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Haematology > Infection in Haematological Malignancy > Flashcards

Infection in Haematological Malignancy Flashcards

1
Q

Neutrophils

A

Bacterial and fungal infection

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2
Q

Monocytes

A

Fungal infection

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3
Q

Eosinophils

A

Parasitic infections

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4
Q

T lymphocytes

A

Fungal and viral infection, PJP

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5
Q

B lymphocytes

A

Bacterial infection

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6
Q

Supportive measures aimed at reducing risk of sepsis in haematological malignancy

A 
Prophylaxis
Growth factors e.g. G-CSF
Stem cell rescue/transplant
Protective environment 
Intravenous immunoglobulin replacement
Vaccination
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7
Q

What is the cause of neutropenia in haematological malignancy?

A

Marrow failure is higher risk than immune destruction

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8
Q

What is significant risk/high risk of neutropenia?

A

<0.5 x 10^9/l - significant

<0.2 x 10^9/l - high

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9
Q

What duration of neutropenia classes as high risk?

A

> 7 days

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10
Q

Additional risk factors for infection

A

Disrupted skin/mucosa
Altered flora/antibiotic resistance
Lymphopenia
Monocytopenia

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11
Q

Causes of disrupted skin/mucosal surfaces

A

Hickman line, venflons
Mucositis affecting GI tract
GVHD

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12
Q

GVHD

A

Graft versus host disease

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13
Q

Causes of altered flora/antibiotic resistance

A

Prophylactic antibiotics

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14
Q

Causes of lymphopenia

A

Disease process e.g. Lymphoma
Treatment eg Fludarabine, ATG
Stem cell transplantation, GVHD

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15
Q

Causes of monocytopenia

A

Hairy cell leukaemia

Chemotherapy

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16
Q

Febrile neutropenia bacterial causes

A

60-70% gram positive bacteria

30-40% gram negative bacteria

17
Q

Gram positive bacteria

A

Staphylococci

Streptococci

18
Q

Gram negative bacteria

A

Escherichia coli
Klebsiella spp
Pseudomonas aeruginosa

19
Q

Fungal infection in immunocompromised patients

A

Candida spp

Monocytopenia and monocyte dysfunction contributes to risk of fungal infection

20
Q

Presentation of neutropenic sepsis

A 
Fever with no localising signs
Rigors
Chest infection/ pneumonia
Skin sepsis
Urinary tract infection
Septic shock
21
Q

Sepsis six

A 
3 out =>
Blood cultures
Urine output
Lactate
3 in =>
IV antibiotics
IV fluids
Oxygen
22
Q

Infection in severely lymphopenic patients

A 
Atypical pneumonia
   -PJP
   -CMV
   -RSV
Viral
   -Shingles
   -Mouth ulcers (Herpes simplex)
   -Adenovirus
   -EBV
23
Q

PJP

A

Pneumocystis Jirovecii

24
Q

CMV

A

Cytomegalovirus

25
Q

RSV

A

Respiratory syncytial virus

Haematology (18 decks)

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