Haematology Flashcards
Iron deficiency anaemia (IX findings)
low hb, low MCV, low serum iron, low ferritin( can be high in inflammation, so not reliable), high TIBC(amount of unbound transferrin blood), wider red blood cell distribution width(as different RBC getting chucked out from bone marrow as it goes into overdrive), peripheral blood smear shows microcytic and hypochromic RBC, low transferrin saturation
what breaks down meat into b12
pepsin
where is intrinsic factor made
parietal cells in stomach
where is B12/intrinsic factor complex absorbed
Terminal ileum
excessive WCC, philadelphia chromosome- which leukaemia
Chronic Myeloid leukaemia
x-linked(brothers) factor VIII or Factor Ix deficiency, bleeds into joint and muscles
- haemophilia(a- factor VIII)(b-Factor-ix)
- avoid IM injections and NSAID
key two investigations for haemophilia(2)
1) Raised APTT
2) low factor VIII or IX assay
INR 5.0-8.0- no bleeding - what to do about warfarin
stop warfarin for 1-2 days, reduce subsequent warfarin dose
INR 5.0-8.0- with minor bleeding
IV vitamin K 1-3mg, Stop warfarin treatment and restart when INR <5
Major bleeding- patients on warfarin
IV Vitamin K 5mg, stop warfarin treatment.+ give dried prothrombin complex/ Fresh frozen plasma
Target Cells - which conditions(4)
1) Iron deficiency anaemia
2) Post splenectomy
3) Liver disease
4) Thalassaemia
Key bone marrow cells for AML
Auer Rods
Heinz bodies(3 causes)
- denatured haemoglobins due to spleen being removed.
- G6PD deficiency
- sulfonamides
uraemia cells
Burr
why is warfarin not used in pregnancy
it is teratogenic
Antiphospholipid syndrome anticoag when pregnant
Aspirin(increased platelet activation opposed by aspirin) and LMWH
slowly enlarged lymph nodes, lymphocytosis, treated with chlorambucil and fludarabine, which condition
Chronic Lymphocytic Leukaemia
Smear Cells(ruptured cell membranes-lymphocytes), which leukaemia
Chronic lymhocytic leukaemia
Type of cell for myelofibrosis,myelodysplastic syndrome,
teardrop red cells
G6pd inheritance type
X- linked - predominantly affect African males
Polycythemia rubra vera symptoms( hyperviscosity, bath, feet and hands)
- Headaches, dizzyness, tinnitus and visual disturbances
- itching after a hot bath
- burning sensation in fingers and toes(erythromelalgia)
photosensitive rashes, arthralgia, anaemia, thrombocytopenia- which condition
SLE
pernicious anaemia
low B12
reduction in Hb, WCC(leukopenia), thrombocytopenia
Aplastic anaemia
2 key risks for patients with aplastic anaemia
Bleeding and infection
key side effect of chloramphenicol
Aplastic anaemia(suppression)
Amyloidosis investigations
biopsy, positive congo red stain and red green birefringence under polarised light microscopy
DVT in cancer patient treatment
LMWH for 6 months and then risk assess
Provoked DVT(COCP)
LMWH for 5 days + Vit K antagonist for 3 months/ doac for 3 months
which leukaemia caused by chemotherapy
Acute Myeloid leukaemia
Complication tumours of chemotherapy
Breast, Lung, Thyroid, Bone , colon
key immunosuppresant that causes gingival hypertrophy
ciclosporin
Haemolyric transfusion reaction symptoms(3)
fever, hypotension and red-coloured urine.
key difference symptom between TRALI and TACO
TRALI has fever
First line treatment for hodgkins disease
Chemotherapy and Radiotherapy
Thrombocythaemia(>1000 Platelets) what drug to start
Aspirin 75mg OD(minimises risk of thrombosis and stroke)
Causes of hyperviscosity syndrome(4)
Polycythemia rubra vera, leukaemia, myeloma, waldenstroms macroglobulinemia
Definition of hyperviscosity syndrome
Viscosity of the blood raises enough to impair microcirculation
Symptoms of hyperviscosity syndrome
Lethargy, confusion, bleeding from the GI and GU tract, visual disturbances
Key pathology of ALL chemotherapy - cytomegalovirus and herpes zoster oesophageal finding
Oesophageal ulceration
Which opioid is contraindicated in sickle cell crises
Pethidine
CHOP regime for non hodgkins
Cyclophosphamide, hydroxydaunorubicin, vincristine(oncovin), prednisolone
Facial features of beta thalassemia major
Prominent forehead(frontal bossing), full cheek bones( prominent Malar eminence), depressed bridge of the nose, and overgrowth( hypertrophy) of the upper jaw( maxillae)
Beta thalassemia major ( Cooley’s anaemia) features
- recurrent bacterial infections
- anaemia
- decreased mcv and raised reticulocytes
- enlarged spleen and liver
Sideroblastic anaemia key cause- you ask if they worked in a particular industry
Lead poisoning( paint industry)
- diagnosed with bone marrow biopsy( ring sideroblasts )
Key curative treatment for patients with CML
Bone marrow transplantation from HLA
aplastic crises - low hb and which infection?
parvovirus
