Haematology/Oncology Flashcards
What is methameglobinaemia?
Haemoglobin which has been oxidised from Fe2+ to Fe3+. This causes tissue hypoxia as Fe3+ cannot bind oxygen
Treatment idiopathic thrombocytopenia purpura?
- Oral prednisolone
2. IVIG
Diagnostic criteria for multiple myeloma?
One major and one minor criteria (or three minor criteria in an individual who has other sighs/symptoms)
Major
1. Plasmacytoma
2. 30% plasma cells in a bone marrow sample
3. Elevated levels of M protein in the blood or urine
Minor
1. 10 to 30% plasma cells in a bone marrow sample
2. Minor elevations in the level of M protein in the blood or urine
3. Osteolytic lesions
4. Low levels of other antibodies in the blood
Reversal agent for apixaban and rivaroxaban?
Andexant alfa
Reversal agent for dabigitran
idarucizumab
Treatment for a flare of acute intermittent porphyria?
IV haem arginate
Treatment of acute hereditory angio-oedema?
IV C1 inhibitor concentrte or FFP
Prophylaxis for attacks of hereditary angi-oedema?
Danazol
Tranexamic acid
Treatment for thrombotic thrombocytopenic purpura
Plasma exchange
Causes of normoblastic macrocytic anaemia?
Alcohol Liver disease Hypothyroid Pregnancy Reticulocytosis Myelodysplasia Cytotoxic drugs
Smudge/smear cells
CLL
Treatment of essential thrombocytosis?
Hydroxycarbamide
Interferon alpha
Low dose aspirin reduced teh thrombotic risk
Causes of microcytic anaemia?
Iron deficiency anaemia
Thalassemia
Congenital sideroblastic anaemia
Lead poisoning
Complications of CLL
Anaemia
Hypogammaglobulinaemia (causing recurrent infections)
Warm autoimmune haemolytic anaemia
Transformation to high grade lymphoma
What is richters transformation?
Leukemia cells enter the lymph node and change into high grade fast growing non hodkins lymphoma
Worst prognosis for hodgkins lymphoma (type)
Lymphocyte depleted
Best prognosis for hodgekins lymphoma (type)
Lymphocyte predominent
Reed eternberg cells
Hodgkeins lymphoma
Most common type of hodgkins lymphoma
Nodular sclerosing
What is paroxysmal nocturnal haemoglobinuria
Acquired disorded leading to intravascular haemaolyssi.
- Causes by increased sensitivity of cell membranes to complement due to lack of GPI.
- Patients are more prone to venous thrombosis
- Diagnosis by flow cytometry of blood to detect low levels of CD59 and CD55
What type of Ig causes warm autoimmune haemolytic anaemia
IgG
What type of antibody causes cold autoimmune haemolytic anaemia
IgM
causes of warm autoimmune haemolytic anaemia?
- Idiopathic
- Autoimmune disease such as SLE
- Neoplasia (lymphoma, CLL)
Drugs - methyldopa
Causes of cold haemolytic anaemia
Lymphoma
Mycoplasma
EBV
Blood results in autoimmune haemolytic anaemia
Anaemia Reticulocytosis Low haptoglobin Raised LDH and bilirubin Sperocytes and reticulocytes Positive coombs tests
Target cells
Sick cell Thalassemia Iron deficiency anaemia Hyposplenism Liver disease
Tear drop poiklocytes
Myelofibrosis
Spherocytes
Hereditary sperocytosis
Autoimmune haemolytic anaemia
Basophillic stippling
Lead poisoning
Thalassaemia
Sederoblastic anaemia
Myelodysplasia
Howell Jolly Bodies
Hyposplenism
Heniz bodies
G6PD deficiency
Alpha thalassemia
Schistocytes
Intravscular haemolysis
Mechanical heart valve
DIC
Pencil poikilocytes
Iron deficiency anaemia
Burr cells
Uraemia
Pyruvate kinase deficiency
Acanthocytes
Abetalipoproteinemia
Hypersegmented neutrophils
Megaloblastic anaemia
Gene translocation in burkitts lymphoma
C-myc
Poor prognostic factors in CLL?
Male sex Over 70 Lymphocyte count over 50 Raised LDH TP53 mutation CD38 positive Deletion of 17p
Treatment for ITP?
- Oral prednisolone
IVIG
