Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RW Year 6 > Haematology > Flashcards

Haematology Flashcards

1
Q

Pencil cells (elliptocytes)

Microcytic anaemia

Hypochromia

Anisopoikelocytosis

Koilonychia

Glossitis

Angular stomatitis

Diagnosis?

A

Iron deficiency anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tx of Iron deficiency anaemia

A

(1) Oral ferrous sulphate
(2) IV Iron dextran

Once Hb corrected –> continue iron supplementation for 6 months

(to restore iron stores)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hb electrophoresis of different types of Thalassemia

A

alpha-thal = increased HbH

Beta-thal major = increased HbF, increased HbA2

Beta-thal minor = increased HbA2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hair-on-end appearance on skull X-ray

A

B thalassaemia major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs of anaemia

Hepatosplenomegaly

Frontal bossing

Failure to thrive

Diagnosis?

A

Beta thal major or intermedia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Microcytic anaemia

Target cells

Raised reticulocytes

A

Beta Thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx of Beta Thalassaemia Major

A

Blood tranfusions

+ Iron chelation therapy

+ Splenectomy

(spleen enlarges due to extramedullary erythropoiesis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of alpha-thal

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Infections

Pallor

Easy bruising

Pancytopenia

Low reticulocytes

Hypocellular bone marrow

Diagnosis? Treatment?

A

Aplastic anaemia

Blood tranfusion

+ Platelet transfusion (if < 10 x 10^9/L)

+/- Granulocyte transfusion

+/- Prophylactic antibiotics, antivirals or anti-fungals

Immunosupressants

—– [1] Anti-thymocyte globulin (ATG) + Ciclosporin A (CSA)

or HSCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Low Hb, Low WCC, Low Platelets

Diagnosis?

A

Aplastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of aplastic anaemia

A

Idiopathic (40%)

  • Autoimmune

Acquired

  • Drugs (AEDs)
  • Viral infection (Parvovirus B19)
  • Radiation

Inherited

  • Fanconi’s anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of Vit B12 deficiency

A

Low intake

  • Vegan (low meat, fish, diary)

Low IF

  • Pernicious anaemia
    • Anti-parietal cell antibodies (90%)
    • ​A​nti-IF antibodies (low sensitivity, highly specific

Low absorption

  • Crohn’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypersegmented neutrophils (>5 lobes)

Macrocytes (RBC with high MCV)

Diagnosis?

A

Vitamin B12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment for Vitamin B12 deficiency

A

If poor diet –> Oral Vitamin B12 (cyanocobalamin)

If poor absorption –> IM Vitamin B12 (hydroxcobalamin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of megaloblastic macrocytic anaemia

A

Vitamin B12 deficiency

Folate deficiency

Drugs (Methotrexate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of folate deficiency

Treatment?

A

Low intake

  • Poor diet (Alcoholic, Elderly) in green vegetables

Low absorption

  • Crohn’s disease
  • Coeliac disease

High demand

  • Pregnancy
  • Malignancy
  • Haemolysis

Treatment = B12 replacement, THEN folate supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of non-megaloblastic macrocytic anaemia

A

Alcohol

Haemolysis (raised reticulocytes)

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Signs of Vitamin B12 defiency /

Subacute degeneration of the spinal cord

A

Peripheral sensory neuropathy

  • Affects Dorsal Columns + Corticospinal tract
  • Gradual onset
  • Initially –> Loss of proprioception
    • Sensory ataxia
    • +ve Romberg’s test
  • Then –> Loss of fine touch (distally)
  • Eventually –> Bilateral spastic paresis

UMN + LMN signs

  • UMN: Spastic weakness, Upgoing plantars
  • LMN: Loss of reflexes

Normal pain and temperature sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pernicious anaemia is associated with

A

Gastric cancer

Pernicious anaemia –> increase Gastrin –> increase risk of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

High urobilinogen

Schistocytes

Anaemia

Jaunduce (High unconjugated BR)

High reticulocytes

High LDH

Low haptoglobins

Diagnosis?

A

Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of herediatary haemolytic anaemia

A

Hereditary haemolytic anaemia

Membrane defects

  • Hereditary spherocytosis
  • Elliptocytosis

Metabolics defects

  • G6PD deficiency

Haemoglobinopathies

  • Sickle cell anaemia
  • Thalassaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Causes of acquired haemolytic anaemia

A

Autoimmune haemolytic anaemia

  • Warm antibodies (associated with CLL) and Cold antibodies

Microangiopathic haemolytic anaemia (MAHA)

  • HUS (Haemolytic uraemic syndrome)
  • TTP (Thrombotic thrombocytonpenic purpura)
  • DIC

Isoimmune

  • Haemolytic transfusion reaction
  • Haemolytic disease of the newborn

Infection

  • Malaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Warm auto-antibodies

Type of Ig

Type of haemolysis

Cause

A

Warm-autoantibodies

IgG

Extravascular haemolysis

Associated with CLL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cold auto-antibodies

Type of Ig

Type of haemolysis

Cause

A

Cold auto-antibodies

IgM

Intravascular haemolysis

Associated with Mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Ix for hereditary spherocytosis
Osmotic fragility test
26
Heinz bodies Triggered by Fava beans
G6PD deficiency
27
Ix for autoimmune haemolytic anaemia
**Direct Antiglobulin test** (DAT) / **Coomb's test** Look for RBC coated with antibodies using anti-human globulin
28
Triad of HUS
**MAHA** * Schistocytes * Low Hb * High conjugated BR * High LDH **Acute renal failure** * Oliguria * Haematuria **Low Platelets** * Bruising
29
Pentad of TTP
HUS + Fever + Fluctuating CNS signs MAHA AKI Low platelets Fever Fluctuating CNS signs
30
Anaemia Low platelets High Urea, High Creatinine High BR (unconj), High LDH Blood film: Schistocytes
HUS/TTP
31
Cause of HUS Sx Tx
Causes * **E coli O157:H7** (Shiga toxin) * Streptococcal spp. * Familial Symptoms * **_TRIAD = MAHA + Thrombocytopenia + AKI_** * **Bloody diarrhoea**, N&V, Abdo pain * **Dehydration** * **Petechiae** or **Purpura** * +/- **Fever** * +/- **Fluctuating CNS signs** Tx * IV Fluids * +/- RBC tranfusion * +/- Dialysis
32
Cause of TTP
**Genetic mutation in ADAMTS13** --\> ADEMTS-13 deficiency --\> release of large vWF multimers --\> Platelet activation --\> Fibrin deposition --\> Renal failure, Schistocytes, Low platelets + Fever + Fluctuating CNS signs
33
Tx of TTP
(1) **Plasma exchange** (replaces ADAMTS13) **+ Prednisolone** **+ Long term Aspirin** (2) **Immunotherapy** (3) **Splenectomy**
34
**Low Platelets** **High Fibrin degradation produces / High D-dimer** **High PT/APTT** **Low fibrinogen** Diagnosis?
DIC
35
Tx of DIC
Treat underlying condition **Platelet tranfusion** **FFP transfusion** **Heparin/LMWH**
36
Hb - ↓ MCV - ↓ Serum iron - ↓ Serum ferritin - ↓ Transferrin / Total iron binding capacity (TIBC) - ↑ Transferrin saturation - ↓
Iron deficiency anaemia
37
Hb - ↓ MCV - ↓ /\<-\> Serum iron - ↓ Serum ferritin - ↑ /\<-\> Transferrin / Total iron binding capacity (TIBC) - \<-\>/↓ Transferrin saturation - \<-\>
AoCD
38
Hb - ↓ MCV - ↓ Serum iron - \<-\> Serum ferritin - \<-\> Transferrin / Total iron binding capacity (TIBC) - \<-\> Transferrin saturation - \<-\>
Thalassaemia trait
39
Causes of (true) polycythaemia
**Polycythaemia rubra vera** (JAK2 mutation) ==\> high red cell mass **Secondary polycythaemia** = high erythropoietin * Appropriate response - Hypoxia * Inappropriate response - Renal carcinoma
40
**Pruritis after a hot bath** **Plethoric face (red)** **Blurred vision** **Tinnitus** **Choreiform movements** **Splenomegaly** Diagnosis?
Polycythaemia
41
**High Hb** **Low MCV** **High Haematocrit** Diagnosis?
Polycythaemia rubra vera
42
Ix to DDx between Polycythaemia rubra vera and Secondary polycythaemia
Polycythaemia rubra vera * **High RBC, High WCC, High Platelets** * **Low erythropoietin** * **JAK2 mutation** * _Bone marrow biospy:_ **erythroid hyperplasia** Secondary polycythaemia * **High RBC**, \<-\> WBC, \<-\> Platelets * **High erythropoietin**
43
Complications of polycythaemia
Hyperviscosity --\> **Thrombosis** * **Stroke** * **MI** * **PE** * **Budd-Chiari syndrome**
44
APTT measures
**Intrinsic pathway** (damaged endothelium) 12 --\> 11 --\> 9 (+8) --\> 10
45
PT measures
**Extrinsic pathway** (Trauma) **7** (+TF) --\> 10
46
Tx of polycythaemia rubra vera
* **Aspirin** * Regular **venesections** * Cytoreductive therapy * **Hydroxycarbamide**
47
Causes of low platelets
Low production * Bone marrow failure Increased use * ITP * HUS/TTP * DIC
48
**Recent viral infection** **Bleeding** (easy bruising, mucosal bleeding, epistaxis) **Otherwise well** **Low Platelets** Normal PT and APTT Normal Fibrinogen Normal D dimers Dx? Definitive Ix?
**Immune thrombocytopenic purpura (ITP)** Anti-platelet antibodies
49
ITP vs TTP vs DIC Investigations
*_ITP_*: low platelets, everything else normal *_TTP_*: low platelets, anaemia, schistocytes *_DIC_*: low platelets, high fibrin degradation products, prolonged PT/APTT
50
Tx for ITP
(1) **Oral Prednisolone + IVIG** (2) **Splenectomy** or Rituximab (mAb against B cells) **+/- Platelet transfusion**
51
Prolonged APTT Normal PT Normal platelets Bleeding into joints
Haemophilia A or B
52
Cause of Haemophilia
X-linked recessive Haemophilia A = F8 deficiency Haemophilia B = F9 deficiency
53
Tx of Haemophilia
Factor 8/9 concentration Tranexamic acid Desmopressin (DDAVP --\> increase F8)
54
**Prolonged APTT** **Normal PT** **Normal platelets** **Low vWF antigen / function assay** **Recently started Aspirin** **Black ethnicity** Diagnosis? Inheritance?
**Von Willebrand's disease** (Type 1-3) Type 1-2 are Autosomal dominant Most common inherited bleeding disorder
55
Diagnosis of G6PD Tx inheritanace
G6PD level: low X-linked recessive Treatment * Folate * Splenectomy + Vaccination + ABx prophylaxis * Treat anaemia * Treat jaundice
56
Triggers for G6PD
57
Triggers for sickle cell crises
**Hypoxia** **Dehydration** **Infection** Cold temperature Stress
58
Presentation of sickle cell crises
Trigger (infection, hypoxia, dehydration) Anaemia Jaundice Painful crisies * Dactylitis * Acute chest syndrome * Bone pain * Stroke * Priapism Splenomegaly
59
Blood film features of hyposplenism
Target cells Howell Jolly bodies
60
Diagnosis of Sickle Cell
*_Definitive Ix_*: **Hb isoelectric focusing** Monitor levels of HbS % *_Screening Ix_*: **Hb solubility testing**
61
Treatment of Sickle Cell disease
Acute * ABCDE * Oxygen * IV Fluids * ANalgesia * Antibiotics * +/- Blood transfusion Chronic * Hydroxycarbamide (increase HbF) * +/- BM transplant Prophylaxis * Vaccination * Penicillin * Folic acid * Avoid triggers (dehydration, infection, hypoxia)
62
**Sickle cell disease** **+ severe anaemia** **+ low Reticulocyte count** Diagnosis?
**Parvovirus B19 infection** --\> Transient red cell aplasia
63
Cut off for red cell tranfusion
"10/30 rule" If **Hb \< 10 g/dL** *_or_* **Haematocrit \< 30%**
64
Cut off for acute leukaemia What is it called below this?
% Blast cells \> 20% --\> **Acute Leukaemia** % Blast cells \< 20% --\> **Myelodysplasia**
65
**Blasts cells on peripheral blood film** Diagnosis?
Acute leukaemia
66
Markers of ALL
*_Acute lymphoblastic leukaemia_* **+ve TdT** **Lymphoblasts** Anaemia, Thrombocytopenia, Neutropenia
67
Markers of AML
*_Acute myeloid leukaemia_* **Auer rods** **Myeloblasts** Anaemia, Thrombocytopenia, Neutropenia
68
Which leukaemia is associated with Down's syndrome
Acute Myeloid Leukaemia
69
**Anaemia** **Thrombocytopenia** **Neutropenia** **Gum swelling** **Auer rods** **Sudan black staining +ve** Diagnosis?
Acute myeloid leukaemia
70
**Anaemia** **Thrombocytopenia** **Neutropenia** **Organ infiltration** **Testicular swelling** **Thymic swelling** **Hepatosplenomegaly** _Blood film_: **Lymphoblasts** _BM aspirate_: **Hypercellular with \>20% lymphoblasts** Diagnosis?
Acute lymphoblastic leukaemia (ALL)
71
**Philadelphia chromosome** What protein? Which condition? Which translocation?
**Chronic myeloid leukaemia** Philadelphia chromosome t(9,22) BCR-ABL protein
72
**Anaemia** **Thrombocytopenia** **_Lymphocytosis_** **_Granulocytosis_** (high neutrophils, eosinophils, basophils) **_Splenomegaly_** Diagnosis?
**Chronic myeloid leukaemia** t(9,22) BCR-ABL protein Splenomegaly
73
Anaemia Thrombocytopenia **_Non-tender lymphadenopathy_** **_Autoimmune haemolytic anaemia_** (DAT +ve) **Lymphocytosis** Blood film: **Smudge / Smear cells**
Chronic lymphocytic leukaemia (**CLL**)
74
**Reed-Sternberg cells** (Owl's eyes)
Hodgkin's lymphoma
75
**Painless enlarging mass** Lymphadenopathy Pruritis B symptoms (fever, night sweats, weight loss) (EBV)
Hodgkin's lymphoma
76
**_EBV_** **Painless enlarging mass** **_Hepatosplenomegaly_** **B symptoms** (fever, night sweats, weight loss) Mycosis fungoides (skin rash) Hypercalacemia
Non-Hodgkin's lymphoma
77
Features of Multiple Myeloma
CRAB * **Calcium - hypercalcemia** (osteoclast activation) * **Renal failure** (due to paraprotein deposition) * **Anaemia** (due to marrow infiltration) * **Bone pain** (osteoclast activation) Hepatosplenomegaly Peripheral neuropathy
78
Ix of MM
_Bloods_: Anaemia (AoCD), High Cr, High Ca, NORMAL ALP _Blood film_: **Rouleaux formation** _Serum protein electrophoresis_: **paraprotein** (monoclonal band) _Urine_: **Bence-Jones proteins**
79
**Ringed sideroblasts** **Spleen NOT enlarged** _BM aspirate_: **Hypercellular marrow \< 20% blasts**
**Myelodysplasia**
80
**Tear-drop RBCs (dacrocytes)** **Massive splenomegaly** **Leucoerythroblastosis** (circulating RBC and WBC precursors) **"Dry tap"** on BM aspirate
Myelofibrosis
81
Richter's transformation
CLL to Diffuse large B cell lymphoma (NHL)
82
Staging for HL and NHL
**Ann Arbor staging** ## Footnote Stage 1 = 1 LN Stage 2 = 2 LN (same side of diaphragm) Stage 3 = 2 LN (different sides of diaphragm) Stage 4 = extranodal involvement (e.g. Liver)
83
HL vs NHL
HL * Localised to a single nodal group * Spreads contigously * Painless lymphadenopathy * B symptoms NHL * Multiple LN sites * Spreads discontinuously * May affect CNS (unlike HL)
84
Starry sky appearance
Burkitt's lymphoma
85
HTLV-1 is associated with Blood film finding?
Adult T cell lymphoma / leukaemia (ATLL) Flower cells
86
Tx for APML
ATRA (All trans-retinoic acid)
87
Define blast crisis
CML --\> Acute leukaemia (\>20% blast cells) ==\> bone marrow failure (anaemia, thrombocytopenia, neutropenia)
88
Tx for CML
Imatinib
89
Staging system for CLL
Binet staging system
90
JAK2 mutations
Polycythaemia rubra vera Myelofibrosis

RW Year 6 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions