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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
Summarise two types of Non Hodgkin's lymphoma
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
26
What chemotherapy is used in Non-Hodgkin's lymphoma treatment?
``` RCHOP o Rituximab o Cyclophosphamide o Adriamycin o Vincristine o Prednisolone ```
27
Define Hodgkin's lymphoma and a main presenting symptom
Expression of CD30 and loss of B cell antigens presenting with painless lymphadenopathy
28
What chemotherapy is used in Hodgkin's lymphoma treatment?
``` ABVD o Adriamycin o Bleomycin o Vinblastine o Dacarbazine ```
29
Define Myeloma
Cancer of plasma cells (WBCs) with most patients having an abnormal monoclonal protein called an M protein
30
What is the classic triad of myeloma?
Increased plasma cells in bone marrow Clonal immunoglobulin or paraprotein Lytic bone lesions
31
What 2 treatment methods can be used for Myeloma?
Asymptomatic: watch and wait Symptomatic: chemotherapy, radiotherapy, bisphosphonates
32
What are myeloproliferative disorders and what mutation is commonly associated?
Slow growing blood cancers with an increase in one or more types of mature blood progeny JAK2 mutation
33
What is myelofibrosis?
A myeloproliferative disorder where blood cell production moves to spleen and liver so pt. can present with extreme spleno/hepatomegaly
34
What are myelodysplastic syndromes and how are they treated?
Cancers characterised by dysplasia where immature blood cells don’t mature in bone marrow TX: - Blood transfusion - Growth factors - Immunosuppression
35
Define leukaemia
Liquid malignancy of WBCs characterised by abnormal accumulation of leukocytes in bone marrow +/- blood +/- other tissues
36
Give 3 symptoms of acute leukaemia
Lethargy Infection Bone pain
37
Give 2 symptoms of ALL and which chromosome translocation is implicated
Limping and purpuric rash Philadelphia chromosome (4:11 BRC-ABL translocation)
38
What symptoms can occur in CML and how is BRC-ABL significant in diagnosis?
B symptoms If BRC-ABL is negative it is NOT CML
39
How does Imatinib work for CML?
Targets BRC-ABL, blocking phosphorylation
40
What may a blood film in CLL show?
Abnormal lymphocytes | Low RBCs/platelets
41
Give 3 treatments for CLL
Monitor Chemotherapy Stem cell transplant
42
Define Von Willebrand disease
Deficiency of Von Willebrand factor which binds to and stabilises factor VIII and binds platelets to collagen
43
What would PT and APTT show in Von Willebrand disease?
PT: in reference range for Von Willebrand disease APTT: prolonged
44
Give 3 treatments for Von Willebrand disease
Desmopressin (causes release of Von Willebrand antigen from platelets) Antifibrinolytic therapy VWF-containing concentrate
45
Define haemophilia
Bleeding disorder usually X-linked recessive
46
What is haemophilia A?
Factor VIII deficiency
47
What is haemophilia B?
Factor IX deficiency
48
What is haemophilia C?
Factor XI deficiency
49
Give 3 symptoms of haemophilia
- Excessive bruising - Menorrhagia - Cutaneous purpura
50
Give 3 risks of haemophilia
- Fx - Male - Age>60
51
Give 2 treatments of haemophilia
Factor concentrate in emergencies Antifibrinolytic agent in emergency
52
Define thrombocytopenia and give 2 causes
Low circulating platelet count - Increased platelet clearance - BM disorders
53
Give 3 symptoms of thrombocytopenia
Easy bruising Petechiae Epistaxis
54
Give 2 treatments for thrombocytopenia
Blood/platelet transfusion | Splenectomy
55
Define thrombophilia and give 3 causes
Hypercoagulable state, propensity to venous thrombosis due to an abnormality in the coagulation system - Antithrombin deficiency - Pregnancy - Protein C deficiency
56
Give 3 symptoms of thrombophilia
Calf swelling Pain along deep venous system SOB
57
Give 3 risks of thrombophilia
Unprovoked VTE Age Pregnancy
58
What 3 things may be seen on a blood film of thrombophilia
Spherocytes Thrombocytopenia Pancytopenia
59
Give 2 treatments of thrombophilia
Heparin | DOAC
60
Define pancytopenia and give 2 causes
Reduced RBC, WBC and platelets in peripheral blood below lower limits of normal Decreased RBC production BM failure
61
Give 3 symptoms of pancytopenia
Petechiae Purpura Easy bruising
62
What 3 things may be seen on examination in pancytopenia
Weight loss Petechiae Splenomegaly
63
Give 3 possible treatments for pancytopenia (depending on cause)
Immunosuppressant BM transplant Stem cell transplant
64
Give 3 causes of bone marrow failure
- Chemotherapy - AI disorders - Pregnancy
65
Give 2 complications of pancytopenia
Sepsis | Severe bleeding
66
What are the CRAB features of myeloma which indicate a need for treatment?
C: Calcium high R: Renal failure A: Anaemia B: Bone pain
67
Give one blood test, one procedure and one scan used in the investigation of lymphoma
Serum LDH Bone marrow aspirate PET scan
68
What is the mechanism of action of Rituximab and what is it used to treat?
Targets the B-cell marker CD20 | Used in lymphoma
69
Give 3 investigations for myeloma
Blood film (Rouleaux) Urinary Bence Jones protein Bone marrow aspirate
70
Which cells can be seen on a Hodgkin's lymphoma blood film?
Reed Sternburg cells

4th Year Exam (20 decks)

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