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Rhi’s MSRA > Haematology/ Infectious Diseases > Flashcards

Haematology/ Infectious Diseases Flashcards

1
Q

CML chromosome abnormality? Name and translocation?

A

Phildelphia chromosome! (‘CreaMLy cheese!)
Translocation 9,22

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2
Q

Chromosome abnormality in ALL?

A

T (4;11)

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3
Q

3 phases of CML?

A

-chronic phase (easily controlled, near-normal life)
-accelerate phase (unstable course)
-Blast crisis (usually fatal)

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4
Q

Malaria - what does temperature do during illness?

A

Spikes of fever each day - up and down

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5
Q

Lymphadenopathy, splenomegaly, weight loss, fatigue, night sweats. Likely DX?

A

Non-Hodgkin’s lymphoma

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6
Q

How does acute lymphocytic leukaemia present?

A

Purpura, bleeding, infection

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7
Q

Antibodies in SLE?

A

Antinuclear antibodies

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8
Q

Is Hodgkin’s or non-hodgkin’s lymphoma more common?
What is the most common non-Hodgkin’s lymphoma

A

NHL is >5x as common as Hodgkin’s

Diffuse large B-cell lymphoma

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9
Q

What type of lymphoma is H pylori associated with?

A

Gastric MALT lymphoma

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10
Q

Staging system for Lymphoma?

A

Ann Arbour

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11
Q

Epidemiology of NHL?

A

White people are higher risk than black/Asian people
Median age of presentation = 50

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12
Q

Whereabouts in lung does primary lesion of TB usually present?

A

Upper region of lung

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13
Q

Sputum sample test to diagnose TB?

A

Ziehl-Neelsen stain for acid-fast bacilli

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14
Q

Treatment for ACTIVE TB?

A

RIPE for 4 months
Continue RI for 2 months

(Rifampicin, isoniazid, pyrazinamide & ethambutol)

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15
Q

Treatment for LATENT TB?

A

RI (rifampicin & isoniazid) for 3 months
OR
isoniazid alone for 6 months

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16
Q

Screening skin test for latent TB?

A

Mantoux test

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17
Q

What is Malaria and how is it spread?

A

Infection with Plasmodium Protozoa

Transmitted by female mosquitoes

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18
Q

How long after infection, and with what symptoms, does Malaria present?

A

-weeks after exposure
-HEADACHE
-flu-like illness (fever, malaise, fatigue, body aches)
-may have diarrhoea/GI syx

Severe malaria - cerebral malaria, severe anaemia, renal failure, pulmonary oedema

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19
Q

Standard to diagnose malaria?

A

Giemsa-stained thick and thin peripheral blood films/smears

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20
Q

When after ingestion of Salmonella typhi does typhoid fever present?

A

7-14 days

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21
Q

Symptoms of typhoid fever?

A

-rising temp over course of each day, drops by subsequent morning
-CONSTIPATION (abdo pain and constipation) from inflamed Peyer patches
-3rd week 1 - severe abdo distension, foul ‘pea-soup’ diarrhoea
-Blanching, truncal maculopapules

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22
Q

Diagnosis of typhoid fever?

A

CULTURE isolation
(Can also culture bone marrow aspirate)

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23
Q

How is Dengue spread?

A

Dengue virus is spread by mosquitoes

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24
Q

How does Dengue present?

A

High fevers
FACIAL FLUSHING
bleeding
Abdo pain
Cardiomyopathy

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25
Q

Serodiagnosis for Dengue?

A

Rise in antibody titre in paired igG or IgM specimens

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26
Q

In VWD, what happens to
-bleeding time
-platelet count
-APTT

A

Prolonged bleeding time
NORMAL platelet level
Prolonged APTT

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27
Q

How is VWD inherited?

A

Autosomal dominant (mostly!)

28
Q

Treatment for VWD bleeding?

A

TXA (mild bleeding)
Desmopressin
factor 8 concentrate

29
Q

How does non-haemolytic transfusion reaction present?

A

Fever, chills, malaise

30
Q

How does TACO (Transfusion associated circulatory overload) present?

A

Acute onset pulmonary oedema
Usually occurs 6 HOURS post transfusion
Hypotension

31
Q

Short stature, shield-shaped chest, widely spaced nipples, triangular shaped neck, primary/secondary amenorrhoea. Dx?

A

Turner’s syndrome (45XO)

32
Q

Best investigation for typhoid?

A

Blood cultures (technically best to do bone marrow cultures but painful!)

33
Q

How and when does typhoid present?

A

Symptoms start 7-14 days after ingestion of salmonella typhi!
TyPhoid- several Ps!
-GI syx - diffuse abdominal pain, constipation (inflamed PEYER patches)
-Skin - blanching, truncal maculoPapules
-2nd week - splenomegaly, bradycardia
-3rd week - abdominal distension, bowel PERFORATION due to necrotic PEYER patches, PEA soup diarrhoea!

34
Q

Most common cause of Scarlet fever?

A

Group A strep! (Remember because causes inflamed red tonsils)

35
Q

Cause of Slapped cheek/5th disease?

A

Parvovirus B19 virus

36
Q

Is HIV a notifiable disease?
What about Creutzfeld-Jakob disease?

A

NO to both!!

37
Q

How is Haemophilia inherited?

A

X-linked recessive
Therefore occurs almost exclusively in males!

38
Q

Most useful blood test to diagnose haemophilia?

A

APTT (activated partial thromboplastin time)

39
Q

Which clotting factor does Haemophilia A affect?
Haemophilia B?

A

A = 8 (‘At!’)
B = 9

40
Q

What parts of the coagulation cascade does warfarin affect?

A

2,7,9,10 (Cab’s phone Lock Screen!)

41
Q

Anaphylaxis is mediated with which antibody!

A

IgA (‘IgAnanaphylaxis!’)

42
Q

What causes allergic rhinitis? (3 categories)

A

-Seasonal - grass, tree pollens
-Perennial (throughout year) -House dust mites!
-Occupational - workplace allergens ie flour

43
Q

Hyposensitization (specific allergen immunotherapy) is of proven benefit from what allergy?

A

Wasp venom anaphylaxis

44
Q

Both parents are carriers of cystic fibrosis. Chances of child having CF?

A

25%!
(25% normal, 50% carrier, 25% affected)

45
Q

How does autoimmune haemolytic anaemia look like on bloods?

A

Anaemia
Signs of haemolysis- reticulocytosis, low haptoglobin, increased lactate dehydrogenase, elevated indirect bilirubin, positive Coombs test
Blood film - reticulocytes and spherocytes (Note- spherocytes not specific to spherocytosis!!)

46
Q

Young patient with microcytic anaemia but normal ferritin . Likely Dx?

A

Thalassaemia!

47
Q

Name of anaemia with pancytopenia and hypOcellular bone marrow?

A

Aplastic anaemia - bone marrow stops making enough stem cells! Commoner in YOUNGER patients

48
Q

1st line treatment for chlamydia?

A

Doxycycline!! (Note CHANGED FROM Azithromycin Unless in pregnancy/breastfeeding, contraindicated so still use Azithromycin!)

49
Q

Causes of macrocytic anaemia? (2 categories)

A

MEGALOBLASTIC:
-B12 deficiency
-folate deficiency
-terminal ileum resection/gastrectomy
-drugs - sulfonamides

NORMOBLASTIC:
Liver disease
Alcoholism
Hypothyroidism
Myelodysplasia
Drugs - anticonvulsants

50
Q

HIV-related opportunistic infections

A

-Mycobacterium
-Candidiasis
-Pnemocystis jirovecii pneumonia
-Toxoplasmosis
-Cryptococcus
-Cytomegalovirus

51
Q

Target appearance following insect bite - Dx?
Tx?

A

Erythema migrans - LYME DISEASE from tick bite

  • treat with abx
52
Q

How is sickle cell inherited?

A

Autosomal recessive

53
Q

How is spherocytosis inherited?

A

Autosomal DOMINANT (often linked to chromosomes 8)

54
Q

How does hereditary spherocytosis present?

A

Anaemia, splenomegaly, and jaundice

55
Q

Highest risk sexual behaviour for getting HIV!

A

Receptive anal sex (bottoming) as lining of rectum is thin

56
Q

Complication of chlamydia in:
-women
-men

A

Pelvic inflammatory disease
Epididymo-orchitis

57
Q

Main advantage of active over passive immunisation?

A

Antibody persists for LONGER PERIOD

(may take days/ weeks to develop but lasts longer, whereas passive gives immediate, but short lived protection!)

58
Q

What is multiple myeloma?
How is it characterised?

A

-progressive malignant disease of PLASMA CELLS
-characterised by PARAPROTEINAEMIA (Proliferation of abnormal monoclonal immunoglobulins in the blood) - this causes diffuse bone marrow infiltration. Causing bone destruction and bone marrow failure!!

59
Q

How does multiple myeloma present?

A

Most commonly BONE PAIN & ANAEMIA

Also fatigue, infections, hypercalcaemia, renal impairment as affects MULTIPLE organs including bones, kidneys, immune system!

60
Q

How common is multiple myeloma?

A

2ND most common haematological malignancy (after non-Hodgkin’s lymphoma)

61
Q

What type of virus is influenza?

A

Orthomyxovirus

62
Q

Risk of having a child with Down’s syndrome at these ages?:
-20
-30
-35
-40
-45

A

20 = 1/1500
30 = 1/800
35 = 1/270
40 = 1/100
45 = >1/50

63
Q

Most common cause of bacterial meningitis in adults ?

A

Strep pneumoniae

64
Q

Most common causes of bacterial meningitis in
-kids >3m and adults?
-neonates

A

Kids >3m/adults: ‘PIM’ (2nd word starts)
-Strep Pneumoniae
-Haemophilus Influenza B
-Neisseria meningitidis

Neonates <1m: ‘LESA’ (‘lesser/smaller’)
-Listeria monocytogenes
-E Coli
-Strep Agalactiae

65
Q

If, on haemoglobin electrophoresis of pt with IDA, there are ‘absent beta bands’ what is the diagnosis?

A

Beta-thalassaemia
(With Alpha-thalassaemia, there should be alpha chains)

66
Q

How does Schistosomiasis present?

A

‘Swimmer’s itch’ - fresh water - caused by flatworm
Also fever, lethargy, myalgia

Rhi’s MSRA (12 decks)

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