Haematology Flashcards
What are the causes of a normocytic anaemia?
Anaemia of chronic disease (low iron, low TIBC, raised ferritin) CKD Aplastic anaemia Haemolytic anaemia Acute blood loss
What is the commonest inherited bleeding disorder?
Von Willebrand’s disease
What is the inheritance of Von Willebrand’s?
Mostly autosomal dominant
What are the features fo Von Willebrands?
Epistaxis
Menorrhagia
Rare- muscle hameatoma,, haemarthroses
What is the management of Von Willebrands?
TXA for mild bleeding
Desmopressin
Factor VIII concentrate
What investigation results would suggest Von Willebrands?
Bleeding time prolonged
APTT may be prolonged
Factor VIII may be reduced
What factor is Von Willbrand a carrier for? What does it do?
Factor VIII
Promotes platelet adhesion to damaged endothelium
What are the features of ITP?
Thrombocytopenia (low platelets)
Anaemia
Purpura
What may ITP follow?
Infection or vaccination
What is the treatment for ITP?
None- self limiting
Who is chronic ITP more common in?
Young/middle-aged women
What conditions are spherocytes found in’?
Hereditary spherocytosis
Autoimmune haemolytic anaemia
What does the Coombs test investigate?
Autoimmune haemolytic anaemia
What is polycythaemia vera?
Myeloproliferative disorder caused by clonal proliferation of a marrow stem cell leading to increased red cell volume
What mutation is present in 95% of patients with polycythaemia vera?
JAK2
What are the features of polycythaemia vera?
Hyperviscosity Aquagenic pruritis Splenomegaly Haemorrhage Plethoric appearance HTN in 1/3rd
What are the treatment options for polycthaemia vera?
Venesection
Low dose aspririm
Hydroxycarbamide
IFN
What chromosome is present in over 95% of patients with CML? What gene does this code for?
Philadelphia chromosome
t(9;22)
BCR-ABL
What are the signs and symptoms of CML?
Anaemia/lethargy Massive splenomegaly Weight loss Sweating Abdo discomfort (from splenomegaly) Spectrum of myeloid cells in blood
What is the first line treatment for CML?
Imatinib
What are the causes of B12 deficiency?
Pernicious anaemia Post gastrectomy Vegan/poor diet Crohn's Metformin (rare)
What are the features of B12 deficiency?
Macrocytic anaemia
Sore tongue/mouth
Neuro sx e.g. ataxia
neuropsych sx e.g. mood disturbances
What is IM tydroxycobalamin used for and how often?
B12 deficiency
Every 12 weeks
In B12 and folic acid deficiency which should you replace first? If not what could this precipitate?
B12
Subacute combined degeneration of the cord
What would iron studies show in iron deficiency anaemia?
Iron- low
Ferritin- low
TIBC- high
What is the most common anaemia worldwide?
Iron deficiency anaemia
What are the main causes of iron deficiency anaemia?
Blood loss Inadequate intake Poor absorption (coeliac) Increased requirements (children and pregnancy)
What are the features of iron deficiency anaemia?
Fatigue SOB Palpitations Pallor Koilonychia (spoon nails) Hair loss Atrophic glossitis Post-cricoid webs Angular stomatitis
What is the management of iron deficiency anaemia?
Find and treat cause
Oral ferrous sulphate continued for 3 months after correction
Iron rich diet
What are the common side effects of iron supplementation?
Nausea Abdo pain Constipation Black stool Diarrhoea
What is the definition of neutropenic sepsis?
Neut <0.5x10^9
Patient on anti-cancer treatment
Temp >38 or signs/sx of sepsis
