Haematology/Oncology Flashcards
What is seen on blood film in iron deficiency anaemia?
Microcytic, hypochromic anaemia (low MCV and MCH).
How is iron deficiency anaemia managed?
Increase dietary intake. 5 mg/kg/day oral ferrous salt and vit C to help absorption.
Very rarely, blood transfusion may be required.
How may Henoch-Schonlein Purpura (HSP) present?
Characteristic symmetrical purpuric skin rash over legs, buttocks, arms, ankles. Swollen hands/feet. Arthralgia. Colicky abdo pain. Glomerulonephritis caused by renal IgA deposition (micro or macro haematuria +/- proteniuria). Scrotal pain.
What is the standard follow up schedule for kids who get HSP?
Weekly urine dip for first four weeks then monthly after that for first year.
Some will develop end stage kidney disease
What is the most common type of brain tumour in children?
Astrocytoma
Are Reed-Sternberg cells present in Hodgkin or Non-Hodgkin Lymphoma?
Hodgkin’s lymphoma
How does Hodgkin’s lymphoma tend to present?
Painless lymphadenopathy in neck with firm, large LN. May cause airway obstruction. Long, gradual clinical history.
How does non-Hodgkin’s lymphoma tend to present?
Mediastinal mass (may cause SVCO) with bone marrow infiltration.
Which age group more commonly gets Hodgkin’s lymphoma?
Adolescents
Which age group more commonly gets non-Hodgkin’s lymphoma?
Ages 7-10
What is the inheritance pattern of Haemophilia A and B?
X-linked recessive
Which factor is deficient in Haemophilia A?
Factor 8
Which factor is deficient in Haemophilia B?
Factor 9
What bleeding tendency is seen in each of the severities of Factor 8 deficiency?
Severe (<1% F8): Spontaneous bleeds into joints/muscles
Moderate (1-5% F8): Bleed after minor trauma
Mild (>5-40% F8): Bleed after surgery
Which aspect of the clotting bloods will come back as delayed in haemophilia?
Activated Partial Thrombin Time (APTT).
Prothrombin time will be normally as it only measures factors 2, 5, 9, 10.
How is haemophilia managed?
Recombinant F8 or F9 concentrate via prompt iv infusion for active bleeding. Avoidance of IM injections, aspirin or NSAIDs. If severe, weekly prophylactic infusions of the deficient factor.
Avoid contact sports but active lifestyle is encouraged
What is the peak incidence of leukaemia?
Ages 2-5. Boys more commonly than girls.
What is the most common type of leukaemia in children?
Acute lymphoblastic leukaemia accounts for ~85% in kids.
What symptoms may develop in leukaemia?
Malaise, anorexia, lethargy, pallor, bone pain, infections, bruising, lymphadenopathy, hepatosplenomegaly.
Anaemia, neutropenia, thrombocytopenia.
What is the inheritance pattern of sickle cell anaemia?
Autosomal recessive
Where and what is the genetic mutation in sickle cell disease?
Mutation in the beta-globin gene (Glu –> Val) in codon 6
Which medication can help increase production of HbF in sickle cell disease and therefore prevent future crises?
Hydroxyurea - but requires monitoring for WBC suppression
What is a neuroblastoma?
A tumour arising from neural crest tissue in the adrenal medulla and sympathetic nervous system
How do most neuroblastomas present?
Most have an abdominal mass at presentation but the primary tumour can lie anywhere along the sympathetic chain from neck to pelvis. Causes a lot of non-specific symptoms. Prone to cord compression.
