New Haem Flashcards
What is Hereditary haemorrhagic telangiectasia
Hereditary haemorrhagic telangiectasia (Osler–Weber–Rendu syndrome)
- autosomal dominant condition
- telangiectasia on the and mucous membranes, leading to epistaxis and GI bleeds
What are Howell-Jolly bodies?
Nuclear DNA remnants
found in circulating erythrocytes
What occurs to Howell-Jolly bodies normally?
erythrocytes expel nuclear DNA during maturation process within bone marrow;
the few erythrocytes containing Howell–Jolly bodies are removed by the spleen.
Common causes of Howell–Jolly bodies include
splenectomy secondary to trauma and autosplenectomy resulting from
sickle cell disease.
When would you see Howell Jolly bodies?
If there is NO SPLEEN to remove them!!
so in splenectomy (from trauma) or autosplenectomy from sickle cell disease
describe the rash in GvHD
maculopapular rash
what are symptoms of TRALI
dry cough
dyspnoea
fever
what does essential thrombocytosis present as?
DYSFUNCTIONAL thrombosis / bleeding
what are target cells
RBC - central dense area, ring of pallor
what are causes for target cells
hepatic pathology
hyposplenism
haemoglobinopathies
describe the fever in hodgkin’s lymphoma
Fever >38
PEL-EBSTEIN FEVER = cyclical, every 1-2 weeks
explain what roleaux look like and why they occur
aggregation (stacking) of RBC
Occur in:
- infections
- inflammation: Waldenström’s macroglobulinemia, inflammatory and connective tissue disorders
- malignancy: multiple myeloma, cancers
How long should you give warfarin therapy in provoked vs unprovoked VTE
provoked: 3m
unprovoked: 6months
what is the drug cocktail for Multiple myeloma patients who are unsuitable for stem cell transplant?
MPT: melphalan, prednisolone, thalidomide
what is the drug cocktail for Multiple myeloma patients who ARE suitable for stem cell transplant?
Induction therapy with non-chemotherapeutic: Bortezomib, Thalidomide, and Dexamethasone
OR chemotherapeutic: Vincristine, Doxorubicin, and Dexamethasone
what is an indirect indicator of the rate of proliferation of hodgkin’s lymphoma, and therefore a poor prognostic factor?
Raised LDH
what is trusseau’s syndrome
aka thombophlebitis migrans
this is vessel inflammation that occurs with pancreatic cancer
How do you approach investigating a pt with possible PE/DVT
Wells score!
if 2 or more > CTPA/VQ / USS
if 1 or less > D dimer
what does NICE recommend you do in a person >60 with IDA and no explanation for it?
SUSPECTED CANCER PATHWAY - 2 week wait - for possible GI cancer
In a patient on warfarin with heavy bleeding, what must you give to stop the bleeding and in what order?
Vit K IV Then PCC (Prothrombin Complex Concentrate)
You need vit K so that PCC can activate the clotting factors!
What is tumour lysis syndrome
rapid death of tumour cells by chemotherapy > massive release of intracellular contents.
What is the presentation of tumour lysis syndrome
2 days after high dose chemotherapy
present with dysuria/oliguria, abdominal pain, or weakness.
What are ix for tumour lysis syndrome
U&E (K+ and PO high), Ca (low), uric acid (high)
ECG (metabolic abnormalities e.g. hyperkalaemia may precipitate life-threatening arrhythmias).
How do you manage tumour lysis syndrome
Correct electrolyte abnormlaities
Hyperhydration
when and how do you need to monitor LMWH
antiXa
if pregnant, Renal failure
what is the function of HDL
picks up peripheral cholesterol
returns it to the liver (recycling, GOOD)
WHAT IS THE function of LDL
deposits cholesterol in arterial walls
What are two causes of spherocytes on blood film?
Hereditary spherocytosis
AIHA
what disease can present with slate grey skin in late stages
haemochromatosis / wilson’s
describe organs affected by haemochromatosis and symptoms caused
Accumulation of iron > toxicity of the liver, pancreas, joints, skin, heart, and endocrine organs
describe organs affected by Wilson’s and symptoms caused
Accumulation of copper resulting in toxicity of the liver, kidneys, brain, eyes, heart, and red blood cells
what CD receptor is used to r ecognise bone marrow cells?
CD 34
