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Medicine finals > Haematology > Flashcards

Haematology Flashcards

1
Q

What does aminocytosis mean in regards to a blood film?

What does it indicate?

A

Variation in size of RBCs

Myelodysplastic syndrome and some forms of anaemia

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2
Q

When might Target cells be seen on a blood film?

A

IDA

Post-splenectomy

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3
Q

What are Heinz bodies caused by?

When might they be seen on a blood film?

A

Denatured globin

G6PD
Alpha-thalassaemia

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4
Q

When might Howell-Jolly bodies be seen on a blood film?

A

Post-splenectomy

Severe anaemia

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5
Q

When might Reticulocytes be seen on a blood film?

A

Haemolytic anaemia

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6
Q

What are Schistocytes?

When might they be seen on a blood film?

A

Fragments of RBCs

Haemolytic uraemia syndrome
Disseminated intravascular coagulation
Thrombotic thrombocytopenia purpura

Metallic heart valves
Haemolytic anaemia

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7
Q

What are Sideroblasts?

What does the presence of Sideroblasts indicate on a blood film?

A

immature RBCs that contain blobs of iron

Myelodysplastic syndrome

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8
Q

What are Smudge cells?

What can they indicate if seen on a blood film?

A

Ruptured white blood cells

Chronic lymphocytic leukaemia

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9
Q

What do Spherocytes indicate if present on a blood film?

A

Autoimmune haemolytic anaemia

Hereditary spherocytosis

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10
Q

What are causes of microcytic anaemia?

A 
Thalassaemia
Anaemia of chronic disease
Iron deficiency anaemia
Lead poisoning
Sideroblastic anaemia
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11
Q

What are causes of normocytic anaemia

A

3 As and 2 Hs

Acute blood loss
Anaemia of Chronic Disease
Anaplastic anaemia

Haemolytic anaemia
Hypothyroidism

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12
Q

What are the two types of macrocytic anaemia?

A

Megaloblastic

Normoblastic

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13
Q

What causes megaloblastic anaemia?

A

Impaired DNA synthesis

Folate deficiency
B12 deficiency

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14
Q

What are causes of normoblastic anaemia?

A 
Alcohol 
Liver disease
Drugs - azathioprine
Hypothyroidism
Reticulocytosis
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15
Q

What are the initial investigations required in a patient with suspected anaemia?

A 
Hb
MCV
B12
Folate
Ferritin
Blood film
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16
Q

What do low serum ferritin levels suggest?

A

IDA

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17
Q

What do high serum ferritin levels suggest?

A

Inflammation - infection/cancer

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18
Q

What can be used as a marker of how much transferrin is in the blood?

A

Total iron binding capacity

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19
Q

What causes an increase in TIBC/transferrin levels?

A

Iron deficiency

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20
Q

What causes a decrease in TIBC/transferrin levels?

A

Iron overload

21
Q

What gives an indication of the total amount of iron in the body?

A

Transferrin saturation

22
Q

What kind of sample gives the most accurate results when assessing a patients transferrin saturation?

A

Fasting sample

23
Q

What does a reduced transferrin saturation mean?

A

Reduced iron

24
Q

What does an increased transferrin saturation mean?

A

Increased iron

25
Q

What two things can increase the values of serum ferritin, serum iron, TIBC and Tf % giving the impression of iron overload?

A

Supplementation with iron

Acute liver damage

26
Q

What are the three ways that IDA can be corrected?

A

Blood transfusion
Iron infusion
Oral iron

27
Q

When should an iron infusion not be given?

A

During sepsis - iron feeds bacteria

28
Q

When is oral iron unsuitable?

A

If malabsorption is the cause of the IDA

29
Q

What are the causes of B12 deficiency?

A

Insufficient dietary intake

Pernicious anaemia

30
Q

What cells produce intrinsic factor?

A

Parietal cells

31
Q

What autoantibodies are involved in pernicious anaemia?

A

Intrinsic factor antibody

Gastric parietal cell antibody

32
Q

What type of symptoms can be caused by B12 deficiency?

A 
Neurological symptoms
Peripheral neuropathy with parathesia
Loss of vibration sense or proprioception
Visual changes
Mood or cognitive changes
33
Q

How can dietary B12 deficiency be treated?

A

Oral replacement with cyanocobalamin

34
Q

How can pernicious anaemia be treated?

A

IM cyanocobalamin (3x weekly for 2 weeks then every 3 months)

35
Q

If there is a B12 and folate deficiency, what has to be treated first and why?

A

B12 deficiency first

Treating patients with folate when they have a B12 deficiency can cause subacute combined degeneration of the cord

36
Q

What is the most common form of inherited haemolytic anaemia?

A

Hereditary spherocytosis

37
Q

How is hereditary spherocytosis inherited?

A

Autosomal dominant

38
Q

What signs may be suggestive of hereditary spherocytosis?

A

Jaundice
Gallstones
Splenomegaly
Aplastic crisis in presence of parvovirus

39
Q

When might a patient with hereditary spherocytosis develop an aplastic crisis?

A

Parvovirus

40
Q

What are the features on FBC and blood film which are indicative of hereditary spherocytosis?

A

Spherocytes on blood film

Raised mean corpuscular haemoglobin concentration

Raised reticulocytes

41
Q

How is hereditary spherocytosis managed?

A

Folate supplements
Splenectomy

+/- cholecystectomy if gallstones

42
Q

What is the pattern of inheritance of G6PD deficiency?

A

X-linked recessive

43
Q

In what population is G6PD deficiency most common?

A

Mediterranean and African patients

44
Q

What can trigger G6PD crises?

A

Infections
Medications
Fava beans (broad beans)

45
Q

What are the signs of G6PD that you might see on a blood film?

A

Heinz Bodies
Bite cells
Blister cell

46
Q

How can G6PD deficiency present?

A

Jaundice (neonatal)
Gallstones
Anaemia
Splenomegaly

47
Q

How can a diagnosis of G6PD deficiency be made?

A

G6PD enzyme assay

48
Q

What medications can trigger a G6PD?

A 
Primaquine
Ciprofloxacin
Sulfonylureas
Sulfasalazine
Sulphonamide drugs

Medicine finals (12 decks)

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