Haematology and Oncology Flashcards
Hodgkin lymphoma is characterised by the prescence of which cells?
Reed -Sternberg cells
History of which viral infection increases your risk of non-hodgkin lymphoma?
EBV
What are the red flag presenting features of lymphoma?
Lymphadenopathy
Fever
Pruritus
Weight loss
Night sweats
What virus must be screened for prior to commencing rituximab treatment?
Hepatitis B
What is methaemoglobinaemia?
Where one of the iron molecules in the haemoglobin is oxidised to Fe3+ instead of Fe2+ and cannot bind to any oxygen.
This causes the 3 remaining haemoglobin molecules to bind more tightly to the oxygen.
Normally there is a a NADH in the blood cells that donates an electron to the Fe3+ and reduces it, keeping the levels of methaemoglobin down. But in methemoglobinemia this doesn’t happen.
This leads to tissue hypoxia.
What substances can cause acquired methemoglobinaemia?
Local anaesthetics (benzocaine)
Dapsone (treatment of leprosy)
Nitrates or nitrites
Name 2 symptoms of methaemoglobinaemia?
Cyanosis of peripheries and oral mucosa
Dyspnoea
Headache
Name a sign of methaemoglobinaemia?
Normal Pao2 but decreased oxygen saturations
What is the management of methaemoglobinaemia?
IV methylthionium chloride
Multiple myeloma is caused by what cell proliferation?
Plasma cell
What are the 5 key features of multiple myeloma and the mnemonic to remember them?
C - Hypercalcaemia
R - Renal (light chain deposits within renal tubules)
A - Anaemia (Bone marrow crowding supressing erythropoeisis leading to anaemia)
B - Bleeding (Reduced production of platelets due to bone marrow crowding)
B - Bones (bone marrow infiltration by plasma cells, may present as pain, specifically back pain)
I - Infection (reduction in the production of normal immunoglobulins, increasing susceptibility to infection)
What are the first line investigations in multiple myeloma and what do they show?
FBC - Pancytopenia
U&E - Renal failure (increased urea and creatinine)
Ca2+ - Increased calcium
Urinary bence jones protein
Serum electrophoresis (Monoclonal IgA/IgG proteins present in the serum)
How is the diagnosis confirmed of multiple myeloma?
Bone marrow biopsy (showing elevated levels of plasma cells)
In TTP there is a deficiency of which enzyme?
ADAMTS13
What is the pathophysiology of TTP?
Due to a deficiency of ADAMTS13 abnormally large and sticky multimers of VWF causes platelets to clump within vessels leading to a thrombocytopenia and renal failure.
Name 3 causes of TTP?
Post infection (urinary or GI)
Pregnancy
Drugs (cyclosporin, COCP, penicilin, aciclovir)
Tumours
SLE
HIV
Which drugs can trigger haemolysis in G6PD deficiency?
Primaquine
Ciprofloxacin
SUlphonamides
What is oral allergy syndrome?
IgE mediated hypersensitivity reaction to specific raw, plantbased foods.
Initiated by cross reaction with a non-food allergen most commonly birch pollen, whereby the protein in the food is similar but not identical to the structure in the original allergen. Linked with pollen allergies.
What is the difference in presentation between oral allergy syndrome and a food allergy?
OAS - Only caused by plant based foods. Symptoms normally limited to the oropharynx.
Food allergy - More likely to cause systemic symptoms and potentially lead to anaphylaxis.
