Haematology + oncology Flashcards
Beta Thallassaemia
- electrophoresis
-FBC
Absent B bands on electrophoresis
Microcytic anaemia
Low HCT
Appropriate reticulocyte count
Normal iron studies
SSD - diagnosis
Sickle cells on peripheral blood film
HbS on electrophoresis
Alpha Thalassaemia
alpha bands on electrophoresis
Carcinoid tumour vitamin deficiency
Nician B3 deficiency (Pellagra)
Increased tryptophan metabolism to serotonin
B3 is derived from tryptophan
Carcinoid tumour diagnosis
urine 5-OH-indoleacetic acid levels
(Increased)
Cromogranin A increased often in liver metastasis
Managing bowel colic in colorectal cancer
Buscopan
N+V from functional bowel obstruction in renal cancer
Metoclopramide
N+V due to mechanical bowel obstruction
Cyclizine
N+V from hypercalcaemia
Haloperidol
Haemophilia
- inheritance
- cause
- diagnosis
X-linked recessive
A = Factor VIII deficiency
B = Factor IX deficiency
Raised aPTT
Factor VIII/IX assay to confirm
Haemochromatosis features
Diabetes mellitus
Arthralgia
Hepatomegaly
Hypogonadism
Skin pigmentation
Paroxysmal nocturnal haemoglobinaemia
- Triad
- blood Ix
- treatment
Chronic compliment mediated haemolysis
- Acquired haemolytic anaemia
- Large vessel thrombosis
- Insufficient haematopoiesis
Raised LDH and reticulocytes indicates intravascular haemolysis
eculizumab, anticoagulation, steroids, bone marrow transplant
eculizumab
Inhibits compliment C5 activation and formation of cytolytic attack complex
Henoch-schonlein purpura
- cause/mechanism
- features
- management
- IgA complex deposition in the skin and kidneys
- Purpuric rash, arthritis, nephritis, abdominal pain, GI bleeding, orchitis
- Self-limiting in most cases, monitor, supportive treatment for nephritis
Asbestos cancers
Lung adenocarcinoma
Mesothelioma
Renal adenocarcinoma
Gastrointestinal lymphoma
G6PD deficiency
- Inheritance
- Mechanism of disease
X-linked recessive
Cannot tolerate oxidative stress -> haemolytic anaemia triggered by infection, drugs, broad beans
Hereditary spherocytosis
- Inheritance
- Presentation
- Complications
Autosomal dominant - abnormal RBC membrane
Mild intermittent jaundice, anaemia
Blood film: spherocytes, raised reticulocyte count
Aplastic crisis (parvovirus B19)
Megaloblastic crisis (Folate deficiency)
ITP management
- Oral prednisolone
- Pooled normal IVIG (if bleeding or requires urgent invasive procedure)
Bowel colic from cancer
- treatment
Hyoscine butylbromide
Vitamin deficiency in carcinoid syndrome
Niacin B3 deficiency
B3 derived from tryptophan. Increased tryptophan metabolism to produce large amounts of serotonin -> decreased B3 production
CAs most a/w hypercalcaemia
Breast + lung SCC, MM (via PTHrP secretion)
