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Year 2 Divs > Hematology > Flashcards

Hematology Flashcards

1
Q

Neutrophil - how many lobes?

A

2-5

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2
Q

Lifespan of red blood cell

A

120 days

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3
Q

Lifespan of platelet

A

10 days

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4
Q

Anisocytosis - linked with which group of diseases

A

Myelodysplastic Syndrome

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5
Q

Condition on blood film highlighted by Target Cells (2)

A

Iron Deficiency Anaemia
Post Splenectomy

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6
Q

Condition on blood film highlighted by Heinz Bodies (2)

A

G6PD Deficiency
Alpha-Thalassaemia

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7
Q

Condition on blood film highlighted by Howell-Jolly Bodies (three)

A

Post Splenectomy
Severe Anaemia

SICKLE CELL

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8
Q

Condition on blood film highlighted by Reticulocytes

A

Haemolytic Anaemia

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9
Q

Condition on blood film highlighted by Smudge/ Smear cells

A

chronic lymphocytic leukaemia (CLL)

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10
Q

Normal Hm range for Male & Female

A

130-190g/L (Male)
120-165g/L (Female)

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11
Q

Normal MCV range

A

80-100 Femtoliters

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11
Q

Causes Microlytic Anaemia (TAILS)

A

Thalassaemia
Anaemia of Chronic disease
Iron Deficiency
Lead poisoning
Sideroblastic Anemia

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12
Q

Causes Normocytic Anaemia (5)

A

Haemolytic Anaemia
Hypothyroidism
Acute Blood Loss
Aplastic Anaemia
Anaemia of Chronic Disease

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13
Q

Causes Megablastic Anaemia (2)

A

B12 deficiency
Folate Deficiency

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14
Q

Reasons for Normoblastic Macrocytic Anaemia (5)

A

Drugs (azathioprine)

Hypothryidsim

Alcohol

Reticulcystosis (eg due to haemolyssis)

Liver disease

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15
Q

28 YO woman- fatigue+ Hair Loss
Hb 97g/L
MCV 70fl

Diagnosis?

A

Iron Deficiency Anaemmia

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16
Q

Clinical signs Iron Deficiency Anaemia (2)

A

Nail Spooning (koilonychia)
Angular Chelitis

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17
Q

Possible underlying causes of Iron Deficiency Anaemia (4)

A
  1. Inadequate dietary Iron
  2. Inadequate Iron Absorption (Coeliac)
  3. Increased Iron Requirements (Pregnancy)
  4. Bleeding (heavy periods/GI cancer)
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18
Q

Investigation when cause is unclear for Iron Deficiency Anaemia (dont overthink it Divs)

A

Urgent OGD and

colonoscopy to exclude GI cancer

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19
Q

Treatment for Iron Deficiency Anaemia (3)

A

Oral Iron (Ferrous Sulphate)
Iron Infusion
Blood Transfusion (low Hb)

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20
Q

Hb: 93 g/L
MCV: 112 f/L
B12: 31ng/L
IF Antibodies: +Ve

Diagnosis

A

Pernicious Anaemia

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21
Q

Where is IF produced?

A

Parietal cells of the stomach

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22
Q

Treatment of Pernicious Anaemia

A

Intramuscular Hydroxocobalamin Injections

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23
Q

When Pernicious Anaemia, treat what first? B12 or Folate deficiency?

A

B12 first as treating low folate first can cause subacute combined degeneration of the Spinal Cord

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24
Q

**What are 2 types of Autoimmune Haemolytic Anaemia?

3 key buzzwords for warm?

A

Warm weather Great!

Warm Type IgG (SLE, antibody hemolytic anemia) (more common)

1.Coombs positive
2.Spherocytes
3.Anemia with jaundice

Cold Type IgM (AHA)

Cold weather miserable=(

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25
Q

Mgt of AIHA (4)

A

Blood Transfusions
Steds (1st line warm)
Rituximab
Splenectomy

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26
Q

Blood film findings Haemolysis (AIHA) (2)

A

Raised Reticulcytes
Schistocytes( heart valve buzzoword)

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27
Q

Inherited causes of haemolysis(5)

A

hereditary spherocytosis
hereditary elliptocytosis
thalassaemia
sickle cell anaemia
G6PD deficiency

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28
Q

Miscarriages + swollen leg- which disease

A

DVT

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29
Q

Leg circumference difference significant in DVT

A

> 3cm

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30
Q

Diagnostic test for leg DVT

A

ultrasound doppler

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31
Q

Underlying diagnosis /cause for DVT

A

antiphospholipid syndrome

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32
Q

Test for Underlying diagnosis for DVT

A

antiphospholipid antibodies

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33
Q

Treatment for DVT if not pregnant

A

DOAC (apixaban)

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34
Q

Treatment for DVT if pregnant (2)

A

LMWH

Aspirin

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35
Q

Condition that causes defect in Globin Chains

A

Thalassaemia

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36
Q

2 types of Thalassaemia

A

Alpha - Thalassaemia
Beta - Thalassaemia

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37
Q

Thalassaemia inheritance pattern

A

Autosomal Recessive

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38
Q

Thalassaemia findings when checking:

Abdomen
Sclera
Conjunctiva
FBC

A

Abdomen: Splenomegaly
Sclera: Jaundice
Conjunctiva: Pallor (Anaemia)
FBC: Microcytic Anaemia

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39
Q

Diagnostic test for Thalassaemia

A

Thalassaemia Electrophoresis

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40
Q

Management if required for Thalassaemia (2)

A

Blood Transfusions
Splenectomy

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41
Q

Why monitor Ferrin serum ferritin for Thalassaemia

A

Risk of Iron overload
- give desferoxamine

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42
Q

Potential cure Thalassaemia

A

Bone Marrow Transplant

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43
Q

Black Man- chest pain , cough , infiltrates on chest xray- which disease

A

sickle cell anemia

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44
Q

sickle cell Anemia inheritance pattern

A

autosomal recessive

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45
Q

Name for 1 gene copy in Sickle Cell Anemia

A

Sickle Cell trait

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46
Q

Antibiotic prophylaxis in children with Sickle Cell Anemia

A

Penicillin V

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47
Q

Meds to stimulate HbF production

A

hydroxycarbamide

sickle cell

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48
Q

Cure for Sickle Cell Anemia

A

Bone Marrow Transplant

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49
Q

Acute diagnosis for Sickle Cell Anemia

A

Acute chest syndrome

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50
Q

3 other types of crisis ref Sickle Cell Anemia

A

Vaso occlusive crisis
splenic sequestration crisis
aplastic crisis

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51
Q

male 20-40 . enlarged, ‘‘rubbery’’ non tender lymph nodes. Painful with booze. which disease?

A

Hodgkin’s Lymphoma

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52
Q

B symptoms of Hodgkin’s Lymphoma (3)

A

Night sweats
Fever
Weight loss

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53
Q

Associated virus of Hodgkin’s Lymphoma (2)

A

HIV
epstein barr virus

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54
Q

Diagnostic test for Hodgkin’s Lymphoma

A

Lymph node biopsy

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55
Q

Cell on histology for Hodgkin’s Lymphoma

A

Reed-sternberg Cell

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56
Q

Staging system for Hodgkin’s Lymphoma

A

Ann Arbor

57
Q

Treatment for Hodgkin’s Lymphoma (2)

A

Chemo

Radiotherapy

58
Q

Type of Lymphoma associated with:

Epstein-Barr Virus
H.Pylori in stomach
Rapidly growing painless mass

A

Epstein-Barr Virus = Burkitts Lymphoma

H.Pylori in stomach= Malt Lymphoma

Rapidly growing painless mass= Diffuse Large B cell Lymphoma

59
Q

Male 50-75, itching, bruising, excessing sweating, Very high Hb (208 g/L)

Ruddy complexion
Conjunctival Plethora
Splenogmealy

Which disease

A

Polycythemia vera

60
Q

What is the primary cell line that proliferates in Polycythemia Vera?

A

Erythroid lineage, leading to an abnormal increase in red blood cell production in the bone marrow.

61
Q

key gene mutation for Polycythemia vera

A

JAK2

62
Q

Diagnostic test for Polycythemia vera

A

Bone marrow biopsy

63
Q

Key complication with Polycythemia vera

A

Thrombosis

64
Q

Mgt of Polycythemia vera (3)

A

VAC

Venesection
Aspirin
Chemotherapy

65
Q

2 important myeloproliferative disorders?

A

Primary myeloproliferative (PMF)

Essential thrombocythemia (ET)

{ET= CALR}

66
Q

Potential malignant transformation of Polycythemia vera

A

Acute myeloid leukaemia

67
Q

Over 65, vague weight loss, tiredness and bone pain- disease?

A

multiple myeloma

68
Q

Key features of multiple myeloma

A

CRAB

C- High Calcium
R- Renal Failure
A- Anaemia
B- Bone lesions/pain

69
Q

Specific initial lab tests for multiple myeloma (3)

A

serum protein electrophoresis (SPEP)

Serum free light chain assay

Urine Bence- Jones Protein

70
Q

Test to confirm multiple myeloma

A

Bone Marrow Biopsy

71
Q

Description of skull on xray in multiple myeloma

A

Raindrop Skull

72
Q

First line Chemo for multiple myeloma (3)

A

Bortezomid
Thalidomide
Dexamethasone

73
Q

50 yr old woman, 2 weeks bruising + nose bleeds+ purple spots on shins+ low platelet count

Which disease?

A

Immune Thrombocytopenic Purpura

74
Q

Treatments for
Immune Thrombocytopenic Purpura (4)

A

Steroids(pred, 1st line)
IV Immunogloblins
Rituximab
Splenectomy

75
Q

Normal platelet count range

A

150-450 x 10^9/L

76
Q

Cause of low platelets associated with:

Vitamin deficiency?

Lifestyle?

Drug induced antibodies?

Deficiency of ADAMTS13?

A

Vitamin deficiency= B12 or folate

Lifestyle= Alcohol

Drug induced antibodies= Heparin induced thrombocytopenia

Deficiency of ADAMTS13= Thrombotic Thrombocytopenic Purpura (TTP= Adults)

77
Q

75 yr old

fatigue

pallor

abnormal bruising

auer rods+ myeloblasts detected

Which disease

A

Acute Myeloid Leukaemia

Buzz words:

Myeloblasts
auer rods

78
Q

4 types of high yield Leukaemia

A

Acute lymphoblastic Leukaemia (ALL)
Chronic myeloid Leukaemia (CML)
Chronic Lymphocytic Leukaemia (CLL)
Acute Myeloid Leukemia (AML)

79
Q

Cause of bruising in Acute Myeloid Leukaemia

A

Thrombocytopenia

80
Q

Definitive diagnostic test for Acute Myeloid Leukaemia

A

Bone marrow biopsy

81
Q

Types of disease associated with:

Philadelphia Chromosome?

Smudge cells?

Myelofibrosis?

Richter’s Transformation?

A

Philadelphia Chromosome: CML

Smudge cells: CLL

Myelofibrosis: AML

Richter’s Transformation: CLL

82
Q

Main treatments for Acute Myeloid Leukaemia

A

Chemotherapy

Steroids

83
Q

Cause of High uric acid in Acute Myeloid Leukaemia-

i.e. treating AML (Chemo) makes this happen.

A

Tumour lysis syndrome

84
Q

28 yr old, heavy periods, nosebleeds, mother had hysterectomy at 40

Diagnosis?

A

von willebrand disease

85
Q

4 causes of abnormal /prolonged bleeding in general

A

Disseminated intravascular coagulopathy (DIC)

Haemophilia A and B

Thrombocytopenia

von willebrand disease

86
Q

In von willebrand disease, what is defective glycoprotein?

A

Von willebrand factor

87
Q

Treatments for von willebrand disease (3)

A

Desmopressin
Von willebrand factor infusion
Factor VIII infusion (with VWF)

88
Q

Haemophilia A or B, X-linked or Y-linked?

A

X-linked

89
Q

Underlying pathology in Haemophilia A and B

A

Haemophilia A= No Factor VIII

Haemophilia B= No Factor IX

90
Q

PV- what is increased?

A

RBC

91
Q

ET- What is increased?

A

Platelets

92
Q

CML (rare in children) What is increased?

A

Neutrophils

93
Q

CML (Chronic Myeloid Leukemia), what is the translocation?

A

t(9;22) translocation resulting in the BCR-ABL fusion gene.

philadelphia chromosome

94
Q

CML- WBC low or high?

A

High

95
Q

CNL (Chronic Neutrophilic Leukemia):

What is elevated?

A

Neutrophilia: Persistent mature neutrophil elevation.

No Genetic Mutation

96
Q

CEL (Chronic Eosinophilic Leukemia):

What is elevated and which gene is mutated?

A

Eosinophilia: Elevated eosinophil count in blood.

FIP1L1-PDGFRA Fusion Gene: Commonly associated mutation.

97
Q

PV (Polycythemia Vera):

What is mutation?

What happens to RBC’s?

What does PV morph into

A

JAK2 Mutation

Elevated Hematocrit: Increased red blood cell mass.

AML

98
Q

PMF (Primary Myelofibrosis): Common clinical feature (2)

A

Anemia and Splenomegaly

99
Q

ET (Essential Thrombocythemia): What is high?

What are 2 mutations?

A

Thrombocytosis: Persistently high platelet count.

JAK2 / CALR

100
Q

Mastocytosis:

What is raised?

What is mutated?

A

Mast cells in organ

KIT Mutation: Often associated with D816V mutation in the KIT gene.

101
Q

Coomb’s test positive shows (2)?

A

AIHA
Infection

Basically whenever there is immune cells involved.

102
Q

TACO (3)

A

Hypertension, raised JVP, afebrile

103
Q

TRALI (3)

A

Hypotension, pyrexia, normal/unchanged JVP

104
Q

Warm autoimmune hemolytic anemia (AIHA), 3 key buzzwords would be:

A

Anemia with jaundice
Coombs positive
Spherocytes

105
Q

UNIVERSAL ACCEPTER Blood-

A

NISHANT = UNIVERSAL ACCEPTER AB +

ashwin+baa

106
Q

UNIVERSAL DONER

A

BHARAT= UNIVERSAL DONER O –

107
Q

Myelofibrosis

what buzzword

A

‘tear-drop’ poikilocytes

108
Q

Intravascular haemolysis

buzzword

A

schistocytes

109
Q

ALL (4) Robbie

A

Anemia
Thrombocytopenia
Neutropenia
High WBC

110
Q

ALL CeLLmates have CoMMon AMbitions:

A

(Under 5 and) 45+ - Acute Lymphoblastic Leukaemia ALL

55+ - Chronic Lymphocytic Leukaemia (CeLLmates)

65+ - Chronic Myeloid leukaemia (CoMmon)

75+ - Acute Myeloid leukaemia (AMbitions)

111
Q

Big drop in Hb for Sickle Cell patient? <16 y.o

A

Aplastic Crisis (<16 years old)

112
Q

Rouleaux formation is associated with ?

A

multiple myeloma

113
Q

splenectomy patients will have 2 vaccines…

A

pneumococcus

meningococcal

(Encapsulated)

114
Q

hemolytic anemia (4)

A

↑ LDH
↑ Billrubin
↑ Retic count
↓ Haptoglobin

115
Q

ITP in child key buzzword

A

petechiae and no fever

116
Q

you Play Tennis OUTside = xxx

you Play Table Tennis INside = yyy

A

you Play Tennis OUTside (PT = extrinsic)

you Play Table Tennis INside (aPTT = INtrinsic)

117
Q

MEP -

GMP –

A

MEP – megakaryocyte-erythroid progenitor (platelet/RBC)
GMP – Granulocyte-monocyte progenitor (Granulocytes/ Macrophages)

118
Q
A

Neutrophil
’Neutral’ pink granules
Acute inflammation

Eosinophil
Orange granules
Allergy, parasites

Basophils
Blue granules
IgE mediated reactions

119
Q

Where is blood made

A

Foetus – yolk sac (till week 10)

🡪 liver (starts week 6)

🡪 spleen (3rd to 7th month), marrow (starts week 16)

120
Q

Hyposplenism , which big disease GI

A

Coeliac disease

121
Q

Splenectomy-avoid what for how long after EBV infection

A

Avoid contact sport for 2 months after EBV infection (regardless of whether there’s splenomegaly or not)

122
Q

Iron Deficiency Anaemia, which 2 buzzword (writing)

A

Bloods: pencil poikilocytes

target cells

123
Q

in IDA, Transferrin (total iron binding capacity)
is high or low

A

high

124
Q

sickle cell, what type of mutation

A

point mutation

125
Q

Pancytopenia, peads disease

A

Fanconi’s anaemia

126
Q

ALL chemo helpful line

ROBBIE

A

Hickman line

127
Q

very high WCC, child

A

ALL

128
Q

CML treatment

A

Imatinib works as BCR-ABL1 gene produces tyrosine kinase

129
Q

raised lymphocytes,which cancer

A

Chronic lymphocytic leukaemia

Mature B cells

130
Q

LDH, found which disease

A

Non-Hodgkin’s lymphoma

131
Q
A

Keep going Divs

132
Q

When thinking of ET exclude what?

A

CML

133
Q

Really high platelets, think which 2 diseases

A

PV , ET

134
Q

MGUS (Monoclonal Gammopathy of Undetermined Significance)

Precursor to ?

A

Precursor to myeloma

135
Q

Amyloidosis, buzzword

A

CONGO RED. “APPLE-GREEN’ birefringence

amyloid deposition in myeloma and AA amyloidosis

136
Q

Secondary haemostasis, (2)

A

Tissue factor

Factor VII (7)

137
Q

Virchow’s triad –

A

stasis, endothelial damage, hypercoagulability

138
Q

DVT treatment , tayside

A

dalteparin (Fragmin) is first line in treating suspected DVT/PE

3 months provoked,

6 months unprovoked

6 weeks for isolated calf DVT

139
Q

Factor V Leiden mutation is a common hereditary cause of thrombophilia and is characterized by resistance to what?

A

activated protein C.

140
Q

Spherocytes =

A

hereditary spherocytosis / AI haemolytic anaemia

141
Q

You are a monster, keep going.

A

Champion.

Year 2 Divs (12 decks)

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