Haematology In Systemic Disease

Question 1

Haematological changes are multi-factorial and due to what 3 things

Answer 1

Underlying physiological/ external cause
Complications of disease
Treatment

Question 2

What can be used to treat renal anaemia?

What must be ensured before this can be used

Answer 2

Recombinant Human EPO

Patient must have sufficient iron, B12 and Folate

Question 3

In chronic kidney disease, state 2 RBC abnormalities and give 2 causes for each

Answer 3

Anaemia:

• Blood loss
• Dietary causes

Polychythaemia:

• Renal tumour
• Renal transplant

Question 4

In chronic kidney disease, state 2 neutrophil abnormalities and give 2 causes for each

Answer 4

Neutropenia;

• Immunosuppression
• Autoimmune kidney disease

Neutrophilia;

• Infection
• Inflammation

Question 5

In chronic kidney disease, state 2 Platelet abnormalities and give 2 causes for each

Answer 5

Thrombocytosis;

• Blood loss
• Iron deficiency

Thrombocytopenia;

• Uraemia (Inhibits platelet production)
• Haemolytic Uraemic Syndrome

Question 6

In Rheumatoid Arthritis, state 2 abnormalities when disease Is active and during treatment

Answer 6

When active, High platelet and neutrophils ( as well as CRP)

During treatment, Low platelet and neutrophils

Question 7

What is Felty’s Syndrome

What 2 things cause the cellular abnormality

Answer 7

The triad of Rheumatoid Arthritis, Splenomegaly and Neutropenia

• Low neutrophils due to hypersplenism (from enlarged spleen) destroying them
• Failure of marrow to make them, as myeloid cells are insensitive to GCSF

Question 8

In liver disease, state 1 vessel abnormality, 2 platelet abnormalities and 2 RBC abnormalities

Answer 8

Portal hypertension-> Varices (Dilated veins prone to bleeding)

Thrombocytopenia, Reduced platelet function

Target Cells, Microcytic cells

Question 9

In Post Operative Reactive Changes, state 2 RBC abnormalities and give 1 cause for each

State a specific RBC abnormality after a splenectomy

Answer 9

Anaemia;
- Blood loss before/ during operation

Temporary Relative Polycythaemia;
- Dehydration

After Splenectomy: Howell-Jolly Bodies (DNA Remnants)

Question 10

In Post Operative Reactive Changes, state 2 platelet abnormalities and give 2 causes for each

Answer 10

Thrombocytopenia;

• Drugs
• Sepsis

Thrombocytosis;

• Infection
• Bleeding

Question 11

In Post Operative Reactive Changes, state 2 Neutrophil abnormalities and give 1 causes for each

Answer 11

Neutropenia;
- Sepsis

Neutrophilia;
- Infection

Question 12

State 2 types of infections that can cause Neutropenia

Answer 12

• Sepsis

- Viral infection

Question 13

In Cancer, state 2 RBC abnormalities and give 1 cause for each

Answer 13

Anaemia;

• Chemotherapy
• Fe deficiency

Polycythaemia;
- EPO producing tumors

Question 14

In Cancer, state 2 neutrophil abnormalities and give 2 causes for each

Answer 14

Neutropenia;

• Chemotherapy
• Cancer cells in marrow

Neutrophilia;

• Inflammation
• Infection

Question 15

In Cancer, state 2 platelet abnormalities and give 2 causes for each

Answer 15

Thrombocytopenia;

• Chemo
• Marrow infiltrated by cancer cells

Thrombocytosis;

• Infection
• Inflammation

Question 16

What are cancer patients at high risk of

Answer 16

Venous thrombosis

Question 17

If marrow is infiltrated by cancer cells, what may be seen in blood
Why does this happen

Answer 17

A leucoerythroblastic film (Immature WBCs and nucleated RBCs)

Immature cells spill out from marrow when marrow is under stress

Question 18

Other than cancer, name 4 things that can result in a leucoerythroblastic film

Answer 18

Sepsis/ shock
Storage disorders
Primary myelofibrosis
Megaloblastic anaemia