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THIRD YEAR > Heam > Flashcards

Heam Flashcards

1
Q

dabigatron is excreted how

how does it work

A

renally

direct thrombin inhibitor

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2
Q

extrinsic pathway

intrinsic pathway

A

PTT

APTT

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3
Q

prolonged PTT

A

warfarin
liver disease
vit k defic
DIC

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4
Q

which factor is decreased the fastest in liver disease and why

A

factor 7

has the shortest half life

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5
Q

prolonged APTT

A 
haemophilia
heparin
DIC
WV dx
anti phospholipid
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6
Q

ferritin is what

A

storage iron
acute phase protein
goes up in infections

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7
Q

heriditary spherocytosis is what
what happens
what can be done treatment wise

A

genetic change in a protein leading to a change in the shape
RBCs cleared faster - hameolysis
splectomy and cholescectomy as gallstones due to increased bilirubin
folic acid 5mg/day due to defic

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8
Q

iron therapy what should be seen

A

Hb should go up 10g/L per week

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9
Q

pernicious anaemia is a problem with what

treatment

A

B12 absorption - B12 is needed for division of cells

loading dose of B12 then every 3months

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10
Q

normocytic can be what

A

aplastic anaemia

anaemia of chronic disease

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11
Q

Gp6D come from where

A

mediterranean

african origin

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12
Q

lead poisoning

A

old fashioned house
pain
basophilic stippling
non megaloblastic macrocytic

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13
Q

idiopathic thrombocytopenia purpura

A

had cold/virus before

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14
Q

INR target for VTE
recurrent VTEs
AFib

A
  1. 5
  2. 5
  3. 5
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15
Q

tamoxifen increases the risk of what

A

VTE and endometrial cancer

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16
Q

what do platelet transfusions have more of a risk of than other transfusions and why

A

bacterial infections

stored at room temp - provide a more favourable enviroment

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17
Q

DVT warfarin target

A

INR 2-3

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18
Q 
burrkits lymphoma gene 
caused by what 
in who 
risk of
how can this risk be avoided
A 
C-Myc gene translocation between 8:14
EBV
african population 
chemo can cause tumour lysis syndrome 
rasburicase is given before chemo to decrease the risk
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19
Q

factor 5 leidan is also known as what

A

activated protein C resistance

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20
Q

what is the most common inherited bleeding disorder

A

VW

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21
Q

polycythaemia vera has excessive what
what key symptom/sign
predisposes people to what
20% suffer from what

A

excessive RBCs
intense itching after shower
blood clots
suffer from gouty arthritis

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22
Q

antiphospholipid syndrome increases what

A

APTT

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23
Q

neutropenic sepsis treatment

A

pevacillin and tazobactem

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24
Q

hereditary spherocytosis dx

A

osmotic fragility test

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25
Q

deficiency in both via B12 and folic acid treatment

A

IM B12 and start oral folic acid when B12 levels are normal

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26
Q

rheumatoid arthritis and splenomegaly/neutropenia

A

Feltys

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27
Q

aplastic crisis
signs
cause

A

decreased Hb
presence of reticulocytes
caused by paravirus infection

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28
Q

chronic lymphocytic leukaemia is the commonest what
where are the lymphocytes seen
signs

A

leukaemia in adults
lymphocytes in peripheral blood
LNs enlarged, splenomegaly

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29
Q

LMWH ix

unfractionated ix

A

Xa assay

APTT

30
Q

how much iron is in the plasma pool

A

4mg

31
Q

what is the iron turnover

A

4mg in the pool and move 20mg in a day

32
Q

adult male hb and hc

female

A

130 and 0.38-0.52

120 and 0.37-0.47

33
Q

what do erythroid precursors cluster around

A

a central nursing histiocyte

34
Q

hb concentration
hc
when are both of these not useful

A

spectrophotometric method
ratio of blood
bleed or plasma expansion

35
Q

reticulocytes

A

larger than normal
still have rna
stain purple/deep red
blood film - polychromic

36
Q

cytoplasmic defects
nuclear defects
bad kidneys

what do all of these lead to

A

impaired haemaglobinisation
impaired cell division
ero insta being produced

erythropoiesis present but not effective to hyperprloiferation - low reticulocyte count

37
Q

MCV normal

macrocytic anaemia

A

80-100

>100

38
Q

macrocytic causes true

A

megaloblastic CBF

non megaloblastic - alcol, liver, hypothyroid, marrow failure

39
Q

megaloblastic macrotyic anaemia causes

A

can’t be fucked CBF
cytotoxic drugs - methtrexate
b12 and
folate defic

40
Q

spurious causes of macrocytic anaemia

A

acute blood loss

cold agglutins

41
Q

cold agglutins

A

autoimmune disease against RBC - causes RBC to clump together leading to an increase in MCV

42
Q

non megaloblastic not assoc with anaemia

non megaloblasts assoc with anaemia

A

alcohol, liver dx, hypothyroidism

myelodysplasia, myeloma, aplastic anaemia

43
Q

what do b12 and folate do

A

enable chemical reactions that provide enough nucleotides for DNA synthesis

44
Q

causes of b12 defic

A

coeliac ,crohns, chronic pancreatitis, vegans, bypass

45
Q

causes of folate defic

A

dietary, coeliacs, crohns, haemolysis, exfoliating derm, pregnancy, malignancy, anti convulsants

46
Q

folate

A

dietary follasse -> mono glutamates

absorbed in jejunum

47
Q

b12 source
body stores
absorbed
daily requirement

A

animals
2-4y
ileum
1-3 ug/day

48
Q

folate source
body stores
absorbed
daily requirement

A

leafy veg, yeast destroyed when cooking
4month
D+J
100ug/day

49
Q

what can be caused in b12 deficiency

A

neuro problems

myelin sheath

50
Q

what is pernicious anaemia

A

AI condition with destruction of gastric parietal cells

51
Q

what is pernicious anaemia associated with

A

atrophic gastritis

other AI conditions

52
Q

what does pernicious anaemia lead to

and what are the by products of that

A

ineffective erythropoiesis - RC die prematurely in bone marrow
dead RC - hb (bilirubin) and lactate dehydrogenase

53
Q

ix for pernicious

A

Anti IF - specific but not sensitive

Anti GPC sensative but not specific

54
Q

treatment for pernicious

A

vit b12 hydroxycobalamin infections for life

55
Q

mennorhagia blood loss iron defic

A

commonest cause of blood loss
av 30-40ml/month which 15/20mg a month
heavy >60ml which is over 30mg/month

56
Q

relative defic

absolute defic

A

pregnancy

vegetarian

57
Q

achlorhydra

A

absent or low production of HCl

58
Q

functional iron

A

hb

59
Q

transported iron

A

serum iron
transferrin
transferrin sat

60
Q

storage iron

A

serum ferratin

61
Q

what is tranferrin

A

protein with 2 binding sites for ion atoms

62
Q

what is ferratin

A

large intra cellular protein

spherical protein stores up to 4000 ferric ions

63
Q

when is transferrin high

A

genetic haemochromatosis

64
Q

hb tetramer made up of what

A

2 alpha globin chains and 2 beta globin chains

one team attached to each globin chain

65
Q

HbA
HbA2
HbF

A

alpha2 beta 2
alpha2 8 2
alpha 2 gamma2

66
Q

alpha like chains on which chromosome how many per cell

beta

A

choromosome 16 4 per cell

chromsome 11 2 per cell

67
Q

embryonic Hb

A

gower 1 and 2 and portland

68
Q

foetal hb

A

HbF

69
Q

adult hb

A

HbA2 HbA

70
Q

when are adult levels of hb reached

A

6-12m of age

THIRD YEAR (27 decks)

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