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Year 4 > Interpreting haematology data and haem seminar 2 > Flashcards

Interpreting haematology data and haem seminar 2 Flashcards

1
Q

What is the haematocrit?

A

% of RBC’s in the blood

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2
Q

What is serum ferritin?

A

Directly related to the amount of iron stored in your body

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3
Q

What is transferrin?

A

A blood plasma glycoprotein that plays a central role in iron metabolism and is responsible for ferric-ion deliver

It indicates the amount of iron in the body

High transferrin signifies low iron, meaning there is less iron bound to transferrin

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4
Q

What is TIBC?

A

Total iron-binding capacity (TIBC)

Measures the blood’s ability to attach itself to iron and transport it around the body

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5
Q

What is TF saturation?

A

Transferrin saturation (TF)

Shows how much iron in the blood is bound to transferrin

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6
Q

What is red cell folate?

A

Folate is an important nutrient for growth, development, and the correct function of your red blood cell and nerve tissues

Low folate can prevent RBC’s from developing normally and can cause nerve damage

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7
Q

What is the INR?

A

The INR is found using the results of the prothrombin time (PT) test

Measures the time it takes for your blood to clot

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8
Q

What is the prothrombin time?

A

Measures extrinsic pathway

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9
Q

What is the APTT?

A

Activated partial thromboplastin clotting time

Measures intrinsic pathway

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10
Q

hat causes a megaloblastic anaemia?

A

B12 or folate deficiency

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11
Q

In which disease are Howell-Jolly bodies found?

A

Sickle cell anaemia

They’re DNA-containing inclusions found after erythrocyte maturation

Indicated hyposplenism, but often found in infants

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12
Q

What is Hereditary haemochromatosis?

A

A genetic disorder that causes your body to absorb too much iron

Excess iron is stored in your organs, especially your liver, heart and pancreas.

Too much iron can lead to life-threatening conditions, such as liver disease, heart problems and diabetes and testicular failure

Treatment: regular venesection and monitoring

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13
Q

What is anaemia of chronic disease?

A

A type of anaemia that affects people who have conditions that cause inflammation, such as infections, autoimmune diseases, cancer link, and chronic kidney disease (CKD)

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14
Q

What is haemophilia B?

A

Factor 9 deficiency

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15
Q

What is Polycythemia rubra vera?

A

A type of blood cancer that causes your bone marrow to make too many RBC’s

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16
Q

What is pancytopaenia?

A

Having low levels of all three blood cell types: RBC’s, WBC’s, and platelets

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17
Q

What are some symptoms of pancytopaenia?

A

Tiredness (anaemia)
Infection (Neutropoenia)
Bleeding/bruising (thrombocytopaenia)

18
Q

What are the 2 different types of bone marrow biopsy?

A
  • Aspirate (marrow smears for haematologists)
  • Trephine (tissue sections for pathologists)
19
Q

What’s in the bone marrow?

A
  • Erythoid cells (erythropoiesis)
  • Myeloid cells (myelopoiesis)
  • Megakaryocytes (thrombopoiesis)
20
Q

What is leukaemia?

A

Uncontrolled proliferation of primitive cells in the bone marrow

Causes bone marrow failure, anaemia, Infections, and bleeding

Blasts identified on blood film

21
Q

What is Acute myeloid leukaemia?

A
  • Mostly older adults (>60 yrs)
  • Patients present with pancytopenia or sometimes leucocytosis if high WCC
  • Diagnosed by presence of blasts in the blood, confirmed by bone marrow biopsy:
    Morphology, Immunophenotyping, Cytogenetics analysis (determines prognosis), Molecular analysis (FLT3, NPM1, DNMT3A)
  • Overall cure rate <30%, (approx. 10% if over 60 years)
  • Prognosis depends on cytogenetics and gene mutations

-Treatment with intensive chemotherapy (DA 3+10 regime)
- Allogeneic stem cell transplants is potentially curative

22
Q

What is Acute lymphoid leukaemia?

A
  • Commonest childhood cancer (<10yrs)
  • Cure rate >90%
  • Presents with failure to thrive, lymphadenopathy, anaemia, and lymphocytosis with blasts on blood film

Can be B-cell (more common, better prognosis) or T-cell (usually associated with mediastinal mass due to lymph nodes)

Diagnosis by BM biopsy, flow cytometry, cytogenetics, molecular analysis, and CT scan

  • Treatment with chemotherapy for 2 years
  • Stem cell transplant can be curative
  • Survivors often have long-term problems: Infertility, endocrine, psychological, secondary cancers
23
Q

What is lymphocytosis?

A

An increased number of lymphocytes

24
Q

What is the treatment for neutropenic sepsis?

A

1st line – Tazocin (Piperacillin/Tazobactam) +/- Gentamicin

2nd line – Switch to Meropenem +/- Teicoplanin (for Gram +ve)

3rd line – Add anti-fungal e.g. Ambisome (Amphotericin)

25
Q

What is chronic myeloid leukaemia?

A

High mature WCC (neutrophils, basophils) and massive splenomegaly

Caused by Philadelphia chromosome (causing abnormal BCR-ABL gene) 90% of cases

Treat with Imatinib which inhibits function of BCR-ABL

26
Q

What is Myelodysplasia?

A
  • When immature blood cells in the bone marrow do not mature or become healthy blood cells
  • Can transform into AML

Characterised by ineffective haematopoiesis, anaemia, neutropenia, thrombocytopenia

Treat with Azacytidine (elderly) or curative allografting (young)

27
Q

What is Myelofibrosis?

A

Fibrosis of the bone marrow causing pancytopenia
Eventually transforms into AML

Treat with hydroxycarbamide or JAK inhibitors or allografting

28
Q

What causes excess myelopoiesis in bone marrow?

A

Typically carry JAK2 V617F mutation

Risk of thrombotic events and Splenomegaly

29
Q

What is Essential thrombocythemia?

A

High platelet count

Treat with hydroxycarbamide and aspirin

30
Q

What is the CRAB acronym for?

A

It summarizes the most typical clinical manifestations of multiple myeloma

C = Calcium (goes too high)
R = Renal (kidney problems)
A = Anaemia (low haemoglobin)
B = Bones (holes and fractures)

31
Q

What is a paraprotein?

A

Monoclonal immune globulin fragments or intact immune globulins produced by usually a malignant cone of plasma cells or B cells

Useful for diagnosis and monitoring the disease

32
Q

What is the ‘freelite’ test?

A

Detects “Bence Jones protein” in serum

Proteins that show up in the urine in many people with multiple myeloma

33
Q

What are the different grades of lymphoma?

A

High grade = Burkitt’s, diffuse large B cell (DLBCL), mantle cell lymphoma
- Need urgent intensive chemotherapy, Burkitt’s and DLBCL potentially curable

Low grade = follicular, splenic marginal zone, hairy cell, Waldenstrom’s
- Usually watch and wait management, treat for symptoms or progression

34
Q

What are the stages of lymphoma?

A

I = single lymph node
II = 2 or more, same side of diaphragm
III = disease both sides of diaphragm
IV = extranodal disease (liver, spleen, bone marrow)

35
Q

What is Chronic lymphocytic luekaemia?

A

Type of lymphoproliferative disorder

If p53 wild-type:
- First line treatment with chemo-immunotherapy regime FCR
Eg. Fludarabine, cyclophosphamide, rituximab (anti-CD20 monoclonal Ab)

If p53 mutated or deleted, or progression:
- Use targeted therapy
Eg. Ibrutinib (oral BTK inhibitor) Or venetoclax (BCL2 inhibitor) Or idelalisib (PI3K inhibitor)

36
Q

What is ITP?

A

Immune thrombocytopenic purpura (ITP)

A blood disorder characterized by a decrease in the number of platelets in the blood

37
Q

What is AIHA?

A

Autoimmune haemolytic anaemia

Symptoms: Pallor, jaundice, dark urine

Management:
- Transfuse as required (but difficulty cross-matching)
- Warm AIHA – treat with steroids, splenectomy, Rituximab
- Cold CHAD – treat with immunosuppression

38
Q

What are the causes of splenomegaly?

A

Haematological causes:
- Myelofibrosis, CML, PRV, ET
- Hairy cell leukaemia, lymphomas
- Thalassaemia major

Infective causes:
- EBV, CMV, HIV
- Tropical: (malaria, schistosomiasis)

  • Portal hypertension due to liver disease
  • Rheumatoid arthritis (Felty’s syndrome)
39
Q

What is Hairy cell leukaemia?

A

A rare type of leukaemia that gets worse slowly or does not get worse at all

Called hairy cell leukaemia because the leukaemia cells look “hairy” when viewed under a microscope

40
Q

How is DIC treated?

A

FFP and cryoprecipitate, platelets and treat underlying cause

Year 4 (100 decks)

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