Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a > Haemotology > Flashcards

Haemotology Flashcards

1
Q

Anaemia defenition

A
  • Low RBC mass
  • Increase plasma volume
    eg: Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does reticulocyte count indicate

A

Low - production issue

High - removal issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MCV classification

A

MCV <80 - Microcytic

MCV 80-100 - Normocytic

MCV >100 - Macrocytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Microcytic anaemia causes

A

Iron deficiency
- hypochromic

Chronic disease

Thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Normocytic anaemia causes

A

Acute blood loss

Chronic disease

Combined haemanitic def
- Querey malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Macrocytic anaemia causes

A

Vit B12 def

Alcohol/liver disease

Hyperthyroidism

Folic acid def

Reticulocytosis

FAT RBC MD
D- drugs
AZT/Phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Serum ferritin

A

Major iron storage protein in the body
- directly measure iron levels in the body

  • Acute phase reactant so can be raised falsley in inflammand malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Anaemia general presentation

A

Sx

  • fatigue
  • lethargy
  • dyspnoea
  • palpitations
  • headache

Signs

  • pale skin
  • pale mucous membranes
  • tachycardia (compensatory)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Iron deficiency causes

A 
Poor diet - low iron
Blood loss
- Menorrhagia
- GI bleeding
- Hookworm
Malabsorption - coeliac 
Pregnancy - increased requirements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is iron absorbed

A

Duodenum

*Coelaic disease - Inflamm and duodenal cell destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Iron deficiency anaemia signs

A
  • Brittle hair and nails
  • Atrophic glossitis
  • Kolionychia
  • Angular stomatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Iron deficiency anaemia investigations

A
  • Serum ferritin
  • Low serum ferritin confirms dx
  • Acute phase reactant
  • FBC
    Hypochromic microcytic anaemia
  • Reticulocyte count
  • Reduced
  • Transferrin saturation
  • LOW = Iron deficiency
    HIGH = Iron overload
  • Coeliac serology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Iron deficiency anaemia tx

A 
Ferrous sulphate 
S/E:
- Black stools 
- Nausea
- Constipation 
- Diarrhoea
- GI upset 
- Abdo discomfort

*Take with OJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why should you take ferrous sulphate with OJ

A

Increases acidity - helps with absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the promoting factors for intestinal iron absorption

A
  • Gastric acid
  • Iron def
  • Increase Erythropoeitc -activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anaemia of chronic disease

A
  • Shortening of RBC
  • RBC reduced cell production

CKD
RA
SLE
Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Investigations for new iron def anaemia in an adult withhout a clear underlying cause

A

GI cancer investigations

  • Oesophago-gastroduodenoscopy (OGD)
  • Colonoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the normal rise in iron levels for a pt recieving iron def anaemia tx

A

10 grams/ litre / week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Megaloblastic anaemia

A

B12 and folate

  • Inhibition of DNA synthesis
  • Continued growth without division
  • Macrocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are megaloblasts

A

Erythroblasts with delayed nuclear maturation due to delayed DNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Folate deficiency

A
  • Anaemia

- Neural tube malformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Folate sources

A 
Green leafy veg 
- Spinach 
- Brocolli 
Liver 
Kidney
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long is the folate store in the body + where is it basorbed

A

4 months

Jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of folate def anaemia

A
  • Poor folate diet
    Alcohol
    Poverty
  • Malabsorption
    Coeliac
    IBD - Crohns
  • Pregnancy
  • Anti flolate drug
    Methotrexate
    Phenytoin
  • Haemolysis
  • Malabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Folate deficiency anaemia presentation
``` Anaemia sx - Headache Pallour Lethargy Fatigue ``` Signs - Glossitis NO neuropathy
26
Folate deficiency anaemia investigations
Blood film - Macrocytic anaemia Hypersegmented neutrophil polymorphs Red cell folate levels - LOW *Indicates low body stores SB biopsy only if hx does not suggest dietary deficiency - Looking for small bowel disease
27
Folate deficiency anaemia tx
- Oral folic acid tablets
28
Sources of B12
Animal meats Dairy Milk
29
Length of B12 bodily stores
2-4 years
30
B12 deficiency anaemia
Prenicious anaemia - Megaloblastic - Low reticulocyte count
31
Where is B12 absorbed
- Terminal ileum | - Binds to Intrinsic factor and absobed by enterocytes
32
What is prenicious anaemia
AI disease - Ab against parietal cells or Intrinsic factor - Prevents B12 absorption due to lack of Intrinsic factor
33
Prenicious anaemia causes
Atrophic gastritis Gastrectomy Crohns Coeliac
34
Causes of B12 deficiency anaemia
``` Prenicious anaemia Ileal resection Crohns disease Gastric bypass - Food passes quickly (Pepsin can't act to release B12) - Tapeworm ```
35
B12 def anaemia presentation
``` Sx of anaemia Glossitis Angular stomatitis Neurological sx Lemon - Yellow tinge *pallour + mild jaundice *Excessive Hb breakdown as body tries to remove defective large RBC ```
36
Specific neurological sx of B12 def anaemia
Peripheral neuropathy - w/ numbness or paraesthesia - Weakness - Ataxia - Dementia - Hallucinations - Loss of vibration sense/propioception - Depression - Irritabilty
37
B12 deficiency anaemia investigations
Blood film - Macrocytic RBC - Hypersegmented neutrophils Serum Ab screen - Inrinsic factor Ab Serum B12 Low
38
B12 def anaemia tx
Hydroxyxobalamin - B12 - Tablets - Injections
39
B12 def anaemia complications
HF Angina Neuropathy
40
What is sickle cell disease
Disorder of Hb quality - Autosomal Recessive - Point mutation of the Beta globin gene resulting in a HbS variant
41
Whta is the codon chnage in sickle ell disease
Glutamic acid --> Valine
42
When does SCD manifest
After HbF levels decrease | - Approx 6 months
43
How does HbS affect oxygenation
HbS can carry O2 normally - changes shape when deoxygenated - allows aggregation with other HbS proteins - Insoluble and polymerises - polymerisation distorts RBC into a crescent shape - RBC fragile and easily haemolysed
44
Factors promoting sickling in SCD
``` Acidosis Low flow vessels Infection Dehydration Hypoxia Cold Stress ```
45
What does repeated sickling do to RBCs
Promotes premature destruction - Intravascular haemolysis - Anaemia - Hb spillage --> Jaundice Impaired passage of RBCs in microcirculation due to sickling - Small vessel obstruction - Tissue infarction PAIN
46
Sickle cell trait presentation
``` Sx free with no disability unless in extreme conditions: *Vaso-occlusive events - High altitude - Dehydration - Hypoxia Unpressured aircraft Anasthesia ```
47
Benefit of sickle cell trait
Selective advantage of protection against Falciparum malaria
48
Sickle cell disease presentation
``` Vaso-occlusion - Dactylitis - Avascular necrosis - Pain in long bones spine/ribs/pelvis - stroke - seizures ``` Anaemia Splenic sequestriasation Mesenteric ischaemia
49
Long term SCD complications
CKD Pulmonary HTN Poor growth - avascular necrosis of bones results in shortened deformed bones in kids
50
Vaso-occlusive crisis
- Sickled RBCs clog up capillaries - Distal ischaemia - Assosc with: dehydration Riased haematocrit *PRIAPISM trapping blood in penis causing painful and persistent erection - UROLOGICAL EMERGENCY
51
Splenic sequestrian crisis
- Sickled cells block blood flow to the spleen - Acute enlarged and painful spleen - leads to: * Severe anaemia * Hypovolemic shock
52
Aplastic crisis
- Temp loss of new blood ell production - Triggered by parvovirus B19 infection - Leads to severe anaemia
53
Acute chest syndrome Sx and causes
Sx: - Fever / resp sx - New infiltrates seen on X-ray Causes: - Infection (pneumonia) - Non infective cause (pulmonary vaso-occlusion or fat emboli)
54
Acute sickle cell disease complications
Sickle cell crisis Acute chest syndrome Haemolytic Mesenteric ischaemia
55
Sickle cell disease investigations
Screen neonates - Blood/Heel prick test FBC - Hb Reticulocyte Blood film - Sickled erythrocytes Hb electropharesis - HbSS present - HbA absent
56
Sickle cell disease management
- Analgesia - Tx underlying cause: Abx - Fluids - Folic acid - Tranfuse when falling Hb
57
Disease modifying tx SCD
Hydroxycarbamide - Increase gamma and foetal globin - HbS cannot polymerise as HbF gets in its way so prevents sickling Stem cell transplant Blood transfusion *Beware iron overload
58
Alpha - Thalassaemia
Deficiency in alpha chain synthesis in red cell precursors - Caused by gene deletions found on chromosome 16 - Protection from falciparum malaria
59
Thalassaemia
- Hb quantity disease - AR disease - Precipitation of globin chains on: * RBC precursors --> ineffective erythropoesis *Mature RBC --> Haemolysis Faulty production and premature destruction
60
Thalassaemia - Spleen - Bone marow
Splenomegaly - filters blood to collect destroyed RBCs causing swelling BM expansion - Compensate for chronic anaemia - Susceptibility to fractures - Prominent features: * Pronounced forehead * Malae eminences
61
Thalassaemia presentation
Sx: - Fatigue - Poor growth and development - Pronounced forehead and malar eminences Signs: - Splenomegaly - Gallstones - Jaundice - Pallor - Microcytic anaemia
62
What is HbH disease
3 deleted alpha genes - Low HbA - Severe haemolyticanaemia - Splenomegaly
63
What disease is caused by 4 deleted alpha globin chain genes
- Hb Barts Hydrops Fetalis - Cannot carry oxygen - Not compatible with life - Baby is: Pale Oedematous Big Liver Big spleen
64
Alpha thalassaemia investigations
Bloods - Microcytic Blood smear: - Microcytic + Hypochromic - Target cells Hb Electrophoresis Genetic testing: - Amniocentisis
65
Iron overload - Monitoring - Management
Serum ferritin Chelating agents - Deferiprone
66
Beta - Thalassaemia
Deficiency in Beta globin chain synthesis - Results in excess alpha chains which combine with gamma and delta chains - Increase HbA2 and HbF - Ineffective erythropoesis and haemolysis
67
HbF chains
2 x alpha | 2 x gamma
68
HbA2 chains
2 x aplha | 2 x delta
69
HbA chains
2 x alpha | 2 x Beta
70
Beta - Thalassaemia aetiology
Point mutation in splice sites or promoter sequence on chromosome 11 - Decrease Beta chain production or absence
71
Beta Thalassassaemia phenotypes
B0 , B0 - Major B+ , B+ - Intermedia B , B+ - Minor ``` B0 = none B+ = Reduced ```
72
What does extravascular haemolysis lead to in beta thalassaemia
- Hypoxia - Secondary haemochromatosis - Jaundice
73
Beta thalassaemia minor presentation
Mild anaemia | - Iron stores + ferritin normal
74
Beta thalassaemia intermedia presentation
Moderate anaemia - NO TRASFUSSIONS REQUIRED - splenomegaly - Bone abnormalities - Leg ulcers - Gallstones
75
Beta thalassaemia major presentation
- Severe anaemia - Failure to thrive - chronic infections - Hepatosplenomegaly - Osteopenia - Bone abnormalities * Skull bossing
76
Why does Beta thalassaemia present within the first year
HbF uses up free alpha chains until it runs out in the first 6m
77
Beta thalassaemia major - investigations
FCB: - high reticulocyte count Blood film: - Hypochromic + microcytic anaemia Target cells X Ray: - Hair on end Dx: Hb electrophoresis - Increase HbF and ansent HbA
78
What is anisocytosis
Variation in RBC size | - Iron deficiency anaemia
79
What is poikilocytosis
Variation in RBC shape | - Iron deficiency anaemia
80
Beta thalassaemia tx
- Blood transfusion * Replenish HbA levels - Long term folic acid supplements - endocrine supplements - Promote fitness and healthy lifestyle
81
How to monitor iron overload
MRI - Cardiac - Liver Dexa scan
82
Complications of iron overload
Liver fibrosis + cirrhosis Hypothyroidism Hypocalcaemia Hypogonadasim
83
Inherited haemolytic anaemias
``` Heriditary sperocytosis Hereditary elliptocytosis Thalassaemia Sickle cell disease G6PD deficiency ```
84
Acquired haemolytic anaemias
- AI haemolytic anaemia - Infections - Secondary to systemic disease - Prosthetic valve related haemolysis
85
what is haemolytic anaemia
Anaemia due to premature RBC destruction
86
Haemolytic anaemia general presentation
``` Anaemia Splenomegaly Jaundice Gallstones Leg ulcers ```
87
What is hereditary elliptocytosis
- RBC epilleptical in shape * Horizontal interactions - AD condition
88
What is hereditary spherocytosis
- RBC sphere shaped | - AD condition
89
Membranopathy investigations
FBC: - Anaemia - Reticulocytosis Blood film: Sherocytes and Reticulocytes
90
Membranopathy tx
Folate supplements Splenectomy
91
What is G6PD deficiency
X - linked recessive disease - Glucose -6 - phosphate dehydrogenase deficiency
92
What does G6PD do
- Enzyme for hexose monophosphate shunt - Maintains glutathione in reduced state - Glutathione protects RBCs from oxidatine injury - Shortened RBC lifespan due to oxidative injury
93
Precipitants of oxidative crisis
- Primaquine - Anti malarial - Ciprofloxacin - Sulfonylureas - Sulfasalazine Broad beans Fava beans Infection
94
Enzymeopathies presentation
Jaundice - neonatal Gallstones - anaemia - splenomegaly
95
Enzymeopathies investigations
Blood film: - Bite cells - Blister cells - Heinz bodies G6PD enzyme Assay - may be normal if taken immediately after an attack
96
What should you avoid in G6PD deficiency
Henna
97
What is cold AIHA secondary to
- Lymphoma - Leukemia - SLE - EBV - CMV - HIV
98
How does cold AIHA occur
- Ab bind to RBC and cause agglutnation - Immune system activated - Filtration and destruction in the spleen
99
AIHA tx
Blood transfusions Prednisolone Rituximab Splenectomy
100
Bone marrow failure
- Reduction in number of pluripotent stem cells causes lack of haemopoesis - Reduced number of RBCs to replace old ones causing anaemia
101
Bone marrow failure causes
``` Congenital Acquired - Aplastic anaemia Cytotoxic drugs Radiation Infections ```
102
Bone marrow failure presentation
``` Pancytopenia - Increase susceptibility to infections - Bruising - Bleeding Nose + gums ```
103
Aplastic anaemia investigations
Bloods: - Pancytopenia - Decreased reticulocytes BM biopsy: - Increase fat spaces - Hypocellular marrow
104
DVT presentation
``` Pain Swelling Redness warmth Ankle oedema - Pitting ```
105
DVT investigations
D - Dimer - exclusion only US Doppler Bloods Wells score
106
What causes an increase in D-dimers
post op cancer pregnancy DVT
107
DVT management
- LMWH (Enoxaparin) - Warfarin - DOAC (Apixiban) Prevention - compression stockings - mobilisation - leg elevation
108
MOA LMWH
Enoxaparin - Inactivation of factor Xa - weight adjusted dose
109
MOA Unfractioned heparin
``` Binds to antithrombin Inhibits: - Xa - Thrombin - IXa ```
110
What is APTT
Activated partial thromboplasmin time | - Monitered when ot is on Heparin
111
MOA Warfarin
Prevents activation of clotting factors - 10,9,7,2 - Narrow therpautic range Target = (2-3) - Prolongs PT time
112
What is leukemia
Malignant neoplasm of blast cells (haemopoetic stem cells) - Excessive production of a single type of abnormal white cell - excessive production leads to suppression of all other cell lines (PANCYTOPENIA) - Excessive production leads to blast cells spilling over into the blood from BM
113
Leukemia aetiology/assosc
- Chemicals (Benzene) - Alkylating agents - Radiation damage - Viruses - Genetics * Downs syndrome
114
What is Acute lymphoblastic Leukemia
Malignancy of lymphoid cells affecting B/T cell lineages | - Proliferation of Lymphoblasts
115
ALL assosciations + age
- Downs syndrome - Ionising radiation during pregnancy Under 5 and over 45
116
Commonest childhood cancer
ALL | - Assosc with Down syndrome
117
Common infection is ALL patients
- Chest - Measels - CMV - Pneumocytisis pneumonia - Candidiasis
118
ALL investigations
Bloods: FBC - Blast cells - High WCC BM aspirate - Blast cells CXR: - Abdo lymphadenopathy - Mediastinal lymphadenopathy LP: - Check for CNS involvement
119
What is tumour lysis syndrome
- release of uric acid from cells being destroyed by chemo - can cause AKI Tx: Allopurinol
120
ALL management
- blood/platelet transfusion - Neutropenic regimen - Prophylactic antivirals/fungals/biotics - Pt specific chemo regimens - BM transplants
121
What is CLL
Chronic lymphocytic leukemia - Chronic proliferation and accummulation of mature B-lymphocytes (non functional) - >55 years old
122
What is the commonest leukemia
CLL
123
What influences the risk of CLL development
Mutations Triosmies Deletions
124
CLL presentation
Often Asx - suprise finding on routine FBC - Anaemic - Infection prone - Sweats - Weight loss
125
CLL signs
- Enlarged rubbery non tender nodes | - Hepatosplenomegaly
126
CLL investigations
FBC: - Lymphocytosis - Increase WCC Blood smear: - Smudge/ smear cells BM biopsy: - BM infiltration
127
What can CLL transform to
High grade lymphoma | - Richter syndrome
128
CLL complications
- Warm AIHA - Hypogammaglobinaemia (Low IgG) --> Infection * Herpes zoster - BM failure
129
What is AML
Acute myeloid leukemia - Neoplastic proliferation of blast cells derived from marrow myeloid elements - Commonest leukemia in adults - >75 y/o
130
What can AML be the result of
Result from a transformation from a myeloproliferative disorder - PCRV - Myelofibrosis
131
what is AML a long term complication of
Long term chemo for lymphoma
132
AML presentation -
Similar to ALL - Anaemia - Infection - Bleeding - Hepatosplenomegaly Gum hypertrophy - Infiltration DIC - Thromboplastin release
133
AML investigations
Blood smear: - blast cells w/ AUER RODS BM biopsy: - blast cells
134
Differentiating AML from ALL
Microscopy Immunophenotyping Molecular methods
135
What is CML
Chronic myeloid leukemia - uncontrolled clonal proliferation of myeloid cells - (40-60 y/o)
136
CML cytogenetic changes
Philadelphia chromosome - t(9;22) --> BCR/ABL - tyrosine kinsae activity - stimulates cell division
137
CML investigations
- Cytogenic analysis of blood/BM for Ph chromosome
138
CML Tx
- IMATINIB specific BCR/ABL tyrosine kinase inhibitor chronic phase tx - Chemo - Stem cell transplant
139
What is Lymphoma
B and T cell malignancies of the lymphoid system | - Accumulate in lymph nodes leading to lymphadenopathy
140
What is Hodgkin's lymphoma | - Age
Proliferation of lymphocytes - Bimodal age distribution peak = 20 peak = 75
141
Hodgkin's lymphoma RF
``` HIV EBV Family hx AI condition - RA/SLE Post transplantation ```
142
Hodgkin lymphoma presentation
Lymphadenopathy - Neck - Axilla - Inguinal B symptoms - fever - weight loss - night sweats - fatigue - pruritus - Hepatosplenomegaly - cough - S.O.B - Abdo pain - Recurrent infections
143
Hodgkin lymphoma lymphadenopathy presentation
- Non tender - Rubbery - Pain when drinking alcohol
144
Hodgkin lymphoma investigation
Bloods: - high ESR - LDH LN biopsy: DIAGNOSTIC - Reed sternberg cells CXR: - Mediastinal widening from enlarged lymph nodes CT/PET: - Staging
145
What are reed sternberg cells
- Abnormally large B cells - Multiple nuclei that have nucleoli in them * Apperance of an owl with large eyes
146
Differential diagnosis of lymphadenopathy
- Tonsillitis - TB - HIV - EBV - CMV - Leukemia - SLE - Rheumatoid arthiritis - SLE - Sarcoidosis
147
Lymphoma staging
``` Ann Arbor Classification Stage: 1 2 3 4 ``` Stage A or B A - No systemic sx other than pruritus B - Presence of B sx in the last 6m - fever (>38) - sweats (change of clothes) - loss of weight
148
Hodgkin lymphoma tx
Chemo Radio * Ris of relapse
149
Chemo risks or S/E
``` Leukemia Infertility Alopecia Infection AML NHL Myelosuppression ```
150
Radiotherapy risks
``` Secondary malignancies - lung - breast - melanoma -sarcoma Damage to tissues Hypothyroidism ```
151
What is Non-hodgkins lymphoma
``` Lymphomas without charecteristic cells - Burkitt - MALT Assoc with H-pylori infection - Diffuse large B cell lymphoma ```
152
Non hodgkin lymphoma risk factors
- HIV - EBV - Hep B/C infection - Family hx - H.pylori infection
153
Non hodgkin lymphoma presentation
``` - Painless peripheral node enlargement Extra nodal: - Bowel obstruction - Spinal cord compression - Pancytopenia ```
154
Why is a high LDH a bad indicator of prognosis
Indicates high cell turnover therfore increase proliferation
155
Non hodgkin lymphoma classification
Low grade - incurable - follicular lymphoma High grade - aggressive but curable - diffuse large B cell - Burkitts
156
Features of Burkitts lymphoma
- Jaw lymphadenopathy - Childhood disease - Assosc with EBV infections
157
When should you suspect malaria
Fever + Exotic travel
158
MOA for anti-emetic Onadansetron
5HT3 antagonist | - Centrally acting for drug induced vomitting
159
Actions for pt with febrile neutropenia
Emergency --> ABC Perform cultures Broad spectrum Abx - Gentamicin + Tazosin
160
When should you consider myeloma
Pt's > 50y/o with bone or back pain and unexplained features
161
What is myeloma | - and what is majorly produced
Malignancy of plasma cells | - IgA + IgG majorly produced
162
What is found on urine/serum electrophoresis
Monoclonal paraprotein - Bence Jones proteins - Free IgG light chains filtered by the kidney
163
Myeloma anaemia pathophysiology
Bone marrow infiltration | - Pancytopenia
164
Myeloma bone disease pathophysiology
Increase osteoclast activity and decrease osteoblast activity - Increase RANKL from plasma + stromal cells Osteolytic lesions - Patchy bone metabolism Hypercalcaemia - Increase osteolytic activity
165
Myeloma renal disease pathophysiology
Light chain deposition - Loop of henle - PCT toxic inflammatory effect Hypercalcaemia
166
Myeloma key features | - acronym
C - hypercalcaemia R - Renal failure/ AKI A - Anaemia B - Bone lesions
167
Myeloma investigations
B - Bence jones protein *Urine electrophoresis L - Lytic bone lesions *MRI --> CT --> X-Ray I - Increased ESR P - Pancytopenia *FBC --> Increased Ca2+ Bone marrow biopsy
168
Myeloma X ray findings
Punched out lesions Lytic lesions Raindrop skull
169
Myeloma tx
1. Chemotherapy + High dose dexamethasone (bone pain) - Stem cell transplant - EPO transfusions - Hydration (AKI) - Bisphosphonates - Avoid NSAIDs
170
Pancytopenia defenition
``` Decreased blood cells Anaemia Thrombocytopenia - Easy bleeding - Easy bruising Low WCC - infection prone ```

Phase 2a (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions