Haematology Flashcards
What are the causes of microcytic anaemia? (5)
Thalassaemia Anaemia of chronic disease Iron deficiency anaemia Lead poisoning Sideroblastic
What are the causes of normocytic anaemia? (5)
Anaemia of chronic disease Acute blood loss Aplastic anaemia Haemolytic anaemia Hypothyroidism
What are the causes of macrocytic anaemia? (6)
Megaloblastic - folate and B12 deficiency
Non-megaloblastic - alcohol excess, hypothyroidism, rectiuloctyes, azathioprine
What are some inherited causes of haemolytic anaemia? (5)
Thalassaemia Sickle cell Spherocytosis Elliptocytosis GPD6 deficiency
What are some acquired causes of haemolytic anaemia? (5)
Autoimmune Alloimmune Infection Toxins Prosthetic valve
What test would you do to test for autoimmune haemolysis?
Direct Antiglobulin Test
What are some causes of iron deficiency anaemia? (4)
Blood loss e.g. GI tract, menorrhagia
Dietary
Absorption e.g. coeliac disease
Excessive requirements eg. pregnancy
What will the following be in iron deficiency anaemia?
- Ferritin
- TIBC
- Transferrin saturation
- Low
- High
- Low (indication of stores, % iron attached to transferrin)
When starting iron tablets:
- When should you check FBC?
- How long will the person be on them for?
- 2-4 weeks after starting
2. 3 months after Hb corrected
Which medications can cause folate deficiency? (3)
Methotrexate
Sulfasalazine
Trimethoprim
What must you check before commencing treatment for folate deficiency?
B12 - treating folate before B12 deficiency can precipitate subacute degeneration of the cord
Which medical conditions can cause B12 deficiency? (2)
Coeliac
Crohn’s disease
What blood test is required to diagnose thalassaemia?
Hb electrophoresis
What is the management for major beta-thalassaemia? (2)
regular blood transusions and iron chelation
What are the 4 sickle cell crises?
Vaso-occlusive crisis
Aplastic anaemia (parvovirus B19)
Sequestration (sudden enlargement of spleen)
Acute chest syndrome
What can precipitate a sickle cell crisis? (4)
Infection
Dehydration
Cold
Exertion
What blood test is required to diagnose sickle cell? What would you expect to find?
Hb electrophoresis
HbS
Which medication can be used in sickle cell anaemia?
What is the general management of sickle cell anaemia? (4)
Hydroxycarbamide - stimulates HbF
Avoid triggers, vitamin supplements, vaccinations, antibiotic prophylaxis
What are the different types of blood products available? (5)
What are they used for?
Red blood cells - Hb <70
Platelets - <10 or <30 if significant bleed
FFP - clinically significant bleed
Cryoprecipitate - fibrinogen <1.5 if significant bleeding
Prothrombin concentrate - reverse warfarin if severe bleeding
Which clotting factors are in the:
- Intrinsic pathway?
- Extrinsic pathway?
- VII, IX, XI, XII (and others)
2. II, V, VII, X
Which blood test measures:
- Intrinsic clotting pathway?
- Extrinsic clotting pathway?
Which pathway measures:
- Unfractionated heparin?
- Warfarin?
What special test can you use to test effects of LMWHs?
- APTT - measures effects of heparin
- PT - measures effects of warfarin
Anti-Xa assay
Which medication should be avoided in Von Willebrand’s disease?
NSAIDs
What are the management options for Von Willebrand’s disease? (3)
Tranexamic acid, desmopression, vWF concentrate
In what form of haemophilia can desmopressin be used?
Haemophilia A
What are some of the criteria in the Wells score for PE? (7)
Signs or symptoms of DVT Heart rate >100 Immobilisation for >3 days or surgery in past 4 weeks Previous DVT or PE Haemoptysis Cancer Alternative diagnosis less likely
What are some of the criteria in the Wells score for DVT? (9)
Active cancer
Paralysis or immobilisation of legs
Recently bedridden for >3 days or surgery in past 12 weeks
Localised tenderness along deep venous system
Entire leg is swollen
Calf swelling by >3cm compared to asymptomatic leg
Pitting oedema in symptomatic leg
Collateral superficial veins
Previously documented DVT
What staging system is used in lymphoma?
Ann Arbor
In which type of lymphoma will the lump become tender with alcohol?
Hodgkin’s lymphoma
What are some risk factors for Hodgkin’s lymphoma? (3)
EBV infection, HIV infection, immunosuppression
Which type of lymphoma is associated with chronic malaria?
What special test is there to test for this lymphoma?
Burkitt’s lymphoma
FISH analysis
Which age groups are most likely to be affected by the following leukaemias?
- ALL
- CLL
- CML
- AML
<5 or >45
>55
>65
>75
Which leukaemia is associated with?
- Philidelphia chromosome
- Richter’s transformtion
- Raised WCC
- Autoimmune haemolytic anaemia
- CML
- CLL
- CML
- CLL
What features are part of myeloma? (4)
Calcium
Renal failure
Anaemia
Bone pain
According to NICE, what blood tests should you order is someone >60 presents with persistent bone pain, especially back pain? (4)
FBC
Bone profile
ESR
Plasma viscosity
What tests should you order if someone >60 presents with hypercalcaemia or leukopenia and signs of myeloma?
Serum electrophoresis and urinary Bence-Jones proteins
What are some complications of haematalogical malignanacies? (4)
Low blood cells of any line e.g. neutropenia, anaemia, thrombocytopenia
- Bleeding secondary to thrombocytopenia
- Neutropenic sepsis
Effusions e.g. pericardial, pleural
SVCO
MSCC
