Hematology Flashcards
1
Q
Investigation for lymphoma*
A
> Diagnosis
- Excisional biopsy of LN
(1. architecture of the LN and 2. cell appearance: Reed-Sternberg cells in Hodgkin) - Bone marrow biopsy (if cytopenia occurs - to determine the cause)
- FBC (NCNC anemia)
> Severity and complications
- BUSE/ Cr
- Serum uric acid (Increase turn over -> hyperuricemia -> renal failure)
- ESR (increase ESR or decrease Hb - worse prognosis)
> Assess spread
- CT TAP (for staging - based on extent of nodal and extranodal involvement)
- PET scan (help diagnosis and follow up)
2
Q
Staging of lymphoma*
A
“Ann Arbor Staging”
- I: confined to single LN region
- II: 2 or more LN on the same side of the diaphragm
- III: nodes on both sides of the diaphragm
- IV: spread beyond the LN, eg: liver or bone marrow
- Each stage is either
A: no systemic symptoms
B: presence of B symptoms
3
Q
What is B symptoms
A
- Weight loss >10% in last 6 months
- Unexplained fever >38’C
- Night sweats
4
Q
Investigation for acute leukemia
A
- Blood film, bone marrow: characteristic blast cells
- CXR, CT scan: mediastinal and abdominal lymphadenopathy
- Lumbar puncture: CNS involvement
5
Q
Tumor lysis syndrome
A
- Increase urate, K+, phosphate and decrease calcium
- Risk of arrhythmia and renal failure
- Mx: hydration, uricolytic (eg: allopurinol)
6
Q
Investigation for thalassemia
A
> Confirm diagnosis
- Full blood picture: hypochromic microcytic anemia
- Peripheral blood film: target cells
- Hemoglobin electrophoresis: beta thalassemia
- DNA analysis: alpha thalassemia
> Monitor complications
- Infection: Hep B, C, and HIV screening
- Diabetes: blood glucose level
- Hypothyroidism: T3, 4, TSH
- Hemochromatosis: MRI for heart and liver
7
Q
Management of thalassemia
A
- Regular blood transfusion
- Iron chelation therapy
- Regular monitoring for complication
- Treatment of complication:
Diabetes - OHA/ insulin
Hypothyroidism - thyroxine supplement
