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Hematology > Hematology causes > Flashcards

Hematology causes Flashcards

1
Q

Myelosuppression/agranulocytosis

A
  • Antivirals: Ganciclovir
  • Immunomodulators: Azathioprine
  • Antipsychotics: Atypical Antipsychotics (especially Clozapine)
  • Antiepileptics: Carbamazepine, Phenytoin
  • Antithyroid Drugs: Carbimazole, Propylthiouracil
  • Antibiotics: Co-trimoxazole
  • Cytotoxic Drugs: Methotrexate, Cyclophosphamide, Hydroxyurea
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2
Q

Drug-induced pancytopenia

A
  • Cytotoxics
  • Antibiotics: trimethoprim, sulphonamides, chloramphenicol
  • Anti-rheumatoid: gold, penicillamine
  • Anti thyroid: carbimazole: causes both agranulocytosis and pancytopenia
  • Anti-epileptics: carbamazepine, phenytoin
  • Anti diabetic: sulphonylureas: tolbutamide
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3
Q

Thrombocytopenia

A

Severe Thrombocytopenia:

  • Immune Thrombocytopenia (ITP),
  • Disseminated Intravascular Coagulation (DIC),
  • Thrombotic Thrombocytopenic Purpura (TTP),
  • Hematological Malignancy

Moderate Thrombocytopenia:

  • Heparin-Induced Thrombocytopenia (HIT),
  • Drug-Induced Thrombocytopenia
    • Heparin
    • Sulphonamides
    • Antibiotics (e.g. Rifampicin, Linezolid)
    • Anticonvulsants (e.g. Carbamazepine, Valproate)
  • Viral Infections (e.g., HIV, Hepatitis),
  • Systemic Lupus Erythematosus (SLE) / Antiphospholipid Syndrome,
  • Liver Disease, Hypersplenism
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4
Q

Anticoagulation medications used in HIT

A
  • argatroban (no renal adjustment)
  • bivalirudin
  • fondaparinux

Link

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5
Q

Causes of arterial and venous thrombosis

A
  • Paroxysmal nocturnal haemoglobinuria
  • Paradoxical emboli
  • Myeloproliferative disorders
  • Homocystinuria
  • Sickle cell anaemia

Link Link

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6
Q

Paraproteinaemia

A
  • Myeloma
  • Waldenstrom’s macroglobulinemia
  • Monoclonal gammopathy of uncertain significance (MGUS)
  • Benign monoclonal gammopathy
  • Amyloidosis
  • CLL, lymphoma
  • Heavy chain disease
  • POEMS
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7
Q

TTP

A
  • Post-infection e.g. urinary, gastrointestinal
  • Pregnancy
  • Drugs: ciclosporin, oral contraceptive pill, penicillin, acyclovir, clopidogrel
  • Tumours
  • SLE,
  • HIV
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8
Q

Drugs that cause thrombotic microangiopathy (TMA)

A
  • Quinine (present in tonic water)
  • Calcineurin inhibitors (i.e., cyclosporine and tacrolimus)
  • Gemcitabine
  • VEGF inhibitors (e.g., bevacizumab)
  • Trimethoprim-sulfamethoxazole (Bactrim),
  • Quetiapine
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9
Q

Increased risk of venous thromboembolism

A
  • Tamoxifen
  • Antipsychotics
  • Combined oral contraceptive pill
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10
Q

Massively enlarged spleen

A
  • Chronic myeloid leukemia
  • Myelofibrosis, primary or secondary to polycythemia vera or essential thrombocytosis
  • Gaucher disease
  • Lymphoma, usually indolent, including hairy cell leukemia
  • Kala-azar (visceral leishmaniasis)
  • Hyperreactive malarial splenomegaly syndrome, also called tropical splenomegaly syndrome
  • Beta thalassemia major or severe beta thalassemia intermedia

Link

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11
Q

Hepatosplenomegaly

A
  • Chronic liver disease with portal hypertension
  • Infections: glandular fever, malaria, hepatitis
  • Lymphoproliferative disorders
  • Myeloproliferative disorders e.g. CML
  • Amyloidosis
  • Hemophagocytic lymphohistiocytosis (HLH)
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12
Q

Hyposplenism

A
  • Splenectomy
  • Sickle-cell
  • Coeliac disease, dermatitis herpetiformis
  • Graves’ disease
  • SLE
  • Amyloid
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13
Q

Leucocyte alkaline phosphatase

A

Raised in:
* myelofibrosis,
* leukemoid reactions,
* polycythaemia rubra vera,
* infections, steroids,
* Cushing’s syndrome,
* pregnancy,
* oral contraceptive pill

Low in:
* chronic myeloid leukaemia,
* pernicious anaemia,
* paroxysmal nocturnal haemoglobinuria,
* infectious mononucleosis

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14
Q

Indolent lymphomas

A
  • Follicular lymphoma
  • MALT
  • CLL
  • Hairy cell leukemia
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15
Q

Aggressive lymphomas

A
  • Diffuse large B-cell lymphoma (DLBCL)
  • Mantle cell lymphoma
  • Hodgkin lymphoma
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16
Q

Factor deficiencies prolonging both PT & PTT

A
  • Factor II deficiency
  • Factor V deficiency
  • Factor X deficiency
17
Q

Factor deficiencies and conditions prolonging PTT only

A
  • Factor VIII Deficiency (Hemophilia A)
  • Factor IX Deficiency (Hemophilia B)
  • Factor XI Deficiency
  • Factor XII Deficiency
  • Heparin Therapy
  • Antiphospholipid Syndrome
  • Artifact (e.g., improper sample handling)
18
Q

Factor deficiency prolonging PT only

A
  • Factor VII deficiency
19
Q

DIC

A

Link

20
Q

Causes of hyperviscosity syndrome

A
  • Waldenström’s macroglobulinemia (WM)
  • Myeloma (immunoglobulin A (IgA) or IgM paraprotein)
  • Polycythaemia
  • Leukaemia (leucostasis)
21
Q

Tumor lysis syndrome

A
  • Burkitt’s lymphoma
  • ALL
  • AML
  • Diffuse large B-cell lymphoma

Link

Hematology (7 decks)

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