Haematology Crash Course Flashcards
Unexplained iron-deficiency anaemia
Causes a microcytic anaemia with low ferritin
Men and post-menopausal women - urgent gastroscopy and colonoscopy
Microcytic anaemia causes
Iron deficiency
Chronic disease
Thalassaemia
Recurrent nosebleeds and new red lesions on the skin and lips?
What investigations?
Full blood count - platelets!
Most likely diagnosis is…
ITP is due to the formation of auto-antibodies against…
Platelet antigens
It is an acquired bleeding disorders due to low platelets
May be primary or secondary
Low platelets lead to petechiae, purpura and recurrent bleeding
ITP vs TTP
Most likely diagnosis? - Hodgkin? AML? ALL? CML? CLL?
Chronic lymphocytic leukaemia
Malignant clonal disorders of B cells that causes high white cells and lymphadenopathy
Malignant clonal disorders of B cells that causes high white cells and lymphadenopathy?
Chronic lymphocytic leukaemia
Commonest leukaemia - 60-80years old
Generally slow and indolent malignancy of unknown aetiology
Watch and wait
Leukaemia overview
ALL typically in
Children
Treatment for CML
TKI (e.g. imatinib)
AML vs CML
Massive splenomegaly, lethargy and night sweats…
CML
Bone marrow failure (adults?)
AML
A
Sickle cell disease
Autosomal recessive inherited
Sickle Hb is due to a point mutation in the beta-glob in gene
Sickle Hb polymerises at … tension, which distorts its shape and causes ….
Sickle Hb polymerises at low O2 tension, which distorts its shape and causes vaso-occlusion
Low Hb High urea and creatinine High K+ and calcium High CRP Para protein detected on protein electrophoresis What next?
Bone marrow biopsy
Myeloma
Multiple myeloma
Malignant disorder of plasma cells (mature b lymphocytes)
Characterised by excess secretion of a monoclonal antibody
CRAB (high calcium, renal impairment, anaemia, boney disease)
Definitive diagnosis of multiple myeloma
Bone marrow biopsy
Diagnostic criteria
MGUS, smouldering, myeloma
High Hb + stroke
What investigation to confirm cause of stroke?
JAK2 mutation
Polycythaemia vera - myeloproliferative disorder characterised by an elevated red cell mass
Polycytheamia Vera
What is found in 98% of people with primary polycythaemia Vera?
JAK2
Complications of polycythaemia
What next?
Arrange an US doppler of the left leg
DVT suspected
Deep veins of lower limb
Wells score - risk of DVT
If likely >2, straight to US within 4 hours
D diner if less than 1
Vitamin B12/folate deficiency likely
Macrocytic anaemia
CLL FL MS HL Aplastic anaemia?
Hodgkin lymphoma
Hodgkin lymphoma
Reed stern burg cells
Aplastic anaemia
Abnormal EPO in bone marrow, reduced red cells
Lymphoma
Hodgkin’s and non-hodgkins
Hodgkins - reed sternberg cells
Painless lymphadenopathy and B symptoms
Lymph node biopsy to diagnose!
