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Year 3 Buzzwords > Haematology > Flashcards

Haematology Flashcards

1
Q

Microcytic anaemia causes

A 
Low MCV <80 fl 
Defects in haem synthesis:
- iron deficiency
- anaemia of chronic disease
- sideroblastic anaemia
Defects in globin synthesis
- thalassaemia
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2
Q

Iron deficiency anaemia

A

Blood loss: menorrhagia, upper/lower GI bleed, hookworms
Reduced absorption: coeliac disease, resections
Reduced intake: diet
Increased demands: pregnancy, growth

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3
Q

Sideroblastic anaemia

A

Abnormality of haem synthesis (iron inclusion within the cell)
Inherited or secondary (alcohol/drugs/lead poisoning)

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4
Q

α thalassaemia

A

Microcytic anaemia

2α = trait, 3α = HbH disease, 4α = Hb Barts (incompatible with life)

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5
Q

ß thalassaemia

A

2β = transfusion dependent
Desferioxamine for chelation
Hepatosplenomegaly, jaw protrusion, big forehead, “hair on end” skull XR

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6
Q

Management of sideroblastic anaemia

A

Treat the cause

Inherited: pyridoxine

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7
Q

Management of lead poisoning

A

Remove source
Dimercaprol
D-penicillinamine

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8
Q

Normocytic anaemia causes

A

MCV 80-100
Acute blood loss: peptic ulcer, varices
Failure of RBC production:
- bone marrow failure or suppression (aplastic anaemia, chemotherapy)
- bone marrow infiltration (malignancy)
- renal failure (reduced erythropoietin)
- early iron deficiency or anaemia of chronic disease
- hypothyroidism (+macrocytic)
- vitamin B2/6 deficiency
Haemolysis
Uncompensated fluid increase: pregnancy, fluid overload
Pooling of red cells in spleen: hypersplenism (portal cirrhosis)

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9
Q

Macrocytic anaemia

A 
MCV >100fl
Megaloblastic: vitamin B12 or folate acid deficiency
Drugs (methotrexate, hydroxyurea, azathioprine, zidovudine
Non-megaloblastic: 
Alcohol excess/liver disease (round macrocytes)
Myelodysplasia
Multiple myeloma
Hypothyroidism
Aplastic anaemia
Haemolysis (reticulocytosis)
Drugs
Pregnancy
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10
Q

Blood film findings

  • hypersegmented neutrophils
  • schistocytes
  • spherocytes
  • Howell-Jolly bodies
  • Heinz bodies
  • dacrocytes
  • codocytes
  • burr cells
A

Hypersegmented neutrophils: megaloblastic anaemia, cytotoxic drugs, myelodysplastic syndrome
Schistocytes: MAHA, sickle cell disease
Spherocytes: hereditary spherocytosis, autoimmune haemolytic anaemia
Howell-Jolly bodies: reduced splenic function, severe haemolytic anaemia, myelodysplastic syndrome
Heinz bodies: G6PD
Dacrocytes: myelofibrosis
Codocytes: haemoglobinopathies, iron deficiency anaemia, hyposplenism, liver disease
Burr cells (echinocytes): uraemia, pyruvate kinase deficiency

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11
Q

Haemolytic anaemia

A 
Jaundice + anaemia
Hereditary: 
- membrane defects
- metabolic defects
- haemoglobinopathies
Acquired:
- autoimmune
- isoimmune
- drugs e.g. penicillin, quinine (RBC autoantibodies)
- trauma (MAHA)
- infection
- Paroxysmal nocturnal haemoglobinuria
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12
Q

Sickle cell anaemia

A

African/Afro-caribbean
Symptomatic at altitude/hypoxia
Sickle cell crisis: acute chest syndrome, priaprism, joint pain

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13
Q

Hereditary spherocytosis

A

Osmotic fragility test +ve
Spherocytes on blood film
Splenomegaly

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14
Q

G6P deficiency

A

X-linked recessive
Triggers: moth balls/fava beans/nitrofurantoin/anti-malarials, infection
Heinz bodies

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15
Q

Autoimmune haemolytic anaemia

A

Coomb’s test: erythrocytes with antibodies
Cold-activated: mycoplasma
Warm-activated: CML/lymphoma/SLE

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16
Q

Paroxysmal Nocturnal Haemoglobinuria

A

Red discolouration of urine (haemoglobin and haemosiderin)

Ham’s test: lysis of erythrocytes in acidic solution

17
Q

Haemolytic Uraemic Syndrome

A

Triad: acute renal failure, thrombocytopaenia, microangiopathic haemolytic anaemia
E.coli -> blood cell haemolysis

18
Q

Trhombotic Thrombocytopenic Purpura

A

Pentad: HUS +CNS signs +fever

Clots, low platelets, rash

19
Q

Disseminated Intravascular Coagulation

A

Septic/post-natal/vascular insult

Low fibrinogen + presence of clots

20
Q

Anaemia of chronic disease

A

Rheumatoid arthritis
Cancer
Chronic inflammation

21
Q

Aplastic anaemia

A

Pancytopaenia
Hypocellular bone marrow
Absent reticulocytes

22
Q

Polycythaemia rubra vera

A

Uncontrolled RBC proliferation
JAK2 kinase/V167F mutation
Headaches, dizziness and strokes (viscosity)
Increased mast cells = pruritis after hot showers
Gout, splenomegaly, plethora

23
Q

Secondary polycythaemia

A

Excessive RBC production due to other disease (COPD/EPO-secreting tumour)
Blood doping (athletes)
Sustained hypoxia

24
Q

Immune Thrombocytopenic Purpura

A 
Often idiopathic
Menorrhagia, nosebleeds, purpura
Associated with:
- infections
- autoimmune diseases
- malignancy
- drugs (quinine)
25
Q

ALL

A

Children
Lymphadenopathy
Bone marrow failure: anaemia, neutropaenia, thrombocytopaenia
Blast cells

26
Q

AML

A 
Adults
RARA-PML protein
Auer Rods
Sudan Black B stain (myeloblasts)
Normocytic normochromic anaemia
27
Q

APML

A

Treat with vitamin A and arsenic
tr(15,17)
CNS involvement
Skin rash, gum bleeding

28
Q

CLL

A

Incidental finding
Raised WCC
Smear cells

29
Q

CML

A 
25-40 years
Blast cells
Philadelphia chromosome (BCR-ABL gene tr9,22)
Imantinib
3 phases: chronic > blast > accelerated
30
Q

Hodgkin’s lymphoma

A 
Continuous spread
Painful after EtOH
Lymphadenopathy
Hepatosplenomegaly
Bone marrow failure
Reed-Sternberg cells
31
Q

Non-hodgkin’s lymphoma

A

Non-continuous spread
Burkitt’s lymphoma: mass on jaw, African descent
Marginal zone lymphoma: MALT
Diffuse Large B Cell lymphoma: hepatitis C

32
Q

Multiple myeloma

A

CRAB
Bence Jones urinary protein
Plasma cells
Pathological fractures and back pain

33
Q

Haemophilia

A 
A: Factor 8
B: Factor 9
X-linked
Deep bleeding: haemarthrosis
APTT affected only
34
Q

Von Willebrand disease

A

Superficial bleeding
Loss of vWF
Prolonged APTT and bleeding time

35
Q

Vitamin K deficiency

A

Liver disease

Pancreatic insufficiency

36
Q

Factor V Leiden

A

5% Caucasians

DVT <45yrs

37
Q

Blood Group O

A

x4 increased clot risk

38
Q

Antiphospholipid syndrome

A 
Anti-cardiolupin
Obstetric complications (multiple miscarriages)
Thromboembolism events
Thrombocytopaenia
Livedo reticularis

Year 3 Buzzwords (6 decks)

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