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Phase 2A Med Concise > Haematology > Flashcards

Haematology Flashcards

1
Q

What is anaemia?

A

A decrease in haemoglobin in the blood below the reference range

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2
Q

Anaemia - 3 Types

A

Microcytic - MCV <80
Normocytic - MCV 80-100
Macrocytic - MCV >100

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3
Q

Microcytic anaemia - Causes

A

Iron deficiency
Haemoglobinopathies (Thalassaemia)
CKD

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4
Q

Iron deficiency - Causes

A

Bleeding (Menorrhagia - heavy menstrual bleeding)
Poor diet/malabsorption
Breastfeeding

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5
Q

Iron deficiency - Investigation

A

Serum ferritin

Endoscopy - GI bleeding

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6
Q

What is reticulocyte count?

A

Rate at which RBCs are being made in bone marrow

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7
Q

Causes of raised and low reticulocyte count

A

Raised - blood loss, haemolytic anaemia

Low count - production problem (iron deficiency anaemia)

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8
Q

Iron deficiency - Symptoms

A

Atrophic glossitis
Brittle hair/nails
Angular stomatitis

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9
Q

Iron deficiency - Treatment

A

Ferrous sulphate (Iron tablets)

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10
Q

Ferrous sulphate - Side effects

A 
Constipation
Diarrhoea
Nausea
GI irritation 
Epigastric pain
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11
Q

Normocytic anaemia - Causes

A

Acute blood loss

CKD

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12
Q

Macrocytic anaemia - Causes

A

B12/folate deficiency
Alcoholism/liver disease
Hypothyroidism

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13
Q

3 sources of folate

A

Green vegetables
Fruit
Offal (animal organ meat)

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14
Q

Folate deficiency - Causes

A

Malabsorption
Poor diet
Pregnancy (increased demand)

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15
Q

Pernicious anaemia - Pathophysiology

A

Vitamin B12 malabsorption, B12 needed for RBC production

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16
Q

Pernicious anaemia - Treatment

A

Vit B12 injections/tabs

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17
Q

B12 deficiency - Causes

A

Atrophic gastritis
Gastrectomy
Crohn’s disease
Coeliac disease

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18
Q

Anaemia - Signs and symptoms

A

Signs - Pale skin, tachycardia

Symptoms - Fatigue, faintness, breathlessness, reduced exercise tolerance

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19
Q

Why might patients on anti-coag drugs (warfarin) be over anti-coagulated?

A

Bad patient compliance
Artificial valves
New/interacting drugs

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20
Q

Over anti-coagulation - Symptoms

A 
Bruising
Bleeding
Haemoptysis (coughing up blood from lungs/bronchi)
Haematemesis (vomiting of blood)
Epistaxis - nose bleed
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21
Q

What is disseminated intravascular coagulation (DIC) ?`

A

Thrombosis followed by bleeding

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22
Q

Disseminated intravascular coagulation (DIC) - Causes

A 
Malignancy
Septicaemia
Pregnancy 
Trauma
Infection
Liver disease
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23
Q

Disseminated intravascular coagulation (DIC) - Treatment

A

Blood transfusion

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24
Q

Thrombocytopenia - Causes

A

Reduced platelet production in bone marrow
Excessive peripheral destruction of platelets
Enlarged spleen

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25
Q

Immune thrombocytopenic purpura (ITP) - Pathophysiology

A

Autoimmune destruction of platelets

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26
Q

Immune thrombocytopenic purpura (ITP) - Symptoms

A

Easy bruising
Epistaxis (nose bleeds)
Menorrhagia (menstrual bleeding)
Purpura (skin haemorrhages)

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27
Q

Immune thrombocytopenic purpura (ITP) Investigations

A

Blood tests - Reduced platelets, detection of platelet autoantibodies

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28
Q

Immune thrombocytopenic purpura (ITP) - Treatment

A

Prednisolone (corticosteroid)

Splenectomy

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29
Q

Deep vein thrombosis (DVT) - Virchow’s triad

A

Stasis
Vessel wall injury
Hypercoagulability

30
Q

DVT/thromboembolism - Causes

A 
Age
Obesity
Varicose veins
Long haul traveling
Immobility/bed rest
Plasminogen deficiency 
Thrombophilia
Pregnancy
31
Q

DVT/thromboembolism - Symptoms

A

Calf pain/swelling/warmth
Ankle oedema
Pitting oedema

32
Q

DVT/thromboembolism - Investigations

A

FBC - platelets

Doppler - Wells scote

33
Q

DVT/thromboembolism - Treatment

A

Heparin
Warfarin
NOACs

34
Q

DVT/thromboembolism - Prevention

A

Stockings

Leg elevation

35
Q

What is polycythaemia?

A

Increase in Hb, PCV (packed cell volume) and RBCs

36
Q

Polycythaemia - Primary causes

A

Polycythaemia vera - genetic mutation in JAK2 gene, increased RBC production due to bone marrow cells more sensitive to Epo (erythropoietin)
Primary familial/congenital polycythaemia - genetic mutation in EPOR gene, increased RBC production in response to Epo

37
Q

Polycythaemia - Secondary causes

A

More RBCs due to more circulating Epo due to (Chronic hypoxia, high altitude - poor O2 delivery, tumours releasing excess Epo)

38
Q

Polycythaemia - Symptoms

A

Easy bleeding/bruising
Fatigue
Dizziness
Headaches

39
Q

Polycythaemia - Investigations

A

FBC
Bone marrow biopsy
Genetic testing for JAK2 gene

40
Q

Polycythaemia - Treatment

A

Blood letting

Aspirin (reduces clots)

41
Q

Chronic myeloid leukaemia - Pathophysiology

A

Proliferation of myeloid cells

42
Q

Chronic myeloid leukaemia - Signs and symptoms

A

Signs - Splenomegaly, hepatomegaly, anaemia, bruising

Symptoms - Weight loss, tiredness, fever, sweats, bleeding, abdo discomfort

43
Q

Chronic myeloid leukaemia - Investigations

A

FBC - Raised WCC (all myeloid cells raised - neutrophils, macrophages, basophils)
Cytogenetics (PCR/FISH/karyotype) - Philadelphia chromosome

44
Q

Chronic myeloid leukaemia - Treatment

A

Imatinib/dasatinib (Tyrosine kinase inhibitor)
Hydroxycarbimide (chemo)
Stem cell transplant (curative outcome)

45
Q

Chronic lymphocytic leukaemia - Pathophysiology

A

Accumulation of mature B cells that have escaped apoptosis

46
Q

Chronic lymphocytic leukaemia - Signs and symptoms

A

Signs - Enlarged rubbery non-tender nodes, splenomegaly, hepatomegaly
Symptoms - Anaemia, weight loss, sweats, anorexia

47
Q

Chronic lymphocytic leukaemia - Investigations

A 
FBC - Raised lymphocytes
RAI staging (1-5 scale)
48
Q

Chronic lymphocytic leukaemia - Complications

A

Autoimmune haemolysis (decreased RBCs)
Infection
Marrow failure

49
Q

Chronic lymphocytic leukaemia - Treatment

A

Stem cell transplant
Rituximab (Chemo)
Radiotherapy

50
Q

Acute lymphocytic/myeloid leukaemia - Pathophysiology

A

Lymphocytic - Malignancy of T/B cell lines

Myeloid - Malignancy of myeloid cell lines

51
Q

Acute lymphocytic/myeloid leukaemia - Epidemiology

A

Lymphocytic - Childhood

Myeloid - Adults

52
Q

Acute lymphocytic/myeloid leukaemia - Signs and symptoms

A

Lymphocytic - Bone pain, marrow failure, hepatosplenomegaly, lymphadenopathy, cranial nerve palses, meningism
Myeloid - Marrow failure, hepatosplenomegaly, gum hypertrophy

53
Q

Acute lymphocytic/myeloid leukaemia - Investigation

A

Lymphocytic - FBC (Low RBC, low platelets), clotting screen (DIC occurs), lumbar puncture, cytogenetics
Myeloid - FBC (Low RBC, low platelets), clotting screen (DIC occurs)

54
Q

Acute lymphocytic /myeloid leukaemia - Treatment

A

Supportive - bloods, platelets, fluids
Chemo
Bone marrow transplant

55
Q

Marrow failure - Deficiencies

A

Hb
WBC
Platelets

56
Q

Marrow failure - Signs and symptoms

A

Anaemia
Tiredness
Recurrent infections
Thrombocytopenia - bruising, nose/gums bleeding

57
Q

Difference between lymphoma and leukaemia

A

Leukaemia - Malignancy of lymphocyte precursors arising in bone marrow
Lymphoma - Malignancy of mature lymphocytes arising in lymphatics

58
Q

Lymphoma - 2 Types

A

Hodgkin’s lymphoma - Reed-sternberg cells

Non-hodgkin’s lymphoma - No reed-sternberg cells

59
Q

Hodgkin’s lymphoma - Signs and symptoms

A

Signs - Enlarged lymph nodes, hepatosplenomegaly
Symptoms - Painless, non-tender rubbery lymph node enlargement (cervical, axillary, inguinal), fever, weight loss, night sweats, alcohol-induced lymph node pain, lethargy (lack of energy/enthusiasm)

60
Q

Hodgkin’s lymphoma - Investigation

A

Biopsy
Histology (Reed-sternberg cells)
Ann-arbor system (1-4 scale)

61
Q

Hodgkin’s lymphoma - Treatment

A

Chemo

Radio

62
Q

Non-hodgkin’s lymphoma - Pathophysiology

A

Lymphoma without reed-sternberg cells

Includes gastric MALT (Mucosa associated lymphoid tissue)

63
Q

Non-hodgkin’s lymphoma - Risk factors

A

H.pylori
HIV
Toxins

64
Q

Non-hodgkin’s lymphoma - Symptoms

A

Same as hodgkin’s

Also GI symptoms - Abdo pain, diarrhoea, vomiting

65
Q

Non-hodgkin’s lymphoma - Treatment

A

Chemo - Rituximab

Prednisolone (steroid)

66
Q

Myeloma - Pathophysiology

A

Malignant proliferation of plasma B lymphocytes accumulating in bone marrow, leading to overproduction of Ig causing renal dysfunction

67
Q

Myeloma - Signs and symptoms (CRAB)

A

Hypercalcaemia
Renal impairment (Decreased urine output, oedema)
Infection
Anaemia
Thrombocytopenia (bleeding)
Osteolytic bone lesions (Pepperpot skull - fractures)
Backache

68
Q

Myeloma - Investigations

A

Bloods - Raised urea and creatinine

X-ray of skull (Pepperpot skull)

69
Q

Myeloma - Complications

A

Hypercalcaemia
Spinal cord compression
Hyperviscosity
Acute kidney injury

70
Q

Myeloma - Treatment

A

Analgesia and bisphosphonates (bone pain)
Transfusion (anaemia)
Chemo

71
Q

Warfarin overdose - Treatment

A

Vit K

Beriplex

72
Q

Anaemia - 3 Types and their Causes

A

Microcytic - Iron deficiency
Normocytic - Blood loss
Macrocytic - B12/Folate deficiency

Phase 2A Med Concise (18 decks)

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