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Phase 2a Questions > Haematology > Flashcards

Haematology Flashcards

1
Q

Deep venous thrombosis - Diagnosis

A
  1. Plasma D-dimer
    - Fibrinogen degradation product when clot dissolves
    - Not diagnostic -> raised in cancer, preg, post-op
  2. Compression ultrasound
    - Popliteal V
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2
Q

Anaemia - Definition

A

Decrease of Hg in blood below ref ranges for age and sex of individual.
Due to decreased cell mass or increased plasma volume

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3
Q

Macrocytic Anaemia - Causes

A
  1. B12 deficiency
  2. Folate deficiency
  3. Alcohol excess
  4. Hypothyroidism
  5. Immunosuppression
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4
Q

Chronic Myeloid Leukaemia - Cause

A

Translocation of a gene on chromosome 9 and 22 (BCR/ABL fusion gene)
Tyrosine kinase activity
Stimulate cell division Philadelphia chromosome

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5
Q

Hodgkin’s vs Non-Hodgkin’s lymphoma

A

HL - Reed sternberg cells (mirror image nuclei)

NHL - no characteristic cells

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6
Q

Hodgkin’s Lymphoma - Ann Arbor classification

A 
I - single lymph node region
II - 2+ nodes on same side of diaphragm
III - Nodes on both diaphragm
IV - Beyond lymph nodes - Liver
A/B - B symptoms (fever, weight loss, night sweats)
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7
Q

Tumour lysis syndrome - Definition

A
  1. Life threatening

2. Malignant cells breakdown - neuro, cardio and renal complications

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8
Q

Tumour lysis syndrome - Signs

A
  1. High uric acid
  2. Hyperkalaemia
  3. Hypocalcaemia
  4. Hyperphosphatemia
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9
Q

Hyperkalcaemia - ECG

A
  1. Loss of P waves
  2. Wide QRS complex
  3. Tall tended T waves
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10
Q

Tumour lysis syndrome - Treatment

A
  1. Aggressive hydration
  2. Allopurinol (xanthine oxidase inhibitor) / rasburicase (recombinant urate oxidase) –> reduce uric acid production
  3. Monitor electrolytes –> refer to dialysis
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11
Q

Acute lymphoblastic Leukaemia - Clinical presentation

A
  1. Anaemia
  2. Infection
  3. Bleeding
  4. Bone pain
  5. Lymphadenopathy
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12
Q

Acute lymphoblastic leukaemia - Diagnosis

A
  1. High WCC
  2. Blast cells on blood film / bm
  3. CXR and CT scan –> mediastinal and abdo lymphadenopathy
  4. Lumbar puncture –> CNS involvement
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13
Q

Febrile neutropenia - Definition

A
  1. T> 38 degrees

2. Absolute neutrophil count <1 x109 / L

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14
Q

Myeloma - Pathology

A
  1. Cancer of plasma cells
  2. Progressive bm failure
    (cytokines –> stim osteoclast and inhibit osteoblast)
  3. Monoclonal paraprotein
  4. Immunoparesis
  5. Hypercalcaemia
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15
Q

Hodgkin’s lymphoma - Treatment

A 
R-CHOP
R = Rituximab
(monoclonal Ab --> CD20 expressed on B cells)
C = Cyclophosphamide
H = Hydroxy-daunorubicin
O = Oncovin (vincristine)
P = Prednisolone

Early - 3mths
Late - 6mths w radiotherapy

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16
Q

Hodgkin’s Lymphoma - Epidemiology

A
  1. Male
  2. Teenagers 13-19
  3. Elderly >65
  4. EBV
17
Q

Myeloma - X ray

A
  1. Lytic “punched out” lesions
    - Pepper pot skull
    - Vertebral collapse
  2. Fractures
  3. Osteoporosis
18
Q

Ondansetron

A
  1. Anti-emetic drug

2. 5HT2 antagonist

19
Q

Microcytic anaemia - Causes

A
  1. Iron deficiency anaemia
  2. Anaemia of chronic disease
  3. Thalassaemia
20
Q

Sickle Cell Anaemia - reticulocytes

A

Increased

21
Q

Bacterial infection = raised …

A

Neutrophils

22
Q

Febrile neutropenia - Treatment

A
  1. Broad spectrum IV antibiotics w/out waiting for results w/in 1hr of admission
  2. Do not catheterise if neutropenic –> increased infection risk
23
Q

Aspirin - How it works

A
  1. Inhibits cyclo-oxygenase (COX) irreversibly

2. Inhibits thromboxane formation –> less platelet aggregation

24
Q

Thalassaemia - Blood film

A

Target cells

25
Q

Glucose-6-phosphate dehydrogenase deficiency - Diagnosis

A
  1. Blood count normal b/ween attacks
  2. Blood film in attack
    - Irregularly contracted cells
    - Increased reticulocytes
    - BIte cells (indentation in membrane)
  3. Low G6PD enzyme levels
26
Q

Hypochromic anaemia

A

Pale

Microcytic

27
Q

Folate deficiency - causes

A
  1. Poor intake
  2. Increased demand
  3. Malabsorption
  4. Anti-folate drugs (methotrexate)
28
Q

DVT - risk factors

A
  1. Obesity
  2. Immobility
  3. Varicose V
  4. Pregnancy
  5. Trauma

Phase 2a Questions (14 decks)

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