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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
****What are 2 types of Autoimmune Haemolytic Anaemia? 3 key buzzwords for warm?
Warm Type IgG (SLE, antibody hemolytic anemia) (more common) 1.Coombs positive 2.Spherocytes 3.Anemia with jaundice Warm weather *G*reat! ========= Cold Type IgM (AHA) Cold weather miserable=(
25
Mgt of AIHA (4)
Blood Transfusions Steds (1st line warm) Rituximab Splenectomy
26
Blood film findings Haemolysis (AIHA) (2)
Raised Reticulcytes Schistocytes( heart valve buzzoword)
27
Inherited causes of haemolysis(5)
hereditary spherocytosis hereditary elliptocytosis thalassaemia sickle cell anaemia G6PD deficiency
28
Miscarriages + swollen leg- which disease
DVT
29
Leg circumference difference significant in DVT
>3cm
30
Diagnostic test for leg DVT
ultrasound doppler
31
Underlying diagnosis /cause for DVT
antiphospholipid syndrome
32
Test for Underlying diagnosis for DVT
antiphospholipid antibodies
33
Treatment for DVT if not pregnant
DOAC (apixaban)
34
Treatment for DVT if pregnant (2)
LMWH Aspirin
35
Condition that causes defect in Globin Chains
Thalassaemia
36
2 types of Thalassaemia
Alpha - Thalassaemia Beta - Thalassaemia
37
Thalassaemia inheritance pattern
Autosomal Recessive
38
Thalassaemia findings when checking: Abdomen Sclera Conjunctiva FBC
Abdomen: Splenomegaly Sclera: Jaundice Conjunctiva: Pallor (Anaemia) FBC: Microcytic Anaemia
39
Diagnostic test for Thalassaemia
Thalassaemia Electrophoresis
40
Management if required for Thalassaemia (2)
Blood Transfusions Splenectomy
41
Why monitor Ferrin serum ferritin for Thalassaemia
Risk of Iron overload - give desferoxamine
42
Potential cure Thalassaemia
Bone Marrow Transplant
43
Black Man- chest pain , cough , infiltrates on chest xray- which disease
sickle cell anemia
44
sickle cell Anemia inheritance pattern
autosomal recessive
45
Name for 1 gene copy in Sickle Cell Anemia
Sickle Cell trait
46
Antibiotic prophylaxis in children with Sickle Cell Anemia
Penicillin V
47
Meds to stimulate HbF production
hydroxycarbamide sickle cell
48
Cure for Sickle Cell Anemia
Bone Marrow Transplant
49
Acute diagnosis for Sickle Cell Anemia
Acute chest syndrome
50
3 other types of crisis ref Sickle Cell Anemia
Vaso occlusive crisis splenic sequestration crisis aplastic crisis
51
male 20-40 . enlarged, ''rubbery'' non tender lymph nodes. Painful with booze. which disease?
Hodgkin's Lymphoma
52
B symptoms of Hodgkin's Lymphoma (3)
Night sweats Fever Weight loss
53
Associated virus of Hodgkin's Lymphoma (2)
HIV epstein barr virus
54
Diagnostic test for Hodgkin's Lymphoma
Lymph node biopsy
55
Cell on histology for Hodgkin's Lymphoma
Reed-sternberg Cell
56
Staging system for Hodgkin's Lymphoma
Ann Arbor
57
Treatment for Hodgkin's Lymphoma (2)
Chemo Radiotherapy
58
Type of Lymphoma associated with: Epstein-Barr Virus H.Pylori in stomach Rapidly growing painless mass
****Epstein-**B**arr Virus = **B**urkitts Lymphoma **H**.**P**ylori in stomach= Malt Lym**p****h**oma Rapidly growing painless mass= Diffuse Large B cell Lymphoma
59
Male 50-75, itching, bruising, excessing sweating, Very high Hb (208 g/L) Ruddy complexion Conjunctival Plethora Splenogmealy Which disease
Polycythemia vera
60
What is the primary cell line that proliferates in Polycythemia Vera?
Erythroid lineage, leading to an abnormal increase in red blood cell production in the bone marrow.
61
key gene mutation for Polycythemia vera
JAK2
62
Diagnostic test for Polycythemia vera
Bone marrow biopsy
63
Key complication with Polycythemia vera
Thrombosis
64
Mgt of Polycythemia vera (3)
**VAC** Venesection Aspirin Chemotherapy
65
2 important myeloproliferative disorders?
Primary myeloproliferative (PMF) Essential thrombocythemia (ET) {ET= CALR}
66
Potential malignant transformation of Polycythemia vera
Acute myeloid leukaemia
67
Over 65, vague weight loss, tiredness and bone pain- disease?
multiple myeloma
68
Key features of multiple myeloma
CRAB C- High Calcium R- Renal Failure A- Anaemia B- Bone lesions/pain
69
Specific initial lab tests for multiple myeloma (3)
serum protein electrophoresis (SPEP) Serum free light chain assay Urine Bence- Jones Protein
70
Test to confirm multiple myeloma
Bone Marrow Biopsy
71
Description of skull on xray in multiple myeloma
Raindrop Skull
72
First line Chemo for multiple myeloma (3)
Bortezomid Thalidomide Dexamethasone
73
50 yr old woman, 2 weeks bruising + nose bleeds+ purple spots on shins+ low platelet count Which disease?
Immune Thrombocytopenic Purpura
74
Treatments for Immune Thrombocytopenic Purpura (4)
Steroids(pred, 1st line) IV Immunogloblins Rituximab Splenectomy
75
Normal platelet count range
150-450 x 10^9/L
76
Cause of low platelets associated with: Vitamin deficiency? Lifestyle? Drug induced antibodies? Deficiency of ADAMTS13?
Vitamin deficiency= B12 or folate Lifestyle= Alcohol Drug induced antibodies= Heparin induced thrombocytopenia Deficiency of ADAMTS13= Thrombotic Thrombocytopenic Purpura (TTP= Adults)
77
75 yr old fatigue pallor abnormal bruising auer rods+ myeloblasts detected Which disease
Acute Myeloid Leukaemia Buzz words: Myeloblasts auer rods
78
4 types of high yield Leukaemia
Acute lymphoblastic Leukaemia (ALL) Chronic myeloid Leukaemia (CML) Chronic Lymphocytic Leukaemia (CLL) Acute Myeloid Leukemia (AML)
79
Cause of bruising in Acute Myeloid Leukaemia
Thrombocytopenia
80
Definitive diagnostic test for Acute Myeloid Leukaemia
Bone marrow biopsy
81
Types of disease associated with: Philadelphia Chromosome? Smudge cells? Myelofibrosis? Richter's Transformation?
Philadelphia Chromosome: CML Smudge cells: CLL Myelofibrosis: AML Richter's Transformation: CLL
82
Main treatments for Acute Myeloid Leukaemia
Chemotherapy Steroids
83
Cause of High uric acid in Acute Myeloid Leukaemia- i.e. treating AML (Chemo) makes this happen.
Tumour lysis syndrome
84
28 yr old, heavy periods, nosebleeds, mother had hysterectomy at 40 Diagnosis?
von willebrand disease
85
4 causes of abnormal /prolonged bleeding in general
Disseminated intravascular coagulopathy (DIC) Haemophilia A and B Thrombocytopenia von willebrand disease
86
In von willebrand disease, what is defective glycoprotein?
Von willebrand factor
87
Treatments for von willebrand disease (3)
Desmopressin Von willebrand factor infusion Factor VIII infusion (with VWF)
88
Haemophilia A or B, X-linked or Y-linked?
X-linked
89
Underlying pathology in Haemophilia A and B
Haemophilia A= No Factor VIII Haemophilia B= No Factor IX
90
PV- what is increased?
RBC
91
ET- What is increased?
Platelets
92
CML (rare in children) What is increased?
Neutrophils
93
CML (Chronic Myeloid Leukemia), what is the translocation?
t(9;22) translocation resulting in the BCR-ABL fusion gene. philadelphia chromosome
94
CML- WBC low or high?
High
95
CNL (Chronic Neutrophilic Leukemia): What is elevated?
Neutrophilia: Persistent mature neutrophil elevation. No Genetic Mutation
96
CEL (Chronic Eosinophilic Leukemia): What is elevated and which gene is mutated?
Eosinophilia: Elevated eosinophil count in blood. FIP1L1-PDGFRA Fusion Gene: Commonly associated mutation.
97
PV (Polycythemia Vera): What is mutation? What happens to RBC's? What does PV morph into
JAK2 Mutation Elevated Hematocrit: Increased red blood cell mass. AML
98
PMF (Primary Myelofibrosis): Common clinical feature (2)
Anemia and Splenomegaly
99
ET (Essential Thrombocythemia): What is high? What are 2 mutations?
Thrombocytosis: Persistently high platelet count. JAK2 / CALR
100
Mastocytosis: What is raised? What is mutated?
Mast cells in organ KIT Mutation: Often associated with D816V mutation in the KIT gene.
101
Coomb's test positive shows (2)?
AIHA Infection Basically whenever there is immune cells involved.
102
TACO (3)
Hypertension, raised JVP, afebrile
103
TRALI (3)
Hypotension, pyrexia, normal/unchanged JVP
104
Warm autoimmune hemolytic anemia (AIHA), 3 key buzzwords would be:
Anemia with jaundice Coombs positive Spherocytes
105
UNIVERSAL ACCEPTER Blood-
NISHANT = UNIVERSAL ACCEPTER AB + ashwin+baa
106
UNIVERSAL DONER
BHARAT= UNIVERSAL DONER O –
107
Myelofibrosis what buzzword
'tear-drop' poikilocytes
108
Intravascular haemolysis buzzword
schistocytes
109
ALL (4) Robbie
Anemia Thrombocytopenia Neutropenia High WBC
110
ALL CeLLmates have CoMMon AMbitions:
(Under 5 and) 45+ - **A**cute **L**ymphoblastic Leukaemia **A**LL 55+ - **C**hronic **L**ymphocytic **L**eukaemia (CeLLmates) 65+ - **C**hronic **M**yeloid leukaemia (CoMmon) 75+ - **A**cute **M**yeloid leukaemia (AMbitions)
111
Big drop in Hb for Sickle Cell patient? <16 y.o
Aplastic Crisis (<16 years old)
112
Rouleaux formation is associated with ?
multiple myeloma
113
splenectomy patients will have 2 vaccines...
pneumococcus meningococcal (Encapsulated)
114
hemolytic anemia (4)
↑ LDH ↑ Billrubin ↑ Retic count ↓ Haptoglobin
115
ITP in child key buzzword
petechiae and no fever
116
you Play Tennis OUTside = xxx you Play Table Tennis INside = yyy
you Play Tennis OUTside (PT = extrinsic) you Play Table Tennis INside (aPTT = INtrinsic)
117
MEP - GMP –
MEP – megakaryocyte-erythroid progenitor (platelet/RBC) GMP – Granulocyte-monocyte progenitor (Granulocytes/ Macrophages)
118
Neutrophil ’Neutral’ pink granules Acute inflammation Eosinophil Orange granules Allergy, parasites Basophils Blue granules IgE mediated reactions
119
Where is blood made
Foetus – yolk sac (till week 10) 🡪 liver (starts week 6) 🡪 spleen (3rd to 7th month), marrow (starts week 16)
120
Hyposplenism , which big disease GI
Coeliac disease
121
Splenectomy-avoid what for how long after EBV infection
Avoid contact sport for 2 months after EBV infection (regardless of whether there’s splenomegaly or not)
122
Iron Deficiency Anaemia, which 2 buzzword (writing)
Bloods: pencil poikilocytes target cells
123
in IDA, Transferrin (total iron binding capacity) is high or low
high
124
sickle cell, what type of mutation
point mutation
125
Pancytopenia, peads disease
Fanconi’s anaemia
126
ALL chemo helpful line ROBBIE
Hickman line
127
very high WCC, child
ALL
128
CML treatment
Imatinib works as BCR-ABL1 gene produces tyrosine kinase
129
raised lymphocytes,which cancer
Chronic lymphocytic leukaemia Mature B cells
130
LDH, found which disease
Non-Hodgkin’s lymphoma
131
Keep going Divs
132
When thinking of ET exclude what?
CML
133
Really high platelets, think which 2 diseases
PV , ET
134
MGUS (Monoclonal Gammopathy of Undetermined Significance) Precursor to ?
Precursor to myeloma
135
Amyloidosis, buzzword
CONGO RED. “APPLE-GREEN’ birefringence amyloid deposition in myeloma and AA amyloidosis
136
Secondary haemostasis, (2)
Tissue factor Factor VII (7)
137
Virchow’s triad –
stasis, endothelial damage, hypercoagulability
138
DVT treatment , tayside
dalteparin (Fragmin) is first line in treating suspected DVT/PE 3 months provoked, 6 months unprovoked 6 weeks for isolated calf DVT
139
Factor V Leiden mutation is a common hereditary cause of thrombophilia and is characterized by resistance to what?
activated protein C.
140
Spherocytes =
hereditary spherocytosis / AI haemolytic anaemia
141
You are a monster, keep going.
Champion.

Year 2 Divs (12 decks)

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