Brainscape's Knowledge GenomeTM

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


See full index

Pathology > Haematology - Haematology of systemic disease > Flashcards

Haematology - Haematology of systemic disease Flashcards

1
Q

which anaemias can cancer present with?

A
  • iron def
  • anaemia of chronic disease
  • leucoerythroblastic anaemia
  • haemolytic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how could cancer cause a secondary polycythaemia?

A
  • renal cell cancers and liver cancers can secrete EPO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the most common cause of iron def anaemia?

A

occult blood loss

  • GI cancers (gastric, colon)
  • Urinary tract cancers (renal cell carcinoma, bladder cancer)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Laboratory findings of iron def anaemia

A
  • low ferritin
  • low transferrin saturation
  • high TIBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is leucoerythroblastic anaemia?

A

red and white cell precursor anaemia

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

what are the morphological features on blood film of leucoerythroblastic anaemia?

A
  • teardrop red blood cells (aniso and poikilocytosis)
  • nucleated RBCs (normally have no nucleus)
  • immature myeloid cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what tends to cause leucoerythroblastic anaemia?

A

bone marrow infiltration

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

causes of bone marrow infiltration and so leucoerythroblastic anaemia

A
  1. CANCER (haemopoietic = leukaemia/ lymphoma/ myeloma, non haemopoietic = breast/bronchus/prostate)
  2. SEVERE INFECTION (miliary TB, severe fungal infection)
  3. MYELOFIBROSIS (massive splenomegaly, dry tap on BM aspirate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is haemolytic anaemia?

A

shortened red cell survival

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

what are the distinguishing features of haemolytic anaemia?

A
  • anaemia
  • reticulocytosis
  • raised unconjugated bilirubin
  • raised LDH (intracellular enzyme, released when cells break down)
  • reduced haptoglobins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the 2 main groups of haemolytic anaemia?

A
  • inherited (defects of red cell)

- acquired (defects of the environment)

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

what are the inherited haemolytic anaemias?

A
  • membrane: hereditary spherocytosis
  • cytoplasm/enzymes: G6PD def
  • haemoglobin: sickle cell disease, thalassemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the acquired haemolytic anaemias?

A
  • immune mediated

- non-immune mediated

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

what is the test to distinguish immune mediated and non-immune mediated haemolytic anaemia?

A

DAT or Coombs’ test

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

what does DAT +ve mean?

A

acquired haemolytic anaemia is mediated through immune destruction of RBCs

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

how can AI haemolytic anaemia appear on blood film?

A

formation of spherocytes

17
Q

what systemic disorders is AI haemolytic anaemia associated with?

A
  • cancers of immune system (lymphoma)
  • disease of immune system (SLE)
  • infection (disturbs immune system)
18
Q

What is non-immune haemolytic anaemia?

A

red cell breakdown not caused by immune system

DAT negative

19
Q

causes of non-immune haemolytic anaemia?

A

infection e.g. malaria

can be caused by microangiopathic haemolytic anaemia (MAHA)

20
Q

what are the key features of MAHA?

A
  • RBC fragments
  • thrombocytopenia
  • DIC/bleeding
  • usually caused by underlying carcinoma
21
Q

what is mechanism of MAHA?

A
  • underlying carcinoma release lots of procoagulant cytokines
  • activate coagulation cascade
  • erratic cytokine release = DIC
  • activation of coagulation cascade in parts of microvasculature = fibrin strands
  • RBCs pushed through fibrin strands by BP
  • causes RBCs to fragment
22
Q

what is true polycythaemia? causes?

A

raised red cell mass

  1. polycythemia vera (PV)
  2. secondary (raised EPO)
23
Q

What is PV?

A

clonal myeloproliferative disorder

acquired mutation in JAK 2

24
Q

what can cause a secondary polycythaemia?

A

raised EPO

  • appropriate (high altitude, hypoxic lung injury, cyanotic heart disease)
  • inappropriate (hepatocellular carcinoma, bronchial carcinoma, renal cancer)
25
Q

what are the normal mature white blood cells?

A 
Phagocytes
- granulocytes (neutrophils, eosinophils, basophils)
- monocytes
Immunocytes
- T lymphocytes
- B lymphocytes
- NK cells
26
Q

what are the immature WBCs and where should you find these?

A
  • blasts
  • promyelocytes
  • myelocytes
  • normal in BM not normal in peripheral blood
27
Q

difference between acute and chronic leukaemia?

A
  • mature white cells raised in CHRONIC

- immature blast cells raised in ACUTE

28
Q

what are the causes of neutrophilia?

A
  • corticosteroids (due to demargination)
  • underlying neoplasia
  • tissue inflammation (e.g. colitis, pancreatitis)
  • myeloproliferative/leukaemia disorders
  • infection
29
Q

which diseases DO NOT cause a neutrophilia?

A
  • brucella
  • typhoid
  • many viral infections
30
Q

how would a reactive neutrophilia appear on blood smear?

A
  • band cells (stage in neutrophil maturation, sign that bone marrow is releasing more WBCs)
  • toxic granulation
  • signs of infection/ inflammation
31
Q

how does malignant neutrophilia appear?

A
  • neutrophilia + basophilia + immature myelocytes + splenomegaly = myeloproliferative disorder (CML)
  • neutrophilia + myeloblasts = AML
32
Q

when do you see a monocytosis?

A 
RARE
seen in some chronic infections/ primary haematological disorders
- TB, brucella, typhoid
- Viral: CMV, VZV
- Sarcoidosis
- chronic myelomonocytic leukaemia
33
Q

what causes a reactive eosinophilia?

A
  • parasitic infection
  • allergic diseases (e.g. asthma, RA)
  • underlying neoplasma (Hodgkin’s, T cell lymphoma, NHL)
  • drug reaction (e.g, erythema mutliforme)
34
Q

how do you interpret a lymphocytosis?

A
  • secondary (reactive): more common, response to infection/ chronic inflammation
  • primary (monoclonal lymphoid proliferation e.g. CLL, NHL)
35
Q

causes of a reactive lymphocytosis?

A
  • infection (EBV, CMV, Rubella, Herpes)
  • AI disorders
  • Sarcoidosis
36
Q

how is immunophenotyping carried out?

A
  • monoclonal antibodies targeted at different antigens
  • antibodies fluorescently labelled
  • passed through flow cytometer
  • can determine stage of maturation by antigens present
37
Q

how can immunophenotyping be used to find lymphoproliferative disorders?

A
  • raised lymphocyte count with even mix of kappa and lambda = reactive lymphocytosis
  • lymphoproliferative disorders = overwhelming majority of either kappa or lamdba

Pathology (21 decks)

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