memorise Flashcards
Features of the following
ALL
CLL
AML
CML
ALL- blast cells proliferation of lymphoblasts (premature b lymphocytes)
CLL- smudge/smear cells, richters transformation to high grade lymphoma, warm autoimmune haemolytic anaemia, well differentiated b lymphocytes
CML- philidephia chromosome t9:22
AML- blast cells with auer rods associated with myeloproliferative disorders- polycythaemia ruby vera or myelofibrosis.
Blood films
Target cells
Tear Drop poikilocytes
Spherocytes
Basophillic stippling
Howel-jolly bodies
Heinz Bodies
Schistocytes
Pencil poikilocyytes
Burr cells
Acanthocytes
Target cells- sickle cell, IDA, Hyposplenism, Liver disease
Tear Drop poikilocytes- myelofibrosis
Spherocytes- hereditary spherocytosis, autoimmune haemolytic anaemia
Basophillic stipping- lead poisoning and thalassemia
Howel- jolly bodies- hyposplenism
Heinz Bodies- G6PD, alpha thalassemia
Schistocytes- Intravascular haemolysis, heart valve, DIC
Pencil pokilocytes- IDA
Burr cells- uraemia, pyruvate kinase deficiency
Warfarin reversal
blood test results in Haemophillia, VWD, and Vitamin K deficinecy, dic
dic- A typical blood picture includes:
↓ platelets
↓ fibrinogen
↑ PT & APTT
↑ fibrinogen degradation products
schistocytes due to microangiopathic haemolytic anaemia
Thalaseemia inheritence and features
autosomal recessive
B Minor (one abnormal gene)- mild hypochromic microcytic anaemia, the microcytosis is disproportionate to anemia, ie mcv way too low compared to anaemi. HbA2 is raised
Thalasemia intermedia- 2 defects more severe anaemia
Major- presents in the first year of life with failure to thrive and hepatosplenomegaly
microcytic anaemia
HbA2 & HbF raised
HbA absent
Alpha-
If 1 or 2 alpha globulin alleles are affected then the blood picture would be hypochromic and microcytic, but the Hb level would be typically normal
If are 3 alpha globulin alleles are affected results in a hypochromic microcytic anaemia with splenomegaly. This is known as Hb H disease
If all 4 alpha globulin alleles are affected (i.e. homozygote) then death in utero (hydrops fetalis, Bart’s hydrops)
Blood transfusion reactions
non haemolytic febrile reaction- Fever chills, stop the transfusion give paracetamol
Minor allergic reaction- pruritus, urticaria- stop and antihistamine
Anaphylaxis- hypotension wheezing angiodema- stop, IM adrenaline o2 and fluids
Acute haemolytic reaction eg wrong blood, Fever abdo pain hypotension, stop check all details repeat coombs test
Taco- fluid overload, pulmonary oedema and hypertension- stop IV loop diuretic and oxygen
TRALI0 hypoxia, chest pain hypotension- stop transfusion and give supportive care
what is ludwig’s angina
cellulitis that invades floor of the mouth and neck
neckswelling, dysphagia and fever
treated with airway management
and abx
describe a lymphoma
thyroid swelling
thyroglossal cyst
pharyngeal pouch
cystic hygroma
branchial cyst
cervical rib
carotid aneurysm
lymphoma - rubber painless lymphadenopathy, b symptoms and alcohol painful swallowing
Thyroid swelling- features of thyroid and moves up on swallowing
Thyroglossal cyst- moves up with protrusion of tongue
Pharyngeal pouch- dysphagia, in between cricopharyngeus and thyropharyngeus
Cystic hyogroma- congenital lesion found in neck left side
Branchial cyst- oval mobile mass betwen sternocleidomastoid and pharynx, transluminates
Cervical rib- neck mass associated with thoracic outlet syndrome
Carotid anneurysm- pulsatile lateral neck mass which does not move on swallowing
Mouth and gum conditions
Angiodema
candidasis
geographic tongue
strawberry tongue
black hairy tongue
Angiodema- fluid filled tissues in various aspects of the body- allergies, ACEi, hereditary
Oral candidasis- white spots coat the tongue and palate- miconazole gel and fluconozaole and nystatin
Geographic tongue areas of tongue lose papillae and epithelium- stress, psoriasis, atopy and diabetes
Strawberry tongue- kawasaki and scarlett fever
Black hairy tongue- shedding of keratin from tongues surface- dehydration, dry mouth, poor hygeine and smoking
What is leukoplakia
What is erythroplakia
What is lichen planus
what is gingivitis
what is gingival hyperplasia
apthous mouth ulcers
white patches in the mouth/cheeks precancerous condition and increases risk of squamous cell carcinoma - REFER
Erythroplakia- same as leukoplakia but red
What is lichen planus- autoimmune condition shiny, purplish, flat papules with white lines on the surface- wichams striae- good oral hyfgeine topical steroids
Gingivitis-inflammation of the gums- blood after brushing bad breath= refer to dentist, oral metronidazole, chlorhexidine and hydrogen peroxide mouth wash
Gingival Hyperplasia- abnomral growth on gums- gingivitis, pregnancy, scurvy, aml, ccb, phenytoin, ciclosporin
small painful, well punched out white appearence
IBD, coeliac, behcet, vitamin dificiency and hiv, usually heel on own but can use choline salcyclate
parotid and salivary gland tumours
parotid
most common is plemorphic adenoma- single lesion
second- warthins tumour usually bilateral
kids- haemangioma, kids who have a parotid mass go for this
parotid and salivary gland tumours
parotid
most common is plemorphic adenoma- single lesion
second- warthins tumour usually bilateral
kids- haemangioma, kids who have a parotid mass go for this
