Haematology PassMed Flashcards
name the 4 types of Hodgkins lymphoma
nodular sclerosis
mixed cellularity
lymphocyte predominant
lymphocyte depleted
which Hodgkins lymphoma is most common
nodular sclerosing
what does a reed Sternberg cell look like
a nuclei surrounded by a clear space
what disease is associated with smear cells
CLL
what are the CRAB features that myeloma typically presents with
Calcium elevated
Renal failure
Anaemia
Bone pain
when in myeloma is Alk phos usually only elevated
usually only in metastatic disease
how is vWF deficiency inherited
autosomal Dominant
how is a stage 3 Hodgkins lymphoma defined
involvement of LN regions on both sides of the diaphragm
which infection has strong links with lymphoma
EBV
what is a rouleaux formation and what is it characteristic of
a stacking of RBCs seen in a blood film
it suggests a myeloma
what is a ‘pepper pot skull’ characteristic of
primary hyperparathyroidism
what is a ‘rain drop’ skull characteristic of
myeloma
what are the 3 components of the diagnostic criteria for myeloma
- plasmacytoma
- 30% plasma cells in bone marrow sample
- elevated levels of M protein in the blood or urine
what is a plasmacytoma
a tumour of plasma cells that grows in the soft tissue, characteristic of a myeloma
how does factor V Leiden increase chance of VTE
activated factor V is inactivated much more slowly by activated protein C
what age is NHL most common
it has a bi modal age distribution
most common in 3rd and 7th decade
if you suspect lytic bone metastases in a patient with renal failure and anaemia, what investigation do u do
serum protein electrophoresis
ie - urinary Bence Jones protein
in sickle cell, what are thrombotic crises precipitated by
infection, dehydration, deoxygenation
describe the signs of acute sickle chest syndrome
SO, chest pain, pul infiltrates, low Po2
how is a non-haemolytic febrile reaction treated
temporary transfusion termination and an antipyretic (paracetamol)
what transfusion reaction can DIC be a complication of
acute haemolytic transfusion reaction
what Ig is usually responsible for acute haemolytic transfusion reaction
IgM
what is the cause of non-haemolytic febrile reaction
white blood cell HLA antibodies
how do you differentiate between allergic anaphylaxis transfusion reaction and acute haemolytic transfusion reaction
allergic - urticaria, hypotension, SOB, wheezing and stridor
acute haemolytic - fever, ab pain, chest pain, agitation and hypotension
what are the signs of transfusion related acute lung injury
development of hyperaemia/ARDS within 6hrs of transfusion
has pul infiltrates on XR
what is the main difference between transfusion related acute lung injury and transfusion associated circulatory overload
TACO has hypertension, TRALI has hyPOtension
what deficiency causes a megaloblastic anaemia
B12 and Folate
if a patient is going to be treated for folate deficiency with folic acid, what is it important to replace 1st? why ?
treat the B12 deficiency 1st to avoid precipitating subacute combined degeneration of the cord
what mutation is seen in most polycythemia vera patients
JAK2 mutation
what cancer may myelodysplasia progress to
AML
what is tumour lysis syndrome and what can it result from
results from cell breakdown following chemotherapy
this releases lots of intracellular components such as K, P04 and uric acid
which tumour can cause tumour lysis syndrome when it is treated using chemotherapy
burrkitt’s lymphoma
in what disease is an osmotic fragility test diagnostic
hereditary spherocytosis
what is the one critical mediator of DIC
tissue factor
what role does TF play in DIC
TF binds to coagulation factors that then triggers the extrinsic pathway of coagulation, which goes on to trigger the intrinsic pathway
what does a typical blood pic look like in DIC
low platelets
prolonged APTT and PT
RAISED fibrin degradation products
what chromasome abnormality is seen in most CML patients
Philadelphia chromosome
what is the gene that results from a Philadelphia chromosome mutation and what does this gene code for
BCR-ABL
a tyrosine kinase enzyme
