Haematology Flashcards
Name 2 causes of microcytic anaemia
iron deficiency, chronic disease
Name 2 causes of normocytic anaemia
Blood loss, combined haematinic deficiency
Name 3 causes of macrocytic anaemia
B12 deficiency, alcohol excess, hypothyroidism
What is the treatment for iron deficiency anaemia?
Oral ferrous sulphate
Where is intrinsic factor produced?
Parietal cells in the stomach
What does intrinsic factor bind?
Vitamin B12
Where is B12 absorbed?
terminal ileum
What is perinicious anaemia?
Autoimmune disease against the parietal cells
Glossitis, jaundice and peripheral nerve damage are signs of what kind of anaemia?
B12 deficiency
Acute pain in the hands and feet of an African child may indicate?
Painful crisis, sickle cell anaemia
Where would an adult most likely get pain in a sickle cell crisis?
Long bones, ribs, spine and pelvis
Which gene is responsible for sickle cell?
HbS
What would you find on FBC in sickle cell anaemia?
High reticulocytes
What drug is used as prophylaxis of painful crises in sickle cell anaemia?
Hydroxycarbamide
How are patients with sickle cell anaemia managed?
Folic acid, flu and pneumococcal vaccinations and daily penicillin
“Disproportionate microcytic anaemia” is found in…
beta thalassaemia trait
How is beta-thalassaemia major managed?
repeat transfusions and desferrioxamine
How does alpha thalassaemia, 2 chains affected?
hypochromic and microcytic, normal Hb
How does alpha thalassaemia, 3 chains affected?
hypochromic microcytic anaemia with splenomegaly
How does alpha thalassaemia, all 4 chains affected?
Hydrops fetalis, miscarriage
What happens if you eat fava beans and you have G6PD deficiency?
Haemolysis
Name 3 drugs which can cause haemolysis in those with G6PD deficiency
sulphonamides, quinolones, nitrofurantoin
Briefly describe the meaning of polycythaemia
too many red blood cells/increased Hb concentration in the blood
Gout, ruddy face, thrombosis and splenomegaly may be due to…
Polycythaemia
What happens if someone with polycythaemia has a hot bath?
They get itchy
What would you see in the blood of someone with polycythaemia?
Increased haematocrit, neutrophils and basophils, decreased erythropoietin.
What mutation causes primary polycythaemia/polycythaemia rubra vera?
JAK-2 Kinase
Name some causes of secondary polycythaemia?
COPD, altitute, sleep apnoea
What initiates DIC?
Release of tissue factor
Name 3 causes of DIC
sepsis, surgery, amniotic fluid embolism
Briefly describe ITP?
Idiopathic/Immune thrombocytopenic purpura: immune-mediated reduction in platelet count
What may cause ITP?
Infection or vaccination
What is the treatment for ITP?
None, usually self limiting
What is seen on FBCs in ITP?
Low platelets, everything else is normal
What is the classic pentad of Thrombotic Thrombocytopenic Purpura?
- Fever
- Altered Mental status
- Haemolytic anaemia
- Kidney damage
- Thrombocytoopenia
What is thromboctopenia?
Low platelets
How is TTP managed?
- Plasma exchange
- Prednisolone
- Aspirin
What type of leukaemia are people with Downs Syndrome predisposed to?
ALL
What chromosome is linked to CML?
Philadelphia chromosome
What causes the philadelphia chromosome?
t(9:22)
What is the normal % of blast cells in bone marrow?
1-2%
What % of blast cells are seen in acut leukaemia?
> 20%
What acute leukaemia is more common in adults?
Acute Myeloid Leukaemia, AML
Which chromosome deletions are poor prognositc factors in AML?
Chromosome 5 and 7
What is seen on blood film in AML?
Auer rods
Which chromosome translation is associated with AML?
t(15:17)
What is the diagnostic enzyme in AML?
Myeloperoxidase
What does an increase in granulocytes at different stages of maturation indicate?
CML - chronic myeloid leukaemia
What is the first line treatment of CML?
Imatinib
What is the most common malignancy affecting children?
ALL