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4th Year Exam > Haematology ILOs > Flashcards

Haematology ILOs Flashcards

1
Q

Give 3 signs of iron deficiency anaemia

A

Koilonychia
Atrophic glossitis
Angular stomatitis

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2
Q

Give 3 causes of iron deficiency anaemia

A

Poor dietary intake
Malabsorption
Blood loss

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3
Q

What does low serum ferritin always indicate?

A

Low RES stores of iron

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4
Q

What causes anaemia of chronic disease and what appearance do RBCs show?

A

Failure to use iron or iron trapped in RES

Rouleaux

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5
Q

Give 3 conditions which may cause anaemia of chronic disease

A

Malignancy
Inflammation
Infection

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6
Q

What can B12 deficiency cause?

A

Macrocytic anaemic and neurological symptoms

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7
Q

What is pernicious anaemia?

A

AI condition affecting gastric parietal cells, meaning IF isn’t produced so B12 cannot be absorbed

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8
Q

What can folate deficiency cause?

A

Macrocytic anaemia and neural tube defects

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9
Q

Define thalassaemia

A

Haemoglobin missing normal globin chains due to absent genes

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10
Q

What is alpha thalassaemia?

A

Missing between 1 and 4 alpha globin genes, with symptoms ranging from mild microcytosis to death

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11
Q

What is beta thalassaemia major?

A

Haemoglobin missing both beta globin genes due to AR condition, pt. transfusion dependent

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12
Q

Give 2 causes of microcytic anaemia

A

Iron deficiency

Thalassaemia

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13
Q

Give 1 cause of normocytic anaemia

A

Anaemia of chronic disease

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14
Q

Give 2 causes of macrocytic anaemia

A

B12 deficiency

Alcohol excess

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15
Q

Define sickle cell disease and give 2 treatments

A

AR condition where beta globin gene substitution occurs on chromosome 11 with reduced RBC survival and vaso-occlusion

Tx:

  • Crisis prevention
  • Bone marrow transplant
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16
Q

Define haemolytic anaemia

A

Reduced lifespan of RBCs where bone marrow can’t compensate for cells living less than 20 days

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17
Q

Define cold autoimmune acquired haemolytic anaemia

A

IgM and complement bind to RBCs forming collections of abnormal cells, treat by keeping warm

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18
Q

Define warm autoimmune acquired haemolytic anaemia

A

IgG binds to receptors on RBCs, drug induced causing severe innocent bystander haemolysis. Tx: stop drugs

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19
Q

What is the difference between the direct and indirect Coombs tests?

A

Direct: antibodies on RBC surface
Indirect: antibodies on plasma

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20
Q

Define lymphoma and give 3 symptoms

A

Blood cancer classed as Hodgkin’s (15%) or non-Hodgkin’s (B or T cell) (85%)

Painless rubbery lymphadenopathy
Splenomegaly
B symptoms

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21
Q

What is stage I lymphoma?

A

Single lymph node group

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22
Q

What is stage II lymphoma?

A

More than one lymph node group on same side of diaphragm

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23
Q

What is stage III lymphoma?

A

Lymph node groups on both sides of diaphragm (including spleen)

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24
Q

What is stage IV lymphoma?

A

Extranodal e.g. Liver

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25
Q

Summarise two types of Non Hodgkin’s lymphoma

A

Diffuse large B cell: high grade, patient more unwell but likely to go into remission

Follicular: low grade, more insidious, older patient with 14:18 translocation

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26
Q

What chemotherapy is used in Non-Hodgkin’s lymphoma treatment?

A 
RCHOP
o	Rituximab 
o	Cyclophosphamide 
o	Adriamycin 
o	Vincristine 
o	Prednisolone
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27
Q

Define Hodgkin’s lymphoma and a main presenting symptom

A

Expression of CD30 and loss of B cell antigens presenting with painless lymphadenopathy

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28
Q

What chemotherapy is used in Hodgkin’s lymphoma treatment?

A 
ABVD 
o	Adriamycin
o	Bleomycin 
o	Vinblastine 
o	Dacarbazine
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29
Q

Define Myeloma

A

Cancer of plasma cells (WBCs) with most patients having an abnormal monoclonal protein called an M protein

30
Q

What is the classic triad of myeloma?

A

Increased plasma cells in bone marrow

Clonal immunoglobulin or paraprotein

Lytic bone lesions

31
Q

What 2 treatment methods can be used for Myeloma?

A

Asymptomatic: watch and wait

Symptomatic: chemotherapy, radiotherapy, bisphosphonates

32
Q

What are myeloproliferative disorders and what mutation is commonly associated?

A

Slow growing blood cancers with an increase in one or more types of mature blood progeny

JAK2 mutation

33
Q

What is myelofibrosis?

A

A myeloproliferative disorder where blood cell production moves to spleen and liver so pt. can present with extreme spleno/hepatomegaly

34
Q

What are myelodysplastic syndromes and how are they treated?

A

Cancers characterised by dysplasia where immature blood cells don’t mature in bone marrow

TX:

  • Blood transfusion
  • Growth factors
  • Immunosuppression
35
Q

Define leukaemia

A

Liquid malignancy of WBCs characterised by abnormal accumulation of leukocytes in bone marrow +/- blood +/- other tissues

36
Q

Give 3 symptoms of acute leukaemia

A

Lethargy
Infection
Bone pain

37
Q

Give 2 symptoms of ALL and which chromosome translocation is implicated

A

Limping and purpuric rash

Philadelphia chromosome (4:11 BRC-ABL translocation)

38
Q

What symptoms can occur in CML and how is BRC-ABL significant in diagnosis?

A

B symptoms

If BRC-ABL is negative it is NOT CML

39
Q

How does Imatinib work for CML?

A

Targets BRC-ABL, blocking phosphorylation

40
Q

What may a blood film in CLL show?

A

Abnormal lymphocytes

Low RBCs/platelets

41
Q

Give 3 treatments for CLL

A

Monitor
Chemotherapy
Stem cell transplant

42
Q

Define Von Willebrand disease

A

Deficiency of Von Willebrand factor which binds to and stabilises factor VIII and binds platelets to collagen

43
Q

What would PT and APTT show in Von Willebrand disease?

A

PT: in reference range for Von Willebrand disease

APTT: prolonged

44
Q

Give 3 treatments for Von Willebrand disease

A

Desmopressin (causes release of Von Willebrand antigen from platelets)

Antifibrinolytic therapy

VWF-containing concentrate

45
Q

Define haemophilia

A

Bleeding disorder usually X-linked recessive

46
Q

What is haemophilia A?

A

Factor VIII deficiency

47
Q

What is haemophilia B?

A

Factor IX deficiency

48
Q

What is haemophilia C?

A

Factor XI deficiency

49
Q

Give 3 symptoms of haemophilia

A
  • Excessive bruising
  • Menorrhagia
  • Cutaneous purpura
50
Q

Give 3 risks of haemophilia

A
  • Fx
  • Male
  • Age>60
51
Q

Give 2 treatments of haemophilia

A

Factor concentrate in emergencies

Antifibrinolytic agent in emergency

52
Q

Define thrombocytopenia and give 2 causes

A

Low circulating platelet count

  • Increased platelet clearance
  • BM disorders
53
Q

Give 3 symptoms of thrombocytopenia

A

Easy bruising
Petechiae
Epistaxis

54
Q

Give 2 treatments for thrombocytopenia

A

Blood/platelet transfusion

Splenectomy

55
Q

Define thrombophilia and give 3 causes

A

Hypercoagulable state, propensity to venous thrombosis due to an abnormality in the coagulation system

  • Antithrombin deficiency
  • Pregnancy
  • Protein C deficiency
56
Q

Give 3 symptoms of thrombophilia

A

Calf swelling
Pain along deep venous system
SOB

57
Q

Give 3 risks of thrombophilia

A

Unprovoked VTE
Age
Pregnancy

58
Q

What 3 things may be seen on a blood film of thrombophilia

A

Spherocytes
Thrombocytopenia
Pancytopenia

59
Q

Give 2 treatments of thrombophilia

A

Heparin

DOAC

60
Q

Define pancytopenia and give 2 causes

A

Reduced RBC, WBC and platelets in peripheral blood below lower limits of normal

Decreased RBC production
BM failure

61
Q

Give 3 symptoms of pancytopenia

A

Petechiae
Purpura
Easy bruising

62
Q

What 3 things may be seen on examination in pancytopenia

A

Weight loss
Petechiae
Splenomegaly

63
Q

Give 3 possible treatments for pancytopenia (depending on cause)

A

Immunosuppressant
BM transplant
Stem cell transplant

64
Q

Give 3 causes of bone marrow failure

A
  • Chemotherapy
  • AI disorders
  • Pregnancy
65
Q

Give 2 complications of pancytopenia

A

Sepsis

Severe bleeding

66
Q

What are the CRAB features of myeloma which indicate a need for treatment?

A

C: Calcium high
R: Renal failure
A: Anaemia
B: Bone pain

67
Q

Give one blood test, one procedure and one scan used in the investigation of lymphoma

A

Serum LDH
Bone marrow aspirate
PET scan

68
Q

What is the mechanism of action of Rituximab and what is it used to treat?

A

Targets the B-cell marker CD20

Used in lymphoma

69
Q

Give 3 investigations for myeloma

A

Blood film (Rouleaux)
Urinary Bence Jones protein
Bone marrow aspirate

70
Q

Which cells can be seen on a Hodgkin’s lymphoma blood film?

A

Reed Sternburg cells

4th Year Exam (20 decks)

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