Haematology/ Oncology Flashcards
What are poikilocytes and fragmented res blood cells indicative of?
Iron deficiency anaemia
What is the most likely cause of iron deficiency anaemia in children?
Poor dietary intake combined with excessive cows mild consumption
What populations is thallasaemia more common in?
Asian and Mediterranean
Thallasaemia and iron deficiency anaemia both present with microcytic hypochromic RBC’s how can you differentiate?
In iron def. anaemia there is low ferritin, in thalasaemia there is normal ferritin
What are the two types of thalasaemia?
Alpha and beta
How can you differentiate between alpha and beta thalassaemia?
In beta there is in increase in HbF (fetal haemaglobin) and HbA2 (a normal variant of haemaglobin A)
These are normal or low in alpha thalasaemia
What can precipitate a sickle cell crisis?
Dehydration
Infection
Hypoxia
Acidosis
If a blood film shows target cells, poikilocytes what might this suggest?
Sickle cell anaemia
How is sickle cell diagnosed, what test?
Haemaglobin electrophoresis
What is the commonest haemaglobinopathy?
Sickle cell
What race is sickle cell more common in?
West Africans, Afro Caribbeans
How does sickle cell crisis present?
Painful swelling of hands and feet
What malignancies is Epstein Barr virus involved in the pathogenosis?
Burkitts lymphoma
Lymphoproliferative disease
Nasopharyngeal carcinoma
Describe the change in Hb conc in neonates..
It is high at birth (particularly after delayed cord clamping) and lowest at age 2-3 months
How long after birth does a baby have adequate stores of iron?
4 months
What iron supplements are given to children?
Sytron (sodium iron edetate)
Niferex ( polysaccharide iron complex)
Ferrous sulphate tastes too bad!
How long should iron supplementation be continued for?
At least 3 months to replenish stores
On iron treatment how quickly should iron levels rise?
1 g/dl per week
What does G6PD enzyme deficiency cause?
Episodes of haemolysis..
Causing neonatal jaundice
In children with G6PD deficiency what can precipitate haemolysis?
Infection
And maybe drugs
In haemophilia A what clotting factor is decreased?
Factor 8
In haemophilia B what clotting factor is decreased?
Factor 9
Henoch Schonlein purpurin are related to what other conditions?
Joints Kidneys (protein and haematuria) GI tract (intussception)
What kind of patten might you see on a FBC of a child with leukaemia?
Pancytopenia So Low platelet Low Hb Low WCC (although this could be excessively raised)
What is the other name for a nephroblastoma?
Wills tumour
How might a wills tumour present?
Mostly assymptomatic Can get Abdo mass/pain Haematuria/uti Hypertension
How do you decide whether an anaemia is microcytic or normocytic?
Use the mean cell volume
What is Coombs test?
What conditions might this be positive in?
Measures the presence of IgG on RBCs
Immune related haemolytic anaemia
Haemolytic disease of the newborn
In DKA is potassium high or low?
High
What signs might hyperkalaemia show on an ECG?
Widened QRS and peaked T waves
What is the inheritance pattern for haemophilia A?
X linked recessive
Which is more common haemophilia A or B
A is more common
Which clotting cascade is affected by a deficiency in factor 8 and 9?
How does this affect the prothrombin time?
Intrinsic
It doesn’t as this is a measure of the extrinsic pathway
When do symptoms of haemophilia usually start?
When the child becomes mobile - bleed into joints
