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Ned's PassMed notes 2019/20 > Haematology PassMed > Flashcards

Haematology PassMed Flashcards

1
Q

name the 4 types of Hodgkins lymphoma

A

nodular sclerosis
mixed cellularity
lymphocyte predominant
lymphocyte depleted

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2
Q

which Hodgkins lymphoma is most common

A

nodular sclerosing

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3
Q

what does a reed Sternberg cell look like

A

a nuclei surrounded by a clear space

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4
Q

what disease is associated with smear cells

A

CLL

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5
Q

what are the CRAB features that myeloma typically presents with

A

Calcium elevated
Renal failure
Anaemia
Bone pain

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6
Q

when in myeloma is Alk phos usually only elevated

A

usually only in metastatic disease

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7
Q

how is vWF deficiency inherited

A

autosomal Dominant

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8
Q

how is a stage 3 Hodgkins lymphoma defined

A

involvement of LN regions on both sides of the diaphragm

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9
Q

which infection has strong links with lymphoma

A

EBV

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10
Q

what is a rouleaux formation and what is it characteristic of

A

a stacking of RBCs seen in a blood film

it suggests a myeloma

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11
Q

what is a ‘pepper pot skull’ characteristic of

A

primary hyperparathyroidism

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12
Q

what is a ‘rain drop’ skull characteristic of

A

myeloma

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13
Q

what are the 3 components of the diagnostic criteria for myeloma

A
  1. plasmacytoma
  2. 30% plasma cells in bone marrow sample
  3. elevated levels of M protein in the blood or urine
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14
Q

what is a plasmacytoma

A

a tumour of plasma cells that grows in the soft tissue, characteristic of a myeloma

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15
Q

how does factor V Leiden increase chance of VTE

A

activated factor V is inactivated much more slowly by activated protein C

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16
Q

what age is NHL most common

A

it has a bi modal age distribution

most common in 3rd and 7th decade

17
Q

if you suspect lytic bone metastases in a patient with renal failure and anaemia, what investigation do u do

A

serum protein electrophoresis

ie - urinary Bence Jones protein

18
Q

in sickle cell, what are thrombotic crises precipitated by

A

infection, dehydration, deoxygenation

19
Q

describe the signs of acute sickle chest syndrome

A

SO, chest pain, pul infiltrates, low Po2

20
Q

how is a non-haemolytic febrile reaction treated

A

temporary transfusion termination and an antipyretic (paracetamol)

21
Q

what transfusion reaction can DIC be a complication of

A

acute haemolytic transfusion reaction

22
Q

what Ig is usually responsible for acute haemolytic transfusion reaction

A

IgM

23
Q

what is the cause of non-haemolytic febrile reaction

A

white blood cell HLA antibodies

24
Q

how do you differentiate between allergic anaphylaxis transfusion reaction and acute haemolytic transfusion reaction

A

allergic - urticaria, hypotension, SOB, wheezing and stridor

acute haemolytic - fever, ab pain, chest pain, agitation and hypotension

25
Q

what are the signs of transfusion related acute lung injury

A

development of hyperaemia/ARDS within 6hrs of transfusion

has pul infiltrates on XR

26
Q

what is the main difference between transfusion related acute lung injury and transfusion associated circulatory overload

A

TACO has hypertension, TRALI has hyPOtension

27
Q

what deficiency causes a megaloblastic anaemia

A

B12 and Folate

28
Q

if a patient is going to be treated for folate deficiency with folic acid, what is it important to replace 1st? why ?

A

treat the B12 deficiency 1st to avoid precipitating subacute combined degeneration of the cord

29
Q

what mutation is seen in most polycythemia vera patients

A

JAK2 mutation

30
Q

what cancer may myelodysplasia progress to

A

AML

31
Q

what is tumour lysis syndrome and what can it result from

A

results from cell breakdown following chemotherapy

this releases lots of intracellular components such as K, P04 and uric acid

32
Q

which tumour can cause tumour lysis syndrome when it is treated using chemotherapy

A

burrkitt’s lymphoma

33
Q

in what disease is an osmotic fragility test diagnostic

A

hereditary spherocytosis

34
Q

what is the one critical mediator of DIC

A

tissue factor

35
Q

what role does TF play in DIC

A

TF binds to coagulation factors that then triggers the extrinsic pathway of coagulation, which goes on to trigger the intrinsic pathway

36
Q

what does a typical blood pic look like in DIC

A

low platelets
prolonged APTT and PT
RAISED fibrin degradation products

37
Q

what chromasome abnormality is seen in most CML patients

A

Philadelphia chromosome

38
Q

what is the gene that results from a Philadelphia chromosome mutation and what does this gene code for

A

BCR-ABL

a tyrosine kinase enzyme

Ned's PassMed notes 2019/20 (17 decks)

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