Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Haematology > Flashcards

Haematology Flashcards

1
Q

What are some causes for microcytic anaemia?

A

TAILS

  • Thalassaemia
  • Anaemia of chronic disease
  • Iron deficiency
  • Lead poisoning
  • Sideroblastic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some causes of normocytic anaemia?

A 
Acute blood loss
Chronic disease
Aplastic
Kidney disease
Hypothyroid
Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some causes of macrocytic megaloblastic anaemia?

A

Deficiency of B12 or Folate

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

What are some causes of macrocytic normochromic anaemia?

A 
Alcohol
Liver disease
Reticulocytosis
Hypothyroid
Azathioprine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What other blood tests would you order if you find an anaemia?

A

B12/folate
Reticulocytes - in FBC
Iron studies - iron, TIBC, transferrin, ferritin
TFT’s

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

What are some signs and symptoms of anaemia?

A 
Tired
SOB
Dizzy
Palpitations
Worsening HF/angina/PVD

Pale conjunctiva
Bounding pulse
Postural hypo
Hair loss

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

What are the signs of iron deficiency anaemia?

A

Koilonychia
Angular stomatitis
Atrophic glossitis
Brittle hair and nails

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

What can cause iron deficiency?

A

Reduced intake
Increased excretion - menstruation, GI cancer
Reduced absorption - coeliacs, crowns, PPI
Increased need - pregnancy

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

What would iron studies show in anaemia?

A

Low iron, ferritin, transferrin saturation

Raised TIBC

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

Why is total iron binding capacity high in iron deficiency anaemia?

A

Transferrin may be normal or raised

TIBC is the space of transferrin for iron to be bound. Less iron = more spaces

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

What can give false results for iron deficiency anaemia?

A

Iron tablets
Acute liver damage
Iron containing food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can iron be replaced?

A

Oral - not in malnourished
IV - not if septic
Blood transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What iron studies are seen in anaemia of chronic disease?

A

Low iron, transferrin and TIBC

Raised ferritin

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

Why do you get anaemia of chronic disease?

A

Hepcidin stops iron being available for micro-organisms
Reduced EPO
Impaired erythropoiesis
Reduced red cell survival

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

What are the types of thalassaemia?

A

Alpha - may be incompatible with extra-uterine life
Beta major - both beta genes abnormal
Beta minor - one abnormal beta gene

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

What are some features of thalassaemia and why do you get them?

A

Splenomegaly and Jaundice:

  • Ineffective erythropoiesis with haemolysis
  • Excess alpha chains

Prominent forehead and cheek bones:
- Extramedullary haematopoesis

Thrombosis - hypercoaguable

Iron overload

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

Why does iron overload occur in thalassaemia?

A

Increased absorption due to chronic anaemia
Repeated transfusions
Creation of faulty RBC’s

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

How is thalassaemia managed?

A

Transfusion
Iron chelation - deferoxamine
Bone marrow transplant

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

What are some common features of haemolytic anaemia?

A

Jaundice
Splenomegaly
Gallstones
Dark urine

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

What blood results are seen in a haemolytic anaemia?

A

Normocytic anaemia
High reticulocyte count
High LDL
Unconjugated hyperbilirubinaemia

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

What can precipitate an aplastic crisis?

A

Parvovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does G6PD deficiency appear on blood film?

A

Heinz bodies

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

What can trigger a G6PD crisis?

A

Broad beans
Anti-malarials
Ciprofloxacin
Infection

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

Whats the difference between warm and cold haemolytic anaemias?

A

Warm is idiopathic and due to autoantibodies at room temperature

Cold is often due to leukaemia, SLE, EBV or CMV where autoantibodies lead to clumping at low temperatures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is microangiopathic haemolytic anaemia?

A

Small blood vessels have structural abnormalities that cause haemolysis

Caused by HUS, TTP, DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some complications of sickle cell anaemia?

A 
Increased risk of infection
Vaso-occlusive events - stroke, priapism
CKD
AVN of hip
Splenic sequestration
Aplastic crisis
Acute chest syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the key risk factors for b12 anaemia?

A

Crohns
Vegan diet
Reduced intrinsic factor - pernicious or post-gastrectomy
Inadequate release of b12 from food - alcohol, gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What can cause reduced folate?

A 
Poor intake
Poor absorption - coeliac, diseases affecting duodenum/jejunum
Increased req. - pregnancy
Increased loss - liver disease
Anti-convulsants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does subacute degeneration of the cord present like?

A

Dorsal columns - proprioception, vibration, ataxia
Lateral columns - pyramidal weakness, hyper-reflexia, upgoing plantars

Mix of UMN and LMN

This is why B12 deficiency must be managed before folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What antibodies are associated with pernicious anaemia?

A

Anti-intrinsic factor - MAIN

Anti-parietal cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are some causes of neutrophilia?

A 
Reaction to infection
Inflammation - RA, IBD
Hyposplenism
Hypoxia
Lithium and steroids
CML
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are some causes of neutropenia?

A 
Chemotherapy agents
Carbamazepine, clozapine, carbimazole
Bone marrow failure
Hypersplenism - felty
SLE
Low B12/folate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some causes of lymphocytosis?

A

CLL and lymphoma
Viral infections
Chronic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are some causes of eosinophilia?

A

Allergy
Parasite infections
Drug reactions
Hodgkins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are some causes of thrombocytosis?

A

Reaction to Infection
Essential thrombocytosis
Reaction to iron deficiency anaemia
Post splenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are some causes of thrombocytopenia?

A 
DIC, ITP, TTP, HELLP
Haemorrhage
BM failure
Post transfusion - dilution
Splenomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are some risk factors for VTE?

A 
Pregnancy
Long haul flight
Recent illness
Recent immobility
Antiphospholipid/SLE
Factor V Leiden, antithrombin, protein C&S deficiency
Cancer
COCP/HRT
CML/polycythaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are some risk factors for arterial thrombosis?

A 
Smoking
Diabetes
HTN
Hypercholesterolaemia
Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are some risk factors for bleeding and bruising?

A 
DIC
Haemophilia A/B
Thalassaemia
ITP/TTP
HELLP
On anticoagulation
Leukaemia
HUS
Clotting factor deficiency
Liver disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Summarise the response to injury leading to platelet aggregation

A

1 Von willebrand factor bind to area of vascular injury
2 VwF bind to Glycoprotein 1b receptors and activate ADP to increase expression of Gp11b/IIIa
3 These receptors bind to fibrinogen which leads to further platelet aggregation

41
Q

How are platelets broken down?

A

Plasminogen activated to form plasmin by tPA –> breaks down fibrin mesh

42
Q

What clotting factors are in the intrinsic and extrinsic pathway?

A

Intrinsic: VIII, IX, XI, XII
Extrinsic: VII

Common - X, V, thrombin, fibrin

43
Q

What does the PT test tell you?

A

Extrinsic and common pathway

Most accurate determinant of impact on liver function

Increased by:

  • warfarin, dabigatran, direct Xa inhibitors
  • Vit K deficiency
  • Liver disease
  • DIC
  • Isolated factor 7 deficiency
44
Q

What does APTT tell you?

A

Intrinsic and common pathway

  • Haemophilias and von willebrand
  • Liver disease
  • DIC
  • warfarin, dabigatran, direct Xa inhibitors, unfractionated heparin
  • Vit K
45
Q

What does bleeding time tell you?

A

Platelets

  • Von willebrand
  • TTP, ITP, HUS
  • DIC
  • Thrombocytopenia
  • Aspirin
46
Q

What does TT tell you?

A

Fibrinogen

Increased by dabigatran and unfractionated heparin

47
Q

How does warfarin work and how is it monitored/reversed?

A

Inhibit vit K which is key to platelet aggregation

Monitor PT and INR

Vit K/prothrombin complex

48
Q

How do heparins work and how are they monitored/reversed?

A

Activate antithrombin - LMWH is only factor Xa

LMWH (Dalteparin/enoxaparin) - only affect factor Xa
unfractionated - APTT

Protamine sulphate for unfractionated

49
Q

How does fondaparinux work?

A

Indirect factor Xa inhibitor

50
Q

How do rivaroxaban and apixaban work?

A

Direct factor X/Xa inhibitor

51
Q

How does dabigatran work and how is it monitored/reversed?

A

Antithrombin III inhibitor

Idarucizumab

52
Q

How does aspirin work?

A

COX-1 inhibitor which inhibits thromboxane A2 so reduced platelet aggregation

53
Q

How does clopidogrel work?

A

Inhibit P2Y12 stopping glycoprotein aggregation

54
Q

How are major bleeds on warfarin managed?

A

Stop warfarin
IV Vit K 5mg
IV prothrombin complex

55
Q

How are minor bleeds on warfarin managed?

A

INR >5 - stop warfarin and IV Vit K 5mg

Restart warfarin when INR <5

56
Q

How is a raised INR on warfarin managed with no bleeding?

A

> 8 - Stop warfarin and oral vit K. Restart when <5

5-8 - Stop 2 doses of warfarin and reduce subsequent dose

57
Q

What is heparin induced thrombocytopenia?

A

Reaction to heparin leading to a hypercoaguable state with reduced platelets (consumption thrombocytopenia)

IgG antibodies

5-14 days post heparin treatment

58
Q

How does heparin induced thrombocytopenia present?

A

Stroke, DVT, PE, MI, Ischaemic limb

59
Q

How is heparin induced thrombocytopaenia managed?

A

Stop heparin

Give fondaparinux

60
Q

Why can’t you give warfarin in heparin induced thrombocytopenia?

A

Risk of warfarin necrosis - skin gangrene

61
Q

What are the types of haemophilia, what do they affect and how are they inherited?

A

A - factor VIII - x linked recessive

B - factor IX - x linked recessive

C - factor XI - autosomal recessive

62
Q

How does haemophilia present?

A

Easy bleeding and bruising
Haemarthosis
Muscle haematomas
Prolonged bleeding time post op

63
Q

What blood results are seen in haemophilia?

A

Prolonged APTT

64
Q

How is haemophilia managed?

A

FFP and cryoprecipitate

65
Q

What is von willebrand disease?

A

Autosomal dominant condition where there is a deficiency of von willebrand factor - key in platelet aggregation

66
Q

What blood results does von willebrands disease present with?

A

Prolonged bleeding time

Prolonged APTT - VW factor bind to factor 8 - stop destruction

67
Q

How is von willebrand disease managed?

A

Tranexamic acid

Desmopressin

68
Q

How does von willebrand present?

A

Petechiae
Menorrhagia
Bleeding gums

69
Q

Which clotting factors are affected by vitamin k deficiency and as such what blood result is seen?

A

2, 7, 9 and 10

prolonged APTT and PT - PT affected by 7

70
Q

What can cause a vitamin k deficiency?

A

Dietary insufficiency

Fat malabsorption - cholestasis

71
Q

How would liver disease cause coagulopathy?

A

Global decline in clotting factors affecting both extrinsic and intrinsic pathway

PT is most accurate for liver disease

72
Q

How can hypersplenism affect clotting?

A

Reduced platelets

73
Q

What coagulopathies are seen in renal disease?

A

Haemorrhage

Thrombosis

74
Q

Why is thrombosis seen in renal disease?

A

Uraemia alter platelet function

Increased normal risk factors - dehydrated, immobilised

Loss of proteins in nephrotic syndrome - protein C&S, antithrombin

75
Q

Why is haemorrhage seen in renal disease?

A

Loss of clotting factors in nephrotic syndrome

Anaemia

Uraemia alter platelet function

Deranged VWf

76
Q

Why does coagulopathy occur post massive bleeding?

A

Following acute trauma, increased activated protein C -> fibrinolysis

Fluids result in acidosis, dilution and hypothermia which worsen coagulopathy

77
Q

What happens in DIC?

A

Dying cells release pro-coagulant agents –> small vessel occlusion

Platelets and clotting factors used up –> bleeding elsewhere

78
Q

What is seen on investigation of DIC?

A

Prolonged APTT, PT, bleeding time and reduced platelets, raised D dimer

May see schistocytes on blood film - microangiopathic haemolytic anaemia

79
Q

What are the signs and symptoms of TTP?

A
  • Renal failure
  • Low platelets
  • Anaemia
  • Fever
  • Fluctuating neurology
80
Q

What can cause TTP?

A

Post infection - GI
Pregnancy
Drugs - COCP, cyclosporin, penicillin, aciclovir

81
Q

What is ITP?

A

Antibodies against glycoprotein 2b/3a leads to thrombocytopaenia

  • Petechia/purpure
  • Epistaxis
  • Rare - intracranial bleeds
82
Q

How is ITP managed?

A

Oral pred

IVIG

83
Q

What typically causes ITP in children?

A

Post infection or vaccination

84
Q

What blood results are seen in antiphospholipid syndrome?

A

Prolonged APTT

Thrombocytopaenia

85
Q

What happens in factor V Leiden?

A

Resistance to activated protein C

Clotting factor V is inactivated slowly

High risk of VTE

86
Q

When is packed red cells indicated?

A

Hb <70

Hb <80 in ACS

87
Q

When are platelets indicated?

A

Haemorrhagic shock

Count <20

Bleeding with thrombocytopaenia

Pre-op <50

88
Q

When is FFP indicated? What does it contain?

A

Prolonged PT
DIC
Haemorrhage in liver disease

Factor 5, 8, 9, 10 and fibrinogen

89
Q

When is cryoprecipitate indicated? What does it contain?

A

DIC
VW disease
Haemophilia A

Factor 8, 13, VW and fibrinogen

90
Q

When is prothrombin complex indicated?

A

Major bleed on warfarin

91
Q

How quickly should red blood cells be given?

A

If no emergency - over 90-120 mins

92
Q

Which antibodies do you look for when doing a G&S?

A

ABO

Rhesus

93
Q

What can cause target cells on blood film?

A

Hyposplenism
Iron deficiency anaemia
Sickle cell/thalassaemia
Liver disease

94
Q

What causes Howell jolly bodies on blood film?

A

Hyposplenism

Pencil poikilocytes

95
Q

What causes a tear drop poikilocyte?

A

Myelofibrosis

96
Q

What causes schistocytes?

A

Intravascular haemolysis
Mechanical heart valves
DIC

97
Q

What causes heinz bodies on blood film?

A

G6PD

98
Q

What causes pencil poikilocytes on blood film?

A

Iron deficiency anaemia

99
Q

What causes burr cells on blood film?

A

Uraemia

Finals (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions