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PHASE 2A > HAEMOTOLOGY > Flashcards

HAEMOTOLOGY Flashcards

1
Q

What is polycythaemia?

A

Too many red blood cells or not enough plasma volume

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2
Q

What is ruba vera/ polycthaemia vera?

A

A JAK2 mutation causing increased red blood cell production as more sensitive to bone marrow cells

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3
Q

What can cause secondary polycythaemia?

A

Hypoxia, high altitudes, sixkle cell, tumours, kidney problems

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4
Q

What are the symptoms of polycythaemia?

A

Easy brusing and bleeding, itchy skin

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5
Q

How do we treat polycythaemia?

A

Blood letting, aspirin

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6
Q

Where does eryptosis occur?

A

The spleen, liver and bone marrow

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7
Q

Where are red blood cells made?

A

Bone marrow

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8
Q

Where are platelets derived from?

A

Megakaryocytes in bone marrow

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9
Q

What clotting factors are vitamin K dependant?

A

2,7,9 + 10

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10
Q

What is haemoglobin made off?

A

2 alpha and 2 beta chains

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11
Q

What are the 3 main causes of microcytic anaemia?

A

Iron deficiency
Thalassaemia
Chronic disease

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12
Q

What are the 3 main causes of normocytic anaemia?

A

Bleeding
Chronic disease
combined haematinic deficiency

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13
Q

What are signs of iron deficiency?

A

Koilonychia, angular atomatitis, atrophic glossitis and brittle hair and nails

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14
Q

What are the causes of macrocytic anaemia?

A

B12/folate deficiency
Alcohol excess
Metabolic disease e.g. hypothyroidism

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15
Q

What is the test for B12 deficiency?

A

Shilling test

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16
Q

What is the test for pernicious anaemia?

A

Intrinsic factor antibodies

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17
Q

What diseases can cause B12 deficiency?

A

Coeliac disease, Crohn’s, atrophic gastritis

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18
Q

What is DIC?

A

Cytokins activate the clotting cascades and fibrin deposition. Platelet consumption occurs leading to bleeding whilst organ failure occurs.

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19
Q

what can cause DIC?

A

Sepsis
Trauma
Pancreatitis
Malignancy

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20
Q

What is the treatment for DIC?

A

Treat the underlying cause
Maintain blood volume
Many transfusions
Activated protein C

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21
Q

What is ITP?

A

Immune thrombocytopenic purpura

Ig G binds to platelets which are removed by the reticuloendothelial system

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22
Q

What is TTP?

A

Reduction of ADAMTS13 enzyme leading to spontaneous platelet aggregation in microvascular

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23
Q

What is the treatment for ITP or TTP?

A

Corticosteroids, IV Ig and anti D, remove spleen

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24
Q

What are signs of thrombocytopenia?

A

Purpura, epistaxis (nose bleed) and menorrhagia

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25
Q

What are the investigations for a DVT?

A

Ultrasound, d-dimer and venography

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26
Q

What is the treatment for a DVT?

A

Low molecular weight heparin, anti-coagulation

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27
Q

What is Virchow’s triad?

A

Stasis
Hypercoagulability
Endothelial damage

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28
Q

What is Myeloma?

A

An immunoglobulin overproduction from a mutation in bone marrow plasma cells

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29
Q

What are the signs and symptoms?

A 
CRAB
Hypercalcaemia
Renal impairment
Anaemia
Lytic lesions and osteoporosis
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30
Q

What is seen on a blood film for myeloma?

A

Roleaux formation

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31
Q

What is seen on protein electrophoriesis for myeloma?

A

Monoclonal proteins

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32
Q

What is seen on urine protein electrophoresis for myeloma?

A

Bence- Jones proteins

33
Q

What is high on FBC for myeloma?

A

High ESR, urea and creatine

34
Q

What is the treatment for myeloma?

A 
Rehydration with saline
MRI and Dexamethasone
Plasmaphersis (Hyperviscosity)
Bisphosphonates
Fluids and dialysis (AKI)
35
Q

What is lymphoma?

A

A malignancy of mature lymphocytes arising in the lymphatic system

36
Q

What is leukaemia?

A

Malignancy of lymphocyte precursors in the bone marrow

37
Q

Which lymphoma has Reed Sternberg cells?

A

Hodgkin’s

38
Q

What ages are most commonly effected in Hodgkin’s lymphoma?

A

The young and old

39
Q

What are symptoms of Hodgkin’s lymphoma?

A

Painless non-tendery rubbery lymph nodes, weight loss, fever, night sweats, lethargy

40
Q

What are the signs of Hodgkin’s lymphoma?

A

Enlarged lymph nodes and hepatosplenomegaly

41
Q

What is the treatment of Hodgkin’s lymphoma?

A

Radio and chemotherapy

42
Q

How do we diagnose Hodgkin’s lymphoma?

A

Biopsy
Histology
Reed-Sternberg cells

43
Q

What is the Ann Arbor system used to stage?

A

Hodgkin’s lymphoma

44
Q

What is associated with Non-hodgkin’s lymphoma?

A

MALT

Mucosa associated lymphoid tissue

45
Q

What are the risks for non-hodgkin’s lymphoma?

A

H.pylori
HIV
Toxins

46
Q

What is the treatment for Non-hodgkin’s lymphoma?

A

Chemo
Radio
Rituximab
Steroids

47
Q

What cells are cancerous in chronic myeloid leukaemia?

A

Neutrophils, basophils and eosinophils

48
Q

What is the philadelphia chromosome linked to?

A

Chronic myeloid leukaemia

49
Q

What are the signs of chronic myeloid leukaemia?

A

SPLENOMEGALY
Anaemia
Bruising
Hepatomegaly

50
Q

What are the diagnostic results for chronic myeloid luekaemia?

A

Raised WCC

Cytogenetics- Philadelphia chromosome

51
Q

What is the treatment for chronic myeloid luekaemia?

A

Imatinib
2nd stage- dasatinib, nilotinib
Hydroxycarbimide

52
Q

What age does CML affect?

A

40-60

53
Q

What is Chronic lymphocytic leukaemia a cancer of?

A

Mature B cells

most common type

54
Q

What symptoms does CLL present with?

A

None- usually asysmptomatic

55
Q

What are the signs of CLL?

A

Enlarged rubbery non-tender nodes

splen and hepatomegaly

56
Q

What is seen on a full blood count for CLL?

A

Raised lymphocytes

57
Q

What staging is used for chronic lymphocytic leukaemia?

A

Rai staging

58
Q

What is a complication of CLL?

A

Autoimmune haemolysis (high WCC and normal platelet)
Infection
Marrow failure

59
Q

What is the treatment for CLL?

A

Rituximab
Chemo and radio
Stem cell transplant

60
Q

What is the rule of thirds associated with?

A

Chronic Lymphocytic Leukaemia

61
Q

Which Leukaemia is associated with childhood?

A

Acute lymphoblastic leukaemia

62
Q

What is ALL a malignancy of?

A

B/T lymphocyte cell lines?

63
Q

What are signs/symptoms of ALL?

A 
CNS invlovement
Bone pain
Marrow failure
Lymphadenopathy
Orchidomerglay
64
Q

What are the results of investigations for ALL and AML?

A

Low RBC and platelets
Blood film will have blast cells
DIC may occur on a clotting screen

65
Q

What is the treatment for ALL and AML?

A

Support with blood
chemo
Bone marrow transplant
70-90% cured

66
Q

What is Acute myeloid leukaemia?

A

Malignancy of myeloid cell lines

67
Q

What is a sign of AML?

A

Fever, bone pain, fatigue, pale skin, GUM HYPERTROPHY

68
Q

What micro-organism causes malaria?

A

Plasmodium falcifurum

69
Q

What are the investigations for malaria?

A

Thin and thick blood smear

Rapid diagnostic test and if clear repeat at 12 and 24 hours

70
Q

What is the treatment for uncomplicated malaria?

A

Po Riamet, PO Quinine and doxycycline

71
Q

What is the treatment of none faliciparum malaria?

A

PO Chloroquine

72
Q

What is beta thalassemia?

A

A mutation in beta globlin genes on chromosome 11 leading to underproduction of red blood cells

73
Q

Which of alpha and beta thalassemia is more commom?

A

Alpha

74
Q

What is the treatment for thalassemia?

A

Mild- exercise and give folate

Regular transfusions, iron chelators and ascorbic acid

75
Q

In sickle cell what is the mutation?

A

Glu for val in b chain to create Hbs instaed of HbA

76
Q

What are the signs of thalassemia major?

A

Mexican hat cells in alpha

Bossing of the head

77
Q

What is haemophillia a?

A

Factor viii deficiency

78
Q

What are investigation results for haemohillia a?

A

High APTT

Low factor viii

79
Q

What is haemophillia B?

A

Factor ix deficiency

PHASE 2A (14 decks)

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