Ferritin
Transferrin sats

A

Serum iron - Reduced
TIBC - Increased (body tries hard to bind more iron)
Ferritin - reduced (low iron stores)
Transferrin sats - reduced

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7
Q

Iron profile in iron overload

Serum iron
TIBC
Ferritin
Transferrin sats

Causes

A

Serum iron - Raised
TIBC - low
Ferritin - Raised
Transferrin sats - Raised

Haemochromatosis, Frequent blood transfusion

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8
Q

How is Fit B12 absorbed

What disease decreases

A

Bound by intrinsic factor from parietal cells in stomach
Absorbed from the Ileum

Absence of intrinsic factor (pernicious anaemia)
Disease affecting ileum (e.g. coeliac)

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9
Q

Normal bilirubin production and excretion

A

Hb degraded and bilirubin liberated

Bilirubin conjugated in Liver and passed into bowel in bile

Converted to urobilinogen some is reabsorbed and excreted in urine and some passed in stool

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10
Q

Biomarkers in haemolysis

Bili, LDH, Hb

A

Plasma unconjugated bilirubin will rise

inc amounts of urobilinogen in urine

Lactate dehydrogenase will rise

Hb may be excreted in urine or be converted to haemosiderin for excretion

In excessive cases, reticulocytes may be seen

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11
Q

Testing for cause of haemolysis

A

Osmotic fragility test: spherocytes less resilient to damage

Coomb’s test: tests for autoantibodies in blood (causes agglutination if positive)

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12
Q

Causes of inherited haemolytic anaemia

A 
Abnormal RBC membrane
- Spherocytosis
Abnormal Hb
- Thalassaemia, Sickle cell
Abnormal RBC metabolism
- G6PD deficiency
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13
Q

Causes of acquired haemolytic anaemia

A

Immune mediated
- Warm and cold autoimmune, Transfusion reaction, Heamolysis in the newborn, Adverse drug event
Non-immune
- Malaria, Hypersplenism, Mechanical heart valve, burns

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14
Q

Causes of high RBC (high packed cell volume)

A

Primary polycythemia (Rubra vera)

Secondary polycythemia (Lung disease, RCC, PKD, HCC)

Apparent polycythemia (dehydration)

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15
Q

Causes of neutrophilia

A

Bacterial infection
Malignancy
Inflammation
Necrosis (e.g. following MI)

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16
Q

Causes of neutropenia

A

Post-chemo/radiotherapy
Drug: Clozapine, Carbimazole
Viral infection
Immunosuppression

17
Q

Causes of lymphocytosis

A

Chronic infection (e.g. TB)
Viral infections
CLL
Lymphomas

18
Q

Causes of Eosinophilia

A

Allergic disorders

Atopy

19
Q

Causes of Thrombocytosis

A

Myeloproliferative disorders
CML
Myelodysplasia

Infection
Inflammation
malignancy

20
Q

Causes of thrombocytopenia

A

Leukaemia
Bone marrow replacement (mets, tumour)

HELLP syndrome
DIC
Hypersplenism

21
Q

Causes of pancytopenia

A 
SLE
Bone marrow infiltration (e.g. with tumour)
Hypersplenism
Sepsis
Aplastic anemia
22
Q

What is ESR & Causes of a raised ESR

A

How rapidly RBC form sediment due to plasma proteins. This is non-specific for inflammation as this causes inc in plasma proteins and raised ESR

Infectious disease
Neoplasm
Connective tissue disorder (esp GCA and Polymyalgia Rheumatica)
Anaemia
Renal disease
23
Q

Target cells seen in:

A

Thalassaemia
Iron deficiency
Post splenectomy
Liver disease

24
Q

Heinz bodies

A

Unstable Hb states

E.g Sideroblastic anaemia

25
Q

Auer rods (WBC abnormality)

A

Acute Myeloid Leukaemia

26
Q

Smear cells (WBC abnormality)

A

CLL

27
Q

What Factors does prothrombin time check

A

I, II, V, VII, X

almost the 1972 of Warfarin and so it is used to monitor Warfarin therapy in practice

28
Q

What is the INR, What is normal?

Target usually
Taget in recurrent DVT/PE

A

This is a ratio of how quickly blood clots versus a normal person

normal is 1 (1:1)

target 2.5

Recurrent DVT/PE 3.5

29
Q

APTT factors and when used

A

It relies on all factors apart from VII

Used to monitor Heparin (used less clinically as LMWH more commonly used and needs less monitoring)

30
Q

von Willebrand clotting beware

A

May have normal clotting profiles

31
Q

DIC Pathophys

A

Fibrin deposited in microvasculature resulting in infarction (e.g. due to toxins, infection etc)

Clotting factors used up leaving patient prone to bleeding

32
Q

PT, APTT, Fibrinogen and D-dimer in DIC

A

Raised PT and APTT since clotting factors used up

Reduced fibrinogen (widespread fibrin formation)

Raised D-dimer (breakdown of fibrin deposits)

33
Q

What is D-dimer

A

breakdown product of fibrin

Raised in infection and inflammation but used as non-specific test for DVT/PE

34
Q

PT, APTT and Fibrinogen in:

Warfarin
Heparin

A

Warfarin
PT - raised, APTT - normal and Fibrinogen normal

Heparin
PT - normal, APTT - raised and Fibrinogen normal

35
Q

PT, APTT and Fibrinogen in:

Haemophilia

A

PT - normal, APTT - raised and Fibrinogen - normal

This is because Haemophilia is deficiency of Factor VIII (A) or IX (B) so they affect APTT (all except VII)

36
Q

PT, APTT and Fibrinogen in:

Liver disease

A

PT - high, APTT - high and Fibrinogen normal

37
Q

Multiple Myeloma CRAB

A

Calcium (elevated), Renal Failure, Anaemia, Bone Involvement

Anaemia
Renal impairment (Tamm-horsfell protein)
Plasma cells secrete M-protein (dysfunctional immunoglobulin)
low levels of functional immunoglobulin
Bone involvement (pain, hypercalcaemia, lytic lesions - raindrop skull)
Hyperviscous blood
38
Q

Philedelphia chromosome

A

Seen in:

ALL - Bad prognosis
CML - Good prognosis

Data Interpretation (13 decks)

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