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Specialties > Haematology > Flashcards

Haematology Flashcards

1
Q

What cells can be seen in a Hodgkins Lymphoma biopsy?

A

Reed Sterberg cells

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2
Q

What chemotherapy regime is used for Hodgkin’s Lymphoma?

A 
ABVD
(A)driamycin (also known as doxorubicin)
(B)leomycin
(V)inblastine
(D)acarbazine
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3
Q

What classification system is used for Hodgkin’s Lymphoma?

A

Ann Arbor

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4
Q

What organism is associated with gastric MALT?

A

H. Pylori

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5
Q

Where is lymphadenopathy common in Burkitt’s lymphoma?

A

Jaw - in African children

Ileo-cecal junction in caucasians.

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6
Q

What is the appearance of Burkitt’s on histology?

A

‘Starry sky’

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7
Q

What is the chemotherapy regimen for non-Hodgkins?

A

R-CHOP

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8
Q

What genetic syndromes is ALL associated with? (2)

A

Down’s Syndrome, Klinefelters

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9
Q

What are signs of marrow failure?

A

Anaemia, infection, bleeding

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10
Q

What are four poor prognostic factors in ALL?

A

Older age, male sex, Philadelphia chromosome, CNS involvement

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11
Q

How can AML be differentiated from ALL on microscopy?

A

AML has Auer rods

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12
Q

What is the Philadelphia chromosome mutation?

A

Translocation between chromosome 9 and 22 (BRC-ABL) leading to an over-activation of tyrosine kinase.

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13
Q

What are the three phases of CML?

A

Chronic
Accelerated phase
Blast transformation (becomes AML)

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14
Q

What can be seen on blood film in CLL?

A

Smudge/smear cells

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15
Q

What are the two main causes of death in CLL?

A

Infection

Richter’s syndrome

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16
Q

What viral condition is common in CLL?

A

Shingles (Varicella Zoster)

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17
Q

How are acute and chronic leukaemia differentiated on blood smear?

A

> 20% blast cells classifies it as an acute leukaemia

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18
Q

What is found in the urine of patients with myeloma?

A

Bence Jones proteins - Ig light chains

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19
Q

What is identified in serum electrophoresis of myeloma?

A

Monoclonal protein cells

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20
Q

Name three drugs used in multiple myeloma induction therapy?

A

Bortezomib, dexamethasone, thalidomide

Lenalidomide

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21
Q

What can be used to suppress EPO in secondary polycythemia?

A

Hydroxycarbamine

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22
Q

What gene mutation is associated with poor prognosis in AML?

A

FLT3

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23
Q

What neoplasms could elevated monocyte levels represent?

A

Hodgkin’s lymphoma

Monocytic leukaemia

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24
Q

What is the management of minor bleeding in Haemophilia?

A

Desmopression and tranexamic acid

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25
Q

What is the inheritance pattern of Haemochromatosis?

A

Autosomal recessive

26
Q

What are the symptoms of acute haemolytic transfusion reaction?

A 
Fever +/- rigors (chills)
Abdominal, back, flank, or chest pain
SOB 
Hypotension 
Hemoglobinuria
Sever - Shock and disseminated intravascular coagulation
27
Q

What antibodies are present in pernicious anaemia?

A

Anti-intrinsic factor antibodies

28
Q

How should a patient presenting with extremely high granulocyte/leukocyte count be treated?

A

Leukapheresis

29
Q

What is the management of massive haemorrhage in a patient being treated with warfarin?

A

Withhold warfarin
IV vitamin K
Prothrombin complex

30
Q

Which pathway of the clotting cascade does Haemophilia affect?

A

The intrinsic pathway

31
Q

What is the inheritance pattern of von Willebrand disease?

A

Autosomal dominant

32
Q

What is Plummer-Vinson syndrome?

A

A triad of microcytic anaemia, glossitis and oesophageal webs (difficulty swallowing)

33
Q

What type of myeloma has normal serum calcium, potassium and creatinine but bone marrow plasma cells >10% ?

A

Smouldering myeloma (transition between MGUS and multiple myeloma)

34
Q

What are the morphological signs of Fanconi’s anaemia?

A 
Small wide thumbs
Small kidneys 
High levels of fetal haemoglobin
Hypopigmentation freckles
Low set ears
35
Q

What is the INR target for patients with recurrent thrombotic events?

A

3.5

36
Q

What is the management for AML?

A

Chemotherapy: Cytarabine and daunorubicin

37
Q

What is Richter’s syndrome? (1)

A

Transformation of B cell chronic lymphocytic leukemia (CLL) into a fast-growing diffuse large B cell lymphoma

38
Q

What disease does lymphadenopathy become painful on consuming alcohol? (1)

A

Hodgkin’s lymphoma

39
Q

What class of drug can be used to treat CML? Give an example? (2)

A

Tyrosine kinase inhibitors

Imatinib

40
Q

What infection predisposes to haemolytic uraemic syndrome and what does it release to cause the syndrome? (2)

A

E. Coli

Shiga toxin

41
Q

What are the triad of signs for haemolytic uraemic syndrome (3)

A

Haemolytic anaemia
Thrombocytopenia - purpuric rash
AKI - Oliguria

42
Q

What conditions can schistocytes be seen on blood film? (4)

A

Disseminated intravascular coagulation
Thrombotic thrombocytopenic purpura
Haemolytic uraemic syndrome
Valve disease

43
Q

Who needs to be informed about a case of haemolytic uraemic syndrome? (1)

A

Proper officer - local health protection team (Public Health England)

44
Q

What are the symptoms of TTP?

A 
Anaemia
Thrombocytopenia
CNS involvement 
Fever
Renal impairment
45
Q

What is the underlying mechanism of TTP? (2)

A

Antibodies inhibiting the enzyme ADAMTS13. This results in decreased break down of von Willebrand factor (vWF) into smaller units

46
Q

What are blood and clotting tests derangement in TTP?

A

Prolonged APTT
High lactate dehydrogenase
Low Hb
Low platelets

47
Q

How is TTP managed? (3)

A

IV plasma exchange - gold standard
Rituximab
Prednisolone

48
Q

Name causes of Immune Thrombocytopenia Purpura

A

URTI
HIV
H. Pylori
Autoimmune conditions - SLE, Antiphospholipid syndrome

49
Q

What are the investigations done in ITP and what are the results? (8)

A

Bone marrow biopsy - Normal
Blood film - Normal
Platelets - Low
Serology - Anti platelet antibodies

50
Q

What pregnancy complications can lead to DIC? (4)

A

Pre-eclampsia
Amniotic fluid embolus
HELLP
Placental abruption

51
Q

What test results are done in suspected DIC and what are the expected results?

A

Clotting screen - Prolonged PT and aPTT, low fibrinogen
FBC - Thrombocytopenia
D-dimer - elevated
Blood film - Schistocytes

52
Q

What is the management for DIC? (5)

A 
Treat underlying cause
RBC
Platelets
FFP
Cryoprecipitate
53
Q

What does cryoprecipitate consist of? (4)

A

Fibrinogen
Factor VIII
von Willebrand factor
Factor XIII

54
Q

When is unfractionated heparin used? (1)

A

Massive pulmonary embolism

55
Q

What is seen on clotting screen in Haemophilia A and B?

A

Prolonged APTT

Factor deficiency

56
Q

What can be used to treat mild Haemophilia A? (1)

A

Desmopressin

57
Q

What are the functions of von Willenbrand factor? (3)

A

Transport and protection of factor VIII
Recruits platelets to exposed subendothelium
Platelet adhesion

58
Q

What is the mechanism of action of desmopressin? (1)

A

Stimulates release of vonWillebrand factor from endothelial cells

59
Q

What are symptoms of polycythemia vera?

A

Itchy after hot bath
Facial plethora
Clots
Spent phase - bleeding, anaemia symptoms

60
Q

What mutation is seen in polycythemia vera?

A

JAK2

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